Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 03 - Emergency Health Services › Rule 007.03.16-001 - Rules and Regulations for Emergency Medical Services

Current through Register Vol. 49, No. 6, June, 2024
AUTHORITY
The following Rules and Regulations 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. § 20-13-200et.seq., and other laws of
				the State of Arkansas.
SECTION I.
			 DEFINITIONS
For the purpose of these regulations the following terms are
				defined:
A.
Advanced Emergency
			 Medical Technician:
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
			 Service:
A licensed non-transporting service that is requested to
			 respond to the scene of an emergency and provides Advanced Life Support care to
			 ill or injured patients prior to the arrival of a licensed transporting
			 ambulance service, subject to compliance with the EMS Rules and Regulations
			 relating to the level of care available from the responding
			 personnel.
C.
Air Ambulance:
An Aircraft, fixed or rotary wing, utilized for on-scene responses or
			 transports deemed necessary by a physician and licensed by the Department of
			 Health
D.
Air Ambulance
			 Communication Specialist:
Personnel assigned to receive and coordinate
			 all requests for the air medical service.
E.
Air Ambulance Operation:
One
			 aircraft making one flight in response to a patient transport
			 request.
F.
Air Ambulance
			 Personnel:
Personnel responsible for patient care on an air
			 ambulance.
G.
Air Ambulance
			 Service - Emergency:
An air ambulance service that provides emergency
			 scene flights which can also provide inter-facility transports.
H.
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, and who, in a physician's opinion,
			 cannot be safely transported on a standard commercial or charter flight. Air
			 Ambulances shall be permitted by the Department.
I.
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.
J.
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 is either board certified or board eligible in emergency medicine
			 or general surgery, and is on file with the Department as the Medical Director.
K.
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 transport services (i.e.
			 pediatrics, neonatal, high risk obstetrics), or fixed winged aircraft the
			 individual requires licensure or board eligibility in emergency medicine,
			 general surgery, pediatrics, neonatology, obstetrics or the specialty they have
			 medical oversight for.
L.
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 by immediate family
			 members. Ambulances shall be permitted by the Department.
M.
Ambulance Service:
Entities
			 authorized and licensed by the Department to provide care and transportation of
			 patients upon the streets and highways of Arkansas.
N.
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
			 as outlined in this rule.
O.
Controlled Drugs:
Those drugs identified as Schedule II-V as
			 designated by federal law
P.
Coordination Point:
A fixed location(s) where information about
			 the air ambulance service may be obtained and where the activities of dispatch,
			 resource allocation, and flight operations are conducted.
Q.
Department:
The Arkansas
			 Department of Health.
R.
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. CE activities that are offered online, via CD-ROM or video, or through
			 reading journal articles or listening to audio tapes are considered
			 distributive education. Virtual Instructor Led Training is not considered
			 distributive education.
S.
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 technician (EMT) 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.
T.
Emergency Medical Services Advisory Council:
Those persons
			 appointed by the Governor to assist and advise the Department concerning
			 matters dealing with emergency medical services.
U.
Emergency Medical Services Education
			 Program (EEP):
Those organizations authorized and accredited by the
			 Section or the Committee on Accreditation of Educational Programs (CoAEMSP) to
			 provide EMS education.
V.
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.
W.
Emergency Medical
			 Technician:
A person who has been licensed as an EMT, in
			 Arkansas.
X.
Emergency
			 Medical Services Personnel - Instructor:
A person who has been licensed
			 to teach Emergency Medical Services Personnel courses after completing a
			 Department approved EMSP-Instructor course and completion of all of the
			 instructor requirements.
Y.
Emergency Medical Services Personnel (EMSP):
An individual
			 licensed by the department at any level established by the rules adopted by the
			 State Board of Health under the subchapter and authorized to perform those
			 services set forth in the rules. These shall include without limitation EMT,
			 Advanced EMT, Paramedic, Community Paramedic, Emergency Medical Services
			 Instructor, EMS Instructor Trainer.
Z.
Emergency Request:
A request
			 for assistance to an incident for a condition which is perceived by the
			 individual to have created an actual threat to human life or wellbeing where
			 immediate medical intervention by any Emergency Medical Service Personnel or
			 other health professional is needed.
AA.
Encounter Form:
A patient
			 care record, which has been approved by the Department that describes the EMS
			 encounter and is left with the care facility at time of service or (24)
			 twenty-four hours after transfer of care. This form must include a patient
			 narrative.
BB.
Enrolled
			 student:
A student who is attending an EMSP educational program approved
			 by the Department.
CC.
Extrication Services:
The services provided by the use of
			 equipment for the purpose of gaining access and entry to entrapped
			 patients.
DD.
FAA FAR Part
			 135:
Federal Aviation Administration Regulations governing air taxi
			 operations and commercial operation of fixed-wing and rotor-wing
			 aircraft.
EE.
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 emergency medical patients.
FF.
Flight Nurse:
A registered
			 nurse (RN) licensed to practice in Arkansas who holds a current Arkansas EMT
			 License. For a Flight Nurse that solely provides air ambulance service-
			 specialty services (i.e. pediatrics, neonatal, high risk obstetrics, or fixed
			 wing) the Flight Nurse shall not be required to be an Arkansas licensed EMT and
			 shall not participate in air ambulance service - prehospital
			 transports..
GG.
Flight
			 Physician:
A physician assigned to flight duty, Post Graduate Year (PGY)
			 3 or above, with a current 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, and who is board certified or board
			 eligible in emergency medicine or general surgery or is certified or in the
			 specialty (Neonatal, Pediatrics, high risk obstetrics, etc.) served by the
			 transport service and is certified in at least one of the following: Advanced
			 Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation
			 Program or their equivalent for the patient population served.
HH.
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.
II.
Intercept:
Instances where a
			 transporting service requests assistance from an ambulance service which
			 provides a higher level of medical care and/or transport.
JJ.
Licensure:
Official
			 acknowledgement by the department that an individual has demonstrated
			 competence to perform the emergency medical services required for the licensure
			 under the rules, regulations, and standards adopted by the board upon the
			 recommendation by the Emergency Medical Services Advisory Council.
KK.
Legend Drug:
Any drug which
			 requires a prescription by a licensed physician as required by federal
			 law.
LL.
Mass Casualty
			 Incident:
An incident in which many people are suddenly injured or
			 become ill which results in the services available resources to become
			 overwhelmed; which requires two or more additional ambulance services to
			 respond to the same event; and/or assistance from the Department is needed to
			 help coordinate medical resources for the sick or injured.
MM.
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.
NN.
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.
OO.
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. Each Community Paramedic Medical Director shall be approved by the
			 Department.
PP.
Medical
			 Facility:
Any hospital, medical clinic, physician's office, nursing home
			 or other health care facility.
QQ.
Medical Facility Transport Service:
A medical facility regulated
			 by the Department of Health that owns and operates a stretcher ambulance
			 vehicle.
RR.
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.
SS.
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, Advanced EMTs and Paramedics.
			 NREMT provides a valid, uniform process to assess the knowledge and skills
			 required for competent practice required by (EMS) personnel.
TT.
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
			 ).
UU.
Operational
			 Base:
Facility within the service area of the ground or air ambulance
			 service designated to house the ground or air ambulance(s), crew members,
			 supplies, and communication.
VV.
Paramedic:
A person who has successfully completed a Paramedic
			 education program approved by the Department and is licensed in Arkansas as a
			 Paramedic.
WW.
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.
XX.
Program
			 Director:
Individual responsible for oversight of a Department approved
			 EMS education program. Program directors are authorized to verify the
			 successful completion of EMS education.
YY.
Probation:
An administrative
			 action imposed on an EMS service, EMSP license,EMSP-Instructor license or
			 authorized and accredited training site for violations of EMS Rules and
			 Regulations.
ZZ.
Protocols:
Offline written standing orders authorized by ambulance
			 services, approved and signed by the ambulance service Medical Director of that
			 licensed ambulance service.
AAA.
Provisional Instructor:
An EMT who has completed initial
			 instructor training but is in the process of finishing their teaching
			 requirements, with appropriate recommendation from the Instructor-Trainer,
			 before becoming a licensed EMS Instructor.
BBB.
Reaction Time:
The time
			 from when the emergency call is received by the ambulance services' dispatch
			 and adequate information 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 2 minutes or less.
CCC.
Receiving Facility:
A
			 hospital emergency department or a hospital capable of receiving and treating
			 emergency patients.
DDD.
Revocation:
An administrative action imposed by the Department
			 that terminates an EMS service license, EMT license, EMT-Instructor license or
			 authorized training site for violating EMS Rules and Regulations.
EEE.
Rotor-Wing Aircraft:
A
			 rotor-winged air ambulance licensed by the Department that is specially
			 constructed and equipped and is intended to be used for transportation of
			 emergency medical patients.
FFF.
Service License:
Authorization 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.
GGG.
Short
			 Form:
Abbreviated Patient Care Report that is left at the Receiving
			 Facility at time of transfer of care when an completed encounter form is not
			 available.
HHH.
Skills
			 Evaluator (Basic):
A licensed EMT who has completed the state approved
			 psychomotor skills evaluator course at the basic level and has been certified
			 by the Department.
III.
Skills Evaluator (Advanced):
A licensed Advanced EMT or Paramedic
			 who has completed the state approved psychomotor skills evaluator course at the
			 advanced level and has been certified by the Department.
JJJ.
Specialty Crew Members:
Any
			 person substituted by the Medical Director or the Air Ambulance Service Medical
			 Director (Specialty) for a Specialty Mission.
KKK.
Specialty Mission:
An
			 assignment for air ambulance service for which the specified needs of a
			 particular patient which may require the substitution of particular medical
			 care providers, Medical Direction and/or equipment.
LLL.
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.
MMM.
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.
NNN.
Suspension:
An administrative action imposed by the Department
			 that temporarily removes an EMS service license, EMT License, EMT-Instructor
			 License or training site authorization and accreditation for violating EMS
			 Rules and Regulations.
OOO.
Training Site Representative:
Individual responsible for the
			 organization, coordination, and day-to-day operations of the EMS training
			 programs.
PPP.
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.
QQQ.
Written Warning:
An
			 administrative action imposed on an EMS service, EMT certification,
			 EMT-Instructor certification or authorized training-site for first-time or
			 minor offenses unless otherwise stated.