Post-Licensure Skills (PLS) for Paramedics

Post-Licensure Skills (PLS) for Paramedics are those skills that are above and beyond the normal scope of practice for a Georgia licensed Paramedic as listed in the current Scope of Practice for EMS Personnel.

Paramedics are permitted to perform only those additional post-licensure skills listed below at an EMS agency that has been approved to utilize those post-licensure skills for paramedics, and only once the paramedic has been: trained on those skills; certified as competent; credentialed to perform those skills by the agency’s EMS Medical Director; and only while operating understanding, verbal or written orders from the agency’s EMS Medical Director, transferring physician, or medical control physician.

  1. Initiation and maintenance of Advanced Transport Ventilators (ATV) that are capable of advanced modes (i.e., capable of adjusting more than rate and tidal volume).
  2. Initiation of additional units of blood/blood products
  3. Maintenance of Intra-Aortic Balloon Pumps (IABPs)
  4. Maintenance of Transvenous Cardiac Pacing (TVP) devices
  5. Maintenance of external cardiac support devices, including percutaneous Left Ventricular Assist Devices (pLVAD), Extra Corporeal Membrane Oxygenation (ECMO) devices, etc.
  6. Administration or maintenance of High Flow Oxygen via Nasal Cannula (HFNC/HFNO). (Utilization of a powered mechanical device that may provide heated and/or humidified oxygen at a flow rate that exceeds 15 LPM and requires a specially designed nasal cannula.)   
  7. Initiation of the administration of blood/blood products in the pre-hospital environment. (Approval of this PLS Skill will also include approval of the PLS: Initiation and Maintenance of Additional units Blood/Blood Products).

Georgia licensed Paramedics are only permitted to perform any of the skills above if the following requirements are met for EACH specific skill for EACH EMS agency that the skill will be performed at.

EMS agencies will only be approved to utilize post-licensure paramedic skills if all the requirements below are met.

  • To submit for EMS agency approval:
    1. An application (created by the Authorized Agent) to the Department using the current License Management System, EMS Agency – Apply for Post Licensure Paramedic Skills(s).
      • Once this agency application is submitted, the agency Medical Director will be notified to log into LMS and sign off on the agency application.
    2. An Education request (created by the Training Officer or Authorized Agent) for each post-licensure skill that is being requested. The education request must include:
      • Protocol(s) for each treatment with minimum Department required items and signed by the Medical Director. (See guidance document for each skill below)
      • Education curriculum that includes an agenda, outline, PowerPoints, handouts, skills verification checklist, etc. (See guidance document for each skill below)

    Once an EMS agency is approved for the Post Licensure Skills for Paramedics, the agency approval is for two (2) years and will have an expiration date for the last day of the month the skill was approved.

  • After an EMS agency has been approved for a Post Licensure Paramedic skill and education, the agency must:
    1. Educate each identified Paramedic in the agency approved skill(s)
    2. Once the Paramedic has completed the approved training, roster the Paramedic in that approved education request and enter a completion date and CE: Completed.
    3. Submit an Agency – Indicate Paramedics for Additional Post-Licensure Paramedic Skills application roster of all Paramedics who have been trained, certified as competent, and credentialed by the local EMS Medical Director for each post-licensure skill (must be done prior to the paramedic being permitted to perform those skills);
    4. Once this application is submitted, the agency Medical Director will be notified to log into LMS and sign off on the application.

    **Paramedics will NOT be able to perform PLS skills until this step has been completed.

    1. Notify and obtain approval from the Department regarding any changes to:
      1. Protocols, standing orders, or training curriculum prior to use; and
      2. Replacement of Medical Director within 24 hours of change.


  • To renew EMS agency Post Licensure Skill(s) for Paramedic:
    1. EMS agencies approved for Post Licensure Skill(s) will need to submit for renewal of the skill(s) approved at least 30 business days prior to the current PLS expiration date.
    2. Submit an application to the Department using the current License Management System, EMS Agency – Apply for Post Licensure Paramedic Skills(s).
      1. Once this agency application is submitted, the agency Medical Director will be notified to log into LMS and sign off on the agency application.
    3. Submit an Education Request annually for each PLS skill being requested/approved. If an EMS agency will have a different annual competency/education for currently credentialed Paramedics from newly educated Paramedics, the EMS agency will need to submit two education requests for each skill. If two (2) education requests are submitted for each skill:
      1. Initial PLS education request requirements are the same as above.
      2. Annual competency/continued education requests must include at a minimum hands-on skills verification.

Relevant Guidance Resource Documents


Page last updated 12/16/2022