4765-16-04 EMT-intermediate scope of practice.

(A) In addition to the skills listed in rule 4765-15-04 of the Administrative Code, and in accordance with section 4765.38 of the Revised Code, an EMT-intermediate may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician or registered nurse designated by a physician, or in accordance with written protocols as specified in division (C) of section 4765.38 of the Revised Code:

(1) Cardiac monitor strip interpretation;

(2) Manual defibrillation;

(3) Obtaining blood specimens;

(4) Subcutaneous administration of epinephrine;

(5) Administration of intravenous lifeline and fluid;

(6) Intraosseous infusion;

(7) Saline lock initiation;

(B) In addition to the emergency medical services described in paragraph (A) of this rule, and in accordance with section 4765.38 of the Revised Code, an EMT-intermediate who has completed a training program pursuant to this chapter of the Administrative Code may perform the following emergency medical services only pursuant to the written or verbal authorization of a physician or of the cooperating physician advisory board, or authorization transmitted through a direct communication device by a physician or registered nurse designated by a physician, or in accordance with written protocols as specified in division (C) of section 4765.38 of the Revised Code:

(1) Administration of the following medications:

(a) Sublingual nitroglycerin;

(b) Dextrose fifty percent in water;

(c) Diphenhydramine;

(d) Benzodiazepines;

(e) Bronchodilators;

(f) Naloxone;

(g) Glucagon;

(h) Nitrous oxide;

(i) Nalbuphine;

(j) Morphine sulfate;

(k) Ketorolac, meperidine, or other analgesics for pain relief;

(l) Any additional drug approved by the board.

(2) Administration of nebulized medications;

(3) Administration of intranasal medications;

(4) Orotracheal intubation of the apneic patient;

(5) Dual lumen airway of the apneic patient;

(6) Supraglottic airway of the apneic patient;

(7) Needle decompression of the chest.

(8) Replacement of a tracheostomy tube through a stoma;

(9) Set up and application of a 12-lead electrocardiogram, in accordance with written protocols, in either of the following instances:

(a) When the EMT-intermediate is assisting an EMT-paramedic; or

(b) For the purpose of electronic transmission by the EMT-intermediate, provided the following conditions are met:

(i) The EMT-intermediate does not interpret the electrocardiogram;

(ii) The EMT-intermediate minimizes any delay of patient transport to obtain a 12-lead electrocardiogram;

(iii) The EMT-intermediate utilizes the 12-lead electrocardiogram in conjunction with destination protocols approved by the local medical director.

(10) Any other services pursuant to a research study approved by the board under rule 4765-6-04 of the Administrative Code and within the parameters established by the board for such study.

(C) A physician or cooperating physician advisory board that serves as the medical director for any EMS organization may limit, but not exceed the scope of practice for those EMT-intermediates who provide emergency medical services under the auspices of the physician’s certificate to practice medicine and surgery, or osteopathic medicine and surgery, issued under Chapter 4731. of the Revised Code.

(D) An EMT-intermediate shall not perform emergency medical services within this rule unless the EMT-intermediate has received training as part of an initial certification course or through subsequent training approved by the board. If certain emergency medical services, within the EMT-intermediate scope of practice, were not included in the training specified in this paragraph, the EMT-intermediate must have received training regarding such services approved by the local medical director before performing those services.

Effective: 05/29/2008

R.C. 119.032 review dates: 03/23/2008

Promulgated Under: 119.03

Statutory Authority: 4765.11

Rule Amplifies: 4765.38

Prior Effective Dates: 3/23/03