Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 144 - Emergency Medical Services-air Medical Service Program Authorization › Rule 641-144.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For the purposes of this chapter, the following definitions
				shall apply:
"Air ambulance "
means any privately or
				publicly owned rotorcraft or fixed-wing aircraft which may be specifically
				designed, modified, constructed, equipped, staffed and used regularly to
				transport the sick, injured or otherwise incapacitated who are in need of
				out-of-hospital emergency medical care or whose condition requires treatment or
				continuous observation while being transported.
"Air ambulance crew member"
means an
				individual who has been trained to provide emergency and nonemergency medical
				care at the certification or licensure levels recognized by the department and
				who has been issued a certificate or license by the department.
"Air ambulance service"
means any privately or
				publicly owned service program which utilizes rotorcraft or fixed-wing aircraft
				in order to provide patient transportation and emergency medical
				services.
"Continuous quality improvement"
or
"CQI"
means a program that is an ongoing process to monitor
				standards at all EMS operational levels including the structure, process, and
				outcomes of the patient care event.
"Critical care paramedic "
or
"CCP
				"
means a currently certified paramedic specialist who has
				successfully completed a critical care course of instruction approved by the
				department and has received endorsement from the department as a critical care
				paramedic.
"Critical care transport"
or
"CCT"
means specialty care patient transportation when
				medically necessary, for a critically ill or injured patient needing CCP
				skills, between medical care facilities, and provided by an authorized
				ambulance service that is approved by the department to provide critical care
				transportation and staffed by one or more critical care paramedics or other
				health care professional in an appropriate specialty area.
"Deficiency"
means noncompliance with Iowa
				Code chapter 147A or these rules.
"Department"
means the Iowa department of
				public health.
"Director "
means the director of the Iowa
				department of public health.
"Direct supervision "
means services provided
				by an EMS provider in a hospital setting or other health care entity in which
				health care is ordinarily performed when in the personal presence of a
				physician or under the direction of a physician who is immediately available or
				under the direction of a physician assistant or registered nurse who is
				immediately available and is acting consistent with adopted policies and
				protocols of a hospital or other health care entity.
"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 protocol.
5. Any
			 medical procedure authorized by 641-subrule 131.3(3).
"Emergency medical care provider "
means an
				individual who has been trained to provide emergency and nonemergency medical
				care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic,
				paramedic specialist or other certification levels recognized by the department
				before 1984 and who has been issued a certificate by the department.
"Emergency medical services"
or
"EMS"
means an integrated medical care delivery system to
				provide emergency and nonemergency medical care at the scene or during
				out-of-hospital patient transportation in an ambulance.
"Emergency medical technician-basic"
or
"EMT-B "
means an individual who has successfully completed
				the current United States Department of Transportation's Emergency Medical
				Technician-Basic curriculum and department enhancements, has passed the
				department's approved written and practical examinations, and is currently
				certified by the department as an EMT-B.
"Emergency medical technician-paramedic"
or
"EMT-P"
means an individual who has successfully completed
				the current United States Department of Transportation's (DOT) EMT-intermediate
				curriculum or the 1985 or earlier DOT EMT-P curriculum, has passed the
				department's approved written and practical examinations, and is currently
				certified by the department as an EMT-P.
"Emergency medical transportation "
means the
				transportation by ambulance of sick, injured or otherwise incapacitated persons
				who require emergency medical care.
"EMS advisory council"
means a council
				appointed by the director to advise the director and develop policy
				recommendations concerning regulation, administration, and coordination of
				emergency medical services in the state.
"EMS system "
means any specific arrangement
				of emergency medical personnel, equipment, and supplies designed to function in
				a coordinated fashion.
"Endorsement"
means providing approval in an
				area related to emergency medical care including, but not limited to, CCP and
				emergency medical services.
"FAA "
means Federal Aviation
				Administration.
"FAR "
means Federal Aviation
				Regulation.
"Fixed-wing ambulance "
means any privately or
				publicly owned fixed-wing aircraft specifically designed, modified,
				constructed, equipped, staffed and used regularly to transport the sick,
				injured or otherwise incapacitated who are in need of out-of-hospital emergency
				medical care or whose condition requires treatment or continuous observation
				while being transported.
"Hospital"
means any hospital licensed under
				the provisions of Iowa Code chapter 135B.
"Inclusion criteria"
means criteria determined
				by the department and adopted by reference to determine which patients are to
				be included in the Iowa EMS service program registry or the trauma
				registry.
"Iowa EMS Patient Registry Data Dictionary"
means reportable data elements for all ambulance service responses and
				definitions determined by the department and adopted by reference.
"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 personnel.
"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.
"Nonemergency transportation"
means
				transportation that may be provided for those persons determined to need
				transportation only.
"NTSB "
means National Transportation Safety
				Board.
"Off-line medical direction "
means the
				monitoring of EMS providers through retrospective field assessments and
				treatment documentation review, critiques of selected cases with the EMS
				personnel, and statistical review of the system.
"On-line medical direction"
means immediate
				medical direction provided directly to service program EMS 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.
"Paramedic "
or
"EMT-P "
means
				an emergency medical technician-paramedic.
"Paramedic specalist"
or
"PS"
means an individual who has successfully completed the current United States
				Department of Transportation's EMT-Paramedic curriculum or equivalent, has
				passed the department's approved written and practical examinations, and is
				currently certified by the department as a paramedic specialist.
"Patient"
means any individual who is sick,
				injured, or otherwise incapacitated.
"Patient care report"
or
"PCR"
means a computerized or written report that documents the assessment and
				management of the patient by the emergency care provider in the out-of-hospital
				setting.
"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 care provided
				by emergency medical care providers.
"Preceptor "
means an individual who has been
				assigned by the training program, clinical facility or service program to
				supervise students while the students are completing their clinical or field
				experience. A preceptor must be an emergency medical care provider certified at
				the level being supervised or higher, or must be licensed as a registered
				nurse, physician assistant or physician.
"Protocols"
means written directions and
				orders, consistent with the department's standard of care, that are to be
				followed by an emergency medical care provider in emergency and nonemergency
				situations. Protocols must be approved by the service program's medical
				director and must address the care of both adult and pediatric patients.
"Registerednurse"
or
"RN"
means an individual licensed pursuant to Iowa Code chapter 152.
"Reportable patient data "
means data elements
				and definitions determined by the department and adopted by reference to be
				reported to the Iowa EMS service program registry or the trauma registry or a
				trauma care facility on patients meeting the inclusion criteria.
"Rotorcraft ambulance "
means any privately or
				publicly owned rotorcraft specifically designed, modified, constructed,
				equipped, staffed and used regularly to transport the sick, injured or
				otherwise incapacitated who are in need of out-of-hospital emergency medical
				care or whose condition requires treatment or continuous observation while
				being transported.
"Service director "
means an individual who is
				responsible for the operation and administration of a service program.
"Service program "
or
"service
				"
means any medical care air ambulance service that has received
				authorization by the department.
"Service program area "
means the geographic
				area of responsibility served by any given ambulance or nontransport service
				program.
"Student"
means any individual enrolled in a
				training program and participating in the didactic, clinical, or field
				experience portions.
"Supervising physician"
means any physician
				licensed under Iowa Code chapter 148. The supervising physician is responsible
				for medical direction of emergency medical care personnel when such personnel
				are providing emergency medical care.
"Trainingprogram "
means an NCA-approved Iowa
				college, the Iowa law enforcement academy or an Iowa hospital approved by the
				department to conduct emergency medical care training.
"Transport agreement"
means a written
				agreement between two or more service programs that specifies the duties and
				responsibilities of the agreeing parties to ensure appropriate transportation
				of patients in a given service area.