Adult Emergency Department



Paramedics in the State of Tennessee are licensed. Specific state legislation allows them to function in the emergency department and use their advanced skills in support of the nursing care of the patient. During this time of nursing shortages, you want to provide the highest skill mix possible in the Emergency Department.  Paramedics  bring a unique perspective to the care of the ED patient with their experience in dealing with the same patient population in the prehospital environment.  Paramedics are expected to maintain PALS, ACLS and BTLS or PHTLS.

Paramedic Job Roles and Responsibilities

We constantly get asked about how Paramedics work out in the ED.  They work as good on one side of the door as they do on the the other side!   In fact, through their skills and abilities they have become a time-tested best practice and an integral part of the Vanderbilt strategy for EXCELLENCE in Emergency Care.  Here are the links to the Tennessee EMS Statutes and Rules and Regulations that empower their practice:

Tennessee EMS Act

T.C.A. 68-140-509. Duties and authority of EMS personnel and physician on the scene.

(c) An EMT or EMT-P may function within hospital emergency services under nursing supervision in accordance with policies and procedures adopted by the hospital.

Rules of the Tennessee Department of Health - Bureau of Health Licensure and Regulation - Division of Emergency Medical Services

1200-12-1-.04 3.

Emergency Medical Technician Paramedics or students during training in accredited programs may utilize the following procedures under medical control.

(i) perform electrocardiographic monitoring, recognize and treat cardiac dysrhythmias

(ii) perform gastric, esophageal, or tracheal intubation and suction.

(iii) administer intravenous solutions or blood products by peripheral venipuncture of scalp, extremities, and external jugular veins or intraosseous infusions, or by preestablished indwelling lines.

(iv) administer by oral, parenteral, endotracheal, or other indicated means, medications of any of the following classes of drugs:

(I) antiarrhythmic agents

(II) chronotropic agents

(III) vagolytic agents

(IV) analgesic agents

(V) alkalinizing agents

(VI) vasopressor agents

(VII) anticonvulsive agents; and

(VIII) other drugs which may be deemed necessary by the ordering physician.

(v) perform chest decompression

(vi) perform cricothyrotomy


(1) Emergency Medical Technicians and Emergency Medical Technician-Paramedics shall be permitted to perform extended skills or procedures when such treatment is conducted under authorized medical control and nursing supervision and within the scope of practice as identified in 1200-12-1-.04 Paragraph (3).

(2) All individuals who are employed in this capacity shall demonstrate continued training and competence in order to perform their professional duties.



(Rule 1000-1-.11 (21) Supervision: Means overseeing or inspecting with authority. The basic responsibility of the individual nurse who is required to supervise others is to determine which of the nursing needs can be delegated safely to others, and whether the individual to whom the duties are entrusted must be supervised personally.

Each hospital employing an Emergency Medical Technician or EMT-Paramedic in hospital emergency services will maintain evidence of the continued competence of such individuals, including records of any in-service training or continuing education.when providing patient care while functioning in Hospital Emergency Services under nursing supervision. 

"Experienced" Paramedics Only Section

Older, I mean, more experienced paramedics will enjoy this walk down memory lane. Younger paramedics may enjoy living a little EMS history found at: http://en.wikipedia.org/wiki/Emergency%21!


This page was last updated May 30, 2013 and is maintained by