Approved and Required Medications Lists

Table 1. Medications that may be administered by EMS providers when functioning on behalf of an EMS agency based upon the type of EMS service an EMS agency is licensed to provide.
Medication QRS (including providers at or above the level of EMR) BLS (including providers at or above the level of EMT) IALS (including providers at or above the level of AEMT) ALS (including providers above the level of AEMT) CCT (including providers above the level of AEMT with additional approved training) Air (including providers above the level of AEMT with additional approved training)
Abciximab NO NO NO YES5 YES5 or 6 YES5 or 6
Acetaminophen NO YES YES YES YES YES
Acetylcysteine NO NO NO YES5 YES5 YES5
Activated charcoal NO YES YES YES YES YES
Adenosine NO NO NO YES YES YES
Albumin NO NO NO NO YES5,6 YES5,6
Albuterol (nebulizer solution) NO YES YES YES YES YES
Albuterol with ipratropium bromide (nebulizer solution) NO YES YES YES YES YES
Amiodarone NO NO NO YES YES YES
Anti-coagulants/Platelet Inhibitors: all types (unless otherwise specifically listed) NO NO NO NO YES5,6 YES5,6
Anticonvulsants: all types (unless otherwise specifically listed) NO NO NO NO YES6 YES6
Anti-emetics: all types (not otherwise specifically listed) NO NO NO NO YES5,6 YES5,6
Anti-hypertensives: all types (unless otherwise specifically listed) NO NO NO NO YES6 YES6
Antimicrobials: all types NO NO NO YES YES YES
Antivenom: all types NO NO NO NO YES5,6 YES5,6
Aspirin, oral NO YES YES YES YES YES
Atenolol NO NO NO NO YES5,6 YES5,6
Atropine sulfate NO NO NO YES YES YES
Barbiturates: all types NO NO NO NO YES6 YES6
Benzocaine, topical NO NO NO YES YES YES
Bivalirudin NO NO NO YES5 YES6 YES6
Blood products: all types NO NO NO NO YES5 YES6
Bronchodilators, short-acting medications listed in Statewide BLS protocol and contained in multidose inhaler (MDI), assist with patient's own prescribed medication NO YES YES YES YES YES
Calcium chloride/calcium gluconate NO NO NO YES YES YES
Captopril NO NO NO YES YES YES
Clopidogrel NO NO NO NO YES6 YES6
Crystalloid hypertonic solutions NO NO NO NO YES6 YES6
Crystalloid isotonic solutions, including but not limited to: Isolyte, Lactated Ringers, Normosol, saline (NaCl) (unless otherwise specifically listed). Note—Normal Saline Solution and Dextrose listed separately NO NO NO YES YES YES
Crystalloid solution containing potassium, interfacility transport only, potassium concentration may not exceed 20 mEq/kg unless managed by qualified CCT or Air Medical provider NO NO NO YES5 YES5 YES5
Dexamethasone sodium phosphate NO NO NO YES YES YES
Dextran NO NO NO NO YES5,6 YES5,6
Dextrose (for intravenous bolus in concentrations between 5—50%) NO NO YES YES YES YES
Diazepam NO NO NO YES YES YES
Digoxin NO NO NO NO YES6 YES6
Diltiazem NO NO NO YES YES YES
DiphenhydrAMINE HCl NO NO YES YES YES YES
DOBUTamine NO NO NO YES YES YES
DOPamine NO NO NO YES YES YES
Droperidol NO NO NO YES YES YES
EMLA cream NO NO NO YES YES YES
Enalapril NO NO NO YES YES YES
EPINEPHrine HCl 1 mg/mL (unless otherwise specifically listed) NO NO YES3 YES YES YES
EPINEPHrine HCl 0.1 mg/mL solution and diluted concentrations for intravenous infusion NO NO NO YES YES YES
EPINEPHrine HCl 0.1 mg/mL for cardiac arrest NO NO YES N/A N/A N/A
EPINEPHrine HCl autoinjector, assist with patient's own prescribed medication NO YES YES YES YES YES
EPINEPHrine HCl autoinjector (adult and pediatric dose sizes), (unless otherwise specifically listed) NO NO YES YES YES YES
EPINEPHrine HCl autoinjector (adult and pediatric dose sizes), applies only to EMTs in BLS services approved for EMT EPINEPHrine program NO YES N/A N/A N/A N/A
EPINEPHrine HCl, including racemic (by nebulizer) NO NO YES YES YES YES
Eptifibatide NO NO NO YES5 YES5 or 6 YES5 or 6
Esmolol NO NO NO NO YES6 YES6
Etomidate NO NO NO YES4 YES4 YES4
FentanNYL NO NO NO YES YES YES
Fibrinolytics/thrombolytics: all types NO NO NO NO YES6 YES6
Furosemide NO NO NO YES YES YES
Flumazenil NO NO NO NO YES5 YES5
Glucagon NO NO YES YES YES YES
Glucagon intranasal (nasal powder spray) or intramuscular autoinjector. Note—EMTs must complete additional required education NO YES1 YES YES YES YES
Glucocorticoids/mineralcorticoids (unless otherwise specifically listed) NO NO NO NO YES5,6 YES5,6
Glucose, oral NO YES YES YES YES YES
Heparin (unless otherwise specifically listed) NO NO NO NO YES6 YES6
Heparin (by continuous intravenous infusion) NO NO NO YES5 YES5 or 6 YES5 or 6
Hespan NO NO NO NO YES4,5 YES4,5
Hydralazine NO NO NO NO YES5,6 YES5,6
Hydrocortisone sodium succinate NO NO NO YES YES YES
HYRDROmorphone NO NO NO YES5 YES5 or 6 YES5 or 6
Hydroxocobalamin NO NO NO YES YES YES
Ibuprofen NO YES YES YES YES YES
Immunizations NO NO NO YES10 YES10 YES10
Insulin NO NO NO NO YES6 YES6
Isoproterenol HCl NO NO NO YES5 YES5 YES5
Ketamine NO NO NO YES4 YES4,5,6 YES4,5,6
Ketorolac NO NO YES YES YES YES
Labetolol NO NO NO NO YES5,6 YES5,6
Levalbuterol NO NO NO YES5 YES5 YES5
Levetiracetam NO NO NO YES5 YES5 YES5
Lidocaine HCl NO NO NO YES YES YES
LORazepam NO NO NO YES YES YES
Magnesium sulfate NO NO NO YES YES YES
Mannitol NO NO NO NO YES6 YES5
Metaproterenol NO NO NO NO YES5,6 YES5,6
MethylPREDNISolone NO NO NO YES YES YES
Metoprolol NO NO NO NO YES5,6 YES5,6
Midazolam NO NO NO YES YES YES
Milrinone NO NO NO YES5 YES5,6 YES5,6
Morphine sulfate NO NO NO YES YES YES
Naloxone (unless otherwise specifically listed). Note—autoinjector listed separately NO NO YES YES YES YES
Naloxone, intranasal or intramuscular autoinjector. Note—EMRs and EMTs must complete additional required education with QRS or BLS service participating in naloxone program YES1 YES1 YES YES YES YES
Nerve agent antidote kit, autoinjector only (may include atropine, pralidoxime, and diazepam) NO YES7,8 YES7,8 YES YES YES
Non-depolarizing neuromuscular blocking agents: all types, intravenous bolus during rapid sequence induction, assisting PHRN, PHPE or PHP NO NO NO NO YES6 YES6
Non-depolarizing neuromuscular blocking agents: all types, intravenous infusion during interfacility transport NO NO NO NO YES5 YES5
Nitroglycerin, intravenous and topical NO NO NO YES YES YES
Nitroglycerin, sublingual (unless otherwise specifically listed) NO NO YES YES YES YES
Nitroglycerin, sublingual, assist with patient's own prescribed medication NO YES YES YES YES YES
Nitrous oxide NO NO YES YES YES YES
Norepinephrine NO NO NO YES5 YES5 YES5
Normal Saline Solution (0.9% NaCl solution for intravenous volume infusion) NO NO YES YES YES YES
Ondansetron NO NO YES YES YES YES
Oxygen, delivered by devices within the published scope of practice for the EMS provider YES YES YES YES YES YES
Oxytocin NO NO NO YES YES YES
Pantoprazole NO NO NO YES5 YES5,6 YES5,6
Phenylephrine NO NO NO YES5 YES5 YES5
Potassium Cl (in concentrations above 20 mEq/L) NO NO NO NO YES5,6 YES5,6
Plasmanate NO NO NO NO YES5,6 YES5,6
Pralidoxime NO NO NO YES YES YES
Procainamide NO NO NO YES YES YES
Propofol NO NO NO NO YES5,6 YES5,6
Propranolol NO NO NO NO YES5,6 YES5,6
Prostaglandins: all types NO NO NO NO YES6 YES6
Quinidine sulfate/quinidine gluconate NO NO NO NO YES6 YES6
Sodium bicarbonate NO NO NO YES YES YES
Sodium thiosulfate NO NO NO YES YES YES
Sterile water, for injection NO NO NO YES YES YES
Succinylcholine NO NO NO NO YES6 YES6
Terbutaline NO NO NO YES YES YES
Tetracaine, topical NO NO YES YES YES YES
Theophylline NO NO NO NO YES5,6 YES5,6
Tirofiban NO NO NO YES4 YES5 or 6 YES5 or 6
Tocolytics: all types (unless otherwise specifically listed) NO NO NO NO YES6 YES6
Total Parenteral Nutrition NO NO NO YES5 YES5 YES5
Tranexamic Acid NO NO NO YES YES YES
Verapamil NO NO NO YES YES YES
Medications not listed previously, but within Department-approved air ambulance service protocol for use by PHRN, PHPE and PHP. NO NO NO NO NO YES6
Table 2. Medications required to be carried by a specified EMS vehicle based upon the type of EMS service an EMS agency is licensed to provide. (R=Required)
Medication QRS BLS IALS ALS CCT AIR
Adenosine       R R R
Aspirin, oral   R R R R R
Atropine sulfate       R R R
Benzodiazepines (diazepam, lorazepam or midazolam) At least one type must be carried.       R11,13 R11,13 R11,13
Bronchodilators (nebulizer solution), (albuterol or albuterol with ipratropium bromide) At least one type must be carried.     R9 R9 R9 R9
Dextrose (for intravenous bolus in concentration between 10%—50%)     R R R R
DiphenhydrAMINE HCl       R R R
EPINEPHrine HCl, 1mg/mL concentration (IALS may meet requirement with EPINEPHrine as autoinjector—both adult and pediatric dose sizes—or as solution in vial/ampoule; ALS, CCT and Air must carry 1mg/mL in vial or ampoule)     R R R R
EPINEPHrine HCl, 0.1mg/mL concentration       R R R
EPINEPHrine, autoinjector (adult and pediatric dose sizes)—applies only to BLS services approved for EMT EPINEPHrine program   R4        
Etomidate—applies only to ALS services approved by regional etomidate program       R4 R4 R4
Glucagon         R R
Glucose, oral   R R R R R
Lidocaine HCl       R R R
Naloxone (restrictions on forms for QRS/BLS services listed separately)     R R R R
Naloxone, intranasal kit or intramuscular autoinjector—applies only to QRS/BLS services that meet training requirements. R4 R4        
Narcotic analgesics (fentaNYL or morphine sulfate) At least one type must be carried.       R12,13 R12,13 R12,13
Nitroglycerin, sublingual     R R R R
Normal Saline Solution (0.9% NaCl solution for intravenous volume infusion)     R R R R
Oxygen   R R R R R
Sodium bicarbonate       R R R
Medication within Department-approved air ambulance service protocol for use by PHRN, PHPE or PHP on crew           R

QRS—Quick Response Service; BLS—Basic Life Support ambulance service; IALS—Intermediate Advanced Life Support ambulance service; ALS—Advanced Life Support ambulance service; CCT—Critical Care Transport ambulance service; Air—Air ambulance service.

  1. EMRs and EMTs are restricted to administering this medication by intranasal and intramuscular autoinjector routes only, consistent with Statewide BLS protocols.
  2. EMTs are restricted to administering this medication by intranasal and intramuscular autoinjector routes only, consistent with Statewide BLS protocols.
  3. AEMTs are restricted to administering this medication by intramuscular route only, consistent with Statewide AEMT protocols. AEMTs may not administer this medication by intravenous or intraosseous route.
  4. Permitted for services that meet Department requirements for training, medication stocking and any agency or quality improvement requirements, as verified by the agency's assigned regional EMS council.
  5. During interfacility transport, Ps who are authorized to function for an EMS agency that has been licensed as an ALS, CCT or air ambulance service are restricted to the maintenance and monitoring of medication administration that is initiated at the sending medical facility.
  6. If carried on a CCT ambulance, this medication must be secured so that it is only accessible when a PHRN, PHPE or PHP is part of the crew. Ps who are authorized to function for an EMS agency that has been licensed as a CCT or air ambulance service may only administer this medication when in the direct physical presence of, and supervised by, a PHRN, PHPE or PHP.
  7. May administer to a patient when assisting an EMS provider above the level of AEMT who has determined the dose for the patient consistent with Statewide ALS protocols.
  8. For self or peer rescue only.
  9. One listed type of bronchodilator medication must be carried on each licensed vehicle.
  10. Appropriate for community or peer programs under the oversight of the EMS Agency Medical Director, but not for responses to 9-1-1 calls.
  11. One benzodiazepine class medication must be carried on each licensed vehicle.
  12. One opioid class medication must be carried on each licensed vehicle.
  13. For additional information relating to security and medication tracking requirements for controlled substances, see 28 Pa. Code § 1027.5.