NEMSIS Version 3 - Procedure Label by Category Assessment: Orthostatic Vital Signs Assessment: Patient Assessment SNOMED CT Description SNOMED CT Code Taking orthostatic vital signs 425058005 Continuous physical assessment 422618004 EMS Chapter Two Definition Physical examination Cardiac: 3 Lead ECG Obtained 3 lead electrocardiographic monitoring 428803005 Cardiac: 12 Lead ECG Obtained 12 lead ECG 268400002 Cardiac: 15 Lead ECG Obtained Cardiac: 18 Lead ECG Obtained 15 lead electrocardiographic monitoring 429163003 18 lead electrocardiographic monitoring 425808002 Cardiac Monitoring - Application of electrodes and data transmission Cardiac Monitoring - Rhythm and diagnoistic EKG interpretation Cardiac: Cardiopulmonary Resuscitation (Manual) Cardiopulmonary resuscitation 89666000 Cardiopulmonary Resuscitation (CPR) Cardiac: Cardiopulmonary Resuscitation (Mechanical Device) Mechanically assisted chest compression 429283006 Mechanical CPR Device Cardiac: Cardioversion Cardioversion 250980009 Cardioversion - Electrical Cardiac: Defibrillation External ventricular Defibrillation - Manual (Manual) defibrillation 426220008 Defibrillation - Automated / Semi- Automated (AED) Implantable cardioverter / defibrillator magnet use Cardiac: Intra-Aortic Intraaortic balloon pump Balloon Pump Maintenance maintenance 34475007 Aortic Balloon Pump Monitoring Cardiac: Left Ventricular Assist Device Maintenance Circulatory care: mechanical assist device 386237008 Cardiac: Pacing (External and Internal) Cardiac pacing 18590009 Transcutaneous Pacing Transvenous Pacing - Maintenance
Cardiac: Pericardiocentesis Pericardiocentesis 309849004 Percutaneous Pericardiocentesis Cardiac: Precordial Thump Precordial thump 225708008 Cardiac: Vagal Maneuver Vagal stimulation 128968000 Carotid Massage CNS: Epidural Catheter Maintenance Epidural catheter maintenance 424432007 CNS: Intracranial Pressure Monitoring Procedure for monitoring intracranial pressure 230937006 Maintenance of Intracranial Monitoring lines CPR: Impedance Threshold Device Active compression decompression cardiopulmonary resuscitation with use of inspiratory impedance threshold device 441893003 Inspiratory Impedance Threshold Device General: Contact Medical Control Informing doctor 304562007 General: Decontamination Decontamination 409530006 General: Eye Irrigation Irrigation of eye 49999004 Eye Irrigation Nonivasive Eye Irrigation Morgan Lens General: Hypothermia Induction Therapy Hypothermia induction therapy 430189000 General: Monitoring of Preexisting Devices and Interventions Monitoring of patient 182777000 General: Patient Cooling (Cold Pack or General) Active external cooling of subject 431774007 Therapeutic Induced Hypothermia (TIH) - includes special instructions in the rule Esophageal Temperature Probe for TIH Technology and Pharmacology Dependent Patients General: Patient Warming (Warm Pack or General) Active external warming of subject 431949004 General: Restraint Applied (Chemical) Chemical restraint 406164000 General: Restraint Applied (Physical) Physical restraint 386423001 Restraints - Chemical Restraints - Physical Restraints - Verbal GI/GU: Nasogastric Tube Insertion Insertion of nasogastric tube 87750000 Gastric Decompression - NG/OG Tube Insertion
GI/GU: Gastro Intestinal Tube Maintenance Maintenance of gastrointestinal tract tube 384745002 GI/GU: Orogastric Tube Insertion Insertion of orogastric tube 235425002 GI/GU: Urinary Catheterization Insertion of catheter into urinary bladder 410024004 Gastric Decompression - NG/OG Tube Insertion Urinary Catheterization - Initiation Urinary Catheterization - Maintenance Applied for Stabilization collar 49689007 See "Spinal Immobiliation - Cervical Collar" Trouser Application trouser 448970001 MAST / Pneumatic Anti-Shock Garment Musculoskeletal: Reduction of Dislocated Joint Musculoskeletal: Spinal Immobilization (Cervical) Closed reduction of dislocation 58825001 Cervical spine immobilization 398041008 Musculoskeletal: Spinal Immobilization (Full) Stabilization of spine 426498007 Spinal Immobilization - Cervical Collar Spinal Immobilization - Long Board Spinal Immobilization - Manual Stabilization Musculoskeletal: Splinting (General) Application of splint 79321009 Spinal Immobilization - Seated Patient Splinting - Manual Splinting - Rigid Splinting - Soft Splinting - Vacuum Musculoskeletal: Splinting (Pelvic Binder/Sling) Pelvic sling 182556001 Musculoskeletal: Splinting (Traction) Application of traction using a traction device 302488007 External Pelvic Compression Splinting - Traction OB: Childbirth Delivery procedure 236973005 Assisted Delivery OB: Fetal Heart Monitor External fetal monitor Surveillance surveillance 36708009 Oxygen Therapy - Humidifiers Oxygen Therapy - Nasal Cannula Oxygen Therapy - Non-breather Mask Oxygen Therapy - Simple Face Mask Oxygen Therapy - Venturi Mask Peak Expiratory Flow Testing Pulse Oximetry
Respiratory: Airway Device Removal Respiratory: Airway Opened Removal of device from airway 232708009 Manual establishment of airway 232664002 Respiratory: Bagged Ventilations (via Mask) Bag valve mask ventilation 425447009 Extubation Bag - Valve - Mask (BVM) Respiratory: Bagged Ventilations (via Tube) Lung inflation by intermittent compression of reservoir bag 243140006 Bag - Valve - Mask (BVM) Flow Restrictive Oxygen Powered Ventilatory Device Respiratory: BiPAP Respiratory: Chest Decompression Respiratory: Chest Tube Insertion Respiratory: Chest Tube Maintenance Respiratory: CPAP Respiratory: Cricoid Pressure Applied Respiratory: Cricothyrotomy (Dilation Device) Respiratory: Cricothyrotomy (Needle) Dual pressure spontaneous ventilation support 243142003 Tension pneumothorax relief 182705007 Insertion of pleural tube drain 264957007 Maintenance of thoracic drain 55628002 Continuous positive airway pressure ventilation treatment 47545007 Application of cricoid pressure 241726007 Percutaneous dilatational cricothyroidotomy 232690004 Percutaneous cricothyroidotomy 232689008 Chest Decompression - Needle Chest Tube Insertion Chest Tube Monitoring CPAP Cricoid Pressure - Sellick's Maneuver Cricothyroidotomy - Needle Respiratory: Cricothyrotomy (Surgical) Open cricothyroidotomy 232692007 Cricothyroidotomy - Surgical Respiratory: ETCO2 Colorimetric Detection Respiratory: ETCO2 Digital Capnography Respiratory: Foreign Body Removal Colorimetric respired carbon dioxide monitoring 428482009 Digital respired carbon dioxide monitoring 425543005 Removal of foreign body from airway 232707004 Respiratory: Heimlich Maneuver Heimlich maneuver 23690002 Respiratory: Intubation (Existing Tracheostomy Stoma) Insertion of tracheostomy tube 232685002 Carbon Monoxide Monitoring End Tidal CO2 Monitoring / Capnometry / Capnography Obstruction - Direct Laryngoscopy
Respiratory: Intubation (Nasotracheal) Nasotracheal intubation 232679009 Respiratory: Intubation (Orotracheal Through Laryngeal Mask Airway) Tracheal intubation through a laryngeal mask airway 418613003 Respiratory: Intubation (Orotracheal) Orotracheal intubation 232674004 Respiratory: Intubation (Rapid Sequence) Rapid sequence induction 241689008 Intubation - Nasotracheal Intubation - Orotracheal Intubation - Medication Assisted (paralytics) RSI - Adult age 13 and older Intubation - Medication Assisted (paralytics) RSI - Pediatric age 12 and under Intubation - Medication Assisted (nonparalytic) Intubation - Maintenance with paralytics Respiratory: Intubation using exchange catheter to place invasive airway Respiratory: Laryngeal Mask Airway Insertion Airway exchange catheter procedure 397874007 Laryngeal mask airway insertion 424979004 Respiratory: Laryngoscopy (Direct) Direct laryngoscopy 78121007 Respiratory: Laryngoscopy (Indirect) Indirect laryngoscopy 673005 Respiratory: Mouth-to- Mask/Mouth Ventilation Expired air ventilation 243180002 Respiratory: Nasopharyngeal Airway Insertion Nasopharyngeal airway insertion 182692007 Respiratory: Obturator Airway (EOA) Insertion Obturator airway insertion 232673005 Intubation - Bougie Style Introducer Airway - Supraglottic Intubation - Lighted Stylet Intubation - Digital Airway - Nasal Respiratory: Oropharyngeal Airway Insertion Insertion of oropharyngeal airway 7443007 Respiratory: PEEP Applied Positive end expiratory pressure ventilation therapy, initiation and management 45851008 Respiratory: Retrograde Intubation Retrograde intubation 397892004 Respiratory: Suction Airway Airway suction technique 230040009 Respiratory: Supraglottic Airway Insertion (Double Lumen) Insertion of esophageal tracheal double lumen supraglottic airway 427753009 Airway - Oral PEEP Intubation - Retrograde Suctioning - Tracheobronchial Suctioning - Upper Airway Airway - Supraglottic
Respiratory: Tracheostomy Tube Change Changing tracheostomy tube 2267008 Tracheostomy Maintenance - Includes replacement Trachostomy Maintenance - Airway management only Respiratory: Transtracheal Jet Insufflation Transtracheal jet ventilation 448442005 Respiratory: Ventilator Care and Adjustment Ventilator care and adjustment 385857005 Ventilators - Automated Transport (ATV) Manual Transport Ventilators Soft Tissue: Burn Care Burn care 133901003 Soft Tissue: Escharotomy Escharotomy 70177008 Soft Tissue: General Wound Care Wound care 225358003 Soft Tissue: Hemostatic Agent Application Soft Tissue: Occlusive Dressing Application Soft Tissue: Pressure Dressing Application Application of chemical hemostatic agents 372045002 Application of dressing, occlusive plastic 22206003 Application of dressing, pressure 26906007 Soft Tissue: Tourniquet Application Application of tourniquet 20655006 Soft Tissue: Wound Irrigation Irrigation of wound 225116006 Dressing / Bandaging Hemorrhage Control - Direct Pressure Hemorrhage Control - Pressure Point Hemorrhage Control - Tourniquet Vascular: Arterial Cannulation Vascular: Arterial Cannulation (Femoral Artery) Vascular: Arterial Cannulation (Umbilical Artery) Insertion of catheter into artery 392247006 Femoral artery cannula insertion 233516009 Umbilical artery cannula insertion 233519002 Vascular: Arterial Line Maintenance Arterial catheter care 422744007 Vascular: Arterial Line Monitoring Vascular: Arterial Puncture for Blood Draw Arterial pressure monitoring, invasive method 77938009 Arterial puncture for withdrawal of blood for diagnosis 55841001 Vascular: Central Line Maintenance Care of central line 226005007 Arterial Blood Pressure Indwelling Catheter - Maintenance Central Venous Catheter Maintenance / Patency / Use Central Venous Catheter Insertion
Vascular: Central Venous Pressure Monitoring Central venous pressure monitoring 86265008 Central Venous Catheter Maintenance / Patency / Use Central Venous Pressure Monitor Interpretation Vascular: External Jugular Vein Catheterization Catheterization of external jugular vein 405427009 Vascular: Extremity Vein Catheterization Catheterization of vein 392230005 Vascular: Femoral Vein Catheterization Catheterization of common femoral vein 405442007 Vascular: Intraosseous Cannulation Intraosseous cannulation 430824005 Vascular: Scalp Vein Catheterization Vascular: Subclavian Vein Catheterization Vascular: Swan Ganz (PA Wedge Pressure) Monitoring Vascular: Umbilical Vein Catheterization Vascular: Venous Catheter Removal Peripheral venous cannula insertion - scalp 233526002 Catheterization of subclavian vein 405430002 Pulmonary artery wedge pressure monitoring 42340005 Catheterization of umbilical vein 42550007 Removal of peripheral intravenous catheter 424287005 Vascular: Venous Puncture for Blood Draw Phlebotomy 396540005 Peripheral - Including External Jugular Vein - Initiation Peripheral - Excluding External Jugular Vein Intraosseous - Initiation Venous Blood Sampling - Obtaining Capillary Blood Sampling Invasive Intracardiac Catheters - Maintenance Blood Chemistry Interpretation Blood / Blood By-Products Initiation (out of facility initiation) Colloids - (Albumin, Dextran) - Initiation Crystalloids (D5W, LR, NS) - Initiation / Maintenance Diagnostic Interpretation - Blood Glucose - See also Section 10.3 Diagnostic Interpretation - Blood Lactate - See also Section 10.3 Medication Administration Routes Aerosolized Atomized Auto-Injector Buccal
Endotracheal Tube (ET) Intradermal Intramuscular (IM) Intranasal (IN) Intraosseous Intravenous (IV) Piggyback Intravenous Cannulation - Fluid Administration - Fluid Maintenance - Peripheral - Excluding Jugular - Initiation Intravenous Cannulation - Fluid Administration - Fluid Maintenance - Peripheral - Including Jugular - Initiation Use of Peripheral Indweiling Catheter for IV medications (Does Not include PICC) Intravenous (IV) Push Nasogastric Nebulized Ophthalmic Oral Rectal Subcutaneous Sublingual Sublingual (nitroglycerin) Topical Use of Mechanical Infusion Pumps
EMT EMT - IV AEMT EMT-I Paramedic PCC Chapter 2 Table Comments X X X X X X A.2 X X X A.2 X X X X X X A.2 X X X X X X A.2 X X A.2 X X X A.2 X X X X X X A.2 A.2 A.6, C.2 X X X A.2 A.2
A.2 X X A.2 A.6 X X X A.6 VO X X A.2 VO X X A.6 X X X X X X Section 12 Separate section of the Rules X X X A.6 X X A.1
X X A.1 X X A.6 X X X X X X A.2 X X X X A.1 X X X A.1
X X X A.1 X X X A.1 A.1 X X C.2 X X A.1 X X A.1 X X A.1
X X A.1 X X X A.1 X E.1 A.1 A.1 A.1 Suggested Change - X X X A.1 X X X A.1 X X A.1 A.1 x x x x A.1
X X A.1 X X A.1, C.1 X E.1 X X X X X X A.2 X X X X X X A.2 X X X X X X A.2 A.2 X X X A.2 A.2
X X X A.2 C.2 X X X X A.4 X X X X X A.4 X X X X A.4 X X X X X A.6 A.2 X E.1 A.4 A.4 X X X X X A.4 X X X X A.6
X X X A.5 X X X A.5 X X X X A.5 X X X X X A.5 X X X X A.5 X X X A.5 Suggest creating category for naloxone delivery by EMT X X X X X A.4 X X X X A.4 X X X X X A.4 X X X X X A.5 X X A.5 X X X A.5 X X X A.5 X X X X A.5 X X X A.5 Suggest creating category for PICC to clarify