1. A. A licensee shall ensure that, except as provided in subsection (B):

   1. 1. Each critical care mission is staffed by a medical team of at least two individuals with the following qualifications:

      1. a. For a critical care interfacility transport mission:

         1. i. A physician or registered nurse; and
         2. ii. Another physician, another registered nurse, a Paramedic, or a licensed respiratory care practitioner; and

      2. b. For a critical care mission that is an emergency medical services transport:

         1. i. A physician or registered nurse; and
         2. ii. A Paramedic or another registered nurse;

   2. 2. Each interfacility maternal transport mission is staffed by a medical team that:

      1. a. Complies with the requirements for a critical care mission medical team in subsection (A)(1); and

      2. b. Has the following additional qualifications:

         1. i. Proficiency in advanced emergency cardiac life support that includes didactic instruction and a practical skills test, consistent with training recognized by the American Heart Association;
         2. ii. Proficiency in neonatal resuscitation; and
         3. iii. Proficiency in stabilization and transport of the pregnant patient;

   3. 3. Each interfacility neonatal transport mission is staffed by a medical team that:

      1. a. Complies with the requirements for a critical care mission medical team in subsection (A)(1); and

      2. b. Has the following additional qualifications:

         1. i. Proficiency in pediatric advanced emergency life support that includes didactic instruction and a practical skills test, consistent with training recognized by the American Heart Association; and
         2. ii. Proficiency in neonatal resuscitation and stabilization of the neonatal patient; and

   4. 4. Each advanced life support mission is staffed by a medical team of at least two individuals with the following qualifications:

      1. a. For an advanced life support mission that is an emergency medical services transport:

         1. i. A physician, registered nurse, or Paramedic; and
         2. ii. Another Paramedic or another registered nurse;

      2. b. For an advanced life support interfacility transport mission:

         1. i. A physician, registered nurse, or Paramedic; and
         2. ii. Another Paramedic, a licensed respiratory care practitioner, or another registered nurse.

2. B. If the pilot on a mission using a rotor-wing air ambulance determines, in accordance with the air ambulance service’s written guidelines required under subsection (C)(1), that the weight of a second medical team member could potentially compromise the performance of the rotor-wing air ambulance and the safety of the mission, and the use of a single-member medical team is consistent with the on-line medical direction or on-line medical guidance received as required under subsection (C)(2), an air ambulance service may use a single-member medical team consisting of an individual with the following qualification:

   1. 1. For a critical care mission, a physician or registered nurse; and
   2. 2. For an advanced life support mission, a physician, registered nurse, or Paramedic.

3. C. A licensee shall ensure that:

   1. 1. Each air ambulance service rotor-wing pilot is provided with written guidelines to use in determining when the weight of a second medical team member could potentially compromise the performance of a rotor-wing air ambulance and the safety of a mission, including the conditions of density altitude and weight that warrant the use of a single-member medical team;

   2. 2. The following are done, without delay, after an air ambulance service rotor-wing pilot determines that the weight of a second medical team member could potentially compromise the performance of a rotor-wing air ambulance and the safety of a mission:

      1. a. The pilot communicates that information to the medical team,
      2. b. The medical team obtains on-line medical direction or on-line medical guidance regarding the use of a single-member medical team, and
      3. c. The medical team proceeds in compliance with the on-line medical direction or on-line medical guidance;
   3. 3. A single-member medical team has the knowledge and medical equipment to perform one-person cardiopulmonary resuscitation;
   4. 4. The patient care provided by each single-member medical team, including consideration of each patient’s status upon arrival at the destination health care institution, is reviewed through the quality improvement processes in R9-25-705(A)(11)(b) and (c); and
   5. 5. A single-member medical team is used only when no other transport team is available that would be more appropriate for delivering the level of care that a patient requires.
4. D. A licensee shall ensure that the air ambulance service creates and maintains for each personnel member a file containing documentation of the personnel member’s qualifications, including, as applicable, licenses, certifications, and training records.

Historical Note

New Section made by final rulemaking at 12 A.A.R. 656, effective April 8, 2006 (Supp. 06-1). R9-25-706 renumbered to R9-25-710; new Section R9-25-706 renumbered from R9-25-711 and amended by final rulemaking at 28 A.A.R. 842 (April 29, 2022), effective June 5, 2022 (Supp. 22-2). Amended by exempt rulemaking at 28 A.A.R. 3681 (December 2, 2022), with an immediate effective date of November 8, 2022 (Supp. 22-4).