§ 1027.34. Intermediate advanced life support ambulance service.
(a) Purpose. An EMS agency that operates an intermediate ALS ambulance service employs one or more intermediate ALS ambulances staffed by an ambulance crew capable of providing medical assessment, observation, triage, monitoring, treatment and transportation of patients who require EMS at the AEMT level.
(b) Staffing. The minimum staffing for an intermediate ALS ambulance crew when responding to a call to provide EMS to a patient who requires EMS at the skill level of an AEMT is an EMS provider at or above the AEMT level, a second EMS provider at or above the EMR level and an EMSVO, except that only a two-person ambulance crew is required if the EMSVO is also one of the EMS providers and an EMS provider at or above the AEMT level is available to attend to the patient during patient transport. Responding ambulance crew members may arrive at the scene separately, but the ambulance shall be fully staffed at or above the minimum staffing level before transporting the patient.
(c) Providing EMS when dispatched with a lower level EMS vehicle crew. If an intermediate ALS ambulance and a lower level EMS vehicle crew are dispatched to provide EMS for a patient, the following shall apply:
(1) If the patient is assessed by the intermediate ALS ambulance crew to require EMS above the skill level at which the lower level EMS vehicle crew is operating, and requires transport to a receiving facility, the EMS provider who is responsible for the overall management of the EMS provided to the patient shall decide, consistent with the Statewide EMS protocols, who will transport the patient. An appropriately certified member of the intermediate ALS ambulance crew shall attend to the patient during the transport. If the lower level EMS vehicle is used to transport the patient, the EMS provider in charge shall use the equipment and supplies on the lower level EMS vehicle, supplemented with the additional equipment and supplies, including medications, from the intermediate ALS ambulance.
(2) If at the scene or during transport by the lower level EMS vehicle crew, the EMS provider of the intermediate ALS ambulance crew who has assumed primary responsibility for the patient determines that the lower level EMS vehicle crew is operating at the skill level needed to attend to the patient’s EMS needs, consistent with the Statewide EMS protocols, that EMS provider may relinquish responsibility for the patient to the lower level EMS vehicle crew.
(d) Providing EMS when dispatched with a higher level EMS vehicle crew. If an intermediate ALS ambulance and a higher level EMS vehicle crew are dispatched to provide EMS for a patient, the following shall apply:
(1) Intermediate ALS ambulance crew members shall begin providing EMS to the patient at their skill levels, including transportation of the patient to a receiving facility if the crew determines transport is needed, until higher level EMS is afforded by the arrival of a higher level EMS provider.
(2) Upon the arrival of a higher level EMS vehicle crew, the intermediate ALS ambulance shall continue transporting the patient or release the patient to be transported by the higher level EMS vehicle crew, consistent with the Statewide EMS protocols, as directed by the EMS provider exercising primary responsibility for the patient.
(3) The intermediate ALS ambulance crew shall reassume primary responsibility for the patient if that responsibility is relinquished back to that ambulance crew by the EMS provider of the higher level EMS vehicle crew who had assumed primary responsibility for the patient.
(e) Responding to a call for a patient who requires EMS below the AEMT level. When an intermediate ALS ambulance is employed to respond to a call to provide EMS to a patient who requires EMS below the skill level of an AEMT, the staffing and the responsibilities of the ambulance crew are the same as set forth in § 1027.33 (relating to basic life support ambulance service).
(f) Application. For purposes of this section, the term ‘‘lower level EMS vehicle crew’’ means the EMS vehicle crew of a BLS ambulance or BLS squad vehicle. The term ‘‘higher level EMS vehicle crew’’ means the EMS vehicle crew of an ALS ambulance, ALS squad vehicle or air ambulance.
Source The provisions of this § 1027.34 adopted October 11, 2013, effective April 10, 2014, 43 Pa.B. 6093.
Cross References This section cited in 28 Pa. Code § 1027.33 (relating to basic life support ambulance service); 28 Pa. Code § 1027.35 (relating to advanced life support ambulance service); and 28 Pa. Code § 1027.42 (relating to water ambulance service).
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