Epinephrine Policy

  • All levels of EMT allowed to carry and administer epinephrine.
  • Basics NOT allowed to carry and administer epinephrine, but often may assist with a patient's own prescribed auto-injector.
  • Locality dependent based on Medical Director's approval.

Washington

Contact: Michael Lopez; Manager, Education, Training and Regional Support Section, (360) 236-2841; or Debra Ann Galvan, Training Information Coordinator, (360) 236-2838

Washington has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. Intermediate Life Support Technicians
  3. Paramedic

In 2005, the Washington Legislature passed a law revising the previous language to: RCW 18.73.250 "(1) All of the State's ambulance and aid services shall make epinephrine available to their Emergency Medical Technicians in their emergency care supplies. The emergency medical technician may administer epinephrine. (2) Nothing in this section authorizes the administration of epinephrine by a first responder." This language eliminates the age restriction outlined in the previous language.

Individuals should communicate the nature of the emergency (i.e., allergic reaction with anaphylactic symptoms), so the dispatcher will send appropriate EMS personnel.

To determine EMS coverage in a given jurisdiction, members should contact the state Office of Emergency Medical Services and Trauma System at the number above.

Washington has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Janet Griffith Kastl, Director
Office name:
Office of Emergency Medical Services and Trauma System
P.O. Box 47853
Olympia, Washington 98504-7853
Phone:
(360) 236-2828
Fax:
Email:
Janet.GriffithKastl@doh.wa.gov

Oregon

Oregon has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

All EMTs in the state of Oregon can carry and administer epinephrine via ampule and syringe, preloaded syringe or auto-injector.

When a 911 call is placed, the ambulance dispatched to the emergency scene will have epinephrine on board. Most fire rescue units have epinephrine as well.

Director:
Grant Higginson, MD, MPH, Acting Director
Office name:
Emergency Medical Services and Trauma Systems
800 NE Oregon Street, Suite 607
Portland, Oregon 97232
Phone:
(971) 673-0520
Fax:
Email:
grant.k.higginson@state.or.us

Oklahoma

Oklahoma has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

Protocols for anaphylactic reactions authorize EMT-Basics and Intermediates to administer an epinephrine auto-injector upon approval by Medical Control.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe or auto-injector.

Approximately 20% of the state, predominantly the major metropolitan areas, is covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine local EMS coverage, individuals should contact the State Health Department office in their specific area.

Oklahoma has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Shawn Rogers, Director
Office name:
Oklahoma State Department of Health, Emergency Medical Services Division
1000 N.E. 10th Street, Room 1104
Oklahoma City, Oklahoma 73117
Phone:
(405) 271-4027
Fax:
Email:

Ohio

Ohio has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

First Responders and EMT-Basics can assist a patient in the administration of the patient's prescribed epinephrine auto-injector.

An ambulance may, if approved by their local Medical Director and the State Pharmacy Board, carry epinephrine. EMT-Basics may use the epinephrine carried on board if: 1) the EMT-Basic's Medical Director permits this through online medical direction or offline protocol; and 2) epinephrine was prescribed for the patient prior to the event.

EMT-Intermediates and Paramedics are allowed to carry and administer epinephrine via ampule and syringe, preloaded syringe or auto-injector.

Some areas in Ohio are not covered by EMT-Intermediate or Paramedic service. To determine EMS coverage in their area, individuals should contact their local provider.

Ohio has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Richard N. Rucker, Executive Director
Office name:
Ohio Department of Public Safety, Emergency Medical Services Division
P.O. Box 182073
1970 West Broad Street
Columbus, Ohio 43218-2073
Phone:
(614) 466-9447 or (800) 233-0785
Fax:
Email:
rnrucker@dps.state.oh.us

North Dakota

North Dakota has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are trained and licensed to use an epinephrine auto-injector, but they can carry and use it on a basic life support ambulance service only if their physician Medical Director provides written orders that allow it.

Epinephrine is carried on all Advanced Life Support vehicles, which must be staffed by an EMT-Basic and an EMT-Paramedic. (A registered nurse with CPR and Advanced Cardiac Life Support certification may be used in place of the EMT-Paramedic.)

North Dakota has a law that authorizes laypersons who have responsibility for other people to be trained to give epinephrine for treatment of anaphylaxis.

To determine the level of EMS service in their area, individuals should call the Division of Emergency Medical Services at the number listed above.

Director:
Tim Meyer, Director
Office name:
North Dakota Division of EMS
600 E. Blvd Ave, Dept. 301
Bismarck, North Dakota 58505-0200
Phone:
(701) 328-2388
Fax:
Email:
tmmeyer@nd.gov

North Carolina

North Carolina has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are allowed to administer epinephrine via auto-injector in the treatment of anaphylaxis, provided the EMT-Basic has successfully completed appropriate training, and is acting under appropriate medical direction.

EMT-Intermediates, and Paramedics are allowed to carry and administer epinephrine in either a preloaded syringe or auto-injector.

North Carolina has a law allowing laypersons 18 and older, who have a responsibility for people, to be trained to carry and administer epinephrine for treatment of anaphylaxis due to insect bite.

Most counties in North Carolina are covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). In order to determine the level of EMS service in their area, individuals should call their local hospital.

Director:
Drexdal Pratt, Chief
Office name:
Office of EMS
2707 Mail Service Center
Raleigh, North Carolina 27699-2707
Phone:
(919) 855-3935
Fax:
Email:
drexdal.pratt@ncmail.net

New York

New York has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. Critical Care Technician
  4. EMT-Paramedic

New York State Treatment Protocols for anaphylactic reactions authorize EMT-Basics to assist a patient in administering a patient's prescribed epinephrine auto-injector. If the patient's device is unavailable or expired, the EMT-Basic may administer an epinephrine auto-injector provided that the patient has been prescribed a device, the EMS agency carries an auto-injector, and the EMT-Basic is acting under appropriate medical direction. If the patient has not been prescribed an auto-injector, the EMT-Basic may administer one if authorized by Medical Control.

When placing a call to 911, individuals should specify that the emergency is an allergic reaction.

To determine the level of EMS service in their area, individuals should call one of the 17 regional EMS councils or their local hospital.

Director:
Edward Wronski, Director
Office name:
Bureau of Emergency Medical Services
Hedley Park Place
433 River Street, Suite 303
Troy, New York 12180
Phone:
(518) 402-0996
Fax:
Email:
Egw02@health.state.ny.us

New Mexico

New Mexico has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

Under appropriate medical direction, EMT-Basics can carry and administer pre-measured devices of epinephrine for anaphylaxis, and can assist someone who has a personal pre-measured epinephrine device by administering it for them when they are in distress and unable to do it themselves.

EMT-Intermediates can, under appropriate medical direction, carry and administer epinephrine for anaphylaxis, and can assist someone who has a personal pre-measured epinephrine device.

EMT-Paramedics are authorized unrestricted use of epinephrine. Epinephrine is carried on all Advanced Life Support/Paramedic ambulances.

Ambulance services carrying epinephrine cover most urban areas (about 80% of the state population). Any EMT in New Mexico can ask for an air ambulance intercept that is available throughout most of the state.

To determine the level of EMS coverage in their area, individuals should contact their local medical rescue or ambulance service, or the EMS Bureau at the number listed above.

Director:
Marleen L. Apodaca, RN, MSN; EMS Bureau Chief
Office name:
Emergency Medical Systems Bureau
1301 Siler Road, Building F
Santa Fe, New Mexico 87507
Phone:
(505) 476-7701
Fax:
Email:
Marleen.Apodaca@state.nm.us

New Jersey

New Jersey has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

A 2003 law authorized the development of protocols to allow EMT-Basics to administer epinephrine auto-injectors that are part of a licensed ambulance's supply kit. Until such protocols are developed, EMT-Basics are authorized to assist a patient in administering the patient's own prescribed epinephrine auto-injector.

EMT-Paramedics can carry and administer epinephrine, usually in a preloaded syringe or ampule and syringe. Few Paramedics carry an epinephrine auto-injector.

Even though New Jersey has statewide Advanced Life Support (i.e., rescue units equipped with epinephrine), the 911 dispatcher determines whether a Basic or Advanced Life Support unit is sent. Therefore, it is important to communicate allergic and anaphylactic symptoms to the dispatcher.

New Jersey has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

New Jersey has a law that allows school nurses to administer epinephrine via auto-injector to a student suffering a severe allergic reaction. The nurse may also designate someone else to perform this function in his or her absence.

Director:
Karen Halupke, RN, M.Ed., Director
Office name:
Department of Health and Senior Services, Office of Emergency Medical Services
P.O. Box 360
Trenton, New Jersey 08625-0360
Phone:
(609) 633-7777
Fax:
Email:
ems@doh.state.nj.us

Nevada

Nevada has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Advanced

EMT-Basics do not carry epinephrine, but can assist a patient in administering the patient's own epinephrine auto-injector.

A few Intermediate services carry epinephrine if their protocols have been approved by the State of Nevada EMS office, and their Medical Directors allow it.

EMT-Advanced (Paramedics) can carry and administer epinephrine via preloaded syringe, ampule and syringe, or auto-injector.

Advanced Life Support (i.e., rescue units equipped with epinephrine) covers approximately 15% of the state, predominantly the metropolitan areas.

To determine the level of EMS service in their area, individuals should call their local hospital.

Nevada has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Fergus Laughridge
Office name:
EMS Program Manager
1550 E. College Parkway, Suite 158
Carson City, Nevada 89706
Phone:
(775) 687-3065
Fax:
Email:
flaughridge@ems.state.nv.us

Nebraska

Nebraska has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics and Intermediates are allowed to carry and administer an epinephrine auto-injector with appropriate Medical Director supervision and department-recognized training.

EMT-Paramedics can carry and administer epinephrine via preloaded syringe or auto-injector.

A great deal of the population is covered by Advanced Life Support (i.e., ambulance services equipped with epinephrine). However, most of the rural areas are not covered by Advanced Life Support services.

To determine the level of EMS service in their area, individuals should call their local hospital.

Director:
Dean Cole, EMS Program Administrator
Office name:
Nebraska Department of HHS Regulation and Licensure
P.O. Box 95007
Lincoln, Nebraska 68509-5007
Phone:
(402) 471-0124 or (800) 422-3460 ext. 2-3
Fax:
Email:
dean.cole@hhss.ne.gov

Pennsylvania

Pennsylvania has two levels of Emergency Medical Technician (EMT):

  1. EMT
  2. EMT-Paramedic

A Basic Life Support service in Pennsylvania has the option of carrying epinephrine auto-injectors for administration by the service's EMTs, provided that the service complies with Department of Health epinephrine auto-injector requirements, and for the training of service personnel.

EMTs operating for BLS services that do not carry auto-injectors are authorized to assist with the administration of the patient's prescribed auto-injector.

EMT-Paramedics can carry and administer epinephrine via preloaded syringe or auto-injector.

To find out the level of EMS coverage in their area, individuals should call their local ambulance service.

Director:
Joseph Schmider, Acting Director
Office name:
Pennsylvania Department of Health, Bureau of EMS
Health & Welfare Building Room 1032
7th and Forster Streets
Harrisburg, Pennsylvania 17102
Phone:
(717) 787-8740
Fax:
Email:
PaEMSOffice@state.pa.us

Rhode Island

Rhode Island has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Cardiac
  4. EMT-Paramedic

All EMTs in the state of Rhode Island can carry and administer epinephrine by ampules or vials, or by using a preloaded syringe or auto-injector.

When an emergency call is placed to 911, the ambulance dispatched to the emergency scene will have epinephrine on board.

Director:
Peter Leary, Chief
Office name:
Rhode Island Department of Health, Division of Emergency Medical Services
3 Capitol Hill, Room 105
Providence, Rhode Island 02908
Phone:
(401) 222-2401
Fax:
Email:
Peter.Leary@health.ri.gov

South Carolina

South Carolina has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics and Intermediates can assist a patient in administering their own epinephrine. In addition, legislation passed in the 2006 legislative session will now allow EMT-Basics and Intermediates to administer the auto-injector "while on duty with a licensed SC ambulance service." The Division of EMS and Trauma is charged with developing the new training module for this revision.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

A few rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine.) To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

South Carolina has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Alonzo Smith, Director
Office name:
Division of Emergency Medical Services (EMS), Department of Health and Environmental Control
2600 Bull Street
Columbia, South Carolina 29201
Phone:
(803) 545-4204
Fax:
Email:
SmithAW2@dhec.sc.gov

West Virginia

West Virginia has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

EMT-Basics are not allowed to carry epinephrine, but can assist a patient in administering the patient's own auto-injector, if directed by Medical Control.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Some rural areas of the state are not covered by Advanced Life Support, sophisticated pre-hospital procedures typically performed by Paramedics that include the use of epinephrine. To determine the level of EMS service in their area, members should call the state EMS office at the number above.

West Virginia has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Jim Sowards, Acting Director
Office name:
Office of EMS
350 Capitol St., Room 515
Charleston, West Virginia 25301-3716
Phone:
(304) 558-3956
Fax:
Email:
jimsowards@wvdhhr.org

Wisconsin

Wisconsin has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate Technician
  3. EMT-Intermediate
  4. EMT-Paramedic

All EMTs are trained and allowed to administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Medical First Responders are authorized to administer epinephrine by auto-injector only.

Epinephrine is carried on all ambulances in Wisconsin.

Director:
Larry Gilbertson, Director
Office name:
Bureau of Local Health Support and EMS
P.O. Box 2659
Madison, Wisconsin 53701-2659
Phone:
(608) 261-9781
Fax:
Email:
gilbelm@dhfs.state.wi.us

Wyoming

Wyoming has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics and Intermediates are trained in the use of epinephrine, and can assist a patient in administering the patient's own auto-injector.

EMT-Basics and Intermediates are allowed to carry epinephrine on their ambulances if their local Medical Director deems it appropriate. Local Medical Directors typically decide whether or not their particular ambulance service carries the medication or not. However, very few ambulance services do not carry epinephrine for treatment of anaphylaxis.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

About 98% of the population is covered by 911. However, not all of this is Advanced Life Support coverage (i.e., rescue units equipped with epinephrine). To find out the level of EMS service in their area, individuals should call the state EMS office at the number above.

Director:
Jim Mayberry, Program Manager
Office name:
Emergency Medical Services
Hathaway Building, Room 426
Cheyenne, Wyoming 82002
Phone:
(307) 777-7955 or (888) 228-8996 (in Wyoming only)
Fax:
Email:
jmaybe@state.wy.us

New Hampshire

New Hampshire has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. Paramedic

In 2005 HB257 passed moving EMS protocols from local option to statewide. Within the NH Patient Care Protocols dated 2005, epinephrine for the treatment of anaphylaxis is allowed under standing order for EMT-Basics, EMT-Intermediates, EMT-Paramedics.

EMT-Basics have a mandatory training module that allows them to carry and administer epinephrine auto-injectors.

EMT-Intermediates have a mandatory training module that allows them carry and administer epinephrine via ampule and syringe, preloaded syringe or auto-injector.

Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe or auto-injector.

Epinephrine possession and use for laypersons must be prescribed by the patient's physician.

Director:
Suzanne Prentiss, Bureau Chief
Office name:
Bureau of Emergency Medical Services
33 Hazen Drive
Concord, New Hampshire 03305
Phone:
Phone: (603) 271-4568
Fax:
Email:
sprentiss@safety.state.nh.us

Virginia

Virginia has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Enhanced (Replacing Shock Trauma)
  3. EMT-Intermediate (Replacing Cardiac Technician)
  4. EMT-Paramedic

EMT-Basics are allowed to carry epinephrine personally under certain circumstances and can assist a patient in administering the patient’s own auto-injector.

EMT Enhanced, Intermediate and Paramedic can carry and administer epinephrine personally under certain circumstances and can access the medication from an ALS vehicle equipped with a “drug box” and administer it via various routes.

To determine their local EMS coverage, individuals should call the state EMS office at the number above or contact the local regional council office.

Virginia has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Gary Brown, Director
Office name:
Office of Emergency Medical Services
109 Governor Street, Suite UB-55
Richmond, Virginia 23219
Phone:
(804) 864-7600 or (800) 523-6019 (in Virginia only)
Fax:
Email:
warren.short@vdh.virginia.gov

Vermont

Vermont has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are not allowed to carry epinephrine, but can assist a patient in administering the patient's own auto-injector. EMT-Basics must have a direct order (via phone, radio, etc) from a medical control physician in order to administer the medication.

EMT-Intermediates and Paramedics can carry and administer epinephrine in ampule and syringe, preloaded syringe, or auto-injector form.

To determine the level of EMS service in their area, individuals can either call the state EMS office at the number above, or visit the Vermont EMS web site for a complete service listing.

Vermont has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
W. Dan Manz, Director
Office name:
Department of Emergency Medical Services Division , Department of Health
108 Cherry Street, Box 70
Burlington, Vermont 05402
Phone:
(802) 863-7310 or (800) 244-0911 (in Vermont only)
Fax:
Email:
dmanz@vdh.state.vt.us

Utah

Utah has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are authorized to assist a patient in administering the patient's own prescribed epinephrine auto-injector. Under appropriate medical direction, EMT-Basics may also administer an epinephrine auto-injector that is part of a certified ambulance's medical supply.

EMT-Intermediates and Paramedics can carry and administer epinephrine via auto-injector or ampule and syringe.

To determine the level of EMS coverage in their area, individuals should call the state EMS office at the number above.

Utah has a law that authorizes laypersons and school personnel with responsibility for other people to carry, and be trained to administer, epinephrine for treatment of anaphylaxis.

Director:
Jan Buttrey, Director
Office name:
Bureau of Emergency Medical Services, Utah Department of Health
P.O. Box 142004
Salt Lake City, Utah 84114-2004
Phone:
(801) 538-6435 or (800) 284-1131
Fax:
Email:
jbuttrey@email.state.ut.us

Texas

Texas has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic
  4. Licensed Paramedic

EMT-Basics may, under medical direction (via online communication or protocol), administer an epinephrine auto-injector. This is usually the patient's own, but some services carry their own. EMT-Intermediates may also, under medical direction, administer epinephrine by auto-injector, prefilled syringe, or ampule and syringe.

Paramedics (typically under standing orders) may administer epinephrine through auto-injector, pre-filled syringe, or ampule and syringe.

Texas recently enacted a law that allows all EMTs to carry and administer epinephrine auto-injector devices in accordance with the Texas Department of Health, and a collaborative agreement between the EMS provider and a licensed physician.

Many rural areas in Texas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine), and local Medical Directors have a lot of leeway regarding patient care in Texas. To determine the level of emergency medical service in their area, individuals should call the Bureau of Emergency Management at the number listed above.

Texas has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Terry Bavousett, EMS Director
Office name:
Texas Department of Health, Bureau of Emergency Management
1100 West 49th Street
Austin, Texas 78756-3199
Phone:
(512) 834-6700
Fax:
Email:
emsinfo@tdh.state.tx.us

Tennessee

Tennessee has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intravenous Therapy
  3. EMT-Paramedic

Epinephrine has been required on all ambulances in Tennessee since 1973. All levels of EMT are trained to administer epinephrine via multiple delivery routes during an anaphylactic emergency under appropriate medical direction.

Tennessee also has a law that allows lay individuals who demonstrate a need for epinephrine training based on family or occupational circumstances to receive training in the administration of pre-measured epinephrine.

Director:
Joseph Phillips, Director
Office name:
Tennessee Department of Health, Division of Emergency Medical Services
227 French Landing, Suite 303
Heritage Place, Metro Center
Nashville, Tennessee 37243
Phone:
(615) 741-2584 or (800) 778-4505
Fax:
Email:
joe.phillips@state.tn.us

South Dakota

South Dakota has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate/85
  3. EMT-Intermediate/99
  4. EMT-Paramedic

EMT-Basics and Intermediate/85 are not allowed to carry epinephrine, but can assist a patient in administering the patient's own epinephrine auto-injector.

EMT-Intermediate/99 and Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

In South Dakota, more than 70% of the ambulance services are volunteer and about 85% of the EMTs are Basics. Therefore, it is difficult to provide Advanced Life Support (i.e., rescue units equipped with epinephrine) throughout the state.

To determine EMS coverage in their area, individuals should call the state EMS office at the number listed above.

Director:
Robert Graff, Director
Office name:
Emergency Medical Services, South Dakota Department of Public Safety
118 W. Capitol
Pierre, South Dakota 57501
Phone:
(605) 773-4031
Fax:
Email:
bob.graff@state.sd.us

Montana

Montana has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

EMT-Basics are permitted to administer epinephrine with an auto-injector, providing it is the patient's auto-injector and has been specifically prescribed for the individual patient.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

To determine the level of EMS service in their area, individuals should call their local ambulance service or the state EMS office at the number listed above.

Director:
Jim DeTienne, Section Supervisor
Office name:
EMS & Injury Prevention Section, Department of Public Health & Human Services
P.O. Box 202951
Helena, Montana 59620
Phone:
(406) 444-3895
Fax:
Email:
jdetienne@mt.gov

Missouri

Missouri has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

EMT-Basics who have successfully completed an optional DHSS-approved training course may administer an epinephrine auto-injector. EMT-Basics who have not completed the course are only allowed to assist a patient in administering the patient's own prescribed epinephrine auto-injector.

EMT-Paramedics can carry and administer epinephrine under a doctor's order or protocols.

To determine the level of EMS service in their area, individuals should call their local ambulance service or the state EMS office at the number listed above.

Missouri has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Paula Kempf, Program Manager
Office name:
Unit of Emergency Medical Services, Missouri Department of Health and Senior Services
P.O. Box 570
Jefferson City, Missouri 65102-0570
Phone:
(573) 751-6356
Fax:
Email:
info@dhss.mo.gov

Hawaii

Hawaii has two levels of Emergency Medical Technician (EMT):

  1. EMT
  2. Mobile Intensive Care Technician (Paramedic)

EMTs may assist a patient in administering the patient's prescribed epinephrine auto-injector.

Paramedics can carry and administer epinephrine via a preloaded syringe or auto-injector.

Hawaii has an all Advanced Life Support system, so a paramedic staffs all emergency ambulances.

Hawaii has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Donna Maiava, Program Manager
Office name:
Emergency Medical Services & Injury Prevention System
3627 Kilauea Avenue, Room 102
Honolulu, Hawaii 96816-2317
Phone:
(808) 733-9210
Fax:
Email:
emss@camhmis.health.state.hi.us

Georgia

Georgia has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

In Georgia, EMTs have always been trained above the EMT-Basic level; in fact, Georgia utilizes the National Registry EMT-Intermediate test for certification. Recently, Georgia has begun certifying EMT-Basics, but this is a non-transport certification used by firefighters and First Responder Services. Such EMTs are not part of a two-person crew.

Ninety-four percent of the state is covered by Advanced Life Support (i.e., rescue units, including helicopters, equipped with epinephrine).

In order to determine the level of life support coverage in their area, individuals should call their local hospital or the State EMS office at the number listed above.

Director:
R. David Beam, Director
Office name:
Office of Emergency Medical Services
2600 Skyland Drive, Lower Level
Atlanta, Georgia 30319
Phone:
(404) 679-0547
Fax:
Email:
phemsinfo@dhr.state.ga.us

Florida

Florida has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

The administration of epinephrine is taught as part of the EMT-Basic curriculum, and epinephrine auto-injectors are carried on all licensed ALS ambulances (which constitute 240 out of the 246 licensed ambulance systems in the state). Protocols allow EMTs to administer epinephrine on their own, or they may assist a patient in administering the patient's own prescribed epinephrine.

EMT-Paramedics can carry and administer epinephrine in an ampule and syringe, preloaded syringe or auto-injector form.

Florida Statute 381.88 authorizes "public sector" employees such as tour guides, scout leaders, camp counselors, etc. to become certified to receive a prescription for pre-measured doses of epinephrine, and to administer, in an emergency situation where a physician is not available, the prescribed epinephrine to a person suffering a severeadverse reaction to an insect sting. Such certification costs $25.

Director:
John Bixler, Chief
Office name:
Florida Department of Health, Bureau of Emergency Medical Services
4052 Bald Cypress Way
Bin #C18
Tallahassee, Florida 32311-1738
Phone:
(850) 245-4440
Fax:
Email:
demo_ems@doh.state.fl.us

District of Columbia

Washington, D.C. has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics may administer an epinephrine auto-injector.

EMT-Intermediates must be paired with an EMT-Paramedic and therefore can carry epinephrine in a preloaded syringe.

EMT-Paramedics can carry and administer epinephrine via preloaded syringe.

The entire District of Columbia is covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). However, patients must communicate to the dispatcher that they are experiencing an allergic reaction or having trouble breathing to ensure that an ALS unit arrives at the scene.

Washington, D.C. has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

The Emergency Access to Epinephrine Act was introduced in July 2005, but has not been voted into law as of November 2006. This legislation would authorize all EMTs in the District of Columbia to carry and administer epinephrine.

Director:
Adrian Thompson, Chief
Office name:
DC Fire and Emergency Medical Services Department
1923 Vermont Avenue NW
Suite 201
Washington DC, District of Columbia 20001
Phone:
(202) 673-3331
Fax:
Email:

Delaware

Delaware has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

EMT-Basics may assist a patient in administering the patient's prescribed auto-injector.

EMT-Paramedics can carry and administer epinephrine in an ampule and syringe or preloaded syringe.

The entire state is covered by sixteen (16) ground Advanced Life Support (ALS) units (i.e., rescue units equipped with epinephrine) and two (2) state police helicopters, which also provide ALS. They are assisted by more than sixty (60) volunteer ambulance departments.

Delaware has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Steven Blessing, Director
Office name:
Delaware Office of EMS
655 S. Bay Road
Suite 4-H
Dover, Delaware 19901
Phone:
(302) 744-5400
Fax:
Email:
(302) 744-5429

Connecticut

Connecticut has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. Licensed Paramedic

Public Act 00-135, recently enacted in Connecticut:

  1. Requires all EMTs to receive training in the administration of epinephrine using automatic prefilled cartridge injectors or similar automatic injectable equipment; 
  2. Requires such injectors or equipment to be carried on all licensed or certified ambulances; and
  3. Allows the EMT, after receiving appropriate training, to administer the epinephrine according to written protocols and standing orders of a licensed physician serving as an emergency department director.
Director:
Gary Wiemokly, EMS Section Chief
Office name:
Office of Emergency Medical Services
410 Capitol Avenue
MS #12EMS
Hartford, Connecticut 06134-0308
Phone:
(860) 509-7975
Fax:
Email:
gary.wiemokly@po.state.ct.us

Colorado

EMT-Basics are allowed to carry and administer an epinephrine auto-injector with appropriate Medical Director supervision and department-recognized training.

EMT-Intermediates and Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Many rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Colorado has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Randy Kuykendall, Chief - EMTS Section
Office name:
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80234-1530
Phone:
(303) 692-2980
Fax:
Email:
randy.kuykendall@state.co.us

California

California has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are allowed to carry epinephrine when approved by the local emergency medical services (EMS) agency in which the EMT-Basic is employed. EMT-Basics may also assist a patient in administering the patient's own epinephrine auto-injector.

EMT-Intermediates and Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

All but one rural area is covered by advanced life support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

California has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care. The only laypersons allowed by law in California to administer epinephrine are child daycare providers, who are required to receive first aid, CPR, and preventative health training. (State EMS also oversees this program), and school staff when authorized by that school district.

Director:
Cesar A. Aristeiguieta, M.D., Director
Office name:
California EMS Authority
1930 9th Street
Sacramento, California 95814
Phone:
(916) 322-4336
Fax:
Email:
Director@emsa.ca.gov

Arkansas

Arkansas has three levels of Emergency Medical Technician (EMT):

  1. EMT-Ambulance
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Ambulance and Intermediates do not carry epinephrine, but can assist a patient in administering the patient's own auto-injector.

EMT-Paramedics can carry and administer epinephrine in either a preloaded syringe or ampule and syringe form.

To determine local EMS coverage in their area, individuals should call the state EMS office at the number listed above.

There is no statewide 911 service in Arkansas.

In 1983, Arkansas enacted a bill allowing persons 18 or older with responsibility for other people to be trained to give epinephrine shots for treatment of anaphylaxis due to insect bite.

Director:
David Taylor, Director
Office name:
Arkansas Department of Health and Human Services
P.O. Box 1437, Slot H-38
Little Rock, Arkansas 72203-1437
Phone:
(501) 661-2262
Fax:
Email:
david.taylor@arkansas.gov

Arizona

Arizona has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics are allowed to carry and administer epinephrine auto-injectors after receiving supplemental training, and may assist a patient in administering the patient's own auto-injector. ADHS is considering whether to add the epinephrine auto-injector training to the initial EMT-Basic Course and EMT-Basic Refresher Course.

EMT-Intermediates and Paramedics can carry and administer epinephrine in an ampule and syringe, preloaded syringe, or auto-injector form.

Some rural areas are not covered by Advanced Life Support (i.e., rescue units staffed with EMT-Intermediates or Paramedics), but ADHS is in the process of adopting a rule to require a ground ambulance providing Basic Life Support to carry epinephrine auto-injectors unless it is not primarily serving as the first EMS provider arriving on scene in response to an emergency dispatch.

Arizona has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care. However, a new law that takes effect September 21, 2006, authorizes a person to administer epinephrine to another person suffering from a severe allergic reaction if the person acts in good faith and without compensation and a qualified health professional is not immediately available. The law provides protection from civil liability for resulting injury unless the person acts with gross negligence, wilful misconduct, or intentional wrongdoing. (Laws 2006, Chapter 92, to be codified at A.R.S. 36-2226, available at: http://www.azleg.gov/legtext/47leg/2R/laws/0092.htm?printformat=yes)

Director:
Terry Mullins, Chief
Office name:
Bureau of Emergency Medical Services
150 North 18th Avenue
Suite 540
Phoenix, Arizona 85007-3248
Phone:
(602) 364-3149
Fax:
Email:
mullint@azdhs.gov

Idaho

Idaho has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Advanced
  3. EMT-Paramedic

Agencies licensed to provide Basic and Intermediate Life Support can choose to enroll in the Idaho Epinephrine Auto-Injector Program. This program provides the training and operational parameters enabling the First Responder, EMT-Basic and EMT-Advanced to carry and administer the epinephrine auto injector for an anaphylactic patient.

The Agency Medical Director and/or the EMS Agency provide initial training that meets or exceeds the objectives of the Idaho Epinephrine Training Curriculum Guide and provides annual refresher training. Enrolled agencies agree to assure that two (2) adult and two (2) pediatric dose epinephrine auto-injectors are available to all trained personnel.

EMT-Paramedics (Advanced Life Support) carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Of the 159 eligible Basic and Intermediate Life Support EMS agencies in Idaho, 60 (40%) are enrolled in the program carrying epinephrine auto-injectors. Combining the 31 Advanced Life Support ground and air services carrying epinephrine with those 60 enrolled in the program, 91 of the 190 EMS agencies in Idaho (48 %) are able to administer epinephrine to the anaphylactic patient.

For further information regarding EMS coverage in their area, individuals should call the state EMS office at the number above.

Director:
Dia Gainor, Chief
Office name:
Idaho Emergency Medical Services (EMS) Bureau
590 W. Washington Street
Boise, Idaho 83702
Phone:
(208) 334-4000
Fax:
Email:
IdahoEMS@idhw.state.id.us

Illinois

Illinois has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic (includes EMT-Basic Defibrillators)
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics and Intermediates who have completed a Department-approved course are allowed to carry and administer epinephrine auto-injectors.

EMT-Paramedics are trained to administer epinephrine via auto-injector, or ampule and syringe.

To determine whether or not the ambulances in their area carry epinephrine, individuals should contact their local EMS System Resource hospital.

Director:
Leslee Stein-Spencer, RN, MS, Chief
Office name:
Division of Emergency Medical Services Illinois Department of Public Health
535 W. Jefferson St
Springfield, Illinois 62761
Phone:
(217) 782-4977
Fax:
Email:

Indiana

Indiana has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Basic Advanced
  3. EMT-Intermediate
  4. EMT-Paramedic

EMT-Basics who complete appropriate training may administer an epinephrine auto-injector.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

Many rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Indiana has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Dave Perkins, Acting Director
Office name:
Indiana Department of Homeland Security Division of Emergency Response
Indiana Government Center South
302 W. Washington St., Room E208
Indianapolis, Indiana 46204-2739
Phone:
(317) 232-3980 or (800) 669-7362
Fax:
Email:

Mississippi

Mississippi has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

The Mississippi EMS Standards Procedure for allergic reactions authorizes EMT-Basics to administer a patient's prescribed epinephrine auto-injector, provided the EMT-Basic is acting under appropriate Medical Direction, and has successfully completed appropriate training. EMT-Basics are not authorized to administer an epinephrine auto-injector that is part of a certified ambulance's medical supplies.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

Approximately 94% of the population is covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Mississippi has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Keith Parker, Director
Office name:
EMS/Trauma Care System
P.O. Box 1700
Jackson, Mississippi 39215-1700
Phone:
(601) 576-7380
Fax:
Email:
keith.parker@msdh.state.ms.us

Minnesota

Minnesota has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics and Intermediates may carry and administer epinephrine by auto-injector on a basic life support (BLS) ambulance if the ambulance service has requested and been granted a variance by the Emergency Medical Services Regulatory Board. All BLS ambulance services in Minnesota have been approved for the epinephrine-by-auto-injector variance. Otherwise, they can assist a patient in administering the patient's own auto-injector without regard to a variance.*

Paramedics are trained in the administration of all pharmaceuticals, including epinephrine. Advanced life support (ALS) ambulances carry epinephrine with medical control determining what form is carried and administered by the paramedics.

*One member of the of the Ambulance Team must be certified to administer epinephrine

Epinephrine is available on emergency ambulance calls made in Minnesota

Director:
Pam Biladeau, Executive Director
Office name:
Emergency Medical Services Regulatory Board
2829 University Ave SE, Suite 310
Minneapolis, Minnesota 55414
Phone:
(651) 201-2806
Fax:
Email:
Pam.Biladeau@state.mn.us

Michigan

Michigan has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Specialist/Intermediate
  3. EMT-Paramedic

EMTs and above are trained to administer EpiPens. Legislation was passed in Michigan that requires all basic and limited advanced vehicles to carry EpiPens, and allows the administration of EpiPens by EMTs and Specialists.

The legislation allows MFRs to administer an EpiPen if adopted in protocol by a local Medical Control Authority. The legislation requires that the MFR be properly trained. In order for a Medical Control Authority to allow an MFR to carry an EpiPen, the Medical Control Authority must provide justification that a life support agency that provides basic, limited advanced, or advanced life support is not readily available in that location.

All advanced life support vehicles carry epinephrine.

Approximately 98% of the state population is covered by Advanced Life Support (transport and non-transport equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the local hospital or the state EMS office at the number listed above.

Director:
John Hubinger, Director, Division of Health Policy
Office name:
Michigan Department of Community Health, EMS & Trauma Systems Section
Capitol View Building, 6th Floor
201 Townsend Street
Lansing, Michigan 48913
Phone:
(517) 241-3020
Fax:
Email:
jfhubin@michigan.gov

Massachusetts

Massachusetts has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

All ambulance services are required to carry auto-injected epinephrine on their ambulances for EMT-Basics and Intermediates to administer. Administration of epinephrine at the Basic and Intermediate level is through a Memorandum of Agreement with a hospital for the provision of medical oversight.

Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector.

When a 911 call is placed, the patient must tell the dispatcher to send an Advanced Life Support ambulance (i.e., rescue unit equipped with epinephrine).

Some rural areas (specifically Hampshire and Franklin counties) may not be covered by Basic Life Support vehicles equipped with epinephrine. To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Massachusetts has a bill that allows school personnel to become certified to carry and administer epinephrine.

Director:
Abdullah Rehayem, Acting Director
Office name:
Office of Emergency Medical Services
2 Boylston Street, 3rd Floor
Boston, Massachusetts 02116
Phone:
(617) 753-7300
Fax:
Email:
abdullah.rehayem@state.ma.us

Maryland

Maryland has four levels of Emergency Medical Technician (EMT):

  1. Emergency Medical Technician - Basic
  2. Cardiac Rescue Technician
  3. Cardiac Rescue Technician - Intermediate
  4. Emergency Medical Technician - Paramedic,/li>

As of January 1, 2002, EMT-Basics are allowed to carry and administer epinephrine auto-injectors as part of an Optional Supplemental Protocol.

Cardiac Rescue Technicians and Paramedics can carry and administer epinephrine via preloaded syringe or auto-injector.

All of Maryland is covered by Advanced Life Support (i.e., rescue units equipped with epinephrine).

Maryland has a law allowing persons 18 and older, who have responsibility for other people, to be trained to administer epinephrine auto-injectors for treatment of anaphylaxis due to insect bite. A person certified under this law can obtain and carry an epinephrine auto-injector.

Director:
Richard L. Alcorta, State EMS Medical Director
Office name:
Maryland Institute for Emergency Medical Services Systems
653 W. Pratt Street
Baltimore, Maryland 21201-1536
Phone:
(410) 706-3666 or (800) 762-7157
Fax:
Email:
info@miemss.org

Maine

Maine has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics who have received supplemental training are allowed to carry and administer epinephrine via auto-injector (adult and pediatric).

EMT-Intermediate and Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Maine has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Jay Bradshaw, Director
Office name:
Maine Emergency Medical Services
152 State House Station
Augusta, Maine 04333-0152
Phone:
(207) 626-3860
Fax:
Email:
Maine.ems@maine.gov

Louisiana

Louisiana has three levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Paramedic

EMT-Basics in Louisiana may assist with a patient's prescribed epinephrine auto-injector; however, EMT-Basics are also authorized to administer an auto-injector that is kept on a certified ambulance, provided the EMT-Basic has successfully completed appropriate training, and is acting under appropriate Medical Control.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Most of the parishes in Louisiana (63 out of 64) are covered by Advanced Life Support or Paramedic service. To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Louisiana has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Nancy Bourgeois, Program Manager
Office name:
Department of Health and Hospitals, Office of Public Health
Bureau of Emergency Medical Services
8919 World Ministry Avenue, Suite A
Baton Rouge, Louisiana 70801
Phone:
(225) 763-5700
Fax:
Email:
emsweb@dhh.la.gov

Kentucky

Kentucky has two levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Paramedic

Kentucky's anaphylactic shock treatment protocol authorizes EMT-Basics to administer a patient's own prescribed epinephrine auto-injector; however, if the patient's device is not available, EMT-Basics may administer epinephrine from the stock carried on the ambulance, under appropriate Medical Control.

EMT-Paramedics can carry and administer epinephrine via ampule and syringe, preloaded syringe, or auto-injector form.

Many rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Kentucky has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Brian Bishop, Executive Director
Office name:
Kentucky Board of EMS
2545 Lawrenceburg Road
Frankfort, Kentucky 40601
Phone:
(859) 256-3565
Fax:
Email:
brian.bishop@ky.gov

Kansas

Kansas has five levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Defibrillator
  3. EMT-Intermediate
  4. EMT-Intermediate/Defibrillator
  5. Mobile Intensive Care Technicians (Paramedics)

EMT-Basics are allowed to administer auto-injectable epinephrine if they are functioning in an official capacity for a Kansas licensed ambulance service or an organized first responding organization, have successfully completed a Board-approved training course on epinephrine and anaphylaxis, and are acting in compliance with medical protocols.

EMT-Paramedics can carry and administer epinephrine via preloaded syringe, or auto-injector form.

Many rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Kansas has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Robert Waller, Chief Administrator
Office name:
Board of Emergency Medical Services
Landon State Office Building, Room 1031
900 SW Jackson Street
Topeka, Kansas 66612-1228
Phone:
(785) 296-7296
Fax:
Email:
emsrw@ink.org

Iowa

Iowa has four levels of Emergency Medical Technician (EMT):

  1. EMT-Basic
  2. EMT-Intermediate
  3. EMT-Iowa Paramedic
  4. EMT-Paramedic Specialist

EMT-Basics and Intermediates can assist a patient in administering the patient's own epinephrine auto-injector. In some areas, EMT-Basics and Intermediates are allowed to carry and administer epinephrine auto-injectors with their Medical Director's approval.

EMT-Paramedics and Paramedic Specialists can carry and administer epinephrine via preloaded syringe, or ampule and syringe.

Advanced Life Support (Paramedic) covers about 60% of the state population. To determine the level of EMS service in their area, individuals should call the state EMS office at the number listed above.

Iowa has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Kirk E. Schmitt, Bureau Chief
Office name:
Iowa Department of Public Health, Bureau of EMS
Lucas State Office Bldg.
321 E. 12th Street
Des Moines, Iowa 50319
Phone:
(800) 728-3367
Fax:
Email:
kschmitt@idph.state.ia.us

Alaska

Alaska has four levels of Emergency Medical Technician (EMT):

  1. EMT-I or Basics
  2. EMT-II
  3. EMT-III
  4. Mobile Intensive Care Paramedic

EMT-Is and EMT-IIs can assist a patient in administering the patient's own auto-injector. However, physician medical directors are allowed to authorize additional medications and procedures. By using this process for approving epinephrine, both EMT-Is and EMT-IIs can legally carry epinephrine on the ambulance and can administer the epinephrine to patients in accordance with physician-signed standing orders.

EMT-IIIs and Mobile Intensive Care Paramedics can carry and administer epinephrine in an ampule and syringe, preloaded syringe, or auto-injector form.

Alaska requires that a physician authorize the administration of epinephrine, in any form, either verbally or through standing orders.

Some rural areas are not covered by Advanced Life Support (i.e., rescue units equipped with epinephrine). To determine the level of EMS service in their area, individuals should call the business office of the nearest EMS agency or the state EMS program at the number listed above.

Alaska has no law related to laypersons being trained and certified to carry and administer epinephrine via an auto-injector to someone under their care.

Director:
Kathy McLeron, EMS Unit Manager
Office name:
Emergency Medical Services Unit
Division of Public Health
Box 110616
Juneau, Alaska 99811-0616
Phone:
(907) 465-3027
Fax:
Email:
kathy_mcleron@health.state.ak.us