Section 100019 - Optional Skills(a) In addition to the activities authorized by Section 100018 of this Chapter, public safety personnel may perform any or all of the following optional skills specified in this section when the public safety first aid provider has been trained and tested to demonstrate competence following initial instruction, and when authorized by the Medical Director of the local EMS agency (LEMSA).(b) A LEMSA shall establish policies and procedures that require public safety first aid personnel to demonstrate trained optional skills competency at least every two years, or more frequently as determined by the EMS quality improvement program (EMSQIP).(c) Administration of epinephrine by auto-injector for suspected anaphylaxis. (1) Training in the administration of epinephrine shall result in the public safety first aid provider being competent in the administration of epinephrine and managing a patient of a suspected anaphylactic reaction. The training shall include the following topics and skills:(A) Common causative agents;(B) Signs and symptoms of anaphylaxis;(D) Management to include but not be limited to:1. Need for appropriate personal protective equipment and scene safety awareness.(E) Profile of epinephrine to include, but not be limited to:2. Mechanisms of drug action;5. Dosage and route of administration;(F) Administration of epinephrine by auto-injector including; 1. Site selection and administration;3. Disposal of contaminated items and sharps.(2) At the completion of this training, the student shall complete a competency based written and skills examination for administration of epinephrine which shall include: (A) Assessment of when to administer epinephrine;(B) Managing a patient before and after administering epinephrine;(C) Accessing 9-1-1 or advanced life support services for all patients suffering anaphylaxis or receiving epinephrine administration;(D) Using universal precautions and body substance isolation procedures during medication administration;(E) Demonstrating aseptic technique during medication administration;(F) Demonstrate preparation and administration of epinephrine by auto-injector;(G) Proper disposal of contaminated items and sharps.(d) Supplemental oxygen therapy using a non-rebreather face mask or nasal cannula, and bag-valve-mask ventilation.(1) Training in the administration of oxygen shall result in the public safety first aid provider being competent in the administration of supplemental oxygen and use of bag-valve-mask ventilation for a patient requiring oxygen administration and ventilation. The training shall include the following topics and skills: (A) Integrating the use of supplemental oxygen by non-rebreather mask or nasal cannula based upon local EMS protocols;(B) Assessment and management of patients with respiratory distress;(C) Profile of Oxygen to include, but not be limited to:5. Dosage and route of administration (mask, cannula, bag-valve-mask);(D) Oxygen Delivery Systems; 1. Set up of oxygen delivery including tank opening, use of regulator and liter flow selection;2. Percent of relative oxygen delivered by type of mask;3. Oxygen delivery for a breathing patient, including non-rebreather mask and nasal cannula;4. Bag-Valve-Mask and Oxygen delivery for a non-breathing patient.(2) At the completion of the training, the student shall complete a competency based written and skills examination for the administration of oxygen which shall include the topics listed above and: (A) Assessment of when to administer supplemental oxygen and ventilation with a bag-valve-mask;(B) Managing a patient before and after oxygen administration;(C) Demonstrating preparation of the oxygen delivery system;(D) Demonstrating application of supplemental oxygen by non-rebreather mask and nasal cannula on a breathing patient;(E) Demonstrating use of bag-valve-mask on a non-breathing patient.(e) Administration of auto-injectors containing atropine and pralidoxime chloride for nerve agent exposure for self or peer care, when authorized by the Medical Director of a LEMSA, while working for a public safety provider.(1) Training in the administration of auto-injectors containing atropine and pralidoxime shall result in the public safety first aid provider being competent in the administration of auto-injectors for nerve agent intoxication. The training shall include the following topics and skills: (A) Integrating the use of auto-injectors for nerve agent intoxication based upon local EMS protocols;(B) Assessment and recognition of patients with nerve agent intoxication;(C) Management of patients with nerve agent exposure, including the need for appropriate personal protective equipment, decontamination principles, and scene safety awareness;(D) Profile of atropine and pralidoxime chloride to include, but not be limited to: 5. Dosage and route of administration;(E) Auto-Injector delivery and types (i.e. Duo-Dote, Mark I); 2. Site selection and administration;3. Disposal of contaminated items and sharps;(2) At the completion of the training, the student shall complete a competency based written and skills examination for the administration of auto-injectors containing atropine and pralidoxime chloride for nerve agent intoxication which shall include the topics listed above and:(A) Assessment of when to administer nerve agent auto-injector;(B) Managing a patient before and after auto-injector administration;(C) Accessing 9-1-1 or advanced life support services following administration of atropine and pralidoxime;(D) Demonstrating preparation, site selection, and administration of the auto-injector;(E) Demonstrating universal precautions and body substance isolation procedure during medication administration;(F) Demonstrating aseptic technique during medication administration;(G) Proper disposal of contaminated items and sharps.(f) Administration of naloxone for suspected narcotic overdose. (1) Training in the administration of naloxone shall result in the public safety first aid provider being competent in the administration of naloxone and managing a patient of a suspected narcotic overdose. The training shall include the following topics and skills: (A) Common causative agents;(C) Management to include but not be limited to:(D) Need for appropriate personal protective equipment and scene safety awareness;(E) Profile of Naloxone to include, but not be limited to:4. Routes of administration;(F) Mechanisms of drug action;(G) Calculating drug dosages;(I) Disposal of contaminated items and sharps.(2) At the completion of this training, the student shall complete a competency based written and skills examination for administration of naloxone which shall include:(A) Assessment of when to administer naloxone;(B) Managing a patient before and after administering naloxone;(C) Using universal precautions and body substance isolation procedures during medication administration;(D) Demonstrating aseptic technique during medication administration;(E) Demonstrate preparation and administration of parenteral medications by a route other than intravenous;(F) Proper disposal of contaminated items and sharps.(g) Use of oropharyngeal airways (OPAs) and nasopharyngeal airways (NPAs).(1) Training in the use of OPAs and NPAs shall result in the public safety first aid provider being competent in the use of the devices and airway control and shall include the following topics and skills:(A) Anatomy and physiology of the respiratory system;(B) Assessment of the respiratory system;(C) Review of basic airway management techniques, which include manual and mechanical;(D) The role of OPA and NPA airway adjuncts in the sequence of airway control;(E) Indications and contraindications of OPAs and NPAs;(F) The role of pre-oxygenation in preparation for OPAs and NPAs;(G) OPA and NPA insertion and assessment of placement;(H) Methods for prevention of basic skills deterioration;(I) Alternatives to the OPAs and NPAs.(2) At the completion of initial training a student shall complete a competency based written and skills examination for airway management which shall include the use of basic airway equipment and techniques and use of OPAs and NPAs.Cal. Code Regs. Tit. 22, § 100019
1. New section filed 11-30-87; operative 12-30-87 (Register 87, No. 49). For prior history, see Register 87, No. 10.
2. Renumbering of former section 100019 to section 100018 and renumbering of former section 100020 to section 100019 filed 5-18-2000; operative 6-17-2000 (Register 2000, No. 20).
3. Repealer of former section 100019 and renumbering of former section 100020 to section 100019, including amendment of section heading, section and NOTE, filed 2-5-2015; operative 4-1-2015 (Register 2015, No. 6). Note: Authority cited: Sections 1797.107 and 1797.197, Health and Safety Code. Reference: Sections 1797.182 and 1797.183, Health and Safety Code; and Section 13518, Penal Code.
1. New section filed 11-30-87; operative 12-30-87 (Register 87, No. 49). For prior history, see Register 87, No. 10.
2. Renumbering of former section 100019 to section 100018 and renumbering of former section 100020 to section 100019 filed 5-18-2000; operative 6-17-2000 (Register 2000, No. 20).
3. Repealer of former section 100019 and renumbering of former section 100020 to section 100019, including amendment of section heading, section and Note, filed 2-5-2015; operative 4/1/2015 (Register 2015, No. 8).