<p> 9. Appendix B: Skill Comparison (Blank Checklist for State EMS Office Use) The following checklist provides a blank column to assist states establish their own “gap analysis.” Additional rows are added for state-preferred skills that may exceed the National EMS Scope of Practice Model.</p><p>Skill - Airway/Ventilation/ State State State State EMR EMT AEMT Paramedic Oxygenation SOP SOP SOP SOP Airway - esophageal X X Airway – supraglottic X X Airway – nasal X X X Airway – oral X X X X Bag-valve-mask (BVM) X X X X BiPAP/CPAP X Chest decompression - needle X Chest tube placement – assist X only Chest tube – monitoring and X management Cricoid pressure (Sellick's X X X X Maneuver) Cricothyrotomy – needle X Cricothyrotomy – percutaneous X Demand valve – manually X X X triggered ventilation</p><p>End tidal CO2 X monitoring/capnography Gastric decompression – NG X Tube Gastric decompression – OG X Tube Head tilt - chin lift X X X X Intubation – nasotracheal X Intubation - orotracheal X Jaw-thrust X X X X Jaw-thrust - Modified (trauma) X X X X Mouth-to-barrier X X X X Mouth-to-mask X X X X Mouth-to-mouth X X X X Mouth-to-nose X X X X Mouth-to-stoma X X X X Obstruction – direct X laryngoscopy Obstruction – Manual X X X X Oxygen therapy – Humidifiers X X X Oxygen therapy – Nasal X X X X cannula Oxygen therapy – Non- X X X X rebreather mask Oxygen therapy – partial X X X rebreather mask Oxygen therapy – simple face X X X mask Oxygen therapy – Venturi X X X mask PEEP – therapeutic X Pulse oximetry X X X Suctioning – Upper airway X X X X Appendix B--2009 National EMS Education Standards Gap Analysis Template FINAL: Released 17 July 2009</p><p>Suctioning – tracheobronchial AI X</p><p>Page 2 of 5 Appendix B--2009 National EMS Education Standards Gap Analysis Template FINAL: Released 17 July 2009</p><p>Skill - Airway/Ventilation/ State State State State EMR EMT AEMT Paramedic Oxygenation SOP SOP SOP SOP Ventilator – Automated X X X transport (ATV)</p><p>Skill- State State State State EMR EMT AEMT Paramedic Cardiovascular/Circulation SOP SOP SOP SOP Cardiac monitoring – multi-lead X (interpretive) Cardiac monitoring – single X lead (interpretive) Cardiopulmonary resuscitation X X X X (CPR) Cardioversion – electrical X Carotid massage X Defibrillation – automated / X X X X semi-automated Hemorrhage control – direct X X X X pressure Hemorrhage control – X X X X tourniquet Internal; cardiac pacing – X monitoring only MAST/PASG X X X Mechanical CPR device A A A Transcutaneous pacing - X manual</p><p>State State State State Skill-Immobilization EMR EMT AEMT Paramedic SOP SOP SOP SOP Spinal immobilization – cervical X X X collar Spinal immobilization – long X X X board Spinal immobilization – manual X X X X Spinal immobilization – seated X X X patient (KED, etc) Spinal immobilization – rapid X X X manual extrication Extremity stabilization - manual X X X X Extremity splinting X X X Splint – traction X X X Mechanical patient restraint X X X Emergency moves for X X X X endangered patients</p><p>Skill-Medication State State State State EMR EMT AEMT Paramedic Administration - Routes SOP SOP SOP SOP Assisting a patient with his/her own prescribed medications X X X (aerosolized/nebulized) Aerosolized/nebulized (beta X X agonist) Buccal L X Endotracheal tube X</p><p>Page 3 of 5 Appendix B--2009 National EMS Education Standards Gap Analysis Template FINAL: Released 17 July 2009</p><p>Skill-Medication State State State State EMR EMT AEMT Paramedic Administration - Routes SOP SOP SOP SOP Inhaled – self-administered X X (nitrous oxide) Intramuscular (epinephrine or X X glucagon) Intranasal (naloxone) X X Intravenous push (naloxone, L X dextrose 50%) Intravenous piggyback X Nasogastric X Oral (glucose) X X X Oral (aspirin) X X X Rectal X Subcutaneous (epinephrine) L X Sublingual (nitroglycerin) X L X Auto-injector (self or peer care) X X X X Auto-injector (patient’s own X X X prescribed meds)</p><p>Skill - – IV State State State State EMR EMT AEMT Paramedic Initiation/Maintenance Fluids SOP SOP SOP SOP Access indwelling catheters X and implanted central IV ports Central line – monitoring X Intraosseous – initiation Ped X Intravenous access X X Intravenous initiation - X X peripheral Intravenous – maintenance of X X non-medicated IV fluids Intravenous – maintenance of X medicated IV fluids</p><p>State State State State Skill - Miscellaneous EMR EMT AEMT Paramedic SOP SOP SOP SOP Assisted delivery (childbirth) X X X X Assisted complicated delivery X X X (childbirth) Blood glucose monitoring X X Blood pressure automated X X X Blood pressure – manual X X X X Eye irrigation X X X X Eye irrigation – Morgan® lens X Thrombolytic therapy – X initiation Thrombolytic therapy – X monitoring Urinary catheterization Venous blood sampling X Blood chemistry analysis X</p><p>Page 4 of 5 Appendix B--2009 National EMS Education Standards Gap Analysis Template FINAL: Released 17 July 2009</p><p>Legend of abbreviations for blank checklist A Requires additional specialty training Al Already Intubated L Limited Ped Pediatric Only</p><p>Page 5 of 5</p>