DRAFT CHANGES Page 58 of 58
DEPARTMENT OF HUMAN SERVICES – PUBLIC HEALTH
DIVISION 265
EMERGENCY MEDICAL TECHNICIANS
333-265-0000
Definitions
(1) "Ambulance Service" means any individual, partnership, corporation, association, governmental agency or other entity that holds a [the Division] Public Health-issued ambulance service license to provide emergency and non-emergency care and transportation to sick, injured or disabled persons.
(2) “Business day” means Monday through Friday when Public Health is open for business, this excludes holidays.
(3) [(2)] "Clinical Education (Clinical)" means those hours of the curriculum to synthesize cognitive and psychomotor skills. These hours must be obtained in hospital clinical areas as prescribed by [the Division] Public Health and be performed under a preceptor.
(4) [(4)] "Continuing Education" means instruction designed to provide training to EMTs for the purpose of preparing him or her for renewal of his or her EMT certification. Continuing education does not include attending EMS related business meetings, EMS Exhibits or Trade Shows.
(5) [(4)] "Didactic Instruction" means the delivery of primarily cognitive material through lecture, video, discussion, and simulation by program faculty.
(6) [(5)] "Direct Visual Supervision" means having a preceptor in the ambulance patient compartment or at the patient's side to monitor the EMT in training.
[(6) "Division" means the Health Division of the Department of Human Services and its authorized representatives.]
(7) "Emergency Care" means the performance of acts or procedures under emergency conditions in the observation, care and counsel of the ill, injured or disabled; in the administration of care or medications as prescribed by a licensed physician, insofar as any of these acts is based upon knowledge and application of the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in prehospital emergency care. However, "emergency care" does not include acts of medical diagnosis or prescription of therapeutic or corrective measures.
(8) "Emergency Medical Services (EMS) Agency" means any person, governmental unit, corporation, partnership, sole proprietorship or other entity that utilizes EMTs to provide prehospital emergency or non-emergency care.
(9) "Emergency Medical Technician (EMT)" means a person who has received formal training in prehospital and non emergency care and is state-certified to attend any ill, injured or disabled person. Police officers, fire fighters, funeral home employees and other personnel serving in a dual capacity, one of which meets the definition of "emergency medical technician" are "emergency medical technicians" within the meaning of ORS chapter 682.
(10) "EMS Medical Director" means a licensed physician who provides direction of emergency or non-emergency care provided by a licensed EMS Agency. The EMS medical director must meet the qualifications as defined in OAR 847-035-0020.
[(10)] (11) "EMT-Basic" means a person who completes an EMT-Basic course as prescribed by these rules and is certified by [the Division] Public Health.
[(11)] (12) "EMT-Intermediate" means a person who completes an EMT-Intermediate course as prescribed by these rules and is certified by [the Division] Public Health.
[(12)] (13) "EMT-Paramedic" means a person who completes an EMT-Paramedic course as prescribed by these rules and is certified by [the Division] Public Health.
[(13)] (14) "Field Internship" means those calls acquired by a student during an approved EMT-Paramedic course under a preceptor. A call shall be accepted when the preceptor has documented and verified satisfactory student performance, which includes the application of specific assessment and treatment skills required of a certified EMT-Paramedic.
[(14)] (15) "Formal Case Review" means an educational presentation in which a physician or physician designee utilizes an actual ambulance or rescue call as a basis for educating EMTs. A formal case review includes a review of the call, review of the documentation prepared by the ambulance or rescue crew, discussion of the patient's course of care in the emergency department or hospital inpatient areas, and instruction on the clinical issues raised by the particular patient.
[(15)] (16) "Endorsement" means the manner in which a person may obtain Oregon EMT certification when that person is certified and in good standing in another state or with the National Registry of EMTs. [and is in standing with that state or the National Registry of EMTs.]
[(16)] (17) "In Good Standing" means a person who is currently certified or licensed, who does not have any restrictions placed on his or her certificate or license, or who is not on probation with the certifying or licensing agency for any reason.
[(17) "Medical Director" or supervising physician means a medical or osteopathic a physician licensed under ORS chapter 677, actively registered and in good standing with the Board of Medical Examiners, who provides direction of emergency or non-emergency care provided emergency medical technicians, registered nurses or physician assistants associated with a licensed ambulance service. The medical director must meet the qualifications of a supervising physician as defined in OAR 847-035-0020.]
(18) "Medical Emergencies - Assessment and Management" means EMT continuing education subjects that include, but are not limited to: assessment of the medical patient; acute abdomen; burns; cardiac emergencies; communicable diseases; diabetic emergencies; dyspnea; epilepsy/convulsions; emergency childbirth; emotional disturbances/mental illness; hazardous materials; ingested poisons; near-drowning emergencies; stroke; and temperature related emergencies.
(19) "Non-Emergency Care" means the performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24-hours, including but not limited to observation, care and counsel of a patient and the administration of medications prescribed by a physician licensed under ORS chapter 677, insofar as any of those acts are based upon knowledge and application of the principles of biological, physical and social science and are performed in accordance with scope of practice rules adopted by the Board of Medical Examiners in the course of providing prehospital care as defined by this section.
(20) “Online Medical Supervision” means real-time direct communication by a physician who is providing EMS providers with direction during a patient encounter.
[(20)] (21) "Patient" means an ill, injured or disabled person who may be [transported in an ambulance] cared for by an EMS Agency.
[(21)] (22) "Pediatric Patient - Assessment and Management" means EMT continuing education subjects that include, but are not limited to: pediatric patient assessment; pediatric trauma; emergency care for respiratory distress; airway obstructions; febrile convulsions; cardiac arrest; shock; sudden infant death syndrome and abuse/neglect.
[(22)] (23) "Person" means any individual, corporation, association, firm, partnership, joint stock company, group of individuals acting together for a common purpose, or organization of any kind and includes any receiver, trustee, assignee, or other similar representatives thereof.
[(23)] (24) "Physician Designee" means an EMT-Basic, EMT-Intermediate, EMT-Paramedic, registered nurse, physician assistant or physician that a medical director has authorized to conduct formal case reviews, or approve audiovisual programs or EMS journal articles for EMT continuing education.
[(24)] (25) "Prehospital Care" or “out of hospital care” means that care rendered by EMTs as an incident of the operation of an ambulance and that care rendered by EMTs as incidents of other public or private safety duties, and includes, but is not limited to "emergency care" as defined by this section.
[(25)] (26) "Preceptor" means a person approved by an accredited teaching institution and appointed by the EMS [provider] Agency, who supervises and evaluates the performance of an EMT student during the clinical, skills lab and field internship phases of an EMT course. A preceptor must be a physician, physician assistant, registered nurse, or certified EMT in good standing at or above level for which the student is in training.
[(26)] (27) “Psychomotor Skills” means those patient care skills listed in [the Division] Public Health Skill Performance Reference Guide.
(28) “Public Health” means the Oregon Public Health Division within the Department of Human Services and its authorized representative, Emergency Medical Services and Trauma Systems Section.
[(27) "Psychomotor Skills (Skills)" means those patient care skills listed in [the Division] Public Health's Skill Performance Reference Guide.]
[(27)] (29) "Scope of Practice" means the maximum level of emergency or non-emergency care that an EMT may provide as set forth in OAR 847-035-0030.
[(28)] (30) "Skills Lab[oratory]" means those hours of the curriculum that provides the student with the opportunity to develop the skills for the level of training obtained.
[(29)] (31) "Special Considerations and Support Services" means EMT continuing education subjects that include, but are not limited to: operating around air ambulances; child abuse; crime scene; critical incident stress debriefing; emergency vehicle and ambulance operation; emergencies involving the handicapped; extrication techniques; hazardous materials; incident command systems; injury prevention; lifting and moving patients; medical-legal aspects of EMS; patient care report forms; procedures for triage situations; rape intervention; use of the trauma system; EMS management; and the role and responsibilities of an EMT.
(31) “Standing orders” means the written detailed procedures for medical or trauma emergencies and non-emergency care to be performed by an EMT or First Responder issued by the supervising physician commensurate with the scope of practice and level of certification of the EMT or First Responder.
(32) “Subject Individual” means any Oregon EMT or First Responder Applicant or Oregon EMT or First Responder certificate holder.
[(30] (33)“Teaching Institution" means a two-year community college or four-year degree granting college or a licensed vocational school that is accredited by the Office of Professional Technical Education, Office of Community College Services/Oregon Department of Education.
[(31)] (34) "Trauma Assessment and Management" means EMT continuing education subjects that include, but are not limited to: assessment of the trauma patient; amputation injuries; chest injuries; facial injuries; fractures/dislocations; head/neck injuries; internal injuries; multi-systems injuries; soft tissue injuries; and the control of bleeding and shock.
[(32)] (35) "Unprofessional Conduct" means conduct unbecoming a person certified in prehospital emergency, and non-emergency care, or detrimental to the best interest of the public and includes conduct as defined in ORS 682.025(19).
(a) Unprofessional conduct includes, but is not limited to:
(A) [knowing or w] Willful violation of patient privacy or confidentiality by releasing information to persons not directly involved in the care or treatment of the patient;
(B) [use of i] Illegal drug[s] use on or off duty;
(C) [use of a] Alcohol use within eight hours of going on duty or while on duty or in an on-call status;
(D) [violation of] Direct verbal order[s] violation from a physician who is responsible for the care of a patient;
(E) [v] Violation of orders given by an on-line medical resource physician, whether delivered by radio or telephone;
(F) [v] Violation of standing orders [the written detailed procedures for medical or trauma emergency to be performed by an EMT issued by the medical director commensurate with the scope of practice and level of certification or licensure of the EMT, registered nurse or physician assistant] without direction of a medical director;
(G) [utilizing] Use of invasive medical procedures in violation of generally accepted standards of the medical community;
(H) [a] Any action that constitutes a violation of any statute, municipal code, or administrative rule that endangers the public, or other public safety officials, or other EMTs, patients, or the general public (including improper operation of an emergency medical vehicle);
(I) [I] Instructing, causing or contributing to another individual violating a statute or administrative rule, including EMT acting in a supervisory capacity;
(J) Participation in the issuance of false continuing education documents or collaboration therein, including issuing continuing education verification to one who did not legitimately attend an educational event;
(K) [s] Signing into an educational event of a person not actually present;
(L) [a] Assisting permitting another EMT to exceed his or her lawful scope of practice;
(M) [u] Unlawful use of emergency vehicle lights and sirens;
(N) [p] Providing false or misleading information to [the Division] Public Health, to the State EMS Committee, to the Subcommittee on EMT Certification and Discipline, to an EMS teaching institution or clinical/field internship agency;
(O) [r] Responding to which the EMT is not properly dispatched ("call-jumping"), whether in a private auto, ambulance, or other vehicle, in contravention of local protocols, procedures, or ordinances, or interfering with the safe and effective operation of an EMS system;
(P) [c] Cheating on any examination used to measure EMS related knowledge or skills;
(Q) [a] Assisting another person in obtaining an unfair advantage on EMT examinations;
(R) [d] Defrauding [the Division] Public Health;
(S) [k] Knowingly providing emergency medical care aboard an unlicensed ambulance;
(T) [v] Violation of the terms of a written agreement with [the Division] Public Health;
(U) [e] Engaging in sexual activity constituting a crime in Oregon or engaging in on-the-job sexual harassment which may endanger the public or a person providing emergency medical care;
(V) [a] Arriving for duty in a condition whereby the EMT is likely to become impaired through fatigue, illness, or any other cause, as to make it unsafe for the employee to begin to operate an ambulance or provide patient care; and
(W) [a] Any violation of these rules or any law, administrative rule, or regulation governing ambulances, or EMTs, or emergency medical service systems.
(b) This section does not create any new substantive violations. It is included solely to inform EMS agencies and EMTs as to conduct that [the Division] Public Health regards as already proscribed by the statutory definition of unprofessional conduct.
Stat. Auth.: ORS 682.025 & (ORS 682.215) Renumbered to 682.017 in 2003
Stats. Implemented: ORS 682.025, ORS 682.208, ORS 682.216, ORS 682.220, ORS 682.224 & ORS 682.017
Hist.: HD 18-1994, 6-30-94, cert. ef. 7-1-94; HD 8-1995, f. & cert. ef. 11-6-95; OHD 9-2001, f. & cert. ef. 4-24-01
333-265-0010
Approved EMT Courses
(1) [The Division] Public Health shall approve an EMT course conducted by an Oregon teaching institution which:
(a) Is accredited by the Oregon Department of Education or the Oregon State Board of Higher Education as specified in OAR 581-049-0000 through 581-049-0040. Where it is determined by [the Division] Public Health that in a rural area, adequate training at the EMT-Basic level or EMT Intermediate course is not available through a teaching institution, [the Division] Public Health may, in its sole discretion, authorize an organization licensed by [the Division] Public Health to conduct the EMT courses. Such authorization shall be subject to such terms and conditions as [the Division] Public Health may specify;