Can paramedics do RSI here?

RSI drugs are listed at the Critical Care level, not for standard paramedics.

Your medical director's standing orders set the advanced airway techniques you may perform (7 AAC 26.640); medications beyond the state scope need department approval under 7 AAC 26.670.

A paramedic 'STR' skill: it requires the state's specified training under A.A.C. R9-25-505 before use.

The service applies to the Department of Health and must be approved before any paramedic uses the RSI protocol.

RSI isn't in the California paramedic scope; it's taught in critical care paramedic training, and a local EMS agency can add it only as a trial study approved by the state EMS Authority.

Paralytics and etomidate aren't on the paramedic formulary, so an agency needs a CDPHE waiver (typically three years) to do RSI.

RSI is in the statewide protocols; your sponsor hospital trains and credentials you.

Paralytics are limited to agencies the Office of EMS has approved for RSI (statewide ALS protocols, 2022 edition).

DC Fire and EMS uses medication-facilitated intubation; its protocols list no paralytic agents.

No state RSI rule: each provider's medical director decides in its standing orders.

The agency needs written approval from the Office of EMS and Trauma; without it, paramedics may only maintain paralysis in already-intubated patients on interfacility transports.

RSI is in the statewide standing orders for Hawaii paramedics (MICTs).

RSI is an optional module for paramedics who hold FP-C or CCP-C certification, approved by their medical director, following the EMSPC protocol.

Paralytics aren't in the national education standards, so an EMS System must get IDPH approval before adding them.

Indiana's scope gives paramedics medical-director-approved medications rather than a fixed list; RSI depends on your provider organization's protocol and credentialing.

Iowa's paramedic scope allows medications in the service's approved protocols, and endotracheal intubation; the service medical director credentials you.

Services decide; the state Medical Advisory Council's position asks for a demonstrated need, a medical-director-led program and ongoing review.

Both the service and the paramedic need KBEMS authorization; pediatric RSI is limited to critical care transport and air medical providers.

Medication-assisted intubation is an optional paramedic module: your agency trains you and its medical director authorizes it (2017 scope matrix; the 2024 revision kept the optional-module approach).

The 2025 statewide protocols, which govern all Maine EMS licensees, include no RSI protocol and no paralytic medications.

RSI is an Optional Supplemental Program: a jurisdiction must apply and be approved before its paramedics can use it.

Statewide Treatment Protocols v2026.2 (Sep 1, 2026) have no RSI; paralytics appear only as drugs a paramedic may continue on an interfacility transfer. Services have run medication-assisted intubation under OEMS special-project waivers (105 CMR 170.405).

The state protocol suite limits intubation to patients without a gag reflex and has no drug-assisted intubation protocol; a Medical Control Authority would need state approval for its own.

No state RSI rule: each ambulance service's medical director sets the standing orders.

Paralytics are in the Critical Care Paramedic column only of the state scope (August 2024).

No state RSI rule: each service's medical director writes the treatment protocols.

Drug-assisted intubation needs the Paramedic Critical Care Endorsement.

RSA is in the state model protocols; your service's physician medical director decides whether to adopt it.

The state manual includes an RSI procedure; whether you use it depends on your agency's medical director. Las Vegas and Reno run their own regional protocols.

Patient Care Protocols v9.3 (Nov 7, 2025), protocol 7.8: RSI is a prerequisite protocol; the EMS unit must be authorized by the state (FSTEMS) before its paramedics use it.

The agency needs an OEMS-approved RSI program, and the protocol requires an online medical command order.

RSI is a critical care transport special skill: it needs a bureau-approved critical care course and exam, and an agency with an approved critical care special skill.

RSI is a regional program in New York: your region's REMAC credentials agencies and paramedics (this example is the Susquehanna region's policy).

The county EMS System submits the NCCEP DAI policy, unaltered protocols, training records and peer review to state OEMS for approval.

Medication-assisted intubation is an optional paramedic module; your agency trains you and its medical director authorizes it.

Ohio's scope doesn't list RSI separately: paramedics may intubate and give protocol-approved medications, so it's your medical director's call.

The state protocol set uses medication-assisted intubation without paralytics; an agency that wants RSI submits its own protocol to OSDH for approval.

Paramedics may intubate and give any medication their supervising physician's protocols authorize, so RSI is the medical director's call.

Statewide ALS protocols give paramedics sedation-assisted intubation only; RSI appears only for prehospital RNs under approved air ambulance protocols.

A restricted protocol: you need the state (CEMS) prerequisite plus your agency medical director's sign-off.

A state protocol the service may adopt; if it does, it must be followed as written with 100% case review.

RSI is in the paramedic scope of practice; your service medical director decides whether to authorize it.

Your service medical director confirms competency in writing.

Texas has no state RSI rule: each provider's medical director writes and signs the protocols, RSI included.

RSI isn't in Utah's protocol guidelines; an agency adds it through a state variance or state-approved optional procedure, and only a handful of Utah agencies do.

Paramedics must be credentialed locally and enrolled in an approved Vermont EMS RSI program.

RSI is in the Virginia paramedic scope with an additional-training requirement; your agency's operational medical director decides whether to use it.

Your county medical program director decides; several counties use RSI and others don't.

An optional statewide protocol that needs approval from WVOEMS and your squad's medical director.

Paralytics are optional paramedic medications; the service must get them approved in its DHS operational plan.

The agency needs prior written approval of its RSI protocol from the Office of EMS.