SCOPE OF PRACTICE FOR

EMERGENCY MEDICAL SERVICES

PROFESSIONALS
Document Title: Scope of Practice for Emergency Medical Services Professionals

Document Ref. Number: DOH/HCWS/CEPAR/SoP/ ER-SP/V1/2023 Version: 2.0

New / Revised: Revised

Publication Date: June 2023

Effective Date: Same as the publication date

Document Control: DoH Strategy Sector

All DOH licensed Healthcare Professionals

All DOH licensed Healthcare Providers
Applies To:
All DOH licensed Ambulance Services
All Health Insurance Payers.

Health Workforce Sector, and

Owner:
Center of Emergency Preparedness and Response (CEPAR)

Revision Date: 3 years

Revision Period: 3 years, or more frequent if needed by DOH

Health Workforce Sector at HCWS@doh.gov.ae , Or

Contact: Center of Emergency Preparedness and Response at CEPAR@doh.gov.ae

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 1. Definitions and Abbreviations

Term /
No. Definition
Abbreviation
Emergency Medical Service. This includes but is not limited to 999/998 services, commercial
services, interfacility transport services, hospitals that provide patient transport, event and
1.1 EMS mass gathering medicine, and specialized services such as helicopter emergency medical
service (HEMS) and marine.

Qualified physician licensed by the DOH who is responsible for overall medical direction of
prehospital care provided by all prehospital personnel, His/her responsibilities include
establishment of protocols, policies, and procedures for all patient care activities from
1.2 Medical Director dispatch through triage, treatment, and transport of patients, clinical team privileging,
continuous quality improvement, supervision and direction, in addition to other clinical
leadership activities.

Qualified health care professional licensed by the DOH with a diverse skill range who
delivers advanced critical care when moving patients from one healthcare facility to
another via ground or air ambulance or when responding directly to the scene of a medical
or trauma case as well as providing specialty care transport including infant, child, and
Critical Care perinatal. Responsible for the safe transportation, advanced assessment and treatment of
1.3 Paramedic (CCP) acute traumatic and medical conditions, life or limb saving interventions as outlined in
Clinical Practice Guidelines and Scope of Practice. A CCP may assist with advanced clinical
procedures outside their scope of practice in the presence of a licensed doctor.

Qualified health care professional licensed by the DOH who is responsible to treat seriously
ill and injured patients – including patients in cardiac arrest and with serious traumatic
injuries. He or she is a clinical professional who has developed their skills and theoretical
knowledge to a standard above paramedic. ACPs are highly experienced members of
Advanced Care prehospital teams who are able to provide an enhanced level of care, perform a number of
1.4 Paramedic (ACP) minor procedures and educate other members of staff as per Clinical Practice Guidelines
and Scope of Practice.

Qualified health care professional licensed by the DOH providing basic and advanced care
whose primary focus is to respond to, assess, and triage non-urgent, urgent, and emergency
requests for medical and traumatic care, with a diverse skill range, responsible for the safe
transportation, assessment, and treatment of acute traumatic and medical conditions as
1.5 Paramedic outlined in Clinical Practice Guidelines and Scope of Practice. Qualified in life or limb saving
interventions as privileged and subsequent conveyance of a patient(s) to a hospital or
medical facility.

Qualified health care professional licensed by the DOH providing basic care whose primary
focus is to respond to, assess, and triage emergent, urgent, and non-urgent requests for
Emergency medical and traumatic care, apply basic knowledge, qualified in life or limb saving
1.6 Medical interventions as outlined in Clinical Practice Guidelines and Scope of Practice, and
Technician (EMT) subsequent conveyance of a patient(s) to a hospital or medical facility.

Personnel licensed by the DOH and specially trained to assist other healthcare professionals
in providing prehospital care in medical and traumatic emergencies and immediate
lifesaving care to critical patients who access the emergency medical services system. EMR
Emergency have the knowledge and skills necessary to provide immediate basic lifesaving interventions
1.7 Medical while awaiting additional EMS resources to arrive. Emergency Medical Responders are a
Responder (EMR) vital part of the comprehensive EMS response. Under medical oversight, Emergency
Medical Responders perform basic interventions with minimal equipment.

is the capability of an individual to apply a task-related knowledge, skills and abilities

required to successfully perform an assigned task in a defined work setting.
1.8 Competency

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 The entitlements of a healthcare professional to provide patient care within a Facility
operated by that Provider. Clinical privileges are granted by the privileging committee or
similar structure. The clinical privileges are determined by the individual’s professional
1.9 Clinical privileges license and scope of practice, experience, competence, as well as the facility license and
resources

1.10 Scope of Practice Is the services that a qualified health professional is deemed competent to perform, and
permitted to undertake in line with the terms of their professional license
Rapid Sequence Intubation
1.11 RSI

Department of Health
1.12 DOH

Center of Emergency Preparedness and Response

1.13 CEPAR

2. SOP Purpose

The purpose of this document is to:

2.1. Define the range of clinical, medical, and surgical services provided by Emergency Medical Services and the
associated competencies.
2.2. Describe the professional boundaries, accountabilities, ethical and legal obligations toward patients and
society.
2.3. Serve as a reference for the healthcare workforce, healthcare providers, health services payers and
governance bodies.
2.4. Serve as a reference for Agencies and medical directors who are responsible for ensuring competence,
medical direction, and appropriate practice skills by employed providers.

3. SOP Scope

The scope of practice described in this document, applies to DOH licensed Emergency Medical Services professionals
who wish to practice in the Emirate of Abu Dhabi, and to all healthcare providers who provide and operate Emergency
services

4. Practice Settings

Emergency Medical Services may be provided in licensed healthcare facilities and other settings, including but not
limited to:
4.1 Hospital
4.2 Medical/General clinic
4.3 First Aid Post
4.4 Medical centers
4.5 Provision of Health Service/ Ambulance, Marine and Air Ambulance
4.6 Mass gathering and events
4.7 Specialized systems (e.g., Marine, Rapid Sequence Intubation) and specialized response units

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 5. Standard of Proficiency

Healthcare professionals must practice in accordance with Abu Dhabi and UAE local and federal laws, ethical values,
standards of professional conduct, delineated clinical privileges, scope of practice, and clinical practice guidelines
published by the Department of Health. Emergency Medical Services professionals should update their knowledge, and
skills continually to warrant best treatment outcomes, this include acquiring the digital skills related to medical
technology in Emergency profession.
EMS falls under different levels and categories based on their education, degree, experience and training. The
recognized EMS professional titles are as below (5):
• Emergency Medical Responder (EMR)
• Emergency Medical Technician (EMT)
• Paramedic
• Advanced Care Paramedic (ACP)
• Critical Care Paramedic (CCP)

5.1 Scope of Practice

Public Basic Advanced Life Support Critical Care

Responder Ambulance Ambulance Ambulance

Advanced Care

Critical Care
Emergency

Emergency
Responder

Technician

Paramedic

Paramedic

Paramedic
Medical

Medical
Responsibilities

Airway/Ventilation/Oxygenation

Airway-Laryngeal Mask/Supraglottic X ✓#* ✓ ✓ ✓

Airway-Nasal ✓#* ✓ ✓ ✓ ✓

Airway-Oral ✓#* ✓ ✓ ✓ ✓

Bag-Valve-Mask (BVM) ✓ ✓ ✓ ✓ ✓

Chest Decompression-Needle X X ✓#* ✓ ✓

Chest tube Monitoring X X ✓#* ✓ ✓

CPAP/BiPAP/PEEP NIV X X ✓ ✓ ✓

Cricothyroidotomy – Needle X X ✓#* ✓ ✓

Cricothyroidotomy – Surgical X X X X ✓
End tidal CO₂ X ✓#* ✓ ✓ ✓
Monitoring/Capnometry/Capnography
Gastric Decompression – NG/OG Tube X X X ✓#* ✓
Insertion
Head-tilt/Chin-lift ✓ ✓ ✓ ✓ ✓

Intubation-Medication Assisted X X X X ✓#*

(Paralytic)(RSI)
Intubation-Maintenance with X X X ✓#* ✓
(paralytics)
Intubation-Nasotracheal PULSELESS X X X ✓#* ✓

Intubation-Orotracheal PULSELESS X X ✓#* ✓ ✓

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Jaw-thrust ✓ ✓ ✓ ✓ ✓

Jaw-thrust-Modified (trauma) ✓#* ✓ ✓ ✓ ✓

Mechanical Infant Resuscitator X X ✓#* ✓#* ✓

Obstruction-Direct Laryngoscopy X X ✓#* ✓#* ✓

Obstruction-Manual ✓ ✓ ✓ ✓ ✓

Oxygen Therapy-Humidifiers ✓ ✓ ✓ ✓ ✓

Oxygen Therapy-Nasal Cannula ✓ ✓ ✓ ✓ ✓

Oxygen Therapy-Non-rebreather Mask ✓ ✓ ✓ ✓ ✓

Oxygen therapy – partial rebreather ✓ ✓ ✓ ✓ ✓

mask
Oxygen therapy – simple face mask ✓ ✓ ✓ ✓ ✓

Oxygen Therapy –Venturi Mask X X ✓#* ✓ ✓

Pulse Oximetry ✓ ✓ ✓ ✓ ✓

Suctioning-Trach or ET Tube X X ✓#* ✓ ✓

Suctioning-Upper Airway ✓ ✓ ✓ ✓ ✓

Tracheal Tube Maintenance X X ✓#* ✓ ✓

Ventilators-Automated Transport (AVT) X X X ✓#* ✓#*

Cardiovascular/Circulatory Support

Cardiac monitoring – non-interpretive X ✓ ✓ ✓ ✓

Cardiac monitoring-3 Lead, Suggestive X ✓#* ✓ ✓ ✓

Cardiac monitoring-12 Lead, X X ✓ ✓ ✓

Interpretive
Cardiopulmonary Resuscitation (CPR) ✓ ✓ ✓ ✓ ✓
✓#*
Cardioversion Synchronized X X (Unconsci ✓ ✓
ous
Patients)
✓#*
Cardioversion Unsynchronized X X (Unconsci ✓ ✓
ous
Patients)
Carotid Sinus Massage (Valsalva X ✓#* ✓ ✓ ✓
Maneuver)
Defibrillation-Automated/Semi- ✓ ✓ ✓ ✓ ✓
Automated (AED)
Defibrillation-Manual X X ✓ ✓ ✓

Haemorrhage control-Direct Pressure ✓ ✓ ✓ ✓ ✓

Haemorrhage control-Pressure point ✓#* ✓ ✓ ✓ ✓

Haemorrhage control-Tourniquet ✓#* ✓ ✓ ✓ ✓

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Mechanical CPR Device X ✓#* ✓#* ✓#* ✓#*

Transcutaneous Pacing X X ✓#* ✓ ✓

Transvenous cardiac pacing –
monitoring X X X ✓ ✓
and maintenance
Thrombolysis X X X X ✓#
Arterial Blood Pressure Indwelling X X X X ✓
Catheter-Maintenance
Central Venous Catheter Maintenance X X X X ✓

Immobilization

Spinal Immobilization-Cervical Collar ✓#* ✓ ✓ ✓ ✓

Spinal Immobilization-Long Board ✓#* ✓ ✓ ✓ ✓

Spinal Immobilization-Manual ✓#* ✓ ✓ ✓ ✓

Stabilization
Spinal Immobilization-Seated Patient, ✓#* ✓ ✓ ✓ ✓
etc.
Splinting-Manual ✓#* ✓ ✓ ✓ ✓

Splinting-Rigid ✓#* ✓ ✓ ✓ ✓

Splinting-Soft ✓#* ✓ ✓ ✓ ✓
✓#* ✓ ✓
Splinting-Traction X ✓

Splinting-Vacuum ✓#* X X ✓ ✓

Spinal immobilization clearance (Adult X X X ✓#* ✓

Only)
Medication Administration-Routes

Aerosolized/Nebulized X ✓#* ✓ ✓ ✓

Buccal X ✓ ✓ ✓ ✓

Endotracheal Tube (ET) X X X ✓#* ✓#*

✓#*
Extra-Abdominal Umbilical Vein X X X X
✓#*
Intradermal X X X ✓
✓#* ✓ ✓
Intramuscular (IM) X ✓
(Glucagon)
✓#* ✓ ✓
Intranasal (IN) X ✓
✓#* ✓
Intraosseous X X ✓

Intravenous (IV) Piggyback X X ✓ ✓ ✓

✓#* ✓ ✓
Intravenous (IV) Flush/Bolus X ✓

Naso/Orogastric X X ✓#* ✓#* ✓

Oral ✓#* ✓ ✓ ✓ ✓

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Rectal X X ✓#* ✓ ✓

Subcutaneous X X ✓#* ✓ ✓

Sublingual ✓#* ✓ ✓ ✓ ✓

Topical X ✓#* ✓#* ✓#* ✓

Use of Mechanical Infusion Pumps X X X ✓#* ✓

Intravenous Cannulation/Fluid Administration/Fluid Maintenance

✓#*
Blood/Blood By-Products monitoring X X X ✓
✓#*
Colloids (Albumin, Dextran)-Initiation X X X ✓
Crystalloids (D5, LR, NS)- ✓#* ✓ ✓
Initiation/Maintenance X ✓
✓#* ✓
Intraosseous-Initiation X X ✓
Peripheral Intravenous Catheter ✓#** ✓ ✓
Initiation X ✓
External Jugular Intravenous Catheter X X X X ✓
Initiation
✓#**
Use of Indwelling Cather for IV X ✓ ✓ ✓
medications (Adrenaline
1:10,000)
Miscellaneous

Assisted Delivery X ✓#* ✓ ✓ ✓

Assisted complicated delivery ✓
X X ✓#* ✓
(childbirth)
✓#* ✓ ✓ ✓
Blood Glucose Monitoring ✓

Blood chemistry analysis X X X ✓#* ✓

✓#* ✓ ✓ ✓
Dressing/Bandaging ✓

Eye Irrigation noninvasive X ✓#* ✓ ✓ ✓

Eye irrigation –hands free irrigation
using X X ✓#* ✓ ✓
sterile eye irrigation device
Use of Incubator X X X ✓#* ✓
Immunizations during a public health ✓#*
emergency X X ✓#* ✓#*

Urinary Catheterization-Maintenance X X ✓#* ✓ ✓

Venous Blood Sampling-Obtaining X X ✓#* ✓ ✓

Symbol Reference:
X Outside the title scope of practice
✓ Mandatory for the title clinical privilege
✓#* Optional for the title clinical privilege (should be privileged by the facility Medical Director based on
demonstrated competence in this skill)
✓#** Under direction of a paramedic or higher- level professional, and with additional training and credentialing
as provided by agency medical director and approved by DOH
# In accordance with ST-elevation myocardial infarction (STEMI) Network and Physician oversight/approval
 To be verified annually by Medical Director

7
 6. Specific Learning Requirement / Privileging Requirement

6.1 Emergency Medical Services professionals are obliged to complete all the training that are necessary for the delivery
of safe and quality care, within the Scope of Practice and Clinical Practice Guidelines, and be privileged to provide care by
a facility or agency medical director and by mutual agreement (Refer to the end of each table). This privilege and the
quality assurance program associated with prehospital practice shall be made available to the DOH and reviewed
collaboratively.

6.2 Restraint:
The Emergency Medical Services professionals who provide their services under medical restraint to agitated and
combative patients must be qualified, competent and privileged by the health facility through a privileging system. The
intervention used must comply with the protocols and guidelines for dealing with violent or combative patients.

6.3 Burn management:

Emergency Medical Services professionals shall be competent in Burn Management, and the roles and responsibilities
must be delegated by the facility or service through a privileging system or medical director.

6.4 RSI
Emergency Medical Services professionals licensed and credentialed to perform RSI (Medication Assisted Intubation)
must demonstrate competency in this skill annually as verified by the medical director or delegate. RSI programs and RSI
credentialed professionals will be reviewed by the DOH.

6.5 Cricothyroidotomy – Needle

The use of needle cricothyroidotomy in adult patients has been found to be largely ineffective without pairing to a jet
insufflator. Needle ventilation in adult patients has been found to produce insufficient alveolar ventilation volumes and
should only be used temporarily and as a last resort.

7. Relevant Reference Documents

Relation Explanation / Coding / Publication

No. Reference Date Reference Name
Links

Federal Law No. (5) of 2019 https://www.doh.gov.ae/ar/about/law-and-

on Regulating the Practice of legislations;
1 10-August-2022
Human Medicine and its
Executive Regulations. https://mohap.gov.ae/en/about-us/legal-references

Federal Law No. (5) of 1984

2 10-August-2022
concerning the Practice of
https://www.doh.gov.ae/ar/about/law-and-
Some Health Professions by
legislations
Persons other than Physicians
and Pharmacists

Ministerial Resolution No. https://mohap.gov.ae/app_content/legislations/php

(1448) of 2017 on Adoption
3 10-August-2022 of Code of Ethics and -law-ar-64/mobile/index.html
Professional Conduct for
Health Professionals

Federal Law on the https://www.doh.gov.ae/ar/about/law-and-

Prevention of Communicable
4 10-August-2022 legislations
Disease No. (14) of 2014 and
its Executive Regulations
https://mohap.gov.ae/en/about-us/legal-references

Federal Decree Law No. (4) of https://www.doh.gov.ae/ar/about/law-and-

2016 Concerning Medical legislations
5 10-August-2022
Liability and its Executive
Regulations https://mohap.gov.ae/en/about-us/legal-references

8
 https://www.mohre.gov.ae/ar/laws-and-
Federal Decree Law No. (33)
of 2021 Regarding the regulations/laws.aspx
6 10-August-2022 Regulation of Employment
https://www.mohre.gov.ae/en/laws-and-
Relationship and its Executive
Regulations regulations/laws.aspx

Federal Law No. (2) of 2019 https://www.doh.gov.ae/ar/about/law-and-

Concerning the Use of
7 10-August-2022 Information and legislations
Communication Technology https://mohap.gov.ae/en/about-us/legal-references
(ICT) in Health Fields

The Unified Healthcare

8 10-August-2022 Professionals Qualification https://www.doh.gov.ae/en/pqr
Requirements (PQR)

Advanced Emergency Medical (nremt.org)

Technicians| National
9 15-August-2022
Registry of Emergency
Medical Technicians

10 15-August-2022 EMS Scope of Practice 2022 Wisconsin EMS Scope of Practice

The Role of an Advanced Scottish Trauma Network | The Role of an Advanced

11 15-August-2022
Critical Care Practitioner Critical Care Practitioner

The Role of Intensive Care The Role of Intensive Care Paramedics – Australian
12 15-August-2022
Paramedics Paramedical College (apcollege.edu.au)

13 17-August-2022 Patient Restraint Patient Restraint.pdf (boston-ems.com)

National Association of EMS (PDF) Patient restraint in emergency medical

14 17-August-2022
Physicians services systems

Emergency Medical Emergency Medical Technician (EMT) (gemr.org)

15 17-August-2022
Technician

16 20-August-2022 College of paramedics Scope of Practice (collegeofparamedics.co.uk)

Merchant Raina M., Topjian Alexis A., Panchal Ashish

American heart association R., Adam, C., Khalid, A., Berg Katherine M., . . . null,
guidelines for n. (2020). Part 1: Executive summary: 2020 american
17 09-August-2022 cardiopulmonary heart association guidelines for cardiopulmonary
resuscitation and emergency resuscitation and emergency cardiovascular care.
cardiovascular care Circulation, 142(16), S337-S357.
doi:10.1161/CIR.0000000000000918

Understanding the role of the Understanding the role of the paramedic in primary
18 10-August-2022
paramedic in primary care care: a realist review (biomedcentral.com)

Emergency medical Emergency medical technician (EMT) - NWAS - North

19 11-August-2022 West Ambulance Service
technician

9
 Administration of epinephrine Journal of the American College of Emergency
by advanced emergency Physicians Open, 2(5)
medical technicians for out‐ doi:https://doi.org/10.1002/emp2.12521
20 20-August-2022
of‐hospital cardiac arrest in a
rural emergency medical
services system

Reed-Schrader E, Mohney S. EMS Scope of Practice.

[Updated 2021 Sep 28]. In: StatPearls [Internet].
21 11-August-2022 EMS Scope of Practice Treasure Island (FL): StatPearls Publishing; 2022 Jan-
. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK553179/

TPA - Scope of Practice (torontoparamedic.com)

22 11-August-2022 EMS Scope of Practice

The EMS System. In The Ventura, C., & Denton, E. (2021). The EMS System. In
23 15-August-2022 Emergency Medical The Emergency Medical Responder (pp. 1-7).
Responder Springer, Cham.

EMS Approved and Required Medication List |

EMS Approved and Required Emergency Health Services Federation (ehsf.org)
24 15-August-2022
Medication List

10
 8. Revision List (Changes)

Issue Revision
Clause No. Revision Explanation (changes)
No. Date

Based on the changes of the titles of the Emergency Medical Services

Healthcare professionals, the Scope of Practice for EMS that was
published in 2020 had to be updated.

Old titles:
• Emergency Medical Technician (EMT) -Basic
DOH/GDL/ • Emergency Medical Technician (EMT) -Intermediate
ICMD/SOP • Emergency Medical Technician (EMT) -Advanced/Paramedics
/0.9
April 2023 3 New titles:
• Emergency Medical Responder
• Emergency Medical Technician
• Paramedic
• Advanced Care Paramedic
• Critical Care Paramedic

was changed based on the new titles.

15 August
2022

Addition
under 5.1:
•

Airway-
Esophagea
l-Single
Lumen for 11

primary
EMT
•