SECTION 310:641-5-20. Scope of practice authorized by certification or licensure

(a)   The Department shall establish a scope of practice for each certificate and license level.

(b)   The medical control physician may limit an individual certificate or license holder's scope of practice.

(c)   Certified and licensed emergency medical personnel may perform authorized skills and procedures when authorized by medical control. When emergency medical personnel are without medical control, the scope of practice for any level of emergency medical personnel is limited to first aid, CPR, and the use of the AED.

(d)   Certified Emergency Medical Responders may perform to the following level or within this scope of practice:

(1)   patient assessment, including the determination of vital signs, and triage,

(2)   oxygen administration and airway management,

(3)   basic wound management, including hemorrhage controls to include the use of tourniquets; treatment of shock,

(4)   cardiopulmonary resuscitation (CPR) and the use of only adjunctive airway devices and the use of a semi-automated external defibrillator (SAED),

(5)   splinting of suspected fractures;

(6)   rescue and extrication procedures,

(7)   assistance of patient prescribed medications including sublingual nitroglycerin, epinephrine auto injector and hand held aerosol inhalers,

(8)   administration of agency supplied oral glucose, activated charcoal, aspirin, agency supplied epinephrine auto injector, albuterol or approved substitute per medical direction, and nasally administered or atomized naloxone,

(9)   such other emergency medical care skills and measures included in the instructional guidelines adopted by the Department, and,

(10)   upon the approval of the Department additional skills may be authorized upon the written request of a local medical director,

(e)   A licensed Emergency Medical Technician may perform to the following level or within this scope of practice:

(1)   all skills listed for the Emergency Medical Responder,

(2)   patient assessment, determination of vital signs, diagnostic signs, and triage,

(3)   bandaging, splinting, control of hemorrhage, and shock management,

(4)   Administration of medications per medical direction and approved by the Department,

(5)   maintenance of established intravenous fluids without medications,

(6)   CPR, use of adjunctive airway devices to include supraglottic airway devices, and the use of the AED,

(7)   Upon the approval of the Department, additional skills may be authorized upon the written request of a local medical director.

(f)   A licensed Intermediate may perform to the following level or within this scope of practice,

(1)   all skills listed within the Emergency Medical Responder and Emergency Medical Technician scope of practice,

(2)   establishment of vascular or intraosseous access for the administration of fluids without medications. Approved fluids include; lactated ringers, normal saline, ½ normal saline, dextrose 5%, and dextrose 10%,

(3)   administration of medications per medical direction and approved by the Department,

(4)   venipuncture to obtain blood samples per local medical control,

(5)   the use and placement of definitive airway adjuncts for adults, children, and infants,

(6)   all other emergency medical care skills and measures included in the instructional guidelines adopted by the Department which are not specifically listed above, and

(7)   Upon the approval of the Department, additional skills may be authorized upon the written request of a medical director.

(g)   A licensed Advanced Emergency Medical Technician may perform to the following level and within this scope of practice:

(1)   all skills listed for the Emergency Medical Responder, Emergency Medical Technician and Intermediate,

(2)   other skills and procedures included in the instructional guidelines adopted by the Department, and

(3)   upon approval of the Department, additional skills may be authorized upon the written request of the medical director.

(h)   A licensed Paramedic may perform to the following level or within this scope of practice:

(1)   all skills listed for the other certified or licensed emergency medical personnel

(2)   recognitions, interpretation, treatment of cardiac arrhythmias using a cardiac monitor/defibrillator/external pacemaker,

(3)   advanced management of pediatric emergencies, including resuscitation, airway placement, and medication,

(4)   advanced management of obstetric and gynecologic emergency including medication administration,

(5)   advanced interventions of psychiatric patients including medication administration,

(6)   all other emergency medical skills and measures included in the instructional guidelines adopted by the Department, and

(7)   upon approval of the Department, additional skills may be authorized upon the written request of a medical director.

(i)   Pursuant to 63 O.S. § 1-502.1, emergency medical personnel shall assist Good Samaritans who may have been exposed to a communicable disease. This includes, but is not limited to:

(1)   Providing OSDH information relating to communicable disease exposure, and

(2)   Assistance with completing OSDH approved forms.

(j)   Emergency medical personnel may also consult with a Good Samaritan for potential exposures based on OSDH Guidance.

(k)   The Department will provide support to emergency medical personnel through educational material to ensure evidence based material is available.

[Source: Amended and renumbered from 310:641-5-30 at 33 Ok Reg 1529, eff 9-11-16; Amended at 37 Ok Reg 1423, eff 9-11-20]