Current through Register Vol. 56, No. 24, December 18, 2024
Section 8:41A-5.1 - Scope of practice(a) EMTs-Paramedic shall operate within their approved scope of practice.(b) The following skills and procedures are within the approved scope of practice for an EMT-Paramedic, an EMT-Paramedic student (provided that the student is under the direct supervision of an EMT-Paramedic, registered nurse or physician) or a provisionally certified EMT-Paramedic (within the limits set forth at N.J.A.C. 8:41A-4.2(a)2 ) : 1. Performance all of the skills and procedures approved for EMTs-Basic, as set forth at N.J.A.C. 8:40A-10.1;2. Performance of history taking and physical examination of patients in order to obtain necessary information to permit the rendering of appropriate medical care;3. Utilization of telemetry and proper communications procedures in the field, as defined by the Federal Communications Commission and good professional practice;4. Visualization of the airway by utilization of the laryngoscope and removal of foreign bodies with forceps;5. Application of electrodes and monitoring of cardiac electrical activity, including electrocardiograms;6. Utilization of mechanical cardiopulmonary resuscitation devices; and7. Assessing and managing patients in accordance with the program curriculum.(c) In addition, with medical command authorization or utilizing the standing orders set forth at N.J.A.C. 8:41-7 and 8, the persons identified in (b) above may: 1. Initiate IV therapy, either by direct infusion, IV catheter plug or other cannulae-IV lines;2. Perform venipuncture for the purpose of obtaining blood samples for analysis (excluding blood alcohol levels drawn solely for legal purposes);3. Prepare and administer approved medications and solutions (that is, those set forth at N.J.A.C. 8:41-6.1) by intravenous, intramuscular, subcutaneous, intraosseous, oral, sublingual, topical, inhalation, rectal or endotracheal routes;4. Administer oxygen therapy, including nebulizer treatments in accordance with N.J.A.C. 8:41-6.1, non-invasive positive pressure ventilation, and the provide ventilatory support using approved equipment as specified in N.J.A.C. 8:41;5. Perform cardiac defibrillation, synchronized cardioversion and transcutaneous cardiac pacing;6. Perform electrocardiogram monitoring, including taking of 12-lead electrocardiogram tracings;7. Perform endotracheal intubation (oral and nasal) and nasogastric tube insertion and aspiration;8. Perform pulmonary ventilation by the utilization of oral, nasal, endotracheal or tracheostomy intubation;9. Perform intraosseous infusion;10. Perform needle chest decompression; and11. Perform Valsalva maneuvers;(d) In addition to the skills and procedures identified in (b) and (c) above, a program or service's medical director may choose to allow EMTs-Paramedic to perform the following procedures, subject to approval by the Department: 1. The insertion of esophageal airways, laryngeal mask airways or other commercial airways of similar design and function;2. Access of established central venous catheters and subcutaneous indwelling catheters;3. Access of AV fistulas or shunts;4. Percutaneous needle cricothyrotomy; and5. Rapid sequence induction.(e) The persons identified in (b) above may perform any of the skills and procedures identified in (b) and (c) above in the emergency department of a mobile intensive care hospital provided that the EMT-Paramedic: 1. Is performing under the direct order of a physician;2. Records the treatment on the patient's chart and signs the chart in compliance with institutional policy;3. Is providing medical treatment strictly within the approved scope of practice for an EMT-Paramedic;4. Is present in the emergency department for the sole purpose of meeting training requirements and maintaining the skills necessary for recertification;5. Does not perform the duties or fill the position of another health care professional employed by the hospital;6. Does not delay a response to any dispatch as a result of his or her duties in the emergency department; and7. Is not be utilized to meet any personnel requirement for in-hospital purposes as required by N.J.A.C. 8:43G.N.J. Admin. Code § 8:41A-5.1