A. The Office will publish and maintain an EMS Procedure and Medication Schedule that specifies the medical procedures and medications recommended for use by each EMS certification level issued by the Office. (Medical procedures or medications not included on the EMS Procedure and Medication Schedule are not recommended to be performed by EMS personnel except as provided in 12VAC5-31-1070 of state EMS regulations.) This schedule will be formatted to provide two listings of recommended medical procedures and medications for each certification level, as follows:
1. Essential - Those medical procedures and medications that are the minimum knowledge and skill proficiencies required to maintain state EMS certification at the specified certification level. Instruction in these essential items is included as mandatory content in the corresponding training program curricula. (See also 12VAC5-31-1050 of EMS regulations.)
2. Optional – Those medical procedures and medications that are authorized for instruction and practice at the specified certification level which may be instructed and performed based upon the authority of the applicable Physician Course Director and/or EMS agency Operational Medical Director. These medical procedures and medications are not required to maintain state EMS certification and are not included as mandatory content in the corresponding training program curricula.
Additions to, or deletions from, the EMS Procedure and Medication Schedule will be made as follows:
1. The Medical Direction Committee of the State EMS Advisory Board will periodically review the EMS Procedure and Medication Schedule and any recommended changes made will apply to all providers certified at the specified certification level and all corresponding training programs as of an effective date published by the Office.
2. An EMS Physician must petition the Medical Direction Committee in writing with a request to add or delete a medical procedure or medication from the EMS Procedure and Medication Schedule.
3. The Medical Direction Committee will review the request at a scheduled meeting (Requests received less than thirty (30) days prior to a scheduled meeting may be referred to a future Medical Direction Committee meeting for review.) During its review the Medical Direction Committee will determine the need for the requested change and take action on the request as follows:
a. Recommend to adopt the requested item(s) to the EMS Procedure and Medication Schedule. Once the change is made it will apply to all providers certified at the specified certification level and all corresponding training programs as of an effective date published by the Of fice.
b. Approve the request as a “Pilot” for limited use for investigative purposes by one or more training programs and/or EMS agencies for a specified time period. During the trial period the requesting EMS Physician must submit the findings of the trial investigative use for further review. If the requested change is not later approved by the Office, use of the medical procedure or medication must be terminated at the end of the specified time period.
c. Recommend denial of the request for change. (The EMS Procedure and Medication Schedule will remain as previously published.)
4. Appeal of a request denied by the Medical Direction Committee may be forwarded by the involved EMS Physician to the State EMS Advisory Board for further review and a final recommendation regarding the change made to the Office
C. Any request for changes to the EMS Procedure and Medication Schedule that are submitted to the Office as a Variance or Exemption Request will be reviewed using the procedures specified in this policy.
D. The medical procedures and skills contained in the EMS Procedure and Medication Schedule include listing for these certification levels: (1.) EMS First Responder, (2.) EMT-Basic, (3.) EMT-Enhanced, (4.) EMT-Intermediate and (5.) EMT-Paramedic
E. Although listings for the Transitional ALS Certification levels of EMT-Shock Trauma and EMT-Cardiac are not included in the EMS Procedure and Medication Schedule, EMS Physicians should refer to the corresponding listing for the EMT-Enhanced and EMT-Intermediate levels when authorizing the practice and instruction of EMT-Shock Trauma and EMT-Cardiac level providers. Upon completion of transition to certification at the EMT-Enhanced and EMT-Intermediate the involved providers previously certified at the EMT-Shock Trauma and EMT-Cardiac levels the will be limited to those authorized by the EMS Procedure and Medication Schedule for the current certification level held.
F. The listings in the EMS Procedure and Medication Schedule do not specify the medical procedures and medications for use by licensed medical practitioners or nurses operating with an EMS agency per sections 12VAC5-31-1260, 12VAC5-31-1270 or 12VAC5-31-1280 of state EMS regulations. The Operational Medical Director for an EMS agency will identify the allowed medical procedures and medications for use by any agency members who are licensed medical practitioners or nurses within the allowed scope of practice of the individual as authorized by the Code of Virginia and applicable Department of Health Professions regulations.