Paramedical services include the administration of medications, puncturing the skin or inserting a medical device into a body orifice, activities requiring sterile procedures, or other activities requiring judgment based on training given by a licensed health care professional.

If you have a question about whether a particular task is a paramedical service, ask the questions from the statute:

• Does the task involve puncturing the skin or sticking a medical device into a body opening?

• Does the task require sterile procedures?

• Does the task require the exercise of judgment or make a decision based on training or direction from the recipeint's treament team?

Paramedical services include such things as:

• Administration of medications that go beyond what is covered under nonmedical personal care services (see below)

• Injections

• Breathing treatments, nebulizer

• Pulmonary toileting (pounding lung areas of back and chest to

  loosen secretions)

• Catheter changes or helping void urine with a catheter

• Ostomy or bricker bag irrigation or changes and cleaning and

  maintaining the stoma site

• Range of motion exercises and other home therapy programs

  prescribed by a physician

• Nasal-gastric tube or G-Tube feedings & care of stoma site

• Skin and wound care if there is a decubitus ulcer (bed or pressure

  sore) or a diabetes related wound or, if the person has a history of ecubiti, checking the body for “hot spots” that could turn into a

  decubitus ulcer

• Suctioning through a tracheotomy or through the nose and mouth

  including tracheal (deep) suctioning

• Bowel program for those with spinal cord injuries or neurological

  impairment impacting the gastro-intestinal system

• Digital stool removal

• Insertion of suppositories or administration of an enema

• Adjustment, monitoring and connecting tubing and ventilator; C-PAP or BiPAP machine adjustment, putting on mask

• Monitoring to determine need for an intervention including medications that are given on an as-needed basis rather than on a schedule.

• Cutting toenails when necessary to prevent injury to skin from the nails

This information and more can be found at www.disabilityrightsca.org.