|(a) The following words and terms, when used in this
section, shall have the following meanings, unless the context clearly
(1) Advanced life support--Health care provided to
sustain life in an emergency, life-threatening situation. The term
includes the initiation of intravenous therapy, endotracheal or esophageal
intubation, electrical cardiac defibrillation or cardioversion, and
drug therapy procedures.
(2) Direct supervision--Supervision by a licensed physician
who is present in the same area or an area adjacent to the area where
an emergency medical technician-paramedic or licensed paramedic performs
a procedure and who is immediately available to provide assistance
and direction during the performance of the procedure.
(3) Emergency medical technician-paramedic (EMT-P)
or licensed paramedic (LP)--An individual who is certified by the
Department of State Health Services (DSHS) as minimally proficient
to provide advanced life support that includes initiation and maintenance
of certain procedures under a physician's supervision, including intravenous
therapy, endotracheal or esophageal intubation or both, electrical
cardiac defibrillation or cardioversion, and drug therapy.
(4) Protocols--Written instructions providing EMT-Ps
or LPs with a standardized approach to commonly encountered problems
in a health care facility-based setting, typically in regard to patient
(5) Standing delegation orders--Instructions or orders
provided by a supervising physician to EMT-Ps or LPs, directing them
to perform certain medical care, as allowed by law.
(b) Notwithstanding other law, a person who is certified
as an EMT-P or a LP, is acting under the delegation and direct supervision
of a licensed physician, and is authorized to provide advanced life
support by a health care facility, may in accordance with DSHS rules
provide advanced life support in the facility's emergency or urgent
care clinical setting, including a hospital emergency room and a freestanding
emergency medical care facility.
(c) The supervising physician may use protocols, which
may include standing delegation orders. Such instructions may not
be used in lieu of communication with the supervising physician or
of obtaining the physician's physical assistance and direction during
the performance of a procedure.
(d) The physician who delegates to and directly supervises
advanced life support in a healthcare facility as authorized in this
section remains professionally and legally responsible for the patient
care provided by the EMT-P or LP.
(e) The physician who delegates to and directly supervises
an EMT-P or LP providing advanced life support must ensure that the
EMT-P or LP meets all requirements under the law related to creating
and maintaining a medical record documenting the patient encounter.