Statutes, codes, and regulations
Arizona Administrative Code
Title 9 - HEALTH SERVICESChapter 25 - DEPARTMENT OF HEALTH SERVICES - EMERGENCY MEDICAL SERVICES
Article 5 - MEDICAL DIRECTION PROTOCOLS
Table 5.1 - [Effective 12/31/2024] Arizona Scope of Practice Skills

Ariz. Admin. Code § tit. 9, ch. 25, art. 5, tbl. 5.1

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Current through Register Vol. 30, No. 50, December 13, 2024
Table 5.1 - [Effective 12/31/2024] Arizona Scope of Practice Skills

KEY:

[TICK] = Arizona Scope of Practice skill

STR = Special Training Required skill

* = With training in R9-25-505

A. Airway/Ventilation/Oxygenation

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Airway - nasal

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

2.

Airway - oral

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

3.

Airway - supraglottic

STR

[TICK]

[TICK]

[TICK]

[TICK]

4.

Airway obstruction - dislodgement by direct laryngoscopy

-

-

-

[TICK]

[TICK]

[TICK]

5.

Airway obstruction - manual dislodgement techniques

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

6.

Automated transport ventilator

-

-

STR

[TICK]

[TICK]

[TICK]

7.

Transport ventilator with advanced modes

-

-

-

-

-

[TICK]

8.

Bag-valve-mask (BVM)

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

9.

BiPAP

-

-

-

-

[TICK]

[TICK]

10.

CPAP

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

11.

Chest decompression - needle

-

-

-

[TICK]

[TICK]

[TICK]

12.

Chest tube placement - assist only

-

-

-

-

[TICK]

[TICK]

13.

Chest tube monitoring and management

-

-

-

-

[TICK]

[TICK]

14.

Chest tube placement and management

-

-

-

-

-

[TICK]

15.

Finger thoracostomy

-

-

-

-

-

[TICK]

16.

Cricothyrotomy

-

-

-

-

[TICK]

[TICK]

. 17.

End tidal CO2 monitoring and interpretation of waveform capnography

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

18.

Gastric decompression - NG tube

-

-

-

[TICK]

[TICK]

[TICK]

19.

Gastric decompression - OG tube

-

-

-

[TICK]

[TICK]

[TICK]

20.

Head-tilt chin lift

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

21.

Intubation - endotracheal

-

-

-

[TICK]

[TICK]

[TICK]

22.

Intubation - nasotracheal

-

-

-

-

[TICK]

[TICK]

23.

Jaw-thrust

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

24.

Medication Assisted Intubation (paralytics)

-

-

-

-

STR

[TICK]

25.

Mouth-to-barrier

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

26.

Mouth-to-mask

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

27.

Mouth-to-mouth

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

28.

Mouth-to-nose

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

29.

Mouth-to-stoma

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

30.

Oxygen therapy - high flow nasal cannula

-

-

-

-

[TICK]

[TICK]

31.

Oxygen therapy - humidifiers

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

32.

Oxygen therapy - nasal cannula

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

33.

Oxygen therapy - non-rebreather mask

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

34.

Oxygen therapy - partial rebreather mask

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

35.

Oxygen therapy - simple face mask

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

36.

Oxygen therapy - Venturi mask

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

37.

Pulse oximetry

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

38.

Suctioning - upper airway

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

39.

Suctioning - tracheobronchial of an intubated patient

-

-

[TICK]

[TICK]

[TICK]

[TICK]

B. Cardiovascular/Circulation

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Cardiac monitoring - 12-lead ECG (interpretive)

-

-

-

[TICK]

[TICK]

[TICK]

2.

Cardiac monitoring - 12-lead ECG acquisition and transmission

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

3.

Cardiopulmonary resuscitation

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

4.

Cardioversion - electrical

-

-

-

[TICK]

[TICK]

[TICK]

5.

Defibrillation - automated/semi-auto-mated

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

6.

Defibrillation - manual

-

-

-

[TICK]

[TICK]

[TICK]

7.

Hemorrhage control - direct pressure

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

8.

Hemorrhage control - tourniquet

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

9.

Hemorrhage control - wound packing

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

10.

Mechanical CPR device

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

11.

Telemetric monitoring devices and transmission of clinical data, including video data

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

12.

Transcutaneous pacing

-

-

-

[TICK]

[TICK]

[TICK]

13.

Transvenous cardiac pacing - monitoring and maintenance

-

-

-

[TICK]

[TICK]

[TICK]

14.

Hemodynamic monitoring - invasive (central and arterial)

-

-

-

-

-

[TICK]

15.

ICP (Increased Intracranial Pressure) monitoring

-

-

-

-

-

[TICK]

16.

Circulatory augmentation device monitoring and management (Intra-arterial balloon pump, Impella, etc.)

-

-

-

-

-

[TICK]

17.

Ventricular Assist Device (VAD) - monitoring and management

-

-

-

-

-

[TICK]

C. Splinting/Spinal Motion Restriction/ Patient Restraint

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Cervical collar

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

2.

Long spine board

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

3.

Manual cervical stabilization

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

4.

Seated spinal motion restriction (KED, etc.)

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

5.

Extremity stabilization - manual

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

6.

Extremity splinting

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

7.

Splint-traction

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

8.

Mechanical patient restraint

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

9.

Emergency moves for endangered patients

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

D. Medication Administration - routes/agent types

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Aerosolized/nebulized

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

2.

Endotracheal tube

-

-

-

[TICK]

[TICK]

[TICK]

3.

Inhaled

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

4.

Intradermal

-

-

-

-

[TICK]

[TICK]

5.

Intramuscular

STR

[TICK]

[TICK]

[TICK]

[TICK]

6.

Intramuscular - autoinjector

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

7.

Intranasal

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

8.

Intranasal - unit dose, premeasured

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

9.

Intraosseous - initiation, pediatric or adult

-

-

[TICK]

[TICK]

[TICK]

[TICK]

10.

Intravenous

-

-

[TICK]

[TICK]

[TICK]

[TICK]

11.

Mucosal/Sublingual

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

12.

Nasogastric

-

-

-

-

[TICK]

[TICK]

13.

Oral

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

14.

Rectal

-

-

-

-

[TICK]

[TICK]

15.

Subcutaneous

-

-

[TICK]

[TICK]

[TICK]

[TICK]

16.

Topical

-

-

-

-

[TICK]

[TICK]

17.

Transdermal

-

-

-

-

[TICK]

[TICK]

18.

Use/monitoring of infusion pump for agent administration during interfacility transports

-

-

-

STR

STR

[TICK]

19.

Use/monitoring of agents specified in Table 3-Special Agents Eligible for Administration and Monitoring, established according to A.R.S. § 36-2204 and available through the Department at www.azdhs.gov/ems-regulatory-references

-

-

-

STR

STR

[TICK]

20.

Epinephrine anaphylaxis-prepared kit; only for anaphylaxis when no autoinjector is available

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

21.

Immunizations

-

-

-

[TICK]*

[TICK]*

[TICK] *

22.

Thrombolytics

-

-

-

-

-

[TICK]

E. IV Initiation/Maintenance Fluids

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Access indwelling catheters and implanted central IV ports

-

-

-

-

[TICK]

[TICK]

2.

Central line - monitoring

-

-

-

-

[TICK]

[TICK]

3.

Intraosseous - initiation, pediatric or adult

-

-

[TICK]

[TICK]

[TICK]

[TICK]

4.

Intravenous access

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

5.

Intravenous initiation - peripheral

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

6.

Intravenous- maintenance of medicated IV fluids

-

-

-

[TICK]

[TICK]

[TICK]

7.

Intravenous- maintenance of nonmedicated IV fluids

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

8.

Initiation and maintenance of blood product transfusion

-

-

-

-

-

[TICK]

9.

Intravenous initiation - ultrasound guided IV in a hospital setting

-

-

-

-

STR

[TICK]

F. Miscellaneous

EMR

EMT

AEMT

EMT-I (99)

Paramedic

Paramedic with Critical Care Endorsement

1.

Assisted delivery (childbirth)

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

2.

Assisted complicated delivery (childbirth)

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

3.

Blood chemistry analysis

-

-

-

-

[TICK]

[TICK]

4.

Blood glucose monitoring

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

5.

Blood pressure- automated

-

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

6.

Blood pressure- manual

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

7.

Eye irrigation

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

[TICK]

8.

Eye irrigation hands-free irrigation using sterile eye irrigation device

-

-

-

-

[TICK]

[TICK]

9.

Urinary catheterization

-

STR

STR

STR

STR

[TICK]

10.

Venous blood sampling

-

STR

[TICK]

[TICK]

[TICK]

[TICK]

11.

Arterial blood sampling

-

-

-

-

-

[TICK]

12.

Point of care and laboratory sampling and interpretation

-

-

-

-

-

[TICK]

13.

External fetal monitoring

-

-

-

-

-

[TICK]

14.

Neonatal Isolette monitoring

-

-

-

-

-

[TICK]

15.

Ultrasound

-

-

-

-

-

[TICK]

Ariz. Admin. Code tit. 9, ch. 25, art. 5, tbl. 5.1

Table 5.1 made by exempt rulemaking at 19 A.A.R. 282, effective January 28, 2013 (Supp. 13-1). Amended by exempt rulemaking at 20 A.A.R. 3554, effective 1/1/2015. Amended by exempt rulemaking at 21 A.A.R. 3237, effective 11/24/2015. Amended by final exempt rulemaking at 23 A.A.R. 1161, effective 4/19/2017. Amended by final exempt rulemaking at 24 A.A.R. 2957, effective 9/24/2018. Amended by exempt rulemaking at 27 A.A.R. 1385, effective 8/9/2021. Amended by exempt rulemaking at 28 A.A.R. 3321, effective 9/22/2022. Amended by exempt rulemaking at 30 A.A.R. 3009, effective 12/31/2024.