National Scope

It’s time to weigh in on EMS Scope of Practice revisions

Removing endotracheal intubation from paramedic scope and implementing blood glucometry and CPAP at the EMT level are under consideration

Aug 8, 2017


If you ever wanted the opportunity to weigh in on the future of your profession, the time is now. The National Association of State EMS Officials is seeking input from across the nation during its revision process of the National EMS Scope of Practice. Your input will be valuable in helping to move our practice forward, from EMR to Paramedic level.

A quick history of the EMS Scope of Practice

If you are not familiar with the NASEMSO EMS Scope of Practice, a little bit of background may be helpful. Old timers may recall that the EMS Agenda for the Future, which was published by the National Highway Safety and Transportation Agency in 1996, provided a view of the future for EMS. It also described a pathway on how the industry could realize that future.

Part of that pathway included the development of the EMS Education Agenda for the Future: A Systems Approach, released in 2000. This document described how the educational system for new EMS providers should be structured. There were several components to the system, including:

  • The National Core Content (what could EMS perform),
  • The EMS Scope of Practice (which providers could perform which procedures), and
  • The National EMS Education Standards (what information did each type of provider needed to acquire in order to perform those procedures).

The original National EMS Scope of Practice was released in 2007. Since then, many if not most states have adopted most of the recommended elements related to each level of practice (EMR, EMT, AEMT and paramedic). This had led to greater consistency in how each level is taught, and has allowed greater flexibility for EMS providers to move from state to state.

It is this document that is currently under review.

Why you should participate

EMS is not self-regulating. We rely on others (i.e., government agencies) to set our practice guidelines – part of the reason why we aren’t considered a profession. Not setting our own practice guidelines prevents us from participating fully in our professional development. There are many other reasons that contribute to this issue, but this one is a biggie.

For example, are paramedics ready to have endotracheal intubation removed from their practice? Someone has suggested that in a comment to the draft document. Clearly it doesn’t mean that it will happen. But there will likely be a discussion about it at the committee level. And I’m not sure how well the field paramedic will be represented during those discussions.

On the other side of the coin, someone has also suggested ultrasound as a standard diagnostic tool for the paramedic, and implementing blood glucometry and CPAP at the EMT level nation-wide. I wonder what’s going on their practice area that they feel this is a good national approach.

Make your opinion known

Making comments to the draft document is easy. Go to the website and review the document. Complete a form that includes your thoughts and comments about the draft. Submit it and you’re done.

It’s pretty simple, and pretty significant. It’ll be worth the time and effort to record your input. The need to make our voices heard is greater than ever.

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