(A) Utilize electrocardiographic devices and monitor electrocardiograms, including 12-lead electrocardiograms (ECG).

(B) Perform defibrillation, synchronized cardioversion, and external cardiac pacing.

(C) Visualize the airway by use of the laryngoscope and remove foreign body(ies) with Magill forceps.

(D) Perform pulmonary ventilation by use of lower airway multi-lumen adjuncts, the esophageal airway, perilaryngeal airways, stomal intubation, and adult oral endotracheal intubation.

(E) Utilize mechanical ventilation devices for continuous positive airway pressure (CPAP)/bi-level positive airway pressure (BPAP) and positive end expiratory pressure (PEEP) in the spontaneously breathing patient.

(F) Institute intravenous (IV) catheters, saline locks, needles, or other cannulae (IV lines), in peripheral veins and monitor and administer medications through pre-existing vascular access.

(G) Institute intraosseous (IO) needles or catheters.

(H) Administer IV or IO glucose solutions or isotonic balanced salt solutions, including Ringer's lactate solution.

(I) Obtain venous blood samples.

(J) Use laboratory devices, including point of care testing, for pre-hospital screening use to measure lab values including, but not limited to: glucose, capnometry, capnography, and carbon monoxide when appropriate authorization is obtained from State and Federal agencies, including from the Centers for Medicare and Medicaid Services pursuant to the Clinical Laboratory Improvement Amendments (CLIA).

(K) Utilize Valsalva maneuver.

(L) Perform percutaneous needle cricothyroidotomy.

(M) Perform needle thoracostomy.

(N) Perform nasogastric and orogastric tube insertion and suction.

(O) Monitor thoracostomy tubes.

(P) Monitor and adjust IV solutions containing potassium, equal to or less than 40 mEq/L.

(Q) Administer approved medications by the following routes: IV, IO, intramuscular, subcutaneous, inhalation, transcutaneous, rectal, sublingual, endotracheal, intranasal, oral or topical.

(R) Administer, using prepackaged products when available, the following medications:

(S) In addition to the approved paramedic scope of practice, the CCP or FP may perform the following procedures and administer medications, as part of the basic scope of practice for interfacility transports, when approved by the LEMSA medical director.

(A) Perform or monitor other procedure(s) or administer any other medication(s) determined to be appropriate for paramedic use by the medical director of the LEMSA, that have been approved by the Director of the Authority. Paramedics shall demonstrate competency in performing these procedures and administering these medications through training and successful testing.

(B) The medical director of the LEMSA shall submit a written request, Form #EMSA-0391, revised 01/17, incorporated herein by reference, to the Director of the Authority for approval of any procedures or medications proposed for use in accordance with Section 1797.172(b) of the Health and Safety Code prior to implementation.

(C) The Authority shall, within fourteen (14) days of receiving Form #EMSA-0391, revised 01/17, notify the medical director of the LEMSA that the form has been received and shall specify what information, if any, is missing.

(D) The Director of the Authority, in consultation with the Emergency Medical Services Medical Directors Association of California's (EMDAC) Scope of Practice Committee, shall approve or disapprove the request for additional procedures and/or administration of medications and notify the LEMSA medical director of the decision within ninety (90) days of receipt of the completed request. An approved status shall be in effect for a period of three (3) years. An approved status may be renewed for another three (3) year period, upon the authority's receipt of a written request that includes, but is not limited to, the following information: the utilization of the procedure(s) or medication(s), beneficial effects, adverse reactions or complications, statistical evaluation, and general conclusion.

(E) The Director of the Authority, in consultation with the EMDAC Scope of Practice Committee, may suspend or revoke approval of any previously approved additional procedure(s) or medication(s) for cause.