Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 07 - Pharmacy Services › Rule 007.00.20-001 - Rules For Emergency Medical Services

Current through Register Vol. 49, No. 6, June, 2024
RULES PERTAINING TO EMERGENCY MEDICAL SERVICES
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. §
								20-13-201 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 specially 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 gumey 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 other 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
			 approving and supervising the service's patient care performance improvement
			 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):
Offline 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.
Sliort 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 individuals 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.