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Association Update: NASEMSO Assists Scope of Practice Model, EMS Clinical Guidelines

The National Association of State Emergency Medical Services Officials (NASEMSO) is a leading and respected voice for national EMS policy, with comprehensive commitment to the development of EMS systems that are universal, community-based, integrated, effective, and consistent. Its membership consists of the leaders of state and territory EMS systems, plus associate and corporate members. 

Wherever in government they’re positioned, the mandate of state EMS offices is to protect the public. NASEMSO assists in this mission through state benchmarking efforts, networking opportunities, resource development, and federal, industry, and organizational partnerships. NASEMSO includes member councils for state data managers, EMS medical directors, trauma managers, pediatric emergency care, personnel licensure, and health and medical preparedness.

In addition, several mission-specific committees help coordinate statewide activities throughout a range of program areas, such as air medical, community paramedicine/mobile integrated healthcare, communications and technology, rural EMS, and systems of care for time-sensitive emergencies. 

Several key areas have served as focuses for the development of NASEMSO resources:

Quality EMS education and personnel licensure—NASEMSO engages in strategic partnerships to improve the provision of EMS through safe, reliable, and effective systems. Our commitment to quality EMS education aligns with NHTSA’s EMS Education Agenda for the Future: A Systems Approach and is documented in the statewide implementation of the National EMS Scope of Practice Model, national EMS certification, and national EMS program accreditation.

NASEMSO recently collaborated with the National Council of State Boards of Nursing to derive parts of its decision-making framework to complement state-based rules and regulations related to EMS scope of practice. NASEMSO’s “Scope of Practice Model Decision-Making Framework for Emergency Medical Services” is now available at, as are all documents not otherwise referenced in this column. 

EMS patient care—With encouragement and support from NHTSA and HRSA’s EMS for Children Program, state EMS medical directors sought to improve overall patient care by collaborating with the broader EMS community to establish model EMS clinical guidelines, evidence-based naloxone guidelines, and a protocol for prehospital pain management for children. 

NASEMSO established model air-medical rules for state adoption in 2016. Several states have adopted the model rules, which support requirements related to the qualifications and credentialing of air ambulance medical personnel, data reporting, and other patient care needs.

EMS workforce—In 2014 NASEMSO joined with federal partners to publish EMS Workforce Planning and Development Guidelines for State Adoption to encourage discussion and improve EMS workforce readiness. Guidelines fall into the four categories outlined in NHTSA’s EMS Workforce Agenda (health, safety and wellness; education and certification; data and research; workforce planning and development). 

Crew and patient safety—Safety was the basis for a multiyear project on EMS fatigue conducted through NHTSA’s Office of Behavioral Safety Research. The process developed five evidence-based recommendations fully explained in a special supplement to Prehospital Emergency Care in January 2018 with links to the evidence and an implementation guidebook available at is a compendium of ground ambulance standards and EMS safety resources identified through a partnership between NASEMSO and the National Institute of Standards and Technology. 

License mobility and reciprocity—NASEMSO assists states that wish to provide a pathway for personnel who cross state borders as part of an agency response. The Interstate Commission for EMS Personnel Practice (the “EMS Compact”) is currently active with 16 member states and growing. Visit 

Benchmarking state practices—NASEMSO coordinates collaboration among states and documents best practices through a series of monographs, such as for state EMS licensing practices; state trauma system planning and development; and EMS transport of special pathogens. NASEMSO is currently revising the National EMS Assessment, which provides a comprehensive description of EMS, EMS emergency preparedness, and 9-1-1 systems at state and national levels using existing data sources. The report is due early next year.

Systems of specialized care—The Systems of Care Project is a NHTSA-funded effort to identify best practices involving system integration, coordination of resources, evidence to support practice/destination decisions, and special EMS competencies. Priority focus is on systems of care where quantifiable evidence is already available on trauma, STEMI, and stroke, with others as time permits. Data will come largely from a survey of state EMS offices supplemented by NEMSIS and other existing information. 

Kathy Robinson, RN, EMT-P, QAS, is strategic partnerships director for the National Association of State EMS Officials (NASEMSO). 

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