(A) In addition to the emergency medical
services listed in rule 4765-12-04 of the Administrative Code and in accordance
with section 4765.37 of the Revised Code, an emergency medical technician may
perform the following emergency medical services:
(1) Endotracheal suctioning through a
previously established airway;
(2) Endotracheal
suctioning through a stoma;
(3) Oxygen administration, including the
following:
(a) Partial rebreather masks;
(b) Venturi masks.
(4) Ventilation management, to include
the use of a positive pressure ventilation device, including the
following:
(a) Manually triggered ventilators;
(b) Automatic transportation ventilators.
(5) Traction splint;
(6) Rapid extrication
procedures.
(B) In accordance with division (B) of
section 4765.37 of the Revised Code, an emergency medical technician may
perform the following additional 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, physician assistant designated by a
physician, or registered nurse designated by a physician, or in accordance with
written protocols as specified in division (B) of section 4765.37 of the
Revised Code:
(1) Pulse oximeter and
capnography equipment application and reading;
(2) Dual lumen airway of pulseless and
apneic patients only;
(3) Oxygen humidifier equipment
application and monitoring;
(4) Extraglottic airway of pulseless and
apneic patients only;
(5) Continuous positive airway pressure
(CPAP);
(6) End tidal carbon dioxide monitoring
and detecting;
(7) Chest compression assist
devices;
(8) Negative impedance threshold
devices;
(9) Administration of
aspirin;
(10) Helmet removal;
(11) Glucose monitoring
system;
(12) Administration of oral
glucose;
(13) Administration of epinephrine
auto-injector to a patient suffering from anaphylaxis;
(14) Assisted administration of sublingual
nitroglycerin, which shall consist of either of the following:
(a) Assisting with patient's prescribed nitroglycerin upon
the patient's request and with written protocol;
(b) Assisting with EMS-provided nitroglycerin with verbal medical
direction.
(15) Assisted administration of
aerosolized or nebulized medications, which shall consist of either of the
following:
(a) Assisting with a patient's prescribed aerosolized or
nebulized medications upon the patient's request and with written
protocol;
(b) Assisting with EMS-provided aerosolized or nebulized
medications with verbal medical direction.
(16) Prehospital advanced life support
assistance, to include the setting up of an intravenous administration kit in
the presence of an advanced emergency medical technician or
paramedic;
(17) Transport of a central/peripheral
intravenous access without an infusion;
(18) Set up and application of a cardiac
monitor in the presence of an advanced emergency medical technician or
paramedic;
(19) Set up and application of a
twelve-lead electrocardiogram, in accordance with written protocols, in either
of the following instances:
(a) When the emergency medical technician is assisting an
paramedic; or
(b) For the purpose of electronic transmission by the emergency
medical technician, provided the following conditions are met:
(i) The emergency medical
technician does not interpret the electrocardiogram;
(ii) The emergency
medical technician minimizes any delay of patient transport to obtain a
twelve-lead electrocardiogram;
(iii) The EMT utilizes
the twelve-lead electrocardiogram in conjunction with destination protocols
approved by the local medical director.
(20) Any other services approved by the
board pursuant to rule 4765-6-01 of the Administrative Code;
(21) 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) The utilization of waveform
capnography is mandatory for all patients requiring invasive airway devices
with the exception of stable patients with no cardiac or pulmonary complaints
or symptoms unless ordered by the transferring physician.
As used in this rule, an invasive airway device
is any airway device inserted or pre-positioned into a patient's airway by
means of the mouth, directly into the trachea, or into the trachea by means of
a tracheostomy tube, cricothyrotomy or nasotracheal intubation. Dual lumen and
extraglottic airways, even though they are blindly inserted into the
hypopharynx or the esophagus, are considered invasive airway devices.
(D) 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 emergency medical technicians 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.
(E) An emergency medical technician shall not perform emergency
medical services within this rule unless the emergency medical technician 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 emergency medical technician scope of practice, were not
included in the training specified in this paragraph, the emergency medical
technician must have received training regarding such services approved by the
local medical director before performing those services.
