Virginia Office of Emergency Medical Services Scope of Practice - Procedures for EMS Personnel
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1 Specific tasks in this document shall refer to the Virginia Education Standards. AIRWAY TECHNIQUES Airway Adjuncts Airway Maneuvers Alternate Airway Devices Oropharyngeal Airway Nasopharyngeal Airway Head tilt jaw thrust Jaw thrust Chin lift Cricoid Pressure Management of existing Tracheostomy Non Visualized Airway Devices Supraglottic Cricothyrotomy Needle Surgical Obstructed Airway Clearance Intubation Manual Visualize Upper-airway direct laryngoscopy Nasotracheal Orotracheal - Over age 12 Pharmacological facilitation with paralytic Adult Neuromuscular Blockade Pharmacological facilitation without paralytic Confirmation procedures Pediatric Orotracheal Pediatric paralytics Pediatric sedation ** Endotracheal intubation is prohibited for all levels except Intermediate and Paramedic Page 1 of 6
2 Oxygen Delivery Systems Suction Nasal Cannula Venturi Mask Simple Face Mask Partial Rebreather Face Mask Non-rebreather Face Mask Face Tent Tracheal Cuff Oxygen Hood O2 Powered Flow restricted device Humidification Manually Operated Mechanically Operated Pharyngeal Bronchial-Tracheal Oral Suctioning Naso-pharyngeal Suctioning Endotracheal Suctioning Meconium Aspiration Neonate with ET Ventilation assisted / mechanical Mouth to Mask Includes :mouth to Mouth to Mask with O2 Bag-Valve-Mask Adult Bag-Valve-Mask with supplemental O2 Adult Bag-Valve-Mask with supplemental O2 and reservoir Adult Bag-Valve-Mask Pediatric Page 2 of 6
3 Bag-Valve-Mask with supplemental O2 Pediatric Bag-Valve-Mask with supplemental O2 and reservoir Pediatric Bag-Valve-Mask neonate/infant Bag-Valve-Mask with supplemental O2 Neonate/Infant Bag-Valve-Mask with supplemental O2 and reservoir Neonate/Infant Noninvasive positive pressure vent. BiPAP;CPAP;PEEP Jet insuflation Mechanical Ventilator (Manual/Automated Transport Ventilator) Anesthesia ( Local) Pain Control & Sedation Self Administered inhaled analgesics Pharmacological (non-inhaled) Blood and Component Therapy Administration Diagnostic Procedures Blood chemistry analysis Capnography Pulmonary function measurement Pulse Oximetry Ultrasonography Genital/Urinary Bladder catheterization Foley catheter Page 3 of 6
4 Head and Neck ICP Monitor Control of epistaxis Tooth replacement Hemodynamic Techniques Hemodynamic Monitoring Obstetrics Arterial catheter maintenance Central venous maintenance Access indwelling port Intraosseous access & infusion Peripheral venous access and maintenance Umbilical Catheter Insertion/Management Cutdown Monitoring Existing IVs Mechanical IV Pumps ECG acquisition 3, 4, 12, etc lead ECG Interpretation 3, 4, 12, etc lead Invasive Hemodynamic Monitoring Vagal Maneuvers/Carotid Massage Delivery of newborn Other Techniques Vital Signs Bleeding control direct pressure, el Foreign body removal Incision/Drainage Intravenous therapy includes blood sampling Medication administration Nasogastric tube Orogastric tube Page 4 of 6
5 Pericardiocentesis Pleural decompression Patient restraint physical Patient restraint chemical Sexual assault victim management Trephination of nails Wound closure techniques Wound management Pressure Bag for High altitude Treat and Release Vagal Maneuvers/Carotid Massage Intranasal medication administration Resuscitation Skeletal Procedures Cardiopulmonary resuscitation (CPR) (all ages) Cardiac pacing Defibrillation/Cardioversion AED AED for EMR, EM Post resuscitative care Care of the amputated part Fracture/Dislocation immobilization techniques Fracture/Dislocation reduction techniques Spine immobilization techniques Thoracic Thoracostomy (refer to "Other Techniques") Body Substance Isolation / PPE Lifting and moving techniques Page 5 of 6
6 Gastro-Intestinal Techniques Management of non-displaced gastrostomy tube Ophthalmological Morgan Lenses Corneal Exam with fluorescein Ocular irrigation Page 6 of 6
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