Scope of Practice by Canadian Province

[rock_shoes]

The allowable scope of practice can vary significantly by province in Canada so I thought I would try and start a thread allowing us to discuss and compare a little more directly. Since I'm from BC and currently training in Alberta I'll start with those two.

EMA FR

1 An EMA holding a licence in the category EMA FR may provide the following services:

(a) scene assessment;

( B ) assessment of level of consciousness, skin colour and temperature, pulse, and respiration;

© rapid body survey to identify and attend to any life threatening injuries followed by a secondary assessment consisting of a physical examination, medical and incident history, and vital signs;

(d) cardiopulmonary resuscitation;

(e) basic wound and fracture management;

(f) maintenance of airways and ventilation.

EMR

2 An EMA holding a licence in the category EMR may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of EMA FR;

( B ) occupational first aid;

© lifting/loading, extrication/evacuation and transportation;

(d) cervical collar application and spinal immobilization on a long spine board;

(e) blood pressure assessment by auscultation and palpation;

(f) emergency fracture management/immobilization;

(g) oropharyngeal airway suctioning;

(h) oxygen administration and equipment;

(i) administration of semi-automatic or automatic external defibrillator;

(j) soft tissue injury treatment.

PCP

3 An EMA holding a licence in the category PCP may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of EMR;

( B ) administration of the following intravenous, oral, sublingual, subcutaneous, inhaled, intra-muscular or nebulized medications:

(i) narcotic antagonist;

(ii) bronchodilator;

(iii) anti-histaminic;

(iv) sympathomimetic agent.

ACP

4 An EMA holding a licence in the category ACP may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of PCP;

( B ) electrocardiogram rhythm interpretation, cardioversion, external pacing and manual defibrillation;

© initiation and maintenance of intraosseous needle cannulation;

(d) nasopharyngeal airway;

(e) maintenance of intravenous routes using intermittent infusion devices, including IV pumps;

(f) initiation of external jugular vein cannulation;

(g) cricothyrotomy and needle thoracentesis;

(h) gastric intubation and suction;

(i) maintenance of intravenous lines with medications;

(j) insertion and maintenance of advanced airway devices which do not require laryngoscopy;

(k) use and interpretation of end tidal CO2 monitoring devices;

(l) administration of colloid and non-crystalloid volume expanders;

(m) administration of the following intravenous, oral, nebulized, endotracheal, intraosseous, intramuscular and rectal medications:

(i) anti-arrhythmic;

(ii) electrolyte – calcium therapy;

(iii) diuretic;

(iv) anti-coagulant;

(v) narcotic;

(vi) anti-pyretic;

(vii) anti-cholinergic;

(viii) sedative;

(ix) anti-emetic – anti-nauseant;

(x) histamine antagonist;

(xi) anti-convulsant;

(xii) alkalizer.

CCP

5 An EMA holding a licence in the category CPP may provide the services specified in this Schedule and Schedule 2 for the category of ACP.

ITT

6 An EMA holding a licence in the category ITT may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of PCP;

( B ) pediatric and neonatal electrocardiogram interpretation and manual defibrillation;

© intraosseous therapy;

(d) administration of the following intravenous, oral, nebulized, endotracheal, intraosseous, intramuscular and rectal medications:

(i) anti-arrhythmic;

(ii) bronchodilator;

(iii) anti-pyretic;

(iv) anti-cholinergic;

(v) anti-hypoglycemic agent;

(vi) sedative – anti-epileptic;

(vii) anti-emetic – anti-nauseant;

(viii) histamine antagonist;

(ix) anti-convulsant;

(x) alkalizer;

(e) maintenance of intravenous routes using intermittent infusion devices;

(f) mechanical ventilation;

(g) maintenance and monitoring of arterial and central venous catheters;

(h) gastric intubation and suction;

(i) management of chest tubes and chest drainage systems;

(j) intravenous blood product administration;

(k) use of incubators for thermoregulation;

(l) administration of drug therapy on the direct order of a medical practitioner who is designated by an employer as a Transport Advisor.

Schedule 2

Services – Licence Endorsement

[section 10]

EMA FR

1 If an EMA holds a licence in the category EMA FR, the board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) use of airway management techniques including oropharyngeal airways, oral suction devices and oxygen-supplemented mask devices to assist ventilation;

( B ) use of an automatic or semi-automatic external defibrillator;

© cervical collar application and spinal immobilization on a long spine board;

(d) administration of oxygen;

(e) administration of oral glucose;

(f) emergency childbirth;

(g) ventilation using pocket mask and bag/valve/mask devices.

EMR

2 If an EMA holds a licence in the category EMR, the board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) maintenance of intravenous lines without medications or blood products while transporting persons between health facilities;

( B ) use and interpretation of a pulse oximeter;

© administration of the following oral, sublingual or inhaled medications:

(i) anti-anginal;

(ii) anti-hypoglycemic agent;

(iii) analgesia;

(iv) platelet inhibitors;

(d) use and interpretation of a glucometer;

(e) chest auscultation.

PCP

3 If an EMA holds a licence in the category PCP, the board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) initiation of peripheral intravenous lines;

( B ) administration of the following intravenous fluids and medications:

(i) anti-hypoglycemic agent;

(ii) isotonic crystalloid solutions;

(iii) vitamin B1;

© endotracheal intubation.

ACP

4 If an EMA holds a licence in the category ACP, the board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) mechanical ventilation;

( B ) administration of drug therapy on the direct order of a medical practitioner who is designated by an employer as a Transport Advisor;

© urinary catheterization;

(d) arterial line management and central venous pressure monitoring;

(e) infusion of blood products;

(f) point of care testing using capillary, venous or arterial sampling;

(g) collection of arterial and venous blood samples;

(h) interpreting laboratory and radiologic data;

(i) performing and interpreting 12 lead electrocardiograph;

(j) chest tube management;

(k) central line management;

(l) management of parenteral feeding lines and equipment;

(m) provision of trans-venous pacing.

For the complete act for BC please see Emergency and Health Services Act: Emergency Medical Assistants Regulation.

For Alberta the following links will get you on your way.

EMERGENCY MEDICAL TECHNICIAN

EMERGENCY MEDICAL TECHNOLOGIST-PARAMEDIC

As someone who is currently licensed in BC as a PCP-IV and registered in Alberta as an EMT the frustrations are many. Combining the competencies for the two provinces would allow me to work to the complete NOCP for PCP. Instead I have to scratch my head and remember what I'm allowed to do in which province.

[Happiness]

I thought that somewhere down the line they were going to make the PCP a Canadian wide license. Might be wrong. On that list you can add to the PCP the King airway. I have been told that I will get this protocol in the next year or so..... We will see.

By the rock when did you leave us.......

[rock_shoes]

I thought that somewhere down the line they were going to make the PCP a Canadian wide license. Might be wrong. On that list you can add to the PCP the King airway. I have been told that I will get this protocol in the next year or so..... We will see.

By the rock when did you leave us.......

I did hear that. I've also heard mention that some form of injectable pain management is on the way. I don't know what the timeline is on any of these proposed additions.

I haven't entirely left yet. I still have my number for the time being. I'm just doing ACP training at SAIT in Calgary right now. I wasn't willing to wait for the Justice Institute to get its act together because, at the current rate, that isn't going to happen in my lifetime.

[tniuqs]

Ha Ha ..

I just happen to have registration in AB and licencing in BC as ACP and you think YOU are confused

I just wing it .

ps Happy .. it will be a cold day in AB before the term PCP is used sorry bout that, no wait its - 34 C outside

[Siffaliss]

Happy .. it will be a cold day in AB before the term PCP is used sorry bout that, no wait its - 34 C outside

Maybe one of my patients tomorrow will be high on PCP ...