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Leaders Demand Change to EMS Scope of Practice for COVID-19 Pandemic

Calling paramedics an "untapped resource" in the COVID-19 pandemic, paramedic Nikiah G. Nudell, MS, NRP, FACPE, and others recently published in the Journal of Rural Health a call to expand the paramedic scope of practice, specifically to include the operation of ventilators in the out-of-hospital setting.  

In rural America there are already limited EMS resources, making the changes to the scope of practice an urgent need during the pandemic, the authors write.

The commentary, whose authors also include Brad Boehringer, MSN, NRP, PCP; Peter O’Meara, PhD; and Gary Wingrove, FACPE, CP-C, argues that "the healthcare system and the nation are missing the opportunity to leverage the skills and knowledge of nationally registered paramedics to carry out more advanced skills related to airway and ventilation management as members of interdisciplinary teams during the current pandemic."

Nudell and his fellow authors claim that while the National Scope of Practice for EMS providers is useful during normal operations, in a pandemic the standards can hinder innovation when flexibility is needed.

"This topic needs to be addressed at the national level and then again in the states that follow the national scope of practice disallowing ventilator management," says Nudell. "Ambulance-based paramedics, with additional ventilator training, have a proven track record of safe and effective management of ventilated patients. They make a natural choice for managing these patients, if they receive the minimal additional training required."

The authors write that currently, with the "healthcare system bursting at the seams," paramedics are "unable to fully engage in the healthcare system at a time when their skills and experience are most needed."

"The time to provide this training is now," Nudell says. 

Read the commentary, "An Emergency Amendment to the National Scope of Practice for Paramedics in the Setting of a Global Pandemic", in the Journal of Rural Health.

For further information, contact: Nikiah G. Nudell, American Paramedic Association, 23 W. Central Entrance, PMB 321, Duluth, MN 55811; e-mail: 

Hilary Gates, MAEd, NRP, is the senior editorial and program director for EMS World.

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