title: Assessing EMS scope of practice for utility and risk: the New Mexico EMS Interventions Assessment Project, Phase One results.
abstract: BACKGROUND
  Few emergency medical services (EMS) interventions in New Mexico have been assessed for efficacy, potential harm, or potential benefit. There is concern that many interventions added over the years may be outdated, harmful, or ineffective in the EMS setting. A formal process for reviewing the state EMS scope of practice using literature review and expert consensus is discussed. In Phase One of the project, interventions in the New Mexico EMS scope of practice were prioritized for further review by surveying a national cadre of EMS experts to evaluate EMS interventions using a utilitarian harm/benefit metric.
  
  
  METHODS
  An electronic survey based on the 2010 New Mexico EMS Scope of Practice statute was administered from March through June, 2011. A national cadre of 104 respondents was identified. Respondents were either State EMS medical directors or EMS fellowship directors. Respondents were asked to rate the potential harm and the potential benefit of specific EMS interventions on a 5-point ordinal scale. Median harm and benefit scores were calculated.
  
  
  RESULTS
  A total of 88 completed surveys were received following 208 emailed invitations to 104 respondents (43% response rate). Twenty-two (22) highest-priority interventions (those with a harm/benefit median score ratio of >1) were identified. Seven additional second-priority interventions were also identified. These interventions will be advanced for formal literature review and expert consensus.
  
  
  CONCLUSIONS
  The New Mexico EMS Interventions Project offers a novel model for assessing a prehospital scope of practice.
authors.affiliation: Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Marc-David
authors.initials: MD
authors.lastname: Munk
authors.forename: Lynne
authors.initials: L
authors.lastname: Fullerton
authors.forename: Laura
authors.initials: L
authors.lastname: Banks
authors.forename: Sarah
authors.initials: S
authors.lastname: Morley
authors.forename: Robert
authors.initials: R
authors.lastname: McDaniels
authors.forename: Stuart
authors.initials: S
authors.lastname: Castle
authors.forename: Kyle
authors.initials: K
authors.lastname: Thornton
authors.forename: Michael E
authors.initials: ME
authors.lastname: Richards
mesh_terms: D001291:Attitude of Health Personnel; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D009516:New Mexico; D018570:Risk Assessment