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EMS Scope of Practice

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Overview

Between 2016–2018, a subject matter expert panel (Panel) comprised used an evidence-based approach to identify practice gaps between the 2007 Scope of Practice Model and emerging science, current EMS practice, and community needs. The Panel was comprised of organizational representation from EMS and fire communities, state EMS directors, EMS medical directors, EMS educators, EMS field providers, and an EMS researcher.

When the scientific literature was inconclusive, expert opinion was used to improve descriptions, roles, and attributes of each level that would support changes in practice by addressing two fundamental questions:

  1. Is there evidence that the procedure or skill is beneficial to public health?
  2. What is the clinical evidence that the new skill or technique as used by EMS personnel will promote access to quality health care or improve patient outcomes?
The project was funded through a cooperative agreement from the National Highway Traffic Safety Administration (NHTSA) and the Health Resources & Services Administration (HRSA).

Final project documents and other related materials are linked below. 

Documents & Resources

Documents

  • National EMS Scope of Practice Model 2019 (updated in August 2021 to include Change Notices 1.0 & 2.0). This updated version adds intramuscular injection, vaccinations during a public health emergency, and nasal swab specimen collection to the scope of practice of EMS clinicians at the EMT and higher levels.
  • Rapid Process for Emergent Changes to the National EMS Scope of Practice Model (Sept 2018). In response to a recommendation from the National EMS Advisory Committee, NHTSA and NASEMSO convened a group of experts to develop a new standardized urgent update process for the Scope of Practice Model, outlined in this document.

Educational Resources

  • 2019 National EMS Scope of Practice Revision Presentation. Comprehensive overview of the revision. 
  • Talking points for state EMS officials
  • Venn Diagrams. Resource for licensing boards and instructors demonstrating the relationship among education, certification, licensure, and credentialing. 
  • Scope of Practice Model Decision-Making Framework for EMS. These guidelines are for educational purposes only, and do not purport to establish a standard of care or advise a course of action for patient care in any particular situation. Persons with specific EMS scope of practice questions are encouraged to contact their agency’s legal advisor and/or state licensing authority for interpretive assistance as needed.

For more information:
info@nasemso.org