Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 142 - Out-of-hospital Do-not-resuscitate Orders › Rule 641-142.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For the purpose of these rules, the following definitions shall
				apply:
"Adult"
means an individual 18 years of age
				or older.
"Attending physician"
means a physician
				selected by, or assigned to, the patient who has primary responsibility for the
				treatment and care of the patient.
"Attending physician assistant"
means the
				physician assistant selected by, or assigned to, the patient who has primary
				responsibility for the treatment and care of the patient.
"Comfort care"
means care within the scope of
				the health care provider's training and certification to alleviate pain and
				suffering, but does not include resuscitative measures.
"Department"
means the Iowa department of
				public health.
"Emergency medical care"
means such medical
				procedures as:
1. Administration of
			 intravenous solutions.
2.
			 Intubation.
3. Performance of
			 cardiac defibrillation and synchronized cardioversion.
4. Administration of emergency drugs as
			 provided by rule by the department.
5. Any other medical procedure approved by
			 the department, by rule, as appropriate to be performed by emergency medical
			 care providers who have been certified in that procedure.
"EMS provider"
means an emergency medical
				care provider as defined in Iowa Code section
				147A.1.
"Health care provider"
means a person,
				including an emergency medical care provider, who is licensed, certified, or
				otherwise authorized or permitted by the law of this state to administer health
				care in the ordinary course of business or in the practice of a
				profession.
"Hospital"
means any hospital licensed under
				the provisions of Iowa Code section
				135B.1.
"Life-sustaining procedure"
means any medical
				procedure, treatment, or intervention, including resuscitation, which utilizes
				mechanical or artificial means to sustain, restore or supplant a spontaneous
				vital function, and when applied to a patient in a terminal condition, would
				serve only to prolong the dying process. "Life-sustaining procedure" does not
				include the provision of nutrition or hydration except when required to be
				provided parenterally or through intubation or the administration of medication
				or performance of any medical procedure deemed necessary to provide comfort
				care or to alleviate pain.
"Medical direction"
means direction, advice,
				or orders provided by a medical director, supervising physician, or physician
				designee (in accordance with written parameters and protocols) to emergency
				medical care providers.
"Medical director"
means any physician
				licensed under Iowa Code chapter 148 who shall be responsible for overall
				medical direction of the service program and who has completed a medical
				director workshop, sponsored by the department, within one year of assuming
				duties.
"On-line medical direction"
means immediate
				medical direction provided directly to service program emergency medical care
				providers, in accordance with written parameters and protocols, by the medical
				director, supervising physician or physician designee either on scene or by any
				telecommunications system.
"Out-of-hospital do-not-resuscitate
				identifier"
or
"OOH DNR identifier"
means a durable
				yet easily removable unique identification approved by the department and worn
				by a patient who has an out-of-hospital do-not-resuscitate order.
"Out-of-hospital do-not-resuscitate order"
or
"OOH DNR order"
means a written order on a form approved by
				the department, signed by an attending physician, executed in accordance with
				the requirements of Iowa Code section
				144A.7A and issued consistent
				with Iowa Code section
				144A.2, that directs the
				withholding or withdrawal of resuscitation when an adult patient in a terminal
				condition is outside the hospital.
"Out-of-hospital do-not-resuscitate protocol"
or
"OOH DNR protocol"
means the statewide protocol approved by
				the department and intended to avoid unwarranted resuscitation by emergency
				medical care providers when a valid out-of-hospital do-not-resuscitate order or
				identifier is encountered.
"Patient"
means any individual who is sick,
				injured, or otherwise incapacitated.
"Physician"
means any individual licensed
				under Iowa Code chapter 148.
"Physician assistant"
or
"PA"
means an individual licensed pursuant to Iowa Code
				chapter 148C.
"Physician designee"
means any registered
				nurse licensed under Iowa Code chapter 152, or any physician assistant licensed
				under Iowa Code chapter 148C and approved by the board of physician assistants.
				The physician designee acts as an intermediary for a supervising physician in
				accordance with written policies and protocols in directing the actions of
				emergency medical care providers.
"Qualified patient"
means any adult patient
				as defined in Iowa Code section
				144A.2.
"Registered nurse"
or
"RN"
means an individual licensed pursuant to Iowa Code chapter 152.
"Resuscitation"
means any medical
				intervention that utilizes mechanical or artificial means to sustain, restore,
				or supplant a spontaneous vital function, including but not limited to chest
				compression, defibrillation, intubation, and emergency drugs intended to alter
				cardiac function or otherwise to sustain life.
"Service program"
or
"service"
means any medical care ambulance service or
				nontransport service that has received authorization by the department.
"Supervising physician"
means any physician
				licensed under Iowa Code chapter 148, 150, or 150A. The supervising physician
				is responsible for medical direction of emergency medical care providers when
				such providers are providing emergency medical care.
"Terminal condition"
means an incurable or
				irreversible condition that, without the administration of life-sustaining
				procedures, will, in the opinion of the attending physician, result in death
				within a relatively short period of time or a state of permanent
				unconsciousness from which, to a reasonable degree of medical certainty, there
				can be no recovery.