1. (1) To become Critical Care licensed, a provider service must:

   1. (a) Submit a Critical Care Practice application.
   2. (b) Follow the approved Alabama EMS Critical Care Patient Care Protocols in addition to the Alabama EMS Patient Care Protocols.
2. (2) To be eligible for a Critical Care license, each provider service medical director must attend, or call in for, the majority of the quarterly quality assurance meetings.

3. (3) Each provider service shall:

   1. (a) Carry all required equipment listed on the Critical Care Equipment List.
   2. (b) Carry only the medications that are listed in the Critical Care medication formulary that has been approved by the OEMS.

4. (4) To obtain a Critical Care endorsement, a paramedic must:

   1. (a) Present a Board approved application and proof of the IBSC CCP or FP certification, or hold a valid, unencumbered Alabama registered nurse license and certification from the Board of Certification for Emergency Nursing as a Certified Flight Registered Nurse (CFRN) or Certified Transport Registered Nurse (CTRN).
   2. (b) Have 3 years licensed at the paramedic level.
   3. (c) Medical Director shall verify skill competencies.

5. (5) The critical care endorsement shall be valid so long as the paramedic maintains:

   1. (a) Current licensure as a paramedic by the Board.
   2. (b) Current certification through the IBSC or a valid, unencumbered Alabama registered nurse license and certification from the Board Certification for CFRN or CTRN.
6. (6) A paramedic with a Critical Care endorsement shall be authorized to perform the skills and procedures included in the Alabama EMS Critical Care Patient Care Protocols in addition to the Alabama EMS Patient Care Protocols.
7. (7) A licensed paramedic with a Critical Care endorsement shall be responsible for providing the OEMS with copies of his or her current IBSC or Board Certification in Emergency Nursing certification.
8. (8) Provider services must keep all training documents on file for auditing purposes and made available to the OEMS upon request.

Author: William Crawford, M.D., Jamie Gray

Statutory Authority: Code of Ala. 1975, §22-18-1, et seq.

Editor’s Note: Rule 420-2-1-.33 was renumbered 420-2-1-.13 as per certification Filed February 20, 2019; effective April 7, 2019.

History: New Rule: Filed April 20, 2011; effective May 25, 2011. Repealed and New Rule: Filed March 16, 2017; effective April 30, 2017. Repealed and New Rule: Filed February 20, 2019; effective April 7, 2019. Repeal and New Rule: Published April 30, 2020; effective June 14, 2020. Repeal and New Rule: Published February 28, 2022; effective April 14, 2022.