(a)

1. (1) Paramedics and AEMTs may function within their scope of practice while off-duty or while not staffing a permitted ambulance within the licensed ambulance service’s area with whom the EMSP is employed provided.

2. (2)

   1. (A) The following must be submitted to the Department of Health for review and approval prior to implementation of this practice:

(i) Written approval from the ambulance service medical director;

1. (ii) Written approval from the ambulance service director;

   1. (iii) Verification that the individual or individuals are licensed by the department to perform the skills requested; and

      1. (iv) Medical director-approved treatment protocols addressing this specific practice and any equipment carried by the EMSP.
   2. (B) In all cases, paramedic and AEMT level of care must be maintained throughout transport if paramedic care is initiated.

2. (3) A paramedic or AEMT who is solely employed in the industry and serves on the facility's emergency response team or an emergency response team affiliated with or sponsored by a governmental entity may, while on duty, perform any skill that is listed in their approved protocols if they meet all of the following requirements:

   1. (A) Written approval from the team's medical director, submitted to the department for review;
   2. (B) Written approval is received from the team’s medical director and shall be submitted to the department for review and approval;
   3. (C) The submission of medical director-approved protocols specific to this practice to the department prior to implementation of the response team;
   4. (D) Verification that the EMSPs are licensed by the department to perform the skills;
   5. (E) EMSPs’ performance is not tied to a licensed ambulance service at the time they are performing skills for the response team; and
   6. (F) In all cases, paramedic and AEMT level of care must be maintained throughout transport if advanced care is initiated.

(b)

1. (1) EMSPs are permitted to perform only those skills and administer only those medications outlined in the current National Highway Traffic Safety Administration’s National EMS Scope of Practice Model once they are:

   1. (A) Licensed at that provider level; and
   2. (B) Credentialed by the EMS service’s medical director.
2. (2) To provide patient care in Arkansas, all EMSPs must hold a current Arkansas EMSP license.

3. (3)

   1. (A) Paramedic services approved to provide rapid sequence intubation (RSI) must first apply for approval and meet all department RSI requirements.
   2. (B) Approval must be granted by the department before implementation of the skill or utilization of protocol.
   3. (C) Paramedics are allowed to use paralytics to maintain the paralysis of an already intubated patient if approved by medical direction.
4. (4) EMSPs may transport a police dog injured during a law enforcement or correctional agency’s work to a veterinary hospital or clinic if there is not a person requiring immediate medical attention or transport at the time as set forth by Arkansas Code § 20-13-217.

5. (5)

   1. (A) EMSPs may administer prescription medications to patients with a health condition that is listed as rare by the National Institutes of Health and a condition that could be fatal for which a patient seeks specialized healthcare as set forth in Arkansas Code § 20-13-218.

   2. (B) Prescription medications administered shall be:

      1. (i) Carried by a patient;
      2. (ii) Administered via routes of delivery that are within the scope of practice for the EMSP;
      3. (iii) Intended to treat specific health conditions; and
      4. (iv) Not listed on the drug formulary set out by the department.