Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 41 - Office of Preparendess and Emergency Response Systems › Rule 007.41.21-001 - Emergency Medical Services

Current through Register Vol. 49, No. 6, June, 2024
AUTHORITY
The following Rules pertaining to Emergency Medical Services
				are duly adopted and promulgated by the Arkansas State Board of Health pursuant
				to the authority expressly conferred by the Laws of the state of Arkansas in
				Ark. Code Ann. § 20-13-20 et.seq., and other laws of the state of
				Arkansas.
SECTION I. DEFINITIONS
For the purpose of these rules the following terms are
				defined:
A. Advanced Emergency Medical
			 Technician (AEMT): A person who has successfully completed an advanced EMT
			 education program approved by the Department and is licensed as an advanced
			 EMT.
B. Advanced Response Agency: A
			 licensed non-transporting agency that is requested to respond to the scene of
			 an emergency.
C. Air Ambulance: A
			 fixed or rotary wing aircraft, utilized for on-scene responses or transports
			 deemed necessary by a physician and licensed by the Department.
D. Air Ambulance Communication Specialist:
			 Personnel assigned to receive and coordinate all requests for the air ambulance
			 service.
E. Air Ambulance Service -
			 Emergency: An air ambulance service that provides emergency scene flights which
			 can also provide inter-facility transports.
F. Air Ambulance Service: An entity operating
			 an aircraft used for air transportation that is specifically designed to
			 accommodate the air medical needs of persons who are ill, injured, wounded, or
			 otherwise mentally or physically incapacitated or helpless; who may require
			 emergency medical care in-flight.
G. Air Ambulance Service Area: The area of
			 operation within the state of Arkansas for a licensed air ambulance service as
			 defined by the service and on file with the Department.
H. Air Ambulance Service Medical Director: An
			 Arkansas licensed medical doctor (MD) or doctor of osteopathy (DO) who provides
			 medical oversight for any licensed air ambulance service, and who is either
			 board certified or board eligible in emergency medicine or general surgery and
			 is on file with the Department as the medical director.
I. Air Ambulance Service Medical Director
			 (Specialty): An Arkansas licensed medical doctor (MD) or doctor of osteopathy
			 (DO) who provides medical oversight for any licensed air ambulance service,
			 that solely provides specialty air transport services (e.g. pediatrics,
			 neonatal, high risk obstetrics), rotary or fixed winged aircraft. The
			 individual requires licensure or board eligibility in the specialty designation
			 of the air ambulance service for which they have medical oversight.
J. Air Medical Personnel: Personnel
			 responsible for patient care on an air ambulance.
K. Ambulance (Ground): Those vehicles used
			 for transporting any person by stretcher or gurney upon the streets or highways
			 of Arkansas, excluding vehicles intended solely for personal use. All
			 ambulances shall be issued a permit by the Department.
L. Ambulance Service: Entities authorized and
			 licensed by the Department to provide care and transportation of patients upon
			 the streets and highways of Arkansas.
M. Community Paramedic: A paramedic that is
			 licensed by the Department and provides care/services to patients not qualified
			 for home health services or who are qualified but have rejected home health
			 services; and meets all additional licensure requirements.
N. Controlled Drugs: Drugs identified as
			 Schedule II-V as designated by federal law.
O. Coordination Point: A fixed location(s)
			 where information about an air ambulance service may be obtained and where
			 activities such as dispatch, resource allocation, and flight operations are
			 conducted.
P. Department: The
			 Arkansas Department of Health.
Q.
			 Distributive Education: An educational activity in which the learner, the
			 instructor, and the educational materials are not all present at the same time,
			 and students and instructors are not able to interact in real time. Continuing
			 Education (CE) activities that are offered online, via audio or video, or
			 through reading journal articles are considered distributive education. Virtual
			 Instructor Led Training is not considered distributive education.
R. Emergency Medical Services: The
			 transportation and medical care provided to the ill or injured prior to arrival
			 at a medical facility by licensed Emergency Medical Services Personnel or other
			 healthcare providers and continuation of the initial emergency care within a
			 medical facility subject to the approval of the medical staff and governing
			 board of that facility; and comprehensive integrated medical care in emergency
			 and non-urgent settings with the oversight of a physician.
S. Emergency Medical Services Advisory
			 Council: Those persons appointed by the Governor to assist and advise the
			 Department concerning matters dealing with emergency medical
			 services.
T. Emergency Medical
			 Services Education Program (EEP): Those organizations authorized and accredited
			 by the Department or the Committee on Accreditation of Educational Programs
			 (CoAEMSP) to provide EMS education.
U. EMS Education Program Training Site
			 Authorization and Accreditation: Authorization and accreditation issued by the
			 Department or the Committee on Accreditation of Educational Programs (CoAEMSP)
			 to an organization for the purpose of engaging in EMS education in the state of
			 Arkansas.
V. Emergency Medical
			 Services Provider (EMSP): An individual licensed by the department at any level
			 established by the rules adopted by the State Board of Health and authorized to
			 perform those services set forth in the rules. These shall include without
			 limitation EMT, AEMT, paramedic, community paramedic, EMSP-
			 Instructor.
W. Emergency Medical
			 Services Provider - Instructor: A person who has been licensed to teach
			 Emergency Medical Services Provider courses after completing a Department
			 approved EMSP - Instructor course and completion of all the instructor
			 requirements.
X. Emergency Medical
			 Technician: A person who is licensed as an EMT, in Arkansas
Y. Emergency Vehicle Operator: A person who
			 has successfully completed a nationally recognized first responder course with
			 a minimum of forty (40) hours of training and an Emergency Vehicle Operator
			 course.
Z. Emergency Request: A
			 request for assistance to an incident which is perceived to have created an
			 actual threat to human life or wellbeing where immediate medical intervention
			 by any EMSP or other health professional is needed.
AA. Encounter Form: A patient care report
			 (PCR), that includes all State required data elements, and which has been
			 approved by the Department that describes the EMS encounter and is left with
			 the facility at time of service or within (24) twenty-four hours after transfer
			 of care. This form may be electronic or a hard copy and must include a patient
			 narrative.
BB. FAA FAR Part 135:
			 Federal Aviation Administration Regulations governing air taxi operations and
			 commercial operation of fixed-wing and rotor-wing aircraft.
CC. Fixed Wing Aircraft: A fixed-wing air
			 ambulance licensed by the Department that is specially constructed and equipped
			 and is intended to be used for transportation of patients.
DD. Flight Nurse: A registered nurse (RN)
			 licensed to practice in Arkansas who holds a current Arkansas EMSP license. An
			 RN that solely provides air ambulance specialty services (e.g. pediatrics,
			 neonatal, or high risk obstetrics), or fixed-wing transports the flight nurse
			 shall not be required to be an Arkansas licensed EMSP and shall not participate
			 in air ambulance service - prehospital transports.
EE. Flight Physician: A physician assigned to
			 flight duty. The physician must be a Post Graduate Year (PGY) 3 or above, with
			 a current and valid license to practice medicine as a medical doctor (MD) or
			 doctor of osteopathy (DO) in Arkansas or in the state of primary operation of
			 the air ambulance service. This physician must be board certified or board
			 eligible in emergency medicine or general surgery or is certified in the
			 specialty (e.g. Neonatal, Pediatrics, high risk obstetrics, etc.) served by the
			 transport service. This physician must be certified in at least one of the
			 following: Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life
			 Support (PALS), Neonatal Resuscitation Program (NRP) or their equivalent for
			 the patient population served.
FF.
			 Ground Ambulance Service Area: The contiguous land area within a county defined
			 by city or identifiable geographical landmarks or county boundaries for which
			 area the ground ambulance service has an operational base and commits to
			 provide all emergency medical services requested. Service area maps shall be
			 kept on file and renewed annually with the services license renewal.
GG. Intercept: Instances where a transporting
			 service requests assistance from an ambulance service which provides an equal
			 or higher level of medical care and/or transport.
HH. Licensure: Official acknowledgement by
			 the Department that an individual has demonstrated competence to perform the
			 emergency medical services required for licensure under the rules and standards
			 adopted by the Arkansas Board of Health upon the recommendation by the
			 Emergency Medical Services Advisory Council.
II. Legend Drug: Any drug which requires a
			 prescription by a licensed physician as required by federal law.
JJ. Mass Casualty Incident: An event
			 involving a number of people who are suddenly injured or become ill that
			 overwhelms the local ambulance services, where the number of casualties vastly
			 exceeds the local resources and capabilities in a short period of time. If two
			 or more additional ambulance services are required to respond to the same
			 event; and/or assistance from the Department is needed to assist in the
			 coordination of medical resources, then the Department shall be
			 notified.
KK. Medical Director
			 (Advanced Life Support Services): An Arkansas licensed medical doctor (MD) or
			 doctor of osteopathy (DO) who shall be registered with the Department that is
			 familiar with the design and operation of EMS systems and experienced in
			 pre-hospital emergency care and emergency management of ill and injured
			 patients. The medical director shall be board certified or board eligible in
			 Emergency Medicine or have current experience in emergency medicine. For ALS
			 services that currently have a medical director that is not Board Certified in
			 Emergency Medicine and holds a current ACLS card, they shall be authorized to
			 utilize that medical director until such time they change or replace medical
			 directors.
LL. Medical Director
			 (Basic Life Support Services): An Arkansas licensed medical doctor (MD) or
			 doctor of osteopathy (DO) who is either an emergency department physician, or a
			 physician who is either board certified or board eligible in their particular
			 specialty.
MM. Medical Director
			 (community paramedic service): An Arkansas licensed medical doctor (MD) or
			 doctor of osteopathy (DO) who is either board certified or board eligible in a
			 specialty that is involved in direct patient contact.
NN. Medical Facility: Any hospital, medical
			 clinic, physician's office, nursing home or others health care
			 facility.
OO. Medical Facility
			 Transport Service: A medical facility regulated by the Department that owns and
			 operates an licensed ambulance.
PP.
			 Mutual Aid: An agreement between emergency responders to lend assistance across
			 jurisdictional boundaries. This may occur due to an emergency response that
			 exceeds local resources.
QQ.
			 National Registry of Emergency Medical Technicians (NREMT): A not-for-profit,
			 independent, non-governmental agency that functions as a registration agency
			 which issues certificates of competency verified by achievement of minimal
			 competencies of EMTs, AEMTs and paramedics. NREMT provides a valid, uniform
			 process to assess the knowledge and skills required for competent practice
			 required by licensed EMSPs.
RR. Of
			 Unsound Mind: Means and includes the inability to perceive all relevant facts
			 related to One's condition and proposed treatment of whether the inability is
			 only temporary or has existed for an extended period of time or occurs or has
			 occurred only intermittently and whether or not it is due to natural state,
			 age, shock or anxiety, illness, injury, drugs or sedation, intoxication, or
			 other cause of whatever nature. (See Ark. Code §
									20-9-601
			 ).
SS. Operational Base: Facility
			 within the service area of the ground or air ambulance service(s) designated to
			 house the ground or air ambulance(s), crew members, supplies, and communication
			 equipment.
TT. Paramedic: A person
			 who has successfully completed an accredited paramedic education program
			 approved by the Department and is licensed in Arkansas as a
			 paramedic.
UU. Patient Care
			 Performance Improvement Plan: A written plan that provides objective,
			 systematic and comprehensive monitoring of the quality, safety and
			 appropriateness of patient care; identifying and prioritizing opportunities for
			 improvement. The ambulance service medical director will be responsible for
			 plan.
VV. Program Director: An
			 Individual responsible for oversight of a Department approved EMS education
			 program. Program directors are authorized to verify the successful completion
			 of EMS education.
WW. Probation: An
			 administrative action imposed on an EMS service, any EMSP license, or
			 authorized and accredited training site for violations of EMS Rules.
XX. Protocols (Guidelines): Off line written
			 standing orders authorized by ambulance services, approved and signed by the
			 ambulance service medical director of the licensed ambulance service.
YY. Provisional Instructor: An EMSP who has
			 completed initial instructor training but is in the process of finishing their
			 teaching requirements, with appropriate recommendation from the training
			 program, before becoming a licensed EMS Instructor.
ZZ. Reaction Time: The time from when the
			 emergency call is received by the ambulance services dispatch and adequate
			 information is made available which identifies the location and nature of the
			 call, and until the ambulance is enroute. This time shall be two (2) minutes or
			 less.
AAA. Receiving Facility: A
			 hospital emergency department, hospital, or medical facility capable of
			 receiving and treating patients.
BBB. Revocation: An administrative action
			 imposed by the Department that terminates any EMSP license, or authorized
			 training site for violating EMS Rules.
CCC. Rotor-Wing Aircraft: A rotor-winged air
			 ambulance permitted by the Department that is specially constructed and
			 equipped and is intended to be used for transportation of emergency medical
			 patients.
DDD. Service License:
			 License issued by the Department to a person, firm, corporation, association,
			 county, municipality, or other legal entity for the purpose of engaging in care
			 and/or transport of patients in the state of Arkansas.
EEE. Short Form: Abbreviated, Department
			 approved Patient Care Report that is left at the medical facility at time of
			 transfer of care when a completed encounter form is not available.
FFF. Specialty Crew Members: Any person
			 substituted by the medical director or the air ambulance service medical
			 director (Specialty) for a specialty mission.
GGG. Specialty Mission: An assignment for an
			 air ambulance where the specified needs of a particular patient may require the
			 substitution of particular medical care providers, medical direction and/or
			 equipment.
HHH. Specialty Purpose
			 Service: A licensed service that provides a specific medical service to a
			 limited population group and emergency evacuation services only, and does not
			 participate in the business of providing continuous general population response
			 for emergency medical services.
III. Stretcher: any apparatus that is used to
			 transport indiviuals in the supine or Fowler's position. This includes all
			 devices that can be transformed from wheelchair to stretcher.
JJJ. Suspension: An administrative action
			 imposed by the Department that temporarily removes an EMS service license, any
			 EMSP License, or training site authorization and accreditation for violating
			 EMS Rules.
KKK. Training Site
			 Representative: Individual responsible for the organization, coordination, and
			 day-to-day operations of the EMSP training programs.
LLL. Volunteer Ambulance Service: An
			 ambulance service operating an EMT-volunteer permitted ambulance that is
			 staffed by personnel who perform and give services without expectation of
			 compensation.
MMM. Written Warning:
			 An administrative action imposed on an EMS service, EMSP license, or authorized
			 training-site for violating EMS Rules.