You asked if state regulation prohibits emergency medical technicians (EMTs) from using combi-tubes for intubation of patients.

A combi-tube is an invasive airway procedure. It is not in the current national EMT scope of practice or state regulations for EMTs, according to the Office of Emergency Medical Services (OEMS) of the Department of Public Health (DPH). But DPH regulations do allow for its use by paramedics and EMT-intermediates (EMT-I).

Apparently, this issue was recently raised when some existing basic life support (BLS) service providers filed “upgrade” applications requesting OEMS permission to let EMTs use these devices. OEMS reviewed the EMT regulations and the scope of practice and consulted with the State Medical Advisory Committee (SMAC). The SMAC is composed of the medical directors of each regional medical services council and the OEMS medical director. It advises OEMS on medical matters within the state’s EMS system (see DPH reg. §19a-179-1(dd)).

EMTs’ use of this procedure was not medically supported by the committee’s medical directors and it was determined not to be supported by current regulations. DPH sent a letter to each EMS sponsor hospital’s medical director reinforcing these regulations. According to OEMS, this caused many to reassess their current practice for BLS services and withdraw authorization for use of combi-tubes by EMTs. (The paramedic and EMT-I levels are unchanged. )

JK: tjo