as nitroglycerin and aspirin are used to treat cardiac ailments such as angina and myocardial infarctions Diuretic medications such as furosemide to treat congestive heart failure and severe hypertension Antiarrhythmics such as amiodarone, adenosine, lidocaine and magnesium sulfate used to treat abnormal heart rhythms such as ventricular tachycardia and ventricular fibrillation Antiemetics such as promethazine or ondansetron used for nausea and vomiting Antidotes for a variety of toxins such as naloxone (opioids), pralidoxime (organophosphates), sodium bicarbonate (tricyclic antidepressants), and hydroxocobalamin (cyanide). Blood products and tranexamic acid in cases of hemorrhagic shock Broad spectrum antibiotics such as ceftriaxone or vancomycin for cases of sepsis Hormones like oxytocin to control post-partum bleeding Skills by certification level As described above, many jurisdictions have different levels of paramedic training, leading to variations in what procedures different paramedics may perform depending upon their qualifications. Three common general divisions of paramedic training are the basic technician, general paramedic or advanced technician, and advanced paramedic. Common skills that these three certification levels may practice are summarized in the table below. The skills for the higher levels automatically also assume those listed for lower levels. Medicolegal authority The medicolegal framework for paramedics is highly dependent on the overall structure of emergency medical services in the territory where they are working. In many localities, paramedics operate as a direct extension of a physician medical director and practice as an extension of the medical director's license. In the United States, a physician delegates authority under an individual state's Medical Practice Act. 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. In places where paramedics are recognised health care professionals registered with an appropriate body, they can conduct all procedures authorised for their profession, including the administration of prescription medication, and are personally answerable to a regulator. For example, in the United Kingdom, the Health and Care Professions Council regulates paramedics and can censure or strike a paramedic from the register. In some cases paramedics may gain further qualifications to extend their status to that of