Health, Department of

Emergency Medical Services - General

Chapter 7: Ambulance Service Systems

Effective Date: 02/14/1992 to 08/10/1995

Rule Type: Superceded Rules & Regulations

Reference Number: 048.0023.7.02141992

Date Filed 02/14/92

Expr Date

Supr Date

Repeal Date

Document Type RULES

CHAPTER VII

AMBULANCE SERVICE SYSTEMS

Section 1. Operation Approval. Before engaging or employing E.M.T.-II or Paramedic personnel, all ambulance services shall establish a system in accordance with this Chapter and obtain operational approval from the Division. A system shall consist of one (1) or more ambulance services, a physician medical director, and a sponsor hospital.

Section 2. Program Committee. A person desiring to establish a system utilizing E.M.T.-II or Paramedic personnel shall form a Program Committee. The Program Committee shall consist of, at a minimum:

1. (a) A physician licensed to practice medicine in this state who agrees to act as program director;
2. (b) Representatives from the sponsor hospital;
3. (c) Ambulance service(s) representative(s) from the area who will employ or utilize the attendants.

Section 3. Application.

1. (a) The Program Committee shall submit an application to the Division. The application may contain:
2. (i) The names of the Program Committee members;
3. (ii) A description of the medical need for the proposed system, including any supporting documentation;
4. (iii) An explanation of how the system shall be operated in compliance with the Division's regulations.
5. (b) The application shall be reviewed by the Division, the Task Force on Medical Training, and the Board of Medical Examiners.

Section 4. Sponsor Hospital.

1. (a) An E.M.T.-II or Paramedic system shall obtain the commitment of a sponsor hospital.
2. (b) The system shall be approved by the administration and medical staffs of the sponsor hospital.

(c) Eligibility requirements. The sponsor hospital:

(i) For an E.M.T.-II system shall have a registered nurse on duty for the emergency room twenty-four (24 hours a day.

(ii) For a paramedic system shall have a registered nurse, capable of constant voice communication coverage with a physician, on duty in the emergency room twenty-four (24) hours a day.

(A) The registered nurse shall be:

(I) Currently certified in Advanced Cardiac Life Support in accordance with the August 1987 standards of the American Heart Association, and as amended.

(II) Supervised in accordance with the Wyoming Nursing Act. W.S. 33-21-119 et seq.

(III) Immediately available at all times to communicate with E.M.T.-II or Paramedic personnel in the field.

(B) The physician shall be:

(I) Currently certified in Advanced Cardiac Life support in accordance with the 1987 standards of the American Heart Association, as amended.

(II) Available to communicate with the E.M.T.-II or Paramedic personnel in the field.

(iii) Shall explain the medical role of E.M.T.-II and Paramedic personnel to hospital employees.

(iv) Shall cooperate with the Division in the collection of statistical data.

(v) Shall maintain radio base station communications capability between the sponsor hospital and the ambulance(s).

(vi) Shall provide and resupply, as necessary, the E.M.T.-II or Paramedic units with medications and supplies used in the field. The ambulance service using the supplies and medications shall be responsible for reimbursing the hospital.

(vii) Shall provide clinical experience with supervision for trainees during the training program and for continuing medical education.

(viii) Shall provide for audit in review of E.M.T.-II cases quarterly and Paramedic advanced life support cases monthly. All concerned E.M.T.-II or Paramedic personnel shall attend the meetings.

(ix) Shall commit to participation in a minimum of one continuing education program for

Paramedic personnel monthly as required by Chapter VIII.

(x) For a Paramedic system shall have an ICU/CCU Department.

Section 5. Physician Medical Director. Both E.M.T.-II 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 duties shall include at a minimum:

(a) Monitoring trip reports where E.M.T.-II activities were carried out. The trips must be monitored quarterly.

(b) Monitoring Paramedic trip report forms where advanced life support activities were carried out. The trips shall be monitored each month.

(c) Review E.M.T.-II defibrillation or intubation incidents with all concerned personnel before submitting reports to the Division.

(d) Filing with the Division current copies of E.M.T.-II or Paramedic written authorizations and protocols.

Section 6. Communications Systems. Systems utilizing E.M.T.-II and Paramedic personnel shall maintain a communications system capable of:

(a) Voice communication between the ambulance and the sponsor hospital and physicians.

(b) Two-channel OEM voice and EKG recording tape units for E.M.T. and E.M.T.-II systems utilizing automatic or semiautomatic defibrillation certified personnel.

(c) Tape recording medical communications between the sponsor hospital and Paramedic personnel on advanced life support treatment calls.

(d) Biomedical telemetry is not mandatory. In situations where the sponsor hospital and the committee do not feel telemetry is needed, it is not required, but it must be agreed by both the committee and the sponsor hospital that the Paramedic be authorized to read and interpret

electrocardiograms in the field. Where telemetry is not used it is required to have an EKG strip chart writer in the field, and advanced life support treatment tapes will be reviewed for purposes of medical audit by the local committee and the State Task Force, as deemed necessary.

Section 7. Decision. The Division shall notify the Program Committee following its decision. The Division shall approve the system if it meets the requirements of this Chapter. The Division shall provide recommendations for future compliance if the system is disapproved.