Wyo. Code R. 048-0023-7
Emergency Medical Services - General
Chapter 7: Advanced Life Support (ALS) Systems
Effective Date: 12/08/2008 to Current
Rule Type: Current Rules & Regulations
Reference Number: 048.0023.7.12082008
Section 1. Operation Approval. Before engaging or employing EMT Intermediate or Paramedic personnel, all ALS services shall establish a system in accordance with this Chapter and obtain operational approval from the Division. An ALS system shall consist of one (1) or more (ALS) services, a physician medical director, and a sponsor hospital.
(a) 'EMT Intermediate system' means an ALS service that has been authorized by the Board and the Division to utilize EMT Intermediate personnel in accordance with the guidelines established by the Board and the Division.
(b) 'Paramedic System' means an ALS service that has been authorized by the Board and the Division to utilize Paramedic personnel in accordance with the guidelines established by the Board and the Division.
(a) The physician medical director shall submit an application to the Division. The application for an ALS system shall contain:
(i) A description of the medical need for the proposed system, including any supporting documentation; and
(ii) A proposed operations manual.
(b) The application shall be reviewed by the Division and the Task Force on Prehospital Care. The Task Force shall provide a recommendation to the Board for final review.
(a) An ALS service shall obtain the commitment of a sponsor hospital.
(b) The system shall be approved by the hospital administrator and chief of the medical staff of the sponsor hospital.
(c) Eligibility requirements. The sponsor hospital:
(i) For an EMT Intermediate system, shall have a registered nurse on duty for the emergency room twenty-four (24) hours a day and capable of constant voice communication coverage with a physician.
(ii) For a Paramedic system, shall have a registered nurse, on duty in the emergency room twenty-four (24) hours a day and capable of constant voice communication coverage with a physician.
(A) The registered nurse shall:
(I) (Be) current in Advanced Cardiac Life Support (ACLS) with the standards of the American Heart Association;
(II) Have audited the Advanced Trauma Life Support (ATLS) course of the American College of Surgeons or an equivalent nursing trauma course;
(III) Function in accordance with the Wyoming Nursing Act; W.S. 33-21-119, et seq.; and
(IV) Be immediately available at all times to communicate with EMT Intermediate, or Paramedic personnel in the field.
(B) The Physician shall:
(I) Be current in Advanced Trauma Life Support (ATLS) with the standards of the American College of Surgeons or its equivalent from the American College of Emergency Physicians;
(II) Be current in Advanced Cardiac Life Support (ACLS) with the standards of the American Heart Association;
(III) Be available to communicate with the EMT Intermediate or Paramedic personnel in the field;
(IV) Explain the medical role of EMT Intermediate and Paramedic personnel to appropriate hospital staff;
(V) Cooperate with the Division in the collection of statistical data;
(VI) Maintain direct communications capability between the sponsor hospital and the ALS service(s);
(VII) Provide clinical experience with supervision for trainees during the training program and for continuing medical education;
(VIII) Provide for audit in review of EMT Intermediate cases and Paramedic advanced life support cases as outlined in Chapter 8. All concerned EMT Intermediate or Paramedic personnel shall attend the meetings; and
(IX) Practice in a hospital which has an intensive care unit or a monitored bed unit (MBU).
Section 4. Physician Medical Director. Both EMT Intermediate and Paramedic systems shall be supervised by a physician medical director. The physician medical director shall be a physician licensed to practice medicine in this state. The physician medical director's duties shall include at a minimum:
(a) Filing with the Division copies of current protocols and authorizations, that have been reviewed and approved by the Division and the Task Force, for EMT Intermediate or Paramedic systems;
(b) Monitoring PCRs where EMT Intermediate activities were carried out. The trip reports shall be monitored quarterly;
(c) Monitoring Paramedic PCR forms where advanced life support activities were carried out. The trip reports shall be monitored quarterly; and
(d) Reviewing reports of EMT Intermediate and Paramedic advanced skills usage with all concerned personnel, then submitting reports to the Division no later than December 31st of each year or as requested by the Division.
Section 5. Communication Systems. All ALS service systems shall maintain a communication system capable of:
(a) Voice communication between the ALS service and the sponsor hospital and physicians;
(b) Voice and/or EKG recording units for services utilizing manual, automatic or semiautomatic defibrillation certified personnel.
(c) Telemetry is not mandatory except for the EMT Intermediate ambulance services approved for the optional cardiac level skills and medications. Advanced life support data shall be reviewed for the purpose of medical audit by the Physician Medical Director, the Division and the Physician's Task Force, as deemed necessary.
Section 6. Decision. Upon receipt of all required information, the Division shall notify the Program Committee within ten (10) working days following its decision. The Division shall approve the system if it meets the requirements of this Chapter. If the proposed system does not meet the requirements of this Chapter, the Division shall not approve the system. If the Division does not approve the application for the system it shall provide recommendations for future compliance and applicant may reapply.