Scope of Practice Question

[Ken Lawson-Williams <Macgyver@FlightMedicMail.com>]

QUESTION: Is UVC and/or UAC line placement during the mid to late stages of a Neonatal Resuscitation (per NRP algorhythm/course) within basic Paramedic or RN scope of practice in your service? Or would it be considered to be the initiation of a central line and thus out of scope? 

By strict dictionary/legal definition they could be interpreted as central lines as both access core/central vessels. I have placed them only 3 times in 11 years (18 field deliveries) so it likely is not all that common an intervention for providers as an overall part of their practice despite it's 17% useage in my delivery experience. None of my medical directors have had any concerns/problem with the placements as were clinically indicated and/or covered within a protocol. However, they may not have looked at the scope of practice issues since the skill is a fundamental part of NRP. After all, it isn't a "central line placement" in the same sense as it would be on an infant/pede/adult (subclavian or internal jug spring to mind). More like a femoral access.

Just curious to see how the issue is dealt with in different parts of the world - or if it is even considered at all....

Fly Safe. 
Ken L-W CCEMT-P/WMT

"If in the last few years you haven't discarded a major opinion or 
acquired a new one, check your pulse. You may be dead."
- Gelett Burgess

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