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Efforts are underway to come up with new titles for those who work in the emergency medical service profession. The new effort is called The National EMS Scope of Practice Model.
What is a “scope of practice”? Essentially, a scope of practice is a set of skills (intubation, starting IV, taking a blood pressure, etc.) that a state legally allows to you perform and not perform under your license or certification. Usually, the range of skills is established in a state law, statute, rule or regulation.
In 1996, the EMS Agenda for the Future identified at least 44 different levels of EMS provider certifications in the United States. It is highly likely that the number has increased since 1996. For example, as an EMT, in one state you may be allowed to defibrillate with an AED, but in another state, you may be not. The National EMS Scope of Practice Model is an attempt to provide a consistent definition on a national level of titles for EMS providers and what set of skills each provider level can do. Because states have the final say on authorization of medical licenses or certifications, it is each state’s decision whether to accept whatever comes of the effort to define new titles and what set of skills the EMS provider can perform.
How does this affect you? Regardless of whether you are an EMT, paramedic, administrator, educator or medical director, you have a chance to have input on the final document. Go to www.emsscopeofpractice.org, obtain a copy of the EMS SOP Model draft, read it, and if you want to comment, the website has instructions on how to submit your comments. But do not delay; comments are due Jan. 30.
What is driving this effort, how will you be affected and why would you want a say in the matter?
It all started in 2000, when the National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration (HRSA) created a consensus-based document called, “National EMS Education Agenda for the Future: A Systems Approach.” The purpose of creating this agenda was multi-faceted. First, EMS provider levels vary from state to state. One state may call an EMT who is trained and licensed to start IVs an EMT-I, while another state calls that person an EMT-IV. Also, skills that are currently performed by EMTs and paramedics are determined by the national standard curriculum, instead of the medical needs of the community. This is especially true in rural communities, where paramedics could be more beneficial in health-related issues since they may be the highest medical licensees for miles.
Another reason is that the education of EMTs and paramedics in many cases was based on what educators thought the students needed to know, rather than on any data, research or patient outcomes. Finally, the agenda was created because there is no true career ladder for those who work in the EMS profession. The proposed Scope of Practice Model creates a new level of the current paramedic level.
The National EMS Scope of Practice Model has been in the works for over a year. The project is being managed by the National Association of State EMS Directors and the National Council of State EMS Training Coordinators. The International Association of Fire Fighters (IAFF) and the International Association of Fire Chiefs (IAFC), EMS professional-interest organizations and federal agencies have been meeting to come up with draft recommendations. Here are some of titles and skills levels for which they are looking for comments: