​Paramedic Scope of Practice​

The following standards of practice are published as provided for in the Code of West Virginia, Article Four-C, Chapter Sixteen and West Virginia Division of Health Legislative Rules Title 64, Series 48​.


This listing of procedures is intended as guidance for EMS personnel affiliated with and/or during employment with ambulance services, first responder, or rescue providers within the West Virginia EMS system.

Procedures listed must be authorized by duly engaged physician medical directors and must be performed according to written and published protocols and/or direct voice communication with a medical command center. Certain procedures may require direct verbal orders from medical command physicians.

The Paramedic may render rescue, basic first aid, and cardiopulmonary resuscitation services, and:

  1. ​Perform initial, focused, and on-going patient assessments
  2. Perform respiratory assistance utilizing oral and nasal airways, ventilation devices, and/or oxygen
  3. Apply suctioning techniques to clear airways
  4. Apply dressings and bandages
  5. Apply splints and immobilization devices
  6. Apply spinal immobilization devices
  7. Provide care for obstetrical emergencies including assisting in childbirth
  8. Provide ordinary reasonable care for ill and/or injured persons in accordance with generally accepted standards
  9. Apply Pneumatic Anti-Shock Garment (PASG) in accordance with established regional protocols
  10. Assume primary patient care responsibility in an ambulance patient compartment while on a call
  11. Utilize EMS communications equipment in accordance with accepted radio and telephone procedures
  12. Utilize automated defibrillators
  13. Administer activated charcoal
  14. Administer oral glucose
  15. Perform endotracheal intubation
  16. Utilize electrocardiograph monitors
  17. Perform electrical countershock and defibrillation
  18. Perform transcutaneous pacing
  19. Administer those State approved Medications/Solutions authorized in writing by both individual and regional medical directors
  20. Perform intraosseous procedure
  21. Place nasogastric tube
  22. Perform "finger stick" blood glucose testing procedures
  23. Utilize pulse oximetry monitors
  24. Perform 12-lead electrocardiograms
  25. Utilize automatic ventilators
  26. Perform needle cricothyrotomy when all other ventilation attempts have failed and endotracheal intubation is not possible
  27. Perform chest decompression with catheter and flutter valve
  28. Perform phlebotomy procedures

Revised 06/02/2005​