Idaho EMSPC Scope of Practice OLD (ISC) Curriculum License Levels NEW 2011 IEC Curriculum License Levels

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AIRWAY / VENTILATION / OXYGENATION Idaho EMSPC Scope of Practice - OLD (ISC) Curriculum License Levels NEW IEC Curriculum License Levels Effective July 1, 2016 1 View of All Levels Across EMR- 1-1-2012) A 1 Advanced Airway devices not intended to be inserted into trachea 2,3,OM*~ X* X* X 2 Airway Nasal X X X X X X 3 Airway Oral X X X X X X X 4 Airway Obstruction - removal of foreign body by direct laryngoscopy X 5 Bag-Valve-Mask (BVM) X X X X X X X 6 BiPAP X 7 Chest Decompression Needle X 8 Chest Tube Placement 2,3,OM 9 Chest Tube Monitoring & Management X 10 CPAP 2, OM 2,OM 2,OM X 11 Cricoid Pressure (Sellick) X X X X X X X 12 Cricothyrotomy Needle/Percutaneous X 13 Cricothyrotomy - Surgical 2,OM 3X 14 Demand Valve Manually triggered, flow restricted, ventilation X X X X X 15 End Tidal CO 2 Monitoring/Capnometry 2,3,OM~ 2,OM 2,OM X 16 Finger Sweep X X X X X X X 17 Gastric Decompression NG Tube X 18 Gastric Decompression OG Tube X 19 Head-tilt/chin-lift X X X X X X X 20 Intubation Digital X 21 Intubation Medication Assisted (non-paralytic) X 22 Intubation Medication Assisted (paralytics) (RSI) 2,3,OM 3X 23 Intubation - Nasotracheal X 24 Intubation - Orotracheal X 25 Intubation Retrograde 26 Jaw-thrust X X X X X X X 27 Jaw-thrust - Modified (trauma) OM OM X X X X X 28 Modified Chin Lift X X X X X X X 29 Mouth-to-Barrier X X X X X X X 30 Mouth-to-Mask X X X X X X X 31 Mouth-to-Mouth X X X X X X X 32 Mouth-to-Nose X X X X X X X 33 Mouth-to-Stoma X X X X X X X 34 Obstruction Direct Laryngoscopy X

35 Obstruction Manual X X X X X X X 36 Oxygen Therapy Humidifiers X X X X X X 37 Oxygen Therapy Nasal Cannula X X X X X X X 38 Oxygen Therapy Non-rebreather Mask X X X X X X X 39 Oxygen Therapy Partial Rebreather Mask X X X X X X 40 Oxygen Therapy Simple Face Mask X X X X X X 41 Oxygen Therapy Venturi Mask X X X X X X 42 PEEP Therapeutic (>6cm H 2 O pressure) X 43 Pulse Oximetry 2,OM X 2,OM X X 44 CO Oximetry 2,4,OM 2,4,OM 2,4,OM 2,4,OM OM 45 Suctioning Tracheobronchial via advanced airway 2,OM X X X 46 Suctioning Upper Airway X X X X X X X 47 Ventilators Automated Transport (ATV) for non-intubated patients X X X 48 Ventilators Automated Transport (ATV) X 49 Ventilators, Automated Enhanced Assessment & Management 3X NEW IEC Curriculum License Levels CARDIOVASCULAR / CIRCULATION Effective July 1, 2016 2 View of All Levels Across EMR- A 50 EKG - 12-lead data acquisition 2,OM 2,OM 2,OM 2,OM X 51 EKG - 12-lead interpretation X 52 EKG - 3-lead rhythm interpretation X 53 Cardiopulmonary Resuscitation (CPR) X X X X X X X 54 Cardioversion Electrical X 55 Carotid Massage X 56 Defibrillation Automated / Semi-Automated X X X X X X X 57 Defibrillation Manual X 58 Hemorrhage Control Direct Pressure X X X X X X X 59 Hemorrhage Control Dressing X X X X X X X 60 Hemorrhage Control - Pressure Point X X X 61 Hemorrhage Control Tourniquet 2,OM X X X X X X 62 Impedance Threshold Device (ITD) OM OM OM OM OM 63 IABP monitoring & management 3X 64 Invasive Hemodynamic Monitoring 3X 65 Mechanical CPR Device X X X X X 66 Pericardiocentesis 2,3,OM 67 Pacing - Transcutaneous X 68 Pacing - Transvenous & Epicardial monitoring & management 3X

IMMOBILIZATION NEW IEC Curriculum License Levels 70 Cervical Stabilization Cervical Collar 2,OM 2,OM X X X X X 71 Spinal Immobilization Long Board 2,OM 2,OM X X X X X 72 Cervical Stabilization Manual X X X X X X X 73 Spinal Immobilization Seated Patient (KED, etc.) 2,OM 2,OM X X X X X 74 Extremity Stabilization - Manual X X X X X X X 75 Extremity Splinting 2,OM 2,OM X X X X X 76 Extremity Splinting Traction X X X X X 77 MAST/PASG for Pelvic Immobilization Only X X X X X 78 Pelvic Immobilization Devices OM OM OM OM OM VASCULAR ACCESS / FLUIDS EMR- A NEW IEC Curriculum License Levels EMR- A 79 Arterial Line Monitoring & Access Only 3X 80 Central Line Placement 2,3,OM 81 Central Line Monitor & Maintain Only X 82 Intraosseous Pediatric 2,OM X X X 83 Intraosseous Adult 2,OM OM X X 84 Peripheral Initiation (includes External Jugular) 2,OM X X X 85 Umbilical - Initiation 2,3,OM 86 IV Fluid infusion - Non-medicated 2,OM X X X 87 IV Fluid infusion - Maintenance of Medicated Fluids X TECHNIQUE OF MEDICATION ADMINISTRATION NEW IEC Curriculum License Levels Only includes techniques required to administer meds listed in the medication formulary. Does not include techniques for assisting a patient in administering his/her own medications. Effective July 1, 2016 3 View of All Levels Across

EMR- A 88 Aerosolized (MDI) X X 89 Auto-Injector X X X X X X X 90 Buccal X X X X X 91 Endotracheal Tube (ET) X 92 Inhaled - patient administered (nitrous oxide) X X 93 Intramuscular (IM) 2,OM 2,OM 2,OM 2,OM 2,OM X X 94 Intranasal X X 95 Intraosseous - Pediatric 2,4,OM 2,4,OM X X 96 Intraosseous - Adult 2,4,OM 2,4,OM X X 97 IV Infusion X 98 IV Piggyback X 99 IV Programmable Volume Infusion Device 2, OM 3X 100 IV Push X 101 IV Push-D50/concentrated dextrose solutions only / Naloxone (Narcan) X X 102 Accessing Implanted Central IV Port X 103 Nasogastric X 104 Nebulized (SVN) X X 105 Oral X X X X X 106 Rectal X 107 Subcutaneous 2,OM 2,OM 2,OM X X 108 Sub-lingual X X 109 Topical OM X NEW IEC Curriculum License Levels MISCELLANEOUS 110 Arterial Blood Sampling, Radial Site - Obtaining 111 Assist with Prescribed Meds X X X X X 112 Over-the-Counter Medications (OTC) X 113 Assisted Childbirth Delivery - Normal X X X X X X X 114 Assisted Childbirth Delivery- Complicated X X X X X 115 Blood Chemistry Analysis X 116 Blood Glucose Monitoring - Automated 2,4,OM 2,4,OM X X X 117 Blood Pressure Manual X X X X X X X EMR- A Effective July 1, 2016 4 View of All Levels Across

118 Blood Pressure Automated X X X X X 119 Emergency Moves for Endangered Patients X X X X X X X 120 Eye Irrigation X X X X X X 121 Eye Irrigation Morgan Lens X 122 Mechanical Patient Restraints X X X X X 123 Rapid Extrication X X X X X 124 ICP Monitoring 3X 125 Taser Barb Removal OM OM OM OM OM OM OM 126 Urinary Catheterization 2,3,OM 127 Venous Blood Sampling Obtaining 2,OM X OM X MEDICATION FORMULARY NEW IEC Curriculum License Levels Formulary EMR- A 128 Acetylsalicylic Acid (Aspirin) X 129 Acetylsalicylic Acid (Aspirin) for suspected cardiac chest pain OM X OM X 130 Activated Charcoal X X X X 131 Antihistamines X 132 Blood Products Administration 3X 133 Dextrose 50% X X 134 Dextrose, concentrated solutions X X 135 Epinephrine (Adrenalin) 2,4,OM 2,4,OM 2,4,OM X 2,4,OM X X 136 Glucagon 2,4,OM 2,4,OM 2,4,OM X X 137 Glucose (Oral) X X X X X 138 Inhaled Beta Agonist (MDI) X** X** X** X X 139 Inhaled Beta Agonist (SVN) X** X X 140 Lidocaine - as an adjunct for IO fluid administration 4 OM 4 OM 4 OM X 141 Maintenance of Blood Administration X 142 Atropine sulfate & 2-Pralidoxime chloride auto-injector (e.g. MARK-I, DuoDote) self & peer X X X X 143 Atropine sulfate & 2-Pralidoxime chloride auto-injector (e.g. MARK-I, DuoDote) X X X Atropine sulfate & 2-Pralidoxime chloride auto-injector (Chempack patient use - emergency 144 stockpile release only) 5X 4X 5X 4X 5X 4X X 145 Medical Director Approved Medications X 146 Naloxone (Narcan) 3, SS 3, SS 3, SS 3, SS 3, SS X X 147 Nitroglycerin - Paste OM X 148 Nitroglycerin - Sublingual X** X** X** X X Effective July 1, 2016 5 View of All Levels Across

149 Nitrous Oxide (Nitronox) X X 150 Oxygen X X X X X X X 151 Plasma Volume Expander Administration 3X 152 Thrombolytic Therapy Administration X 153 Vaccinations - at the request of the public health district if credentialed in IM adminstration 5,OM 5,OM 5,OM 5,OM 5,OM X X X in a white square = Existing Idaho scope of practice that will be removed from new curriculum licensure level scope 3X = Provider must complete the FP-C or CCP-C exam (BCCTPC) OM=Optional Module 3, SS = State Statute 54-1733B 2,3,OM = Provider must complete the FP-C or CCP-C exam (BCCTPC) & Medical Director Approval of OM License levels based on previous Idaho Standard Curriculum (ISC) which was based on National Standard Curricula License levels based on new Idaho EMS Curricula (IEC) which is basesd on National Education Standards Levels of Medical Supervision Requires online medical direction before performing 1 Requires completion of training that meets or exceeds specified state-wide training content 2 (Individual scopes of practice, separated by license established by the EMS Bureau level, can be found in the Standards Manual) Requires additional standards as defined by the EMSPC 3 Requires EMSPC protocol 4 Just In Time Training 5 ~End Tidal CO2 Monitoring/ Capnometry must be included if the Supraglottic Airway is selected as an 2,3 OM * Adults Only ** May carry and administer only if already prescribed *** Will be included in Critical Care Curriculum in future scope Effective July 1, 2016 6 View of All Levels Across