NAC450B.447. Authorized activities; oral orders.

     1. An advanced emergency medical technician who is licensed may, in addition to the authorized activities of an intermediate emergency medical technician:

     (a) During training received in a clinical setting, administer medications and perform any other authorized activity under the direct supervision of a physician or a registered nurse supervised by a physician.

     (b) Perform cardiopulmonary resuscitation and defibrillation using a manual defibrillator.

     (c) Monitor and treat cardiac arrhythmias.

     (d) Under the direct supervision of a physician or a registered nurse supervised by a physician, or under such prescribed conditions as are set forth by the medical director pursuant to written protocols of the service or fire-fighting agency, perform such procedures and administer such medications as are approved by the board and recommended by the medical director of the service or fire-fighting agency in accordance with written protocols approved by the Health Division, which may include, but are not limited to:

          (1) Administering intravenous solutions other than blood or blood products.

          (2) Performing gastric suction.

          (3) Performing needle cricothyroidotomy.

          (4) Performing a needle aspiration of the chest.

          (5) Drawing blood specimens for medical analysis.

          (6) Administering additional medications for acute and chronic conditions.

     2. Any oral order from a physician or registered nurse acting on the authority of a physician to the advanced emergency medical technician to perform one of the procedures must originate from an emergency room department of a hospital or any other site designated by the Health Division and must be recorded on magnetic tape or digital disc.

     3. Each tape or digital recording of a physician’s oral orders to an advanced emergency medical technician concerning the procedures must be retained by the hospital or the facility issuing the medical directions, or the regional dispatch center, for at least 90 days after the recording is made.

     4. The advanced emergency medical technician shall enter the physician’s oral order on the report of emergency care. The entry must be countersigned by the physician receiving the patient unless the advanced emergency medical technician performed the procedure pursuant to a written order of the physician or a written protocol of the hospital.

     (Added to NAC by Bd. of Health, eff. 11-12-87; A 8-1-91; R182-01, 3-5-2002)