EMS Commission & EMS Task Force

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Laws & Regulations

LRS 40:1131 - PART VII.  EMERGENCY MEDICAL SERVICES

LRS 40:1133. - SUBPART B.  EMERGENCY MEDICAL PERSONNEL

LRS 40:1133.13 - CIVIL IMMUNITY

LRS 40:1133.14- DUTIES OF EMERGENCY MEDICAL PERSONNEL

Licensure of EMS Practitioners
In accordance with L.R.S. 40:1131 (12), an "EMS practitioner" means an individual who is a licensed emergency medical responder, licensed emergency medical technician, licensed advanced emergency medical technician, or a licensed paramedic.

For more information on the difference between 'licensure' and 'certification' of EMS personnel, the National Registry of EMTs has provided a detailed explaination in the document "The Legal Differences Between Certification and Licensure".

Scope of Practice

On April 8, 2015, the EMS Certification Commission approved the Louisiana EMS Scope of Practice Matrix. The Scope of Practice Matrix defines the maximum scope (procedures) a duly licensed EMS Practitioner may perform, while operating under an approved medical protocol, or on the order of a physician.

Louisiana Scope of Practice Matrix for EMS
Trauma / Injury Management
Skill / Procedure EMR EMT A-EMT Paramedic
Cervical Spinal Immobilization (C-Collar) √*
Cervical Spinal Immobilization (Manual)
Eye Irrigation (Flush with water or saline)
Rigid Splints
Soft Splints
Soft tissue management
Spinal Immobilization (Long-Spine Board) √*
Spinal Immobilization (Manual)
Tourniquet Application
Wound Care - Pressure Bandage (Inclusive of hemostatic bandage)
Helmet removal  
PASG  
Rapid extrication procedures  
Spinal Immobilization (Seated / KED)  
Traction Splints (Femur Fracture)  
Wound Care - Occlusive Dressing  
Morgan Lens Eye Irrigation      
Airway Management
Skill / Procedure EMR EMT A-EMT Paramedic
BVM
Manual removal of obstructed airway
Mouth-to-barrier devices
Nasal cannula
Nasopharyngeal Airway Insertion
Non-rebreather mask
Open and Maintain the airway
Oral Suctioning
Oropharynegeal Airway Insertion
Ventilation with a flow-restricted oxygen-powered device
Capnography Application and Monitoring √*
Carbon monoxide Monitoring √*
Pulse Oximetery √*
Dual lumen airway  
Endotracheal Suctioning  
Extraglottic airways  
Partial rebreather mask  
Positive pressure ventilation devices (manually triggered or automatic ventilators)  
Tracheostomy Maintenance  
Venturi mask  
Administration of nebulized bronchodilators   √*
Automatic-Transport Ventilator   √*
CPAP administration and management   √*
Laryngoscopy for removal of airway obstruction    
Tracheostomy tube replacement    
BiPAP administration and management      
Endotracheal Intubation      
Nasogastric Tube Insertion      
Needle Decompression      
Orogastic Tube Insertion      
Percutaneous/Needle Cricothyrotomy      
Positive end-expiratory pressure (PEEP)      
Surgical Cricothyrotomy      
Transport Ventilator (Manual adjustments)      
Medication Assisted Intubation       √*
Pharmaceuticals
Skill / Procedure EMR EMT A-EMT Paramedic
Aspirin (PO)
Epinephrine (Auto-Injector)
Glucagon (Auto-Injector)
MDI (Patient Assist)
Naloxone (Auto-injector)
Naloxone (IN)
Oral Glucose
Sublingual NTG (Patient Assist)
Bronchodilators   √*
Benzodiazepines    
Dextrose in water    
Diphenhydramine    
Epinephrine 1:1,000 (subcutaneous or intramuscular)    
Glucagon    
Lidocaine for pain relief after intraosseous needle insertions    
Nalbuphine    
Naloxone    
Narcotics or other analgesics for pain relief    
Nitrous oxide    
Normal Saline    
Ondansetron (PO, Adults)    
Medication Administration with evidence of written protocol and education       √*
Medication Administration Routes (for medications in the approved scope of practice)
Skill / Procedure EMR EMT A-EMT Paramedic
Auto-Injector Devices
Intranasal Medication Administration
MDI (Patient Assist)
Sublingual NTG (Patient Assist)
Oral Medication Administration √*
OTC Medications (Patient Assist) √*
Maintenance of pre-established non-medicated IV fluids (D5W, LR, NS)   √*
Intramuscular Medication Administration    
Intraosseous Medication Administration    
Intravenous Medication Administration    
Subcutaneous Medication Administration    
Sublingual Medication Administration    
Intravenous Pump Medication Administration      
Rectal Medication Administration      
Vascular Access
Skill / Procedure EMR EMT A-EMT Paramedic
Blood Glucose Analysis √* √*
Blood Sample Collection for Analysis    
Intraosseous Access    
Peripheral Venous Access (Excluding external jugular)    
Central Line Maintenance      
Peripheral Venous Access (Including external jugular)      
Umbilical Venous Access       √*
Cardiac Arrest Management
Skill / Procedure EMR EMT A-EMT Paramedic
CPR - Manual
Defibrillation - AED
Application of Cardiac Rhythm Monitor √* √*
CPR - External Automated Device √* √*
Interpretation of Cardiac Rhythm Strips    
Defibrillation - Manual     √*
Interpretation of 12-Lead EKG      
Synchronized Cardioversion      
Transcutaneous Pacing      
Other Skills / Procedures
Skill / Procedure EMR EMT A-EMT Paramedic
Body substance isolation precautions
Nerve agent antidote auto-injector kit
Patient Care Report (PCR) documentation
Taking and recording of vital signs
Trauma Triage
Emergency Childbirth √*
Taser barb removal √*
Urinary Catheter maintenance and troubleshooting  
Blood chemistry analysis      
Maintenance of blood administration      
Thrombolytic therapy initiation and monitoring      
Arterial Line Monitoring       √*
Thoracostomy (Tube, Needle, Finger)       √*
PICC Line – Access and Use       √*
CVP Line Monitoring       √*
Digital nerve block       √*
ICP Monitoring       √*
Pericardiocentesis       √*
Extremity wound closure (Suturing / Stapling)       √*
Swan-Ganz Catheter Monitoring       √*
Transvenous Pacing – Maintenance and Troubleshooting       √*
Urinary Catheter Insertion       √*
Access and use of existing central venous catheters and access ports       √*
Community Wellness / Health Promotion / Prevention / Mobile Integrated Healthcare
Skill / Procedure EMR EMT A-EMT Paramedic
Determination of alternate transport location   √* √* √*
Fall prevention assessment   √* √* √*
Injury risk assessment / home safety assessment   √* √* √*
Treat and release protocol implementation   √* √* √*
Care plan follow-up       √*
Comprehensive physical exam       √*
Ear, Nose, and Throat (ENT) assessment (advanced)       √*
Hospital discharge follow-up       √*
Immunizations / vaccinations       √*
Medication compliance monitoring       √*
Mental health assessment (advanced)       √*
Oral health assessment (advanced)       √*
Social evaluation (advanced)       √*
Physician extension under direct tele-medicine supervision in accordance with LRS 37:1271       √*
Notes on Scope of Practice
EMS Practitioners must be licensed by the Louisiana Bureau of EMS and affiliated with a medical director.
All skills/procedures/interventions must be included in agency specific protocols approved by a medical director.
√* Procedures with a "√*" are approved as optional modules. Agencies utilizing these skills must maintain documentation demonstrating all individuals authorized by the agency's medical director to perform these skill(s)/procedure(s) have attended an agency specific training module. Agency documentation of competency validation is required every 24 months.
Employers and/or agency specific medical directors may limit, but not expand the scope of practice.
A licensed Louisiana EMS Practitioner may be licensed/credentialed/certified by other recognized credentialing boards. It is the responsibility of both the employee and the employer to clearly delineate if/when the individual is functioning as an EMS Practitioner or under a separate license/credential.

Related Statues & Rules

The EMSCC is governed by the following statues, rules, and regulations