Special Roles for Emergency Medical Services Professionals

Originally approved February 2018, replacing the following rescinded policy statements:

  • Domestic Violence: The Role of EMS Personnel (1995-2018)
  • EMS as an Essential Public Safety Service (2003/2018)
  • Expanded Roles of EMS Personnel (1997-2018)


The American College of Emergency Physicians (ACEP) believes that Emergency Medical Services (EMS) professionals may fulfill multiple roles in the continuum of a patient’s acute medical care, and supports the following principles:

  • Patient Welfare Screening: In the course of patient assessment and care, EMS professionals may observe situational dynamics that lead prudent healthcare providers to have concern regarding a patient’s exposure or involvement in domestic violence, human trafficking, animal attacks, acts of terrorism or other factors imperiling their mental and/or physical health. EMS professionals must exercise due patient advocacy and fulfill any locally applicable legal reporting requirements to subsequently treating healthcare professionals, law enforcement, protective services, and/or otherwise identified agencies in efforts to protect the wellbeing of the patient and the overall public. Specific education and training to best prepare and protect EMS professionals in this role must be included in initial and continuing EMS curriculums.
  • Operational Specific Scope(s) of Practice: Increasing healthcare system demands may create “gap” needs, opportunities that specially trained EMS professionals may fulfill. Evidence must include a formal needs assessment and be clear and compelling that significant patient benefit will result from the selected scope(s) of practice roles for EMS professionals. Appropriate physician-led medical oversight is essential to the safety and success of operational specific scope(s) of practice programs. Operational specific scope(s) of practice programs must conform to all applicable federal, state, and local regulations and laws.  Appropriate initial and continuing education and continuous quality improvement must be included for EMS professionals expected to fulfill duties in an any scope of practice.  Operational specific scope(s) of practice programs conducted or coordinated by EMS systems must ensure the continuing capabilities of the EMS system and that all patients retain access to emergency care utilizing the prudent layperson standard.
  • “Essential to Public Health & Safety”: While recognized as a formal subspecialty practice of medicine by the American Board of Medical Specialties, EMS additionally represents an essential component to a community’s overall wellbeing in serving the health and medical safety of its citizens. EMS professionals represent indispensable members of a locale’s emergency response system and in aggregate, represent an essential aspect of both national health and human services and national homeland security capabilities. EMS is on par with law enforcement and fire suppression services in importance of critical services within a community. All such critical services should be significantly and adequately funded and included in community resiliency planning and operations.

About this Policy

This policy statement replaces the following policies:

  • “Domestic Violence: The Role of EMS Personnel”
  • “Expanded Roles of EMS Personnel”
  • “EMS as an Essential Public Safety Service”
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