[29 Pa.B. 903]
[Continued from previous Web Page]
Subchapter D. QUALITY [ASSURANCE] IMPROVEMENT PROGRAM § 1001.61. Components.
(a) The Department, in conjunction with the Council, will identify the necessary components for a Statewide EMS quality [assurance] improvement program for the Commonwealth's EMS system. The Statewide EMS quality improvement program shall be operated to monitor the delivery of EMS through the collection of data pertaining to emergency medical care provided by prehospital personnel and providers of EMS.
(b) The Department will develop, approve and update a Statewide EMS Quality Improvement Plan in which it will establish goals and reporting thresholds.
§ 1001.62. Regional programs.
A regional EMS council, after considering input from participants in and persons served by the regional EMS system, shall develop and implement a regional EMS quality [assurance] improvement program to monitor the delivery of EMS, which addresses, at a minimum, the quality [assurance] improvement components identified by the Department. A regional EMS council quality improvement program shall:
(1) Conduct quality improvement audits on the regional EMS system including reviewing the quality improvement activities conducted by the ALS service medical directors and medical command facilities within the region.
(2) Have a regional quality improvement committee that shall recommend to the regional EMS council ways to improve the delivery of prehospital EMS care within the region based upon State and regional goals and reporting requirements.
(3) Develop and implement a regional EMS quality improvement plan to assess the EMS system in the region.
(4) Investigate complaints concerning the quality of care rendered and forward recommendations and findings to the Department.
(5) Submit to the Department reports as prescribed by the Department.
§ 1001.63. [Medical command facilities] (Reserved).
[A medical command facility accredited by the Department shall actively participate in quality assurance programs approved by the Department.]
§ 1001.64. [Ambulance services] (Reserved).
[An ambulance service licensed to operate in this Commonwealth shall actively participate in quality assurance programs approved by the Department. The quality assurance programs shall incorporate prehospital data summary information required by the Department.]
§ 1001.65. Cooperation.
Each individual and entity licensed, certified, recognized, accredited or otherwise authorized by the Department to participate in the Statewide EMS system shall cooperate in the Statewide and regional EMS quality improvement programs, by providing data, reports and access to records as requested by the Department and regional EMS councils to monitor the delivery of EMS.
Subchapter E. TRAUMA CENTERS § 1001.81. Purpose.
The [Department has the duty] purpose of this subchapter is to integrate trauma centers into the Statewide EMS system, by providing access to trauma centers and by providing for the effective and appropriate utilization of resources.
§ 1001.82. Requirements.
To ensure that trauma centers are integrated into the Statewide EMS system, [accredited] trauma centers in this Commonwealth shall:
* * * * * (4) Maintain communications capabilities to allow for direct access by a transferring ground ambulance or [helicopter] air ambulance to insure that patient information and condition updates are available and medical consultation is available to the transferring service. The capabilities shall be in accordance with regional and Statewide EMS telecommunications plans.
Subchapter F. REQUIREMENTS FOR REGIONAL EMS COUNCILS AND THE COUNCIL § 1001.101. Governing body.
A regional EMS council and the Council shall have a governing body[, whether a unit of local government or a public or private nonprofit entity. Responsibility for the contract will rest in the governing body].
* * * * * § 1001.102. [Council director] (Reserved).
[The director shall:
(1) Prepare and annually update written policies and procedures.
(2) Assist the governing body in formulating policy and present the following to the governing body at least annually:
(i) Project goals and objectives which include time frames and available resources.
(ii) Written reports of project operations.
(iii) A performance report summarizing the progress towards meeting goals and objectives.]
§ 1001.103. [Personnel] (Reserved).
[The governing body shall:
(1) Adopt and implement written project personnel policies and procedures which include, but are not limited to:
(i) Recruitment, selection, promotion and termination of staff.
(ii) Utilization of volunteers.
(iii) Wage and salary administration.
(iv) Employe benefits.
(v) Working hours.
(vi) Vacation and sick leave.
(vii) Rules of conduct.
(viii) Disciplinary actions.
(ix) Supervision of staff.
(x) Work performance evaluations.
(xi) Employe accidents and safety.
(xii) Employe grievances.
(2) Adopt a written policy to implement and coordinate personnel management, which includes, but is not limited to, confidential maintenance of personnel records.
(3) Develop written policies and procedures to provide for ongoing staff development. Documentation includes, but is not limited to, an assessment of staff training needs and plans for addressing these needs.
(4) Maintain records on an employe which include, but are not limited to:
(i) An application for employment.
(ii) The results of reference investigations.
(iii) Verification of training experience and professional licensure or registration, if applicable.
(iv) Salary information.
(v) A work performance evaluation.
(vi) Disciplinary actions.
(5) Develop written policies on employe rights, and document efforts by the project to inform staff of the following:
(i) The employee's right to inspect his own records.
(ii) The employe's right to request the correction or removal of inaccurate, irrelevant, outdated or incomplete information from the records.
(iii) The employe's right to submit rebuttal data or memoranda to his own records.
(6) Develop written job descriptions or project positions which include but are not limited to:
(i) A job title.
(ii) Tasks and responsibilities of the job.
(iii) Prerequisite skills, knowledge and experience.]
Subchapter G. ADDITIONAL REQUIREMENTS FOR REGIONAL EMS COUNCILS § 1001.121. Designation of regional EMS councils.
(a) The Department will designate [an] a regional EMS council that satisfies the representation requirements in § 1001.125 (relating to requirements) for each geographic area of this Commonwealth.
* * * * * (c) The Department will evaluate the performance and effectiveness of each regional EMS council on a periodic basis to assure that each council is appropriately meeting the needs of its region in planning, developing, maintaining, expanding, improving and upgrading the [emergency medical services] EMS system in its region.
§ 1001.123. Responsibilities.
[The] In addition to other responsibilities imposed upon regional EMS councils by this part, regional EMS councils have responsibility for the following:
(1) Organizing, maintaining, implementing, expanding and improving the EMS system within the [identified] geographic area [of] for which the regional EMS council has assigned responsibilities.
(2) Developing and implementing comprehensive EMS plans, as approved by the Department. [The plans are subject to approval by the Department and shall include the designation of primary response areas.]
(3) Advising PSAPs, and municipal and county governments, as to EMS resources available for dispatching and recommended dispatching criteria that may be developed by the Department, or by the regional EMS council as approved by the Department.
[(3)] (4) Developing, maintaining, implementing, expanding and improving programs of medical [control and accountability] coordination. The programs are subject to approval by the Department.
[(4)] (5) ***
[(5)] (6) ***
[(6)] (7) ***
[(7)] (8) Providing [licensed] ambulance services with data summary reports.
[(8) Preparing plans for implementing, expanding, improving and maintaining EMS systems in the area. The plan shall contain information as prescribed by the Secretary.
(9) Carrying out, to the extent feasible, the EMS system plans.
(10)] (9) Assuring the reasonable availability of training programs, including continuing education programs, for EMS personnel. The programs shall include those that lead to certification or recognition by the Department. Regional EMS councils may also develop and implement additional educational programs.
[(11)] (10) Monitoring medical command facilities and [medical control and accountability of] prehospital [emergency] personnel [for] compliance with minimum standards established by the Department, and ambulance service medical director and medical command physician medical control of prehospital personnel.
[(12) Developing processes and procedures for] (11) Facilitating the integration of medical command facilities into the regional EMS system in accordance with policies and guidelines established by the Department.
[(13) Determining system needs and recommending the allocation of resources based upon this need assessment. Guidelines for needs assessment will be provided by the Department and shall be consistent with the State EMS plan.
(14) Establishing and implementing criteria for the evaluation or referral of acutely ill and injured persons for transport to the most appropriate facilities in accordance with policies, guidelines and criteria established by the Department. The criteria shall address the treatment and transfer of trauma, cardiac, spinal cord, poison, burns, neonatal and behavioral patients. Facilities in the region may participate on a voluntary basis in the categorization process established by the Department.
(15)] (12) Developing and implementing regional protocols for the triage, treatment, transport and transfer of patients to the most appropriate facility. Protocols shall be developed [by the] in consultation with the regional EMS council's medical advisory [and facilities committees] committee and approved by the [Secretary or a designee] Department. Protocols shall, at a minimum:
(i) Include a method of identifying patients requiring specialized medical care, utilizing measurable criteria to identify patient referral[, including, but not limited to, the seven critical care groups identified in paragraph (14). The Department will provide guidelines for recommended protocols].
(ii) Be based upon the specialty care capabilities of the receiving facilities and available [prehospital] providers of EMS [providers,] prehospital personnel, local geodemographic considerations and transport time considerations.
* * * * * (iv) Be reviewed annually, and revised as necessary in consultation with the regional EMS council's [regional] medical advisory committee.
(v) Be consistent with Chapter 1003 (relating to personnel) which governs the scope of practice of [emergency medical technicians, paramedics,] EMTs, EMT-paramedics and other prehospital [EMS] personnel.
* * * * * (vii) [Prohibit patient transfer unless it is for medical necessity or upon request of the patient.] Address patient choice regarding receiving facility.
[(viii) Require written transfer agreements between appropriate facilities.
(ix)] (viii) Set forth a procedure for the efficient transfer of patients. When appropriate, these regional protocols shall be developed in consultation with specialty care facilities in the region. [The transfer protocols shall contain the following requirements:
(A) The process of transferring patients from one facility to another shall be carried out as expeditiously as possible.
(B) The receiving facility shall have at least one staff person available 24 hours a day, 7 days a week, who, without consultation from other personnel, has the authority to approve or disapprove transfers.
(C) If the facility is designated as a critical care specialty receiving hospital and that hospital disapproves a transfer from another facility, that hospital shall participate in a backup network which will identify another available receiving facility.
(D) Providers involved in a transfer shall insure that necessary patient information and records will accompany the patient. Prehospital and interhospital personnel shall be advised of patient care needs during the transfer. Hospital personnel accompanying the patient shall be familiar with the ambulance and hospital equipment accompanying the patient, and capable of operating the equipment for appropriate administration of care to the patient.
(16) Developing a program to assess the quality of EMS system in its region and investigating complaints concerning the quality of care rendered and forwarding recommendations and findings to the Department in regard to each complaint investigated. Complaint investigations shall be conducted in accordance with administrative rules and procedures and written documentation of facts and findings shall be provided the Department. Quality assurance programs implemented by regional EMS councils shall be consistent with guidelines prescribed by the Department.
(17) Developing a review process for investigating complaints received by either the council or the Department concerning care rendered by prehospital personnel or providers.
(18)] (13) Assisting Federal, State or local agencies, upon request, in the provision of onsite mitigation, technical assistance, situation assessment, coordination of functions or postincident evaluations, in the event of a potential or actual disaster, mass casualty situation or other substantial threat to public health.
[(19)] (14) Maintaining an [EMS resource] inventory of EMS resources and personnel available on a volunteer basis as conditions and circumstances require. Recruitment of volunteer expertise available shall be requested when needed.
[(20)] (15) Designating a regional medical director [subject to approval by the Department.
(21)] (16) ***
(17) Assisting prehospital personnel and ambulance services operating in the regional EMS system to meet the licensure, certification, recertification, recognition, biennial registration and continuing education requirements established under the act and this part, and assisting the Department in ensuring that those requirements are met.
(18) Apprising medical command facilities and ALS ambulance services in the region when an EMT-paramedic or prehospital registered nurse has had medical command authorization removed by an ALS ambulance service in the region.
(19) Developing a conflict of interest policy and requiring all employes and officials to agree to the policy in writing.
[(22)] (20) ***
§ 1001.124. Composition.
Regional EMS councils shall be organized by one of the following:
* * * * * § 1001.125. Requirements.
(a) If the regional EMS council is a unit of local government, it shall have an advisory council which is [broadly representative of EMS providers, public safety agencies, health care facilities, consumers and elected public officials] deemed by the Department to be representative of health care consumers, the health professions, and major private and public and voluntary agencies, organizations and institutions concerned with providing EMS.
(b) If the regional EMS council is a public or private nonprofit organization, its governing body shall [be representative of the following:
(1) EMS providers.
(2) Public safety agencies.
(3) Health care facilities.
(4) Consumers.
(5) Elected public officials] satisfy the representation requirements in subsection (a).
* * * * * (d) The regional[/State] medical advisory committee shall assist the regional EMS council's medical director in matters of medical [control and a majority of its members shall be physicians] coordination.
* * * * *
Subchapter H. ADDITIONAL REQUIREMENTS FOR THE COUNCIL § 1001.141. Duties and purpose.
The Council shall advise the Department on emergency health services issues that relate to manpower and training, communications, ambulance services, special care units, the content of ambulance call reports, the content of rules and regulations, standards and policies promulgated by the Department and other subjects as required by the act or deemed appropriate by the Department or the Council. The Council shall also advise the Department on the content of the Statewide EMS development plan, and proposed revisions to it.
Subchapter I. RESEARCH IN PREHOSPITAL CARE § 1001.161. Research.
(a) [Proposals for clinical] Clinical investigations or studies that relate to direct patient care [shall be] may not be conducted by providers of EMS unless the investigation or study is proposed to and approved by the Department. [An investigation or study may not be undertaken unless approved.]
(b) A proposal for clinical investigation or study shall be presented to the [regional medical director, the medical advisory committee of the regional EMS council, the medical advisory committee of the Council and the Commonwealth Emergency Medical Director for review and comment. Recommendations shall be forwarded to the Department within 60 days from the date the proposal is submitted] Department. If the Department concludes that the proposal may have merit, it will refer the proposal to the Council, and to the regional EMS council having responsibilities in the region where the investigation or study would be undertaken. The Council and the regional EMS council shall have the proposal reviewed by their medical advisory committees and consider the comments of those committees, and shall forward their recommendations to the Department within 60 days after receiving the proposal from the Department.
(c) The Department will approve or disapprove the proposal within 30 days after receiving the recommendations of the Council and the regional EMS council. If the proposal is approved, the [EMS] prehospital personnel identified in the proposal may function in accordance with the proposal and under conditions specified by the Department during the term of the clinical investigation or study.
(d) A proposal shall include and address the following considerations and items in a format specified by the Department:
* * * * * (7) [A letter approving the investigation from the appropriate regional EMS council.] Institutional review board approval when required by law.
* * * * * (10) A plan for providing the Department with progress reports and a final report on the investigation or study.
(e) The Department may direct that the investigation or study be terminated prematurely for its failure to satisfy conditions of approval.
CHAPTER 1003. PERSONNEL
Subchapter A. ADMINISTRATIVE AND SUPERVISORY EMS PERSONNEL § 1003.1. Commonwealth Emergency Medical Director.
(a) Roles and responsibilities. The Commonwealth Emergency Medical Director is responsible for the following:
* * * * * (2) Assisting in the development and implementation of a Statewide EMS quality [assurance] improvement program.
* * * * * (5) Reviewing and evaluating regional transfer and medical treatment protocols and making recommendations for the Statewide [medical protocals] BLS medical treatment protocols and Statewide criteria for the evaluation, triage, treatment, transport, transfer and referral, including bypass protocols of acutely ill and injured persons to the most appropriate facility.
(6) Evaluating regional EMS quality [assurance] improvement programs.
(7) Providing direction and guidance to the regional EMS medical directors for training and quality [assurance activities] improvement monitoring and assistance.
(8) Meeting with [directors] representatives and committees of regional EMS councils and the Council as necessary and as directed by the Department to provide guidance and direction.
* * * * * (b) Equivalent qualifications. If the Commonwealth Emergency Medical Director is not a medical command physician, the Commonwealth Emergency Medical Director shall possess the following qualifications:
* * * * * (3) Knowledge regarding the base station [radio] direction of prehospital personnel and the operation of emergency dispatch.
* * * * * (c) Disclosure. The Commonwealth Emergency Medical Director shall disclose to the Department all financial or other interest in providers of EMS and in other matters which present a potential conflict of interest.
§ 1003.2. Regional EMS medical director.
(a) Roles and responsibilities. Each regional EMS council shall have a regional EMS medical director who shall carry out the following duties:
(1) [Approve] Assist the regional EMS council to approve or reject applications for medical command physicians received from medical command facility medical directors.
* * * * * (3) [Establish and review system-wide medical protocols in] Assist the regional EMS council, after consultation with the regional medical advisory committee [and regional EMS council], to establish and revise transfer and medical treatment protocols for the regional EMS system.
[(4) Assist the Department in ensuring that personnel in the EMS system meet the certification, recertification, recognition, biennial registration and continuing education requirements established under the act.
(5) Establish standards for EMS dispatch to assure that the an appropriate response unit is dispatched to the medical emergency scene and that proper patient evaluation is conducted.
(6)] (4) [Establish] Assist the regional EMS council to establish field treatment protocols for determining when a patient will not be transported to a treatment facility and establish procedures for documenting the reasons for a nontransport decision.
[(7)] (5) [Establish] Assist the regional EMS council to establish field protocols to govern situations in which a patient may be transported without consent, in accordance with Pennsylvania law. The protocols shall cover appropriate documentation and review procedures.
[(8)] (6) [Establish] Assist the regional EMS council to establish criteria for level of care and type of transportation to be provided in various medical emergencies, such as ALS versus BLS, and ground versus air [specialty unit transportation] ambulance, and distribute approved criteria to PSAPs.
[(9) Establish operation standards for medical command facilities.
(10)] (7) Conduct quality [assurance] improvement audits of the regional EMS system including reviewing the quality [assurance] improvement activities conducted by the ALS service medical directors within the region.
[(11)] (8) Serve on the State EMS Quality [Assurance] Improvement Committee.
[(12)] (9) ***
[(13)] (10) Facilitate [and assure] continuity of patient care during inter-regional transport.
[(14)] (11) Recommend to the Department suspension [or], revocation or restriction of prehospital personnel certifications and recognitions.
[(15)] (12) ***
[(16)] (13) ***
[(17) Delegate portions of his authority to other qualified physicians.
(18) Meet with the ALS service medical directors within the region as necessary to disseminate information regarding State statutes, regulations, policies and direction.]
(b) Minimum qualifications.
(1) A regional EMS council medical director shall have the following qualifications:
(i) [A valid license to practice medicine in this Commonwealth as a doctor of medicine or doctor of osteopathy] Licensure as a physician.
* * * * * (iii) Experience in base station [radio] direction of prehospital emergency units.
* * * * * (2) The [Secretary] Department may waive the board certification requirement upon written request by the regional EMS council.
(c) [Medical advisory committee. Each regional EMS council shall have a medical advisory committee to provide the council medical director with advice on issues relevant to the areawide EMS system.] Disclosure. A regional EMS medical director shall disclose to a regional EMS council all financial or other interest in providers of EMS and in other matters which present a potential conflict of interest.
§ 1003.3. Medical command facility medical director.
(a) Roles and responsibilities. A medical command facility shall have a medical command facility medical director. A medical command facility medical director is responsible for the following:
* * * * * (2) Quality [assurance] improvement.
* * * * * (5) Clinical and continuing education training of prehospital [emergency care] personnel.
(6) Recommendations to the regional EMS medical director regarding medical command physician applications from [his institution] the medical command facility.
(b) Minimum qualifications.
(1) A medical command facility medical director shall have the following qualifications:
* * * * * (ii) Board certification in emergency medicine or, [in lieu of this, current ACLS and ATLS certification] have successfully completed the ACLS course within the preceding 2 years and the ATLS course, and either an APLS or PALS course, or other programs determined by the Department to meet or exceed the standards of those programs, along with board certification in surgery, internal medicine, family medicine, pediatrics or anesthesiology.
* * * * * (iv) Experience in base station [radio] direction of prehospital emergency units.
(v) Experience in the training of [basic] BLS and [advanced prehospital emergency health] ALS prehospital personnel.
* * * * * (2) The [Secretary] Department may waive the board certification requirement upon written request by the regional EMS council.
§ 1003.4. Medical command physician.
(a) Roles and responsibilities. A medical command physician shall [carry out the following duties:
(1) Provide] provide medical command to prehospital [emergency health] personnel.
[(2) Assist with the duties of medical control] This includes providing online medical command to prehospital personnel whenever they seek direction.
(b) Minimum qualifications. A medical command physician shall:
(1) [Hold a valid license to practice in this Commonwealth as a Doctor of Medicine or Doctor of Osteopathy] Be a physician.
(2) Be board certified in emergency medicine or[, in lieu of this, be certified in ATLS and] have successfully completed the ACLS course within the preceding 2 years and the ATLS course, and either an APLS or PALS course, or other programs determined by the Department to meet or exceed the standards of those programs.
(3) [Complete] Have completed the [American Medical Association's (AMA's) Continuing Medical Education Credits] continuing medical education credits required for membership in the American Medical Association, or its equivalent, or be serving a [postgraduate] post year III in an approved residency program in emergency medicine or a [postgraduate] post graduate year II in an approved residency program in emergency medicine with concurrent [on-line] online supervision by an approved medical command physician.
* * * * * (6) [Complete base station in medical, command course within 2 years of the adoption of a course by the Department] Have completed the Medical Command Base Station Course.
[(7) Be approved by the regional EMS medical director.]
(c) Approval of medical command physician.
(1) A physician may function as a medical command physician if approved to do so by a regional EMS council.
(2) A regional EMS council shall approve a physician as a medical command physician if the physician demonstrates that the physician will function under the auspices of a medical command facility and establishes one of the following:
(i) That the physician satisfies the qualifications for a medical command physician in subsection (b).
(ii) That the physician has received certification as a medical command physician from the Department upon successfully completing the voluntary medical command physician certification program administered by the Department.
(3) A regional EMS council shall conclude that the physician will be operating under the auspices of a medical command facility if the physician establishes one of the following:
(i) That the facility meets the requirements for a medical command facility prescribed in § 1009.1 (relating to operational criteria).
(ii) That the facility has received recognition as a medical command facility from the Department under § 1009.2 (relating to recognition process).
(d) Notice requirements.
(1) A medical command facility shall give notice to each regional EMS council having responsibility for an EMS region in which the medical command facility anticipates medical command physicians functioning under its auspices will be providing medical command, and shall explain the circumstances under which medical command will be given in that region.
(2) A regional EMS council that has approved a physician as a medical command physician shall give notice of the approval to the Department.
(e) Transfer and medical treatment protocols. A medical command physician shall provide medical command to prehospital personnel in ground ambulances and QRSs consistent with the transfer and medical treatment protocols which are in effect in either the region in which treatment originates or the region in which the prehospital personnel begin receiving online medical command from the medical command physician.
§ 1003.5. ALS service medical director.
(a) Roles and responsibilities. An ALS service medical director is responsible for the following:
(1) Providing medical guidance and advice to the ALS ambulance service[.], including:
(i) Reviewing the Statewide BLS medical treatment protocols and the regional transfer and medical treatment protocols, and ensuring that the ALS ambulance service's prehospital personnel are familiar with them, and amendments and revisions thereto.
(ii) Providing guidance to the ALS ambulance with respect to the ordering, stocking and replacement of drugs, and compliance with laws and regulations impacting upon the ALS ambulance service's acquisition, storage and use of those drugs.
(iii) Participating in the regional and Statewide quality improvement plans, including continuous quality improvement reviews of patient care and its interaction with the regional EMS system.
(iv) Recommending to the relevant regional EMS council, when appropriate, specific transfer and medical treatment protocols for inclusion in the regional transfer and medical treatment protocols.
(2) Granting [or], denying or restricting medical command authorization to members of the ALS ambulance service's prehospital personnel who require this authorization, and participating in appeals from decisions to deny or restrict medical command authorization in accordance with [§ 1003.29] § 1003.28 (relating to medical command authorization).
* * * * * (b) Equivalent qualifications. If the ALS service medical director is not a medical command physician, the ALS service medical director shall:
* * * * * (2) Have experience in the base station [radio] direction of prehospital personnel [and the operation of emergency dispatch].
* * * * * (5) Successfully complete [Parts A and B of] the Medical Command Base Station Course [adopted by the Department].
Subchapter B. PREHOSPITAL [EMS] AND
OTHER PERSONNEL§ 1003.21. Ambulance attendant.
(a) Roles and responsibilities. [Attendants provide first aid in accordance with the American Red Cross First Aid standards and provide CPR in accordance with American Heart Association standards.] An ambulance attendant, as part of the crew of an ambulance or a QRS, may perform BLS activities within the ambulance attendant's scope of practice, as set forth in subsection (c), at the scene of an emergency or enroute to a facility. This section does not prohibit an ambulance attendant from providing BLS services as a good Samaritan.
(b) [Minimum qualifications.] Qualifications. [Ambulance attendants] To qualify as an ambulance attendant an individual shall satisfy one of the following:
(1) Possess a [valid] current certificate evidencing successful completion of an advanced first aid course sponsored by the American Red Cross [or another advanced first aid course approved by the Department] and a certificate issued within the last 2 years evidencing successful completion of a CPR course.
(2) Possess a [valid CPR certification] current certificate evidencing successful completion of a course determined by the Department to be equivalent to the requirements in paragraph (1).
[(3) Be at least 16 years of age.]
(c) Scope of practice. An ambulance attendant shall have the authority to provide the following BLS services if trained to do so:
(1) Patient assessment--including vital signs--and ongoing evaluation.
(2) Pulmonary or cardiopulmonary resuscitation and foreign body airway obstruction management.
(3) Administration of oxygen by means of a resuscitation mask, nasal cannula, nonrebreather mask and bag valve mask.
(4) Insertion of oropharyngeal or nasopharyngeal airways.
(5) Oropharyngeal suctioning
(6) Assessment and management of cardiac, respiratory, diabetic shock, behavioral and heat/cold emergencies, as prescribed within an advanced first aid course meeting the requirements in subsection (b)(1) or (2).
(7) Emergency treatment for bleeding, burns, poisoning, seizures, soft tissue injuries, chest-abdominal-pelvic injuries, muscle and bone injuries, eye injuries and childbirth (including care of the newborn), as prescribed within an advanced first aid course meeting the requirements in subsection (b)(1) or (2).
(8) Application of spinal immobilization devices and splinting materials, including traction splints.
(9) Basic triage and basic maneuvers to gain access to the patient.
(10) Patient lifting and moving techniques.
(11) Use of an automated external defibrillator when approved by the medical director of the ambulance service.
(12) Assist a prehospital practitioner who is above the level of first responder in the use of Department-approved automatic ventilators and pulse oximetry when approved by the medical director of the ambulance service.
(13) Other BLS services taught in a course in advanced first aid sponsored by the American Red Cross, if the ambulance attendant has received training to perform those services in the course or in an equivalent training program approved by the Department, and is able to document having received the training. The Department will publish in the Pennsylvania Bulletin, at least annually, a list of the skills and services taught in the most recent course in advanced first aid sponsored by the American Red Cross. If the course sponsored by the American Red Cross teaches services in addition to advanced first aid, the Department will exclude those services from the published list.
§ 1003.22. First responder.
(a) Roles and responsibilities. A first responder may perform, at the scene of an emergency, enroute to a facility [or trauma center], or in an emergency setting in a facility, the BLS services [set forth] in subsection (e) to stabilize and improve a patient's condition until more highly trained [prehospital] personnel arrive [at the scene]. Following the arrival of more highly trained [prehospital] personnel, a first responder may continue to perform the BLS services within a first responder's scope of practice as set forth in subsection (e) under the direction of more highly trained [prehospital] personnel. This section does not prohibit a first responder from providing BLS services as a Good Samaritan.
(b) Certification.
(1) The Department will certify as a first responder an individual who meets the following qualifications:
* * * * * (iii) Has successfully completed a first responder training course approved by the Department. The Department will publish annually in the Pennsylvania Bulletin a list of courses leading to first responder certification.
(iv) Has passed a written examination for first responder certification prescribed by the Department, or has passed an examination which the Department has determined to be equivalent in both content and manner of administration.
(v) Has passed a practical test of first responder skills prescribed by the Department, or has passed an examination which the Department has determined to be equivalent in both content and manner of administration.
(2) A first responder's certification is valid for 3 years, subject to disciplinary action under section 11(j.1) of the act (35 P. S. § 6931(j.1)) and § 1003.27 (relating to disciplinary and corrective action). [An individual who received certification as a first responder under the voluntary first responder certification program in existence prior to September 2, 1995, will be deemed certified. The certification is valid for 3 years from the date the certification was issued. Following expiration of the deemed certification, the recertification requirements set forth in subsection (c) apply.]
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