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SAN JOAQUIN COUNTY® <br /> EMERGENCY MEDICAL SERVICES AGENCY <br /> TITLE: Paramedic Scope of Practice EMS Policy No. 2560 <br /> A. Perform defibrillation, cardioversion, and external cardiac pacing. <br /> B. Perform electrocardiograms (ECG)'s including 12 leads. <br /> C. Visualize the airway by use of laryngoscope and remove foreign body(ies) with <br /> forceps. <br /> D. Perform continuous positive airway pressure ventilation (CPAP), bi-level positive <br /> airway pressure (BPAP), and positive end expiratory pressure (PEEP). <br /> E. Perform pulmonary ventilation by use of the esophageal airway, lower airway <br /> lumen, endotracheal intubation or other airway adjuncts approved by the <br /> SJCEMSA. <br /> F. Use of respiratory ventilators during transport as approved by the EMS Agency. <br /> G. Institute intravenous (IV) catheters, saline locks, needles, or other cannulae in <br /> peripheral veins; and monitor and administer medications through pre-existing <br /> vascular access. <br /> H. Perform intraosseous access. <br /> I. Administer intravenous glucose solutions or isotonic balanced salt solutions <br /> including Ringer's lactate solution. <br /> J. Obtain venous blood samples. <br /> K. Use laboratory and point of care testing devices' for measuring: <br /> 1. Blood glucose levels. <br /> 2. Carbon monoxide levels. <br /> 3. Capnometry. <br /> 4. Capnography. <br /> 5. Pulse Oximetry. <br /> L. Perform Valsalva's maneuver. <br /> M. Perform needle cricothyrotomy. <br /> N. Perform needle thoracostomy. <br /> O. Perform nasogastric and orogastric tube insertion and gastric suctioning. <br /> P. Monitor thoracostomy tubes. <br /> Q. Monitor IV solution containing potassium equal to or less than 40 mEq./L. <br /> R. Administer using prepackaged products when available: <br /> 1. 10%, 25% and 50% dextrose. <br /> 2. Activated charcoal. <br /> 3. Adenosine. <br /> 4. Aerosolized or nebulized beta-2 specific bronchiodilators. <br /> 5. Aspirin. <br /> 6. Atropine sulfate. <br /> 7. Calcium chloride. <br /> 1 Laboratory and measuring devices may require additional approvals or waivers from applicable federal <br /> or state agencies. <br /> Effective: January 1, 2016 Page 2 of 3 <br /> Supersedes: January 1, 2012 <br /> Approved: Signature on file Signature on file <br /> Medical Director EMS Administrator <br />