 This gives a paramedic the ability to practice within limited scope of practice in law, along with state DOH guidelines and medical control oversight.The authority to practice in this manner is granted in the form of standing orders (protocols) (off-line medical control) and direct physician consultation via phone or radio (on-line medical control).Under this paradigm, paramedics effectively assume the role of out-of-hospital field agents to regional emergency physicians, with independent clinical decision.