EMS Scope of Practice Matrix Update

The State Board of Emergency Medical, Fire, and Transportation Services (EMFTS Board) has the legislative authority to determine the Ohio EMS scope of practice, and it includes the services that can be performed by each level of Ohio EMS certification. All services provided by certified Ohio EMS providers must be authorized by a physician who meets the qualifications to serve as the medical director of an Ohio EMS agency as cited in Ohio Administrative Code 4765-3-05. In addition to authorization, the medical director must provide a written protocol, training, continuing education, and a quality assurance program for the services provided. The medical director of an Ohio EMS agency retains the authority to restrict the performances of services that have been approved by the EMFTS Board. However, regardless of the amount of training provided, the medical director is not permitted to exceed the scope of practice that has been approved by the EMFTS Board.

Within the Ohio EMS scope of practice that has been approved by the EMFTS Board, there are now two categories of authorized services: “core competencies” and “added competencies.” Core competencies are services that are required to be taught and are included in the statewide approved initial training curricula of Ohio EMS education institutions for EMRs, EMTs, AEMTs, and Paramedics. Added competencies are elective services that are not required to be taught and are not included in the statewide approved initial training curricula for EMRs, EMTs, AEMTs, and Paramedics. For services classified as “added competencies,” the qualified medical director is responsible for providing the education for each specific service he or she elects to authorize. Analogous to core competencies, the medical director must also provide training, a written protocol, continuing education, and a quality assurance program for each elective additional competency.

On Dec. 13, 2023, the State Board of Emergency Medical, Fire, and Transportation Services (EMFTS Board) approved the following “added competencies” to be included in the Ohio EMS scope of practice:

1. Emergency Medical Technician (EMT)
    Intramuscular administration of epinephrine via syringe for the treatment of anaphylaxis.

2. Paramedic
    Ultrasound-guided peripheral intravenous access.

These added competencies became effective with the amendments to Ohio Administrative Code (OAC) 4765-15 and 4765-17 on Jan. 1, 2024.

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