New Jersey Administrative Code › Title 8 - HEALTH › Chapter 41 - ADVANCED LIFE SUPPORT SERVICES; MOBILE INTENSIVE CARE PROGRAMS, SPECIALTY CARE TRANSPORT SERVICES AND AIR MEDICAL SERVICES › Subchapter 1 - AUTHORITY, SCOPE AND DEFINITIONS › Section 8:41-1.3 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as used in this chapter, shall
				  have the following meanings, unless the context in which they are used clearly
				  indicates otherwise:
"ACLS certification" or "certification in ACLS" means valid
				  certification in Advanced Cardiac Life Support as issued by the American Heart
				  Association.
"Acute care hospital" means any hospital, validly licensed by the
				  Department, which maintains and operates organized facilities and services for the
				  diagnosis, treatment or care of persons suffering from acute illness, injury or
				  deformity and in which all diagnoses, treatment and care are administered by or
				  performed under the direction of persons who, in accordance with
				  45:9-6, are validly licensed to
				  practice medicine and surgery by the New Jersey State Board of Medical
				  Examiners.
"Advanced life support" or "ALS" means an advanced level of
				  pre-hospital, inter-facility or emergency medical care that includes basic life
				  support functions, cardiac monitoring, cardiac defibrillation, telemetered
				  electrocardiography, administration of anti-arrhythmic agents, intravenous (IV)
				  therapy, administration of specific medications, drugs and solutions, utilization of
				  adjunctive ventilation devices, trauma care and other techniques and procedures
				  authorized in writing by the Commissioner.
"Advanced practice nurse" means a person who is validly licensed
				  by the New Jersey Board of Nursing in accordance with the standards set forth at
				  45:11-45 et seq.
"Advertising" means any information directly or indirectly issued,
				  distributed, hand-delivered or implied through any medium and utilized for the
				  purpose of promoting the service of a provider.
"AHA CPR Guidelines" means the "Guidelines 2000 for
				  Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" as published by the
				  American Heart Association, National Center, 7272 Greenville Avenue, Dallas, TX
				  75231-4596, incorporated herein by reference, as amended and supplemented. A copy of
				  the guidelines is on file and available for inspection at the Office of Emergency
				  Medical Services.
"Aircraft" means a device that is utilized, or intended to be
				  utilized, for flight in the air, and shall include both airplanes and
				  helicopters.
"Air medical service" means an entity that is validly licensed by
				  the Department to provide pre-hospital advanced life support care to accident or
				  trauma victims or ALS inter-facility transfers of acutely ill or injured patients
				  requiring specialty medical care by way of a specially equipped and specially
				  staffed air medical unit.
"Air medical unit" or "AMU" means a specially equipped helicopter
				  or airplane that is validly licensed by the Department and operated in accordance
				  with the standards set forth in this chapter.
"Airplane" means, as defined at
				  14 C.F.R. 1.1, an
				  engine-driven fixed-wing aircraft heavier than air, which is supported in flight by
				  the dynamic reaction of the air against its wings.
"ALS crewmember" means:
1. A registered nurse who meets the requirements set forth at
				  8:41-9.9 or 10.8(d)1 through (d)5vii;
				  and/or
2. An EMT-Paramedic, who staffs a mobile intensive care unit,
				  specialty care transport unit or air medical unit.
"ALS inter-facility transfer" means the transportation of a
				  patient in need of advanced life support care or medical monitoring that is beyond
				  the capabilities of BLS ambulances and their crewmembers from one health care
				  facility to another (such as a nursing home, rehabilitation facility or other
				  facility as provided for at N.J.S.A. 26:2H-2a ) via a specialty care transport unit
				  or air medical unit.
"AMD Standard" means the ambulance design and construction
				  specifications (KKK-A-1822E) published by the Ambulance Manufacturers Division of
				  the Truck Body and Equipment Association. Copies of the standards may be obtained
				  from the Truck Body and Equipment Association, Suite 1220, 5530 Wisconsin Avenue,
				  Washington, D.C. 20015.
"APLS certification" or "certified in APLS" means valid
				  certification in Advanced Pediatric Life Support as issued by the American College
				  of Emergency Physicians and the American Academy of Pediatrics.
"Automated external defibrillator or AED" means a device that can
				  be attached to a patient in cardiopulmonary arrest, analyze an electrocardiogram for
				  the presence of potentially lethal dysrhythmias (specifically, ventricular
				  fibrillation and fast ventricular tachycardia), deliver an electrical defibrillation
				  to the patient in accordance with the requirements of standard treatment protocols,
				  and produce an event summary that documents significant events in the utilization of
				  the device, specifically events prior to and after an electrical
				  defibrillation.
"Available" means ready for immediate utilization (pertaining to
				  equipment, vehicles and personnel) or immediately accessible (pertaining to
				  records).
"Base station" means the actual communications console that
				  permits the receiving of voice communications as well as telemetered
				  electrocardiograms. Such base station shall be readily accessible to the medical
				  command physician.
"Basic life support" or "BLS" means a basic level of pre-hospital
				  care that includes patient stabilization, airway clearance and maintenance,
				  cardiopulmonary resuscitation (CPR) (to the level of the Professional Rescuer or
				  Health Care Provider as issued by either the American Heart Association, the
				  American Red Cross, the National Safety Council or other entity determined by the
				  Department to comply with AHA CPR Guidelines), hemorrhage control, initial wound
				  care, fracture stabilization, victim extrication and other techniques and procedures
				  as defined in the United States Department of Transportation (U.S.D.O.T.) EMT-Basic
				  National Standards Curriculum (obtainable from The National Highway Traffic Safety
				  Administration, 400 7th Street S.W., Washington, D.C. 20590, by accessing their
				  website at
http://www.nhtsa.dot.gov/people/injury/ems
or by calling (888) 327-4236).
"Basic life support ambulance" or "BLS ambulance" means an
				  emergency medical services vehicle that is validly licensed by the Department and
				  operated in accordance with the standards set forth at N.J.A.C. 8:40.
"Basic life support ambulance service" or "BLS ambulance service"
				  means an entity that is validly licensed by the Department to provide pre-hospital
				  basic life support care; and/or BLS inter-facility transfers.
"BLS inter-facility transfer" means the transportation of a
				  patient not in need of advanced life support care from one health care facility to
				  another via a basic life support ambulance.
"Cardiac defibrillation" means the discharge of electrical current
				  through the fibrillating myocardium for the purpose of restoring a perfusing cardiac
				  rhythm.
"Certificate of need" means the formal written approval of the New
				  Jersey Department of Health and Senior Services to construct or expand a health care
				  facility or to institute a new health care service, in accordance with requirements
				  set forth at N.J.A.C. 8:33.
"Certified" or "certification" means official documentation that a
				  person has completed all the requirements of an approved training program and has
				  demonstrated competence in the subject matter to the satisfaction of the certifying
				  agency.
"Commissioner" means the Commissioner of the New Jersey Department
				  of Health and Senior Services.
"Communicable disease" means an illness due to a specific
				  infectious agent or its toxic products, specifically including, but not limited to,
				  those pathogens defined in the Federal bloodborne pathogen standards found at
				  29 C.F.R.
				  1910.1030(b), and which occurs
				  through transmission of that agent or its toxic products from a reservoir to a
				  susceptible host.
"Communications failure," when applied to medical command, means
				  circumstances that prevent ALS crewmembers from engaging in two-way communications
				  with the medical command physician due to technical difficulties.
"Communications failure protocols" means the specific course of
				  treatment to be followed by ALS crewmembers in the event that two-way communications
				  with the medical command physician cannot be made. Communications failure protocols
				  shall first be approved by the Department, in accordance with
				  8:41-3.21.
"Contaminated" means the presence or the reasonably anticipated
				  presence of blood or other potentially infectious materials on an item or
				  surface.
"Contaminated sharps" means any contaminated object that can
				  penetrate the skin including, but not limited to, needles, scalpels, broken glass,
				  broken capillary tubes and exposed ends of dental wires.
"Controlled dangerous substance" means a drug, substance or
				  immediate precursor identified in Schedules I through V of the New Jersey Controlled
				  Dangerous Substances Act (24:21-5 through
				  24:21-8.1 ). The term shall not include
				  distilled spirits, wine or malt beverages, as those terms are defined or utilized in
				  33:1-1 et seq., or tobacco and tobacco
				  products.
"Convicted" or "conviction" means a finding of guilt by a judge or
				  jury, a guilty plea, a plea of nolo contendere or non-vult or entry into a pre-trial
				  intervention program, or other diversionary program authorized under the statutes of
				  the State of New Jersey or under any other state's statutes.
"CPR certification" means valid certification in cardiopulmonary
				  resuscitation to the level of the Professional Rescuer or Health Care Provider as
				  issued by either the American Heart Association, the American Red Cross, the
				  National Safety Council or other entity determined by the Department to comply with
				  AHA CPR Guidelines.
"Crashworthy" means that all supplies, equipment, oxygen systems
				  and patient litters carried on the vehicle shall remain firmly in place and shall
				  not present a hazard to any vehicle occupant in the event of an accident or sudden
				  change in vehicle speed or direction. Crashworthy retention systems shall not
				  incorporate rubber straps, "shock cords" or Velcro(R) type closures. Crashworthy
				  retention systems for some items are covered by specific Federal standards. The
				  Department's test for crashworthiness of other retention systems is whether the item
				  can be removed from place without unlatching or unbuckling the retention
				  system.
"Crewmember" means any person (including, but not limited to, an
				  EMT-Basic, EMT-Paramedic or registered nurse, excluding pilots) who staffs a mobile
				  intensive care unit, specialty care transport unit or air medical unit.
"Crime" means, in accordance with the New Jersey Code of Criminal
				  Justice, specifically
				  2C:1-4, any offense for which a
				  sentence of imprisonment in excess of six months is authorized.
"Department" means the New Jersey Department of Health and Senior
				  Services.
"Department-Initiated-Out-of-Service" or "DIOOS" means the
				  immediate removal from service of a vehicle by Department staff, such that the
				  vehicle may not be utilized for the provision of any basic and/or advanced life
				  support care. Vehicles removed from service in this manner shall be identified by
				  the placement of an official Department "Out-of-Service" sticker on at least one of
				  the vehicle's windows.
"Director" means the person responsible for all activities of a
				  mobile intensive care program or air medical service. The criteria for directors
				  differ for mobile intensive care programs and air medical services. The specific
				  criteria for each is set forth at
				  8:41-9.3 and 11.3, respectively.
"Disorderly persons offense" or "petty disorderly persons offense"
				  shall have the same meaning as the definition provided by the New Jersey Code of
				  Criminal Justice at N.J.S.A. 2C:1-4, incorporated herein by reference, as amended
				  and supplemented. Generally, such offenses are under the jurisdiction of municipal
				  courts, carry out a maximum jail term of six months or less, and are characterized
				  by being minor in nature, not giving rise to the rights of trial by jury or
				  indictment by grand jury. Examples of these offenses include harassment, obstructing
				  a public passage, and fighting in a public place.
"Emergency" means a person's perceived need for immediate medical
				  care in order to prevent death or aggravation of physiological or psychological
				  illness or injury.
"Emergency medical services" or "EMS" means a system for the
				  provision of emergency care and transportation of persons who are sick or injured
				  and in need of immediate medical care.
"Emergency Medical Technician-Basic" or "EMT-Basic" means a person
				  trained in basic life support care and validly certified or recognized by the
				  Commissioner in accordance with the standards for Emergency Medical Technician-Basic
				  certification as set forth at N.J.A.C. 8:40A.
"Emergency Medical Technician-Paramedic" or "EMT-Paramedic" means
				  a person trained in advanced life support care and validly certified or recognized
				  by the Commissioner in accordance with the standards for Emergency Medical
				  Technician-Paramedic certification as set forth at N.J.A.C. 8:41A.
"Emergency response" means the provision of pre-hospital basic
				  life support care by crewmembers staffing a basic life support ambulance, and
				  includes those services that are provided after a call has been received by a 9-1-1
				  dispatcher requiring an immediate response (for example, automobile accidents, mass
				  gatherings, special events and stadium/arena EMS services) as well as emergent
				  responses to long-term care facilities that may or may not be routed through a 9-1-1
				  dispatcher.
"EMS educator" means the person responsible for coordinating all
				  activities associated with the clinical portion of an EMT-Paramedic training
				  program. The specific responsibilities required of an EMS educator are set forth at
				  8:41A-2.4(c)1  through
				  8.
"EMT-Paramedic student" means a person enrolled in an approved
				  EMT-Paramedic training program, as provided for at N.J.A.C. 8:41A. An EMT-Paramedic
				  student shall not be utilized to meet the minimum staffing requirements set forth at
				  8:41-9.8, 10.7 or 11.7.
"EMT-Paramedic training program" means a course of study, as
				  provided for at N.J.A.C. 8:41A, consisting of both didactic and clinical
				  instruction, designed for the purpose of preparing a person to sit for the National
				  Registry of Emergency Medical Technicians-Paramedic Certification
				  Examination.
"Federal Specification, KKK-A-1822" means the Federal
				  Specification for the Star-of-Life Ambulance KKK-A-1822E, Edition E, June 1, 2002,
				  incorporated herein by reference, as amended and supplemented. Copies of the
				  standards may be obtained from the General Services Administration, Centralized
				  Mailing List Service (TCAFL) P.O. Box 6477, Fort Worth, Texas 76115.
"Flight nurse" means a registered nurse who meets the criteria set
				  forth at 8:41-9.9 and who has successfully
				  completed specialized training in air medical care. Flight nurses are given a unique
				  identification number.
"Flight paramedic" means an individual certified by the Department
				  as an Emergency Medical Technician-Paramedic in accordance with the standard set
				  forth in N.J.A.C. 8:41A and who has successfully completed specialized training in
				  air medical care. Flight paramedics are given a unique identification number.
"FMVSS" means Federal Motor Vehicle Safety Standards, as set forth
				  at 49 C.F.R. 571, incorporated herein by reference. Copies of the standards may be
				  obtained from the Superintendent of Documents, Washington, D.C.
"Health care facility" means a facility so defined in the Health
				  Care Facilities Planning Act, N.J.S.A. 26:2H-1.1 et seq.
"Helicopter" means a heavier-than-air aircraft that depends
				  principally for its support in flight on the lift generated by one or more
				  rotors.
"Impervious" means not allowing liquids or dirt to penetrate the
				  surface of the material. For the purposes of this chapter, impervious surfaces do
				  not include coverings made of or containing carpet, velour or cloth.
"In-service" means the presence of a mobile intensive care unit,
				  specialty care transport unit or air medical unit at a sending or receiving health
				  care facility; the picking up, transporting or discharging of any patient; or any
				  instance where the mobile intensive care unit, specialty care transport unit or air
				  medical unit is ready to accept patients and perform advanced life support
				  care.
"ITLS certification" or "certification in ITLS" means valid
				  certification in International Trauma Life Support as issued by the American College
				  of Emergency Physicians.
"JEMS (Jersey Emergency Medical Services) Communications Plan"
				  means the authorized communications plan for emergency medical services, as issued
				  by the Department. Copies of the plan are available, for a fee, from the Office of
				  Emergency Medical Services.
"License" or "licensed" means validly licensed by the Commissioner
				  in accordance with the standards for licensure as set forth in this chapter.
"Medical command" means the medical direction provided to ALS
				  crewmembers by a medical command physician. The criteria for medical command differ
				  for mobile intensive care units, specialty care transport units and air medical
				  units. The specific criteria for each is set forth at
				  8:41-9.6, 10.6 and 11.6,
				  respectively.
"Medical command physician" means a physician validly licensed by
				  the New Jersey Board of Medical Examiners or another state's board of medical
				  examiners (or equivalent licensing agency) who provides medical direction to ALS
				  crewmembers via radio, telephone or other direct means of communications. The
				  criteria for medical command physicians differ for mobile intensive care units,
				  specialty care transport units and air medical units. The specific criteria for each
				  is set forth at 8:41-9.5, 10.5 and 11.5,
				  respectively.
"Medical control" means the general medical oversight provided to
				  the operations of a mobile intensive care program, specialty care transport service
				  or air medical service, including written protocols, quality assurance and other
				  medical supervision of the service's operations.
"Medical director" means the physician responsible for the medical
				  oversight of the operations of a mobile intensive care program, specialty care
				  transport service or air medical service. The specific criteria required of a
				  medical director are set forth at
				  8:41-9.4, 10.4 and 11.4,
				  respectively.
"Medical record" means any information and/or reports (including,
				  but not limited to, patient care reports) that describe a person's physical
				  condition and/or medical history.
"MICU Advisory Council" means the advisory council charged with
				  advising the Commissioner on matters regarding the provision of pre-hospital
				  advanced life support care, as defined at
				  26:2K-16.
"Mobile intensive care hospital" means an acute care hospital
				  authorized by the Commissioner, by way of a certificate of need, to develop and
				  maintain a mobile intensive care program for the purpose of providing advanced life
				  support care to a specific population, geographic region or political
				  subdivision.
"Mobile intensive care nurse" or "MICN" means a registered nurse
				  who meets all of the criteria set forth at N.J.A.C. 8:41-9.9.
"Mobile intensive care program" means a program, operated by a
				  mobile intensive care hospital, which is validly licensed by the Department to
				  provide pre-hospital advanced life support care by way of a specially equipped and
				  staffed mobile intensive care unit. The mobile intensive care hospital shall be
				  vested with the ultimate responsibility for the delivery of services and shall be
				  held accountable for the actions of all of its crewmembers in the event that there
				  are violations of any State or Federal licensing standards.
"Mobile intensive care unit" or "MICU" means a specialized
				  emergency medical services vehicle that is validly licensed by the Department and
				  operated in accordance with the standards set forth in this chapter.
"Mobility assistance vehicle" or "MAV" means a specialized
				  transport vehicle that is validly licensed by the Department and operated in
				  accordance with the standards set forth at N.J.A.C. 8:40.
"Neonatal" means the period of time from the moment of birth up to
				  and including the 28th day following birth.
"Office of Emergency Medical Services" or "OEMS" means the Office
				  of Emergency Medical Services in the New Jersey Department of Health and Senior
				  Services, PO Box 360, Trenton, New Jersey 08625-0360. The telephone number for OEMS
				  is (609) 633-7777.
"PALS certification" or "certification in PALS" means valid
				  certification in Pediatric Advanced Life Support as issued by the American Heart
				  Association.
"Patient" means any person who is ill or injured, living or
				  deceased and with whom a crewmember has established physical or verbal
				  contact.
"Patient care report" means the written documentation completed
				  each time a crewmember makes physical or verbal contact with a patient.
"Pediatric" means the period of time beginning with the 29th day
				  following birth up to, but not including, a person's thirteenth birthday.
"Petty disorderly persons offense" shall have the same meaning as
				  the definition provided by the New Jersey Code of Criminal Justice at N.J.S.A.
				  2C:1-4, incorporated herein by reference, as amended and supplemented. Generally,
				  such offenses are under the jurisdiction of municipal courts, carry a maximum jail
				  term of six months or less, and are characterized by being minor in nature, not
				  giving rise to the rights of trial by jury or indictment by grand jury. Examples of
				  these offenses include harassment, obstructing a public passage, and fighting in a
				  public place.
"Physician" means a person who is validly licensed by the New
				  Jersey State Board of Medical Examiners in accordance with the standards set forth
				  at 45:9-6.
"Physician assistant" means a person who is validly licensed by
				  the New Jersey State Board of Medical Examiners in accordance with the standards set
				  forth at N.J.S.A. 45:9-27.1 3.
"PHTLS certification" or "certification in PHTLS" means valid
				  certification in Pre-Hospital Trauma Life Support as issued by the National
				  Association of EMTs.
"Positive latching mechanism" means a latching mechanism that
				  requires the manual release of the latching device. This does not include magnetic
				  or friction-type latches.
"Pre-hospital" means the period of time prior to the delivery of a
				  patient to a physician or registered nurse at an acute care hospital or satellite
				  emergency department.
"Provider" means a mobile intensive care program, specialty care
				  transport service or air medical service. By virtue of such status, the provider
				  shall assume full legal responsibility for the delivery of services and shall be
				  held accountable for the actions of its crewmembers in the event that there are
				  violations of any State or Federal licensing standards.
"Provider-Initiated-Out-of-Service" or "PIOOS" means the temporary
				  removal from service of a vehicle by the provider. A provider may choose to remove a
				  vehicle from service for various reasons including, but not limited to, when the
				  vehicle is in transit for repairs, when being utilized for official administrative
				  duties or when being utilized in a parade or similar ceremony. Vehicles removed from
				  service in this manner shall be identified by the placement of a placard in one of
				  the vehicle's windows.
"Receiving health care facility" means a licensed health care
				  facility, such as a nursing home, rehabilitation facility or other facility as
				  provided for at N.J.S.A. 26:2H-2a, to which a patient is transferred following
				  evaluation and/or treatment.
"Regional dispatch center" means a facility that provides
				  coordinated dispatching of emergency services for a given area.
"Regional trauma center" means a State designated Level One
				  hospital-based trauma center equipped and staffed to provide emergency medical
				  services to accident or trauma victims.
"Registered nurse" means a person who is validly licensed by the
				  New Jersey State Board of Nursing in accordance with the standards set forth at
				  45:11-26.
"Regulated medical waste" means, as defined at
				  7:26-3A.5, those medical wastes that
				  have been listed or meet the waste characteristic classification criteria described
				  at 7:26-3A.6 and that must be managed in
				  accordance with the requirements of N.J.A.C. 7:26-3A.
"Respiratory care practitioner" means a person who is validly
				  licensed by the New Jersey State Board of Respiratory Care in accordance with the
				  standards set forth at
				  45:14E-10.
"Revocation" or "revoked" means the permanent voiding, withdrawal
				  and/or cancellation of a license or certification.
"Satellite emergency department" means a facility that is owned
				  and operated by an acute care hospital, which provides emergency care and
				  treatment.
"Sending health care facility" means a licensed health care
				  facility such as a nursing home, rehabilitation facility or other facility as
				  provided for at
				  26:2H-2(a),
				  incorporated herein by reference as amended and supplemented, from which a patient
				  is transferred by the patient's attending physician for treatment or services not
				  available at the sending licensed health care facility.
"Specialty care coordinator" means the person responsible for the
				  general operation of a specialty care transport service. The criteria for a
				  specialty care coordinator is set forth at
				  8:41-10.3.
"Specialty care transport service" means an entity that is validly
				  licensed by the Department to provide ALS inter-facility transfers, by way of a
				  specially equipped and staffed specialty care transport unit, between a sending
				  health care facility and a receiving health care facility (such as a nursing home,
				  rehabilitation facility or other facility as provided for at N.J.S.A. 26:2H-2a ) of
				  patients requiring specialized medical intervention or medical monitoring that is
				  beyond the capabilities of BLS ambulances and their crewmembers.
"Specialty care transport unit" or "SCTU" means a specialized
				  transport medical service vehicle that is validly licensed by the Department and
				  operated in accordance with the standards set forth in this chapter.
"Specialty staff" means validly licensed or certified persons such
				  as physicians, specially trained nurses or respiratory care practitioners that may
				  accompany the required crewmembers on a mobile intensive care unit, specialty care
				  transport unit or air medical unit.
"Specific order" means an order by a medical command physician
				  with regard to the treatment of a patient, whether directly transmitted by the
				  physician or relayed through a registered nurse.
"Standing orders" means specific treatment protocols, authorized
				  by the Commissioner, that occur prior to any communications with the medical command
				  physician.
"Star of Life" means the symbol described in certification of
				  registration number 1,058,022, which the United States Commissioner of Patents and
				  Trademarks has issued to the National Highway Traffic Safety Administration.
"Therapeutic agent" means any drug or agent which is utilized in
				  the treatment of the sick or injured, including those authorized in accordance with
				  8:41-6.1.
"Untreated regulated medical waste" means regulated medical waste,
				  as defined in this subchapter, which has not been treated to substantially reduce or
				  eliminate its potential for causing disease.
"Valid" or "validly" means original (not a photo copy), current,
				  up-to-date, not expired, in effect and/or not past the renewal date required by the
				  issuer.
"Vehicle" means a mobile intensive care unit, specialty care
				  transport unit or air medical unit, as defined in this subchapter.