6 Colo. Code Regs. § 1015-3-2-A
A.1.1 In the prehospital setting, additions to these medical acts are not allowed unless a waiver has been granted as described in Section 12 of these rules. A waiver may not be granted for medical acts in the out-of-hospital or clinical settings.
A.1.2 Not all medical acts allowed are included in initial education for various EMS provider levels. All medical directors subject to these rules shall ensure providers are appropriately trained as noted in Sections 5.1.8 and 5.1.9 , Sections 18 (CIHCS) and 19 (Clinical Settings).
A.1.3 In addition to the medical acts allowed in Appendix A, EMS providers may provide services allowable under the Community Assistance Referral and Education Services (CARES) Program, as set forth in Section 25-3.5-1203(3), C.R.S.
TABLE A.1 - AIRWAY/VENTILATION/OXYGEN
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Airway - Supraglottic | Y | Y | Y | Y | Y |
Airway - Nasal | Y | Y | Y | Y | Y |
Airway - Oral | Y | Y | Y | Y | Y |
Bag - Valve - Mask (BVM) | Y | Y | Y | Y | Y |
Carbon Monoxide Monitoring | Y | Y | Y | Y | Y |
Chest Decompression - Needle | N | N | N | Y | Y |
Chest Tube Insertion | N | N | N | N | N |
CPAP | Y | Y | Y | Y | Y |
PEEP | Y | Y | Y | Y | Y |
Cricoid Pressure - Sellick's Maneuver | Y | Y | Y | Y | Y |
Cricothyroidotomy - Needle | N | N | N | N | Y |
Cricothyroidotomy - Surgical | N | N | N | N | Y |
End Tidal CO2 Monitoring/Capnometry/ Capnography | Y | Y | Y | Y | Y |
Flow Restrictive Oxygen Powered Ventilatory Device | Y | Y | Y | Y | Y |
Gastric Decompression - NG/OG Tube Insertion | N | N | N | N | Y |
Inspiratory Impedence Threshold Device | Y | Y | Y | Y | Y |
Intubation - Digital | N | N | N | N | Y |
Intubation - Bougie Style Introducer | N | N | N | Y | Y |
Intubation - Lighted Stylet | N | N | N | Y | Y |
Intubation - Medication Assisted (non-paralytic) | N | N | N | N | N |
Intubation - Medication Assisted (paralytics) (RSI) | N | N | N | N | N |
Intubation - Maintenance with paralytics | N | N | N | N | N |
Intubation - Nasotracheal | N | N | N | N | Y |
Intubation - Orotracheal | N | N | N | Y | Y |
Intubation - Retrograde | N | N | N | N | N |
Extubation | N | N | N | Y | Y |
Obstruction - Direct Laryngoscopy | N | N | N | Y | Y |
Oxygen Therapy - Humidifiers | Y | Y | Y | Y | Y |
Oxygen Therapy - Nasal Cannula | Y | Y | Y | Y | Y |
Oxygen Therapy - Non-rebreather Mask | Y | Y | Y | Y | Y |
Oxygen Therapy - Simple Face Mask | Y | Y | Y | Y | Y |
Oxygen Therapy - Venturi Mask | Y | Y | Y | Y | Y |
Peak Expiratory Flow Testing | N | N | N | Y | Y |
Pulse Oximetry | Y | Y | Y | Y | Y |
Suctioning - Tracheobronchial | N | N | Y | Y | Y |
Suctioning - Upper Airway | Y | Y | Y | Y | Y |
Tracheostomy Maintenance - Airway management only | Y | Y | Y | Y | Y |
Tracheostomy Maintenance - Includes replacement | N | N | N | N | Y |
Ventilators - Automated Transport (ATV)1 | N | N | N | N | Y |
1 Use of automated transport ventilators (ATVs) is restricted to the manipulation of tidal volume (TV or VT), respiratory rate (RR), fraction of inspired oxygen (FIO2), and positive end expiratory pressure (PEEP). Manipulation of any other parameters of mechanical ventilation devices by EMS providers requires a waiver to these rules.
TABLE A.2 - CARDIOVASCULAR/CIRCULATORY SUPPORT
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Cardiac Monitoring - Application of electrodes and data transmission | Y | Y | Y | Y | Y |
Cardiac Monitoring - Rhythm and diagnostic EKG interpretation | N | N | N | Y | Y |
Cardiopulmonary Resuscitation (CPR) | Y | Y | Y | Y | Y |
Cardioversion - Electrical | N | N | N | N | Y |
Carotid Massage | N | N | N | N | Y |
Defibrillation - Automated/Semi-Automated (AED) | Y | Y | Y | Y | Y |
Defibrillation - Manual | N | N | N | Y | Y |
External Pelvic Compression | Y | Y | Y | Y | Y |
Hemorrhage Control - Direct Pressure | Y | Y | Y | Y | Y |
Hemorrhage Control - Pressure Point | Y | Y | Y | Y | Y |
Hemorrhage Control - Tourniquet | Y | Y | Y | Y | Y |
Implantable cardioverter/defibrillator magnet use | N | N | N | N | N |
Mechanical CPR Device | Y | Y | Y | Y | Y |
Transcutaneous Pacing | N | N | N | Y | Y |
Transvenous Pacing - Maintenance | N | N | N | N | N |
Targeted Temperature Management2 | N | N | N | VO | Y |
Arterial Blood Pressure Indwelling Catheter - Maintenance | N | N | N | N | N |
Invasive Intracardiac Catheters - Maintenance | N | N | N | N | N |
Central Venous Catheter Insertion | N | N | N | N | N |
Central Venous Catheter Maintenance/Patency/Use | N | N | N | Y | Y |
Percutaneous Pericardiocentesis | N | N | N | N | N |
2 Targeted Temperature Management (TTM)
1. Approved methods of cooling include:
a. Surface cooling methods including ice packs, evaporative cooling, and surface cooling blankets or surface heat-exchange devices.
b. Internal cooling with the intravenous administration of cold crystalloids (4°C / 39°F)
2. Esophageal temperature probe allowed for monitoring core temperatures in patients undergoing TTM.
3. The medical director should work with the hospital systems to which their agencies transport in setting up a "systems" approach to the institution of TTM. Medical directors should not institute TTM without having receiving facilities that also have TTM programs to which to transport these patients.
TABLE A.3 - IMMOBILIZATION
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Spinal Immobilization - Cervical Collar | Y | Y | Y | Y | Y |
Spinal Immobilization - Long Board | Y | Y | Y | Y | Y |
Spinal Immobilization - Manual Stabilization | Y | Y | Y | Y | Y |
Spinal Immobilization - Seated Patient | Y | Y | Y | Y | Y |
Splinting - Manual | Y | Y | Y | Y | Y |
Splinting - Rigid | Y | Y | Y | Y | Y |
Splinting - Soft | Y | Y | Y | Y | Y |
Splinting - Traction | Y | Y | Y | Y | Y |
Splinting - Vacuum | Y | Y | Y | Y | Y |
TABLE A.4 - INTRAVENOUS CANNULATION / FLUID ADMINISTRATION /FLUID MAINTENANCE
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Blood/Blood By-Products Initiation (out of facility initiation) | N | N | N | N | N |
Colloids - (Albumin, Dextran) - Initiation | N | N | N | N | N |
Crystalloids (D5W, LR, NS) - Initiation/Maintenance | N | Y | Y | Y | Y |
Intraosseous - Initiation | N | N | Y | Y | Y |
Intraosseous Initiation - In Extremis | N | Y | Y | Y | Y |
Medicated IV Fluids Maintenance - As Authorized in Appendix B | N | N | N | Y | Y |
Peripheral - Excluding External Jugular - Initiation | N | Y | Y | Y | Y |
Peripheral - Including External Jugular - Initiation | N | N | Y | Y | Y |
Use of Peripheral indwelling Catheter for IV medications (Does not include PICC) | N | Y | Y | Y | Y |
TABLE A.5 - MEDICATION ADMINISTRATION ROUTES
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Aerosolized | Y | Y | Y | Y | Y |
Atomized | Y | Y | Y | Y | Y |
Auto-Injector | Y | Y | Y | Y | Y |
Buccal | Y | Y | Y | Y | Y |
Endotracheal Tube (ET) | N | N | N | Y | Y |
Extra-abdominal umbilical vein | N | N | N | Y | Y |
Intradermal | N | N | N | Y | Y |
Intramuscular (IM) | Y | Y | Y | Y | Y |
Intranasal (IN) | Y | Y | Y | Y | Y |
Intraosseous | N | Y | Y | Y | Y |
Intravenous (IV) Piggyback | N | N | N | Y | Y |
Intravenous (IV) Push | N | Y | Y | Y | Y |
Nasogastric | N | N | N | N | Y |
Nebulized | Y | Y | Y | Y | Y |
Ophthalmic | N | N | N | Y | Y |
Oral | Y | Y | Y | Y | Y |
Rectal | N | N | N3 | Y | Y |
Subcutaneous | N | N | Y | Y | Y |
Sublingual | Y | Y | Y | Y | Y |
Sublingual (nitroglycerin) | Y | Y | Y | Y | Y |
Topical | Y | Y | Y | Y | Y |
Use of Mechanical Infusion Pumps | N | N | N | Y | Y |
3AEMTs may not employ the rectal administration route in any situation except for the one exception set out in Table B.10, "Benzodiazepine - Diazepam rectal administration."
TABLE A.6 - MISCELLANEOUS
Skill | EMT | EMT-IV | AEMT | EMT-I | P |
Aortic Balloon Pump Monitoring | N | N | N | N | N |
Assisted Delivery | Y | Y | Y | Y | Y |
Capillary Blood Sampling | Y | Y | Y | Y | Y |
Diagnostic Interpretation - Blood Glucose4 | Y | Y | Y | Y | Y |
Diagnostic Interpretation - Blood Lactate4 | N | N | Y | Y | Y |
Dressing/Bandaging | Y | Y | Y | Y | Y |
Esophageal Temperature Probe for TTM | N | N | N | VO | Y |
Eye Irrigation Noninvasive | Y | Y | Y | Y | Y |
Eye Irrigation Morgan Lens | N | N | N | Y | Y |
Maintenance of Intracranial Monitoring Lines | N | N | N | N | N |
Physical examination | Y | Y | Y | Y | Y |
Public Health Related-Oral/Nasal Swab Sample Collection | Y | Y | Y | Y | Y |
Restraints - Verbal | Y | Y | Y | Y | Y |
Restraints - Physical | Y | Y | Y | Y | Y |
Restraints - Chemical | N | N | N | Y | Y |
Urinary Catheterization - Initiation | N | N | N | N | Y |
Urinary Catheterization - Maintenance | Y | Y | Y | Y | Y |
Venous Blood Sampling - Obtaining | N | Y | Y | Y | Y |
4 See also Section 11.4
6 CCR 1015-3-2-A