(A) In addition to
the emergency medical services listed in rule
4765-12-04 of the Administrative
Code and in accordance with
division (B) of
section
4765.37 of the Revised Code, an
emergency medical technician may perform the following emergency medical
services:
(1) Endotracheal suctioning through
a previously established airway;
(2) Endotracheal suctioning through a
stoma;
(3) Oxygen administration,
including the following:
(a) Partial
rebreather masks;
(b) Venturi
masks.
(4) Ventilation
management, to include the use of a positive pressure ventilation device,
including the following:
(a) Manually
triggered ventilators;
(b)
Automatic transportation ventilators.
(5) Traction splint;
(6) Rapid extrication procedures.
(B) In accordance with division
(C)
(B) of
section
4765.37 of the Revised Code, an
emergency medical technician may perform the following additional emergency
medical services only pursuant to the written or verbal authorization of a
physician or of the cooperating physician advisory board, or authorization
transmitted through a direct communication device by a physician, physician
assistant designated by a physician, or registered nurse designated by a
physician, or in accordance with written protocols as specified in division
(D)
(B) of
section
4765.37 of the Revised Code:
(1) Pulse oximeter and capnography equipment
application and reading;
(2) Until January 1, 2013,
orotracheal intubation of pulseless and apneic patients only;
(3)(2) Dual lumen airway
of pulseless and apneic patients only;
(4)(3) Oxygen humidifier
equipment application and monitoring;
(5)(4) Extraglottic airway
of pulseless and apneic patients only;
(6)(5) Continuous positive
airway pressure (CPAP);
(7)(6) End tidal carbon
dioxide monitoring and detecting;
(8)(7) Chest compression
assist devices;
(9)(8) Negative impedance
threshold devices;
(10)(9) Administration of
aspirin;
(11) Pneumatic anti-shock
garment;
(12)(10) Helmet
removal;
(13)(11) Glucose
monitoring system;
(14)(12) Administration of
oral glucose;
(15) Administration of activated
charcoal;
(16)(13) Administration of
epinephrine auto-injector to a patient suffering from anaphylaxis;
(17)(14)
Assisted administration of sublingual nitroglycerin, which shall consist of
either of the following:
(a) Assisting with
patient's prescribed nitroglycerin upon the patient's request and with written
protocol;
(b) Assisting with
EMS-provided nitroglycerin with verbal medical direction.
(18)(15)
Assisted administration of aerosolized or nebulized medications, which shall
consist of either of the following:
(a)
Assisting with a patient's prescribed aerosolized or nebulized medications upon
the patient's request and with written protocol;
(b) Assisting with EMS-provided aerosolized
or nebulized medications with verbal medical direction.
(19)(16)
Prehospital advanced life support assistance, to include the setting up of an
intravenous administration kit in the presence of an advanced emergency medical
technician or paramedic;
(20)(17) Transport of a
central/peripheral intravenous access without an infusion;
(21)(18)
Set up and application of a cardiac monitor in the presence of an advanced
emergency medical technician or paramedic;
(22)(19) Set up and
application of a twelve-lead electrocardiogram, in accordance with written
protocols, in either of the following instances:
(a) When the emergency medical technician is
assisting an paramedic; or
(b) For
the purpose of electronic transmission by the emergency medical technician,
provided the following conditions are met:
(i)
The emergency medical technician does not interpret the
electrocardiogram;
(ii) The
emergency medical technician minimizes any delay of patient transport to obtain
a twelve-lead electrocardiogram;
(iii) The EMT utilizes the twelve-lead
electrocardiogram in conjunction with destination protocols approved by the
local medical director.
(23)(20) Any other
services approved by the board pursuant to rule
4765-6-01 of the Administrative
Code;
(24)(21) Any other
services pursuant to a research study approved by the board under rule
4765-6-04 of the Administrative
Code and within the parameters established by the board for such
study.
(C) The
utilization of waveform capnography is mandatory for all patients requiring
invasive airway devices with the exception of stable patients with no cardiac
or pulmonary complaints or symptoms unless ordered by the transferring
physician.
As used in this rule, an invasive airway device is any airway
device inserted or prepositioned into a patient's airway by means of the mouth,
directly into the trachea, or into the trachea by means of a tracheostomy tube,
cricothyrotomy or nasotracheal intubation. Dual lumen and extraglottic airways,
even though they are blindly inserted into the hypopharynx or the esophagus,
are considered invasive airway devices.
(D) A physician or cooperating physician
advisory board that serves as the medical director for any EMS organization may
limit, but not exceed, the scope of practice for those emergency medical
technicians who provide emergency medical services under the auspices of the
physician's certificate to practice medicine and surgery, or osteopathic
medicine and surgery, issued under Chapter 4731. of the Revised Code.
(E) An emergency medical technician shall not
perform emergency medical services within this rule unless the emergency
medical technician has received training as part of an initial certification
course or through subsequent training approved by the board. If certain
emergency medical services, within the emergency medical technician scope of
practice, were not included in the training specified in this paragraph, the
emergency medical technician must have received training regarding such
services approved by the local medical director before performing those
services.
Notes
Ohio Admin. Code
4765-15-04
Effective:
1/1/2024
Five Year Review (FYR) Dates:
8/29/2023 and
08/01/2028
Promulgated
Under: 119.03
Statutory Authority: 4765.11, 4765.37
Rule Amplifies: 4765.37
Prior Effective Dates:
03/23/2003, 05/29/2008, 02/06/2012, 10/18/2013, 06/15/2018,
01/01/2021