The scope of practice expert panel examined evidence to determine if a procedure or skill is beneficial to a patient and can be done safely by EMS providers. This is the most significant update to the EMS model since 2007. The National EMS Scope of Practice Model defines the knowledge and skills necessary to achieve competency for each level of EMS provider: EMR, EMT, AEMT, and Paramedic.
When NHTSA releases the updated scope, each state, following its legislative mandates or administrative rules, will follow those processes to adopt or update the scope for their state. The rate of adoption or revision is state specific.
- EVIDENCE FOR BETTER PATIENT OUTCOMES: THE SCOPE REVISION WAS BASED ON REVIEWING NEW EVIDENCE TO MAKE MODIFICATIONS, AS NECESSARY. FOR EACH OF THE SKILLS AND MEDICATIONS THE COMMITTEE ASKED TWO QUESTIONS:
- Is there evidence that the procedure or skill is beneficial to public health?
- Is there evidence that the procedure or skill can be done safely?
- BROAD, WIDE-RANGING DISCUSSION: The Scope of Practice Model is all encompassing to important skills and medications, but was broadened to consider special populations, non-traditional roles like community paramedic, and military to civilian transitions.
- Major changes to EMS Scope of Practice: There are major changes in the 2018 National EMS Scope of Practice Model, including deletions from the 2007 model and additions based on current issues, like the opioid crisis, and innovations in equipment and procedures. The deletions from the Scope of Practice, which Bourn stressed were based on reviewing research – or lack – of efficacy, are:
- Military anti-shock trousers
- Spinal immobilization
- Demand valves
- Carotid massage
- Automated transport ventilators (EMT)
- Modified jaw thrust
- Assisting patients with own medications
- Updating the National EMS Education Standards: The 2008 EMS Education standards outline the minimal objectives for entry-level EMS education for all four provider levels. The EMS Agenda for 2050 and new Scope of Practice Model will inform the revision of the National Emergency Medical Services Education Standards. A 2-year project is just beginning to revise the education standards by 2021.