Current through Register Vol. 56, No. 6, March 18, 2024
(a) EMT-Paramedics 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, physician or in-hospital skilled clinician) or a provisionally certified EMT-Paramedic (within the limits set forth at 8:41A-4.2(a)2 ):
1. Performance of all of the skills and procedures approved for EMT-Basic, as set forth at 8:41-12.2;
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; and
7. Assessing and managing patients in accordance with the U.S. Department of Transportation EMT-Paramedic National Standards Curriculum (EMT-P), 1998 edition, published by the National Highway Traffic Safety Administration, incorporated herein by reference, as amended and supplemented. Copies may be obtained by writing to the National Highway Traffic Safety Administration, EMS Division, 400 Seventh Street, SW (NTS 14), Washington, D.C. 20590.
(c) In addition, with medical command authorization or utilizing the standing orders set forth at 8:41-7.1 through 7.22 and 8:41-8.1 through 8.16, 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 (excluding blood alcohol levels drawn solely for legal purposes);
3. Prepare and administer approved medications and solutions (that is, those set forth at 8:41-6.1 ) by intravenous, intramuscular, subcutaneous, intraosseous, intranasal, oral, sublingual, topical, inhalation, rectal or endotracheal routes;
4. Administer oxygen therapy, including nebulizer treatments in accordance with 8:41-6.1, non-invasive positive pressure ventilation, and the provide ventilatory support using approved equipment as specified in this chapter;
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; and
11. 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 EMT-Paramedics 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; and
5. 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; and
7. Is not be utilized to meet any personnel requirement for in-hospital purposes as required by N.J.A.C. 8:43G.
