Wisconsin EMS Scope of Practice

Bureau of Local Health Support & EMS 10-19-2005

First Responder


This EMS provider level identifies individuals who have successfully completed a
program of training that used as a minimum, the 1996 First Responder National
Standard Curriculum with the Wisconsin revised curriculum, and have successfully
completed the testing requirements. First Responder certifications expire on June 30th
of even-numbered years. Recertification requirements include a state approved 18 hour
refresher course, which includes the required Weapons of Mass Destruction training.

AIRWAY / VENTILATION / OXYGENATION


Airway - Lumen (Non-Visualized)***
Airway - Nasopharyngeal
Airway - Oropharyngeal
Bag - Valve - Mask (BVM)
Cricoid Pressure (Sellick)
Manual Airway Maneuvers
Obstruction - Manual
Oxygen Therapy - Nasal Cannula
Oxygen Therapy - Non-rebreather Mask
Oxygen Therapy - Regulators
Pulse Oximetry **
Suctioning - Upper Airway (Soft & Rigid)

CARDIOVASCULAR /
CIRCULATION


Cardiopulmonary Resuscitation (CPR)
Defibrillation - Automated / Semi-
Automated (AED)
Hemorrhage Control - Direct Pressure
Hemorrhage Control - Pressure Point
Hemorrhage Control - Tourniquet
Trendelenberg Positioning

ASSISTED MEDICATIONS - PATIENTS

Auto-Injected Epinephrine ***
Oral Glucose

IMMOBILIZATION

Spinal Immobilization - Manual
Stabilization
Spinal Immobilization - Cervical Collar ***
Spinal Immobilization - Long Board***
Spinal Immobilization - Seated Patient
(KED, etc.)
Splinting - Manual
Splinting - Rigid
Splinting - Soft
Splinting - Vacuum

APPROVED MEDICATION by PROTOCOL

 

Epinephrine for Anaphylaxis
Auto-Injector Only***

MISCELLANEOUS

Assisted Delivery (childbirth)
Blood Pressure -Manual / Automated
Eye Irrigation
Vital Signs - Obtain/ Monitor/ Document
(Pulse, BP, Respiration, Temperature)

REMINDER: Personnel must be trained & competent in all equipment that is used by the service

** Requires documentation of additional training
*** Requires additional training and approval

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EMT-Basic (30-531-3)

This EMS provider level identifies individuals who have successfully completed a
program of training that used, as a minimum, the 1996 EMT-Basic National Standard
Curriculum and the Wisconsin supplemental curriculum, and have successfully
completed the department's testing requirements. EMT-Basic licenses expire on June
30th of even numbered years. Recertification requirements include a state approved 30
hour refresher, which includes the required Weapons of Mass Destruction training.

-Items in red denote change from previous license level -

 

AIRWAY / VENTILATION /
OXYGENATION

CARDIOVASCULAR /
CIRCULATION

Airway - Lumen (Non-visualized) ECG Monitor **
Airway - Nasal (Nasopharyngeal) 12-Lead ECG - (acquire but clinician non -interpretive)***
Airway - Oral (Oropharyngeal) Cardiopulmonary Resuscitation (CPR)
Bag-Valve-Mask (BVM) CPR - Mechanical Device **
Capnography *** Defibrillation - Automated / Semi-Automated (AED)
CPAP*** (Members of CPAP Project ONLY)
Defibrillation - Manual ***
Cricoid Pressure (Sellick) Hemorrhage Control - Direct Pressure
Manual Airway Maneuvers Hemorrhage Control - Pressure Point
Obstruction - Forceps (Direct Visual) Hemorrhage Control - Tourniquet
Obstruction - Manual Trendelenberg Positioning
Oxygen Therapy - Nebulizer  
Oxygen Therapy - Nasal Cannula
ASSISTED MEDICATIONS - PATIENTS
Oxygen Therapy -Non-rebreather Mask Auto-Injected Epinephrine
Oxygen Therapy - Regulators Medicated Inhaler - Prescribed Albuterol
Pulse Oximetry ** Medicated Inhaler - Prescribed Atrovent **
Suctioning -Upper Airway (Soft & Rigid) Nitroglycerin
  Oral Glucose
   
IMMOBILIZATION
MISCELLANEOUS
Spinal Immobilization - Cervical Collar Assisted Delivery (Childbirth)
Spinal Immobilization - Long Board Blood Glucose Monitoring
Spinal Immobilization - Manual Stabilization Blood Pressure - Manual / Automated
Spinal Immobilization - Seated Patient (KED, etc.) Eye Irrigation
Selective Spinal Immobilization *** Vital Signs - Obtain/ Monitor/ Document (Pulse, BP, Respiration, Temperature)
Splinting - Manual Pain Management Techniques
Splinting - Pelvic Wrap / MAST / PASG Patient Physical Restraint Application
Splinting - Rigid  
Splinting - Soft
APPROVED MEDICATIONS BY
PROTOCOL

Splinting - Traction Activated Charcoal
Splinting - Vacuum Albuterol (Nebulized - Unit Dose)
  Aspirin (ASA) for chest pain
MEDICATIONS
Atrovent (Nebulized - Unit Dose)**
HFS 110. 05 (4)(d) Administration of
additional medications approved by the
department based on recommendations of
Epinephrine for Anaphylaxis only Auto-
Injector or manually drawn***
the emergency medical services board Glucagon
under s. 146.58, Stats., the EMS physician Mark I Auto-Injector (For Self & Crew)
advisory committee under s. 146.58 (1), Oral Glucose
Stats., and the Wisconsin EMS program
medical director under s. 146.55 (2m), Stats.
 
REMINDER: Personnel must be trained & competent in all equipment that is used by the service
** Requires documentation of additional training
*** Requires additional training and approval

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Basic Intermediate Technician (3-531-6)

This EMS provider level identifies individuals who have successfully completed a
program of training that used, as a minimum, the 1985 EMT-Intermediate National
Standard Curriculum and have successfully completed the department's testing
requirements. EMT Basic IV-Technician licenses expire on June 30th of evennumbered
years. Recertification requirements include a state approved 30 hour EMT
Basic refresher, which includes the required Weapons of Mass Destruction training and
a 12 hour EMT Basic IV-Technician refresher course.

-Items in red denote change from previous license level -


AIRWAY / VENTILATION /
OXYGENATION


Airway - Lumen (Non-Visualized)
Airway - Nasal (Nasopharyngeal)
Airway - Oral (Oropharyngeal)
Bag-Valve-Mask (BVM)
Capnography-
Non-Intubated / Intubated***
CPAP***
Cricoid Pressure (Sellick)
Intubation - Lighted Stylet ***
Intubation - Endotracheal ***

Manual Airway Maneuvers
Obstruction - Forceps (Direct Visual)
Obstruction - Manual
Oxygen Therapy - Nebulizer
Oxygen Therapy - Nasal Cannula
Oxygen Therapy - Non-rebreather Mask
Oxygen Therapy - Regulators
Pulse Oximetry
Suctioning - Upper Airway (Soft & Rigid)


MEDICATION ADMINISTRATION ROUTES
Aerosolized/Nebulizer
Auto-Injector
Intramuscular(IM)
Intravenous (IV) Push
Oral
Subcutaneous (SQ)
Sub-Lingual (SL)

APPROVED MEDICATION BY
PROTOCOL

Activated Charcoal
Albuterol (Nebulized - Unit Dose)
Atrovent (Nebulized - Unit Dose)
Epinephrine for Anaphylaxis
Auto-Injector or manually drawn***
Aspirin (ASA) for chest pain
Atrovent (Nebulized)
Dextrose 50%
Glucagon
Mark I Auto Injector (For Self & Crew)
Narcan
Nitroglycerin (SL only)

Oral Glucose

IV INITIATION MAINTENANCE/FLUIDS

IV Solutions- D5W, Normal Saline,
Lactated Ringers
Maintenance - Non-Medicated IV Fluids
(D5W, LR, NS)
Peripheral Initiation

MEDICATIONS
HFS 110. 05 (4)(d) Administration of
additional medications approved by the
department based on recommendations of
the emergency medical services board under
s. 146.58, Stats., the EMS physician advisory
committee under s. 146.58 (1), Stats., and
the Wisconsin EMS program medical director
under s. 146.55 (2m), Stats.

CARDIOVASCULAR /
CIRCULATION

ECG Monitor **
12-lead ECG (acquire & clinician noninterpretive)***
Cardiopulmonary Resuscitation (CPR)
CPR Mechanical Device **
Defibrillation - Automated / Semi-
Automated (AED)
Defibrillation - Manual ***
Hemorrhage Control - Direct Pressure
Hemorrhage Control - Pressure Point
Hemorrhage Control - Tourniquet
Trendelenberg Positioning

IMMOBILIZATION

Selective Spinal Immobilization ***
Spinal Immobilization - Cervical Collar
Spinal Immobilization - Long Board
Spinal Immobilization - Manual
Stabilization
Spinal Immobilization - Seated Patient
(KED, etc.)
Splinting - Manual
Splinting - Pelvic Wrap / MAST / PASG
Splinting - Rigid
Splinting - Soft
Splinting - Traction
Splinting - Vacuum

MISCELLANEOUS

Assisted Delivery (Childbirth)
Blood Glucose Monitoring
Blood Pressure - Manual / Automated
Eye Irrigation
Venous Blood Sampling - Obtaining**
Vital Signs - Obtain/ Monitor/ Document
(Pulse, BP, Respiration, Temperature)
Pain Management Techniques
Patient Physical Restraint Application

 
REMINDER: Personnel must be trained & competent in all equipment that is used by the service
** Requires documentation of additional training
*** Requires additional training and approval

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EMT- Intermediate (30-531-4)

This EMS provider level identifies individuals who have successfully completed a
program of training that used, as a minimum, the Wisconsin Revised 1999 EMTIntermediate
National Standard Curriculum, and have successfully completed the
department's testing requirements. EMT-Intermediate licenses expire on June 30th of
even-numbered years. Recertification requirements include 48 hours of approved
continuing education which includes the state required Weapons of Mass Destruction
training.

-Items in red denote change from previous license level -

AIRWAY / VENTILATION /
OXYGENATION


Airway - Lumen (Non-Visualized)
Airway - Nasal (Nasopharyngeal)
Airway - Oral (Oropharyngeal)
Bag-Valve-Mask (BVM)
Chest Decompression - Needle
CPAP ***
Cricoid Pressure (Sellick)
End Tidal CO2 Monitoring/Capnometry
Intubation - Lighted Stylet
Intubation - Orotracheal
Manual Airway Maneuvers
Obstruction - Forceps (Direct Visual)
Obstruction - Manual
Oxygen Therapy - Nebulizer
Oxygen Therapy - Nasal Cannula
Oxygen Therapy - Non-rebreather Mask
Oxygen Therapy - Regulators
Pulse Oximetry
Suctioning - Tracheobronchial
Suctioning - Upper Airway (Soft & Rigid)

CARDIOVASCULAR /
CIRCULATION

 


ECG Monitor
12 Lead ECG
Cardiopulmonary Resuscitation (CPR)
Valsalva
CPR Mechanical Device**
Defibrillation - Automated / Semi-
Automated(AED)
Defibrillation - Manual
Hemorrhage Control - Direct Pressure
Hemorrhage Control - Pressure Point
Hemorrhage Control - Tourniquet
Cardioversion (Unstable Patients only)
Transcutaneous Pacing (Unstable
Patients only)

Trendelenberg Positioning


IV INITATION / MAINTENANCE
FLUIDS


IV Solutions- D5W, Normal Saline,
Lactated Ringers
Intraosseous - Initiation
Peripheral - Initiation
Maintenance - Medicated IV Fluids
Maintenance - Non-Medicated IV Fluids
(D5W, LR, NS)

IMMOBILIZATION


Selective Spinal Immobilization ***
Spinal Immobilization - Cervical Collar
Spinal Immobilization - Long Board
Spinal Immobilization - Manual
Stabilization
Spinal Immobilization - Seated Patient
(KED, etc.)
Splinting - Manual
Splinting-Pelvic Wrap/MAST/PASG
Splinting - Rigid
Splinting - Soft
Splinting - Traction
Splinting - Vacuum

MEDICATION ADMINISTRATION


Routes
Aerosolized/Nebulized
Auto-Injector
Endotracheal Tube (ET)
Intramuscular (IM)
Intraosseous (IO)
Intravenous (IV) Push
Oral
Rectal
Subcutaneous (SQ)
Sub-lingual (SL)

MEDICATIONS & SKILLS


HFS 111.04(4) (b) 2. 'Department approved
medications and skills.' Administration of additional
medications and skills approved by the department
based on recommendations of the emergency medical
services board under s. 146.58, Stats., the EMS
physician advisory committee under s. 146.58 (1),
Stats., and the State EMS program medical director
under s. 146.55 (2m), Stats. Additional skills shall
become effective when approved by the department
based on the recommendations of the entities in this
subdivision and will be incorporated into the next
revision of this chapter.

APPROVED MEDICATIONS BY
PROTOCOL


Activated Charcoal
Adenosine
Albuterol (Nebulized)
Albuterol & Atrovent - Premix Combined
Amiodarone (Bolus only)
Aspirin (ASA) for chest pain
Ativan (Lorazepam) for Seizures
Atropine

Atrovent (Nebulized)
Dextrose 50%
Epinephrine Auto-Injector
Epinephrine 1:1000
Epinephrine 1:10,000

Glucagon
Lasix
Lidocaine (Bolus Only)

Mark I Auto Injector (For Self & Crew)
Morphine
Narcan
Nitroglycerin (SL only)
Valium (Diazepam) for Seizures
Vasopressin

Oral Glucose

MISCELLANEOUS


Assisted Delivery (childbirth)
Blood Glucose Monitoring
Blood Pressure - Manual/Automated
Eye Irrigation
Venous Blood Sampling - Obtaining***
Vital Signs - Obtain/ Monitor/ Document
(Pulse, BP, Respiration, Temperature)
Pain Management Techniques
Patient Physical Restraint Application

Unstable cardiac patients are defined by the AHA under ACLS guidelines

 

REMINDER: Personnel must be trained & competent
in all equipment that is used by the service
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EMT-Paramedic (10-531-1)

This EMS provider level identifies individuals who have successfully completed a
program of training that used, as a minimum, the 1998 EMT-Paramedic National
Standard Curriculum, with the required Wisconsin Revised Curriculum and have
successfully completed the department's testing requirements. EMT-Paramedic
licenses expire on June 30th of even-numbered years. Recertification requirements
include 48 hours of approved continuing education which includes the state required
Weapons of Mass Destruction training

-Items in red denote change from previous license level -

AIRWAY / VENTILATION /
OXYGENATION


Airway - Lumen (Non-Visualized)
Airway - Nasal (Nasopharyngeal)
Airway - Oral (Oropharyngeal)
Bag-Valve-Mask (BVM)
Chest Decompression - Needle
CPAP ***
Cricoid Pressure (Sellick)
Cricothyroidotomy - Surgical/Needle
End Tidal CO2 Monitoring/Capnometry
Gastric Decompression - NG Tube
Intubation - Lighted Stylet
Intubation - Medication Assisted
(non-paralytic)
Intubation - Medication Assisted
(paralytics) (RSI)***
(Requires 2 Paramedics Patient Side)
Intubation - Nasotracheal

Intubation - Orotracheal
Manual Airway Maneuvers
Obstruction - Forceps (Direct Visual)
Obstruction - Manual
Oxygen Therapy - Nebulizer
Oxygen Therapy - Nasal Cannula
Oxygen Therapy - Non-rebreather Mask
Oxygen Therapy - Regulators
Pulse Oximetry
Suctioning - Tracheobronchial
Suctioning - Upper Airway (Soft & Rigid)
Ventilators ***

CARDIOVASCULAR /
CIRCULATION


ECG Monitor
12 Lead ECG
Cardiopulmonary Resuscitation (CPR)
CPR Mechanical Device**
Cardioversion - Electrical
Valsalva
Defibrillation -
Automated / Semi-Automated (AED)
Defibrillation - Manual
Hemorrhage Control - Direct Pressure
Hemorrhage Control - Pressure Point
Hemorrhage Control - Tourniquet
Transcutaneous Pacing
Trendelenberg Positioning

 

MEDICATION ADMINISTRATION

Routes
Aerosolized/Nebulized
Auto-Injector
Endotracheal Tube (ET)
Intramuscular (IM)
Intraosseous (IO)
Intravenous (IV) Piggyback
Intravenous (IV) Push
Oral
Rectal
Subcutaneous (SQ)
Sub-lingual (SL)

IMMOBILIZATION

Selective Spinal Immobilization **
Spinal Immobilization -
Assessment Based
Spinal Immobilization - Cervical Collar
Spinal Immobilization - Long Board
Spinal Immobilization -Manual
Stabilization
Spinal Immobilization -
Seated Patient (KED, etc.)
Splinting - Manual
Splinting- Pelvic Wrap/MAST/PASG
Splinting - Rigid
Splinting - Soft
Splinting - Traction
Splinting - Vacuum

IV INITATION / MAINTENANCE /
FLUIDS

Blood/ Blood By-Products (Maintenance
only)***
Colloids - (Albumin, Dextran)**

IV Solutions- D5W, Normal Saline,
Lactated Ringers
Intraosseous - Initiation
Peripheral - Initiation
Maintenance - Medicated IV Fluids
Maintenance - Non-Medicated IV Fluids
(D5W, LR, NS)

MISCELLANEOUS

Assisted Delivery (childbirth)
Blood Glucose Monitoring
Blood Pressure - Manual/Automated
Eye Irrigation
Initiation of IV at Central Line Port**
Thrombolytic Therapy - Monitoring***

Venous Blood Sampling - Obtaining
Vital Signs - Obtain/ Monitor/ Document
(Pulse, BP, Respiration, Temperature)
Pain Management Techniques
Patient Physical Restraint Application

MEDICATIONS

HFS 112.04(4)b2. Administration of
additional medications approved by the
department based on recommendations of
the emergency medical services board
under s. 146.58, Stats., the EMS physician
advisory committee under s. 146.58 (1),
Stats., and the State EMS program medical
director under s. 146.55 (2m), Stats.
A sample list of commonly
approved medications can be
obtained through the Bureau of
Local Heath Support & EMS

REMINDER: Personnel must be trained & competent in all equipment that is used by the service
** Requires documentation of additional training
*** Requires additional training and approval

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