| (4) The protocols shall address the use of all required,
additional, and/or specialized medical equipment, supplies, and pharmaceuticals
carried on each EMS vehicle in the provider's fleet.
(5) The protocols shall identify delegated procedures
for each EMS Certification or license level utilized by the provider.
(6) The protocols shall indicate specific applications,
including geographical area and duty status of personnel.
(i) EMS Equipment, supplies, medical devices, parenteral
solutions and pharmaceuticals.
(1) The EMS provider shall submit a list, approved
by the medical director and fully supportive of and consistent with
the protocols, of all medical equipment, supplies, medical devices,
parenteral solutions and pharmaceuticals to be carried. The list shall
specify the quantities of each item to be carried and shall specify
the sizes and types of each item necessary to provide appropriate
care for all age ranges appropriate to the needs of their patients.
The quantities listed shall be appropriate to the provider's call
volume, transport times and restocking capabilities.
(2) All critical patient care equipment, medical devices,
and supplies shall be clean and fully operational. All critical patient
care battery powered equipment shall have spare batteries or an alternative
power source, if applicable.
(3) All solutions and pharmaceuticals shall be in date
and shall be stored and maintained in accordance with the manufacturers
and/or U.S. Federal Drug Administration (FDA) recommendations.
(4) The requirements for air ambulance equipment and
supplies are listed in §157.12(h) of this title or §157.13(h)
of this title.
(j) The following items shall be present on each EMS
in-service vehicle and on, or immediately available for, each response-ready
vehicle in quantities, sizes and types as specified in the equipment
list as required in subsection (i) of this section:
(1) Basic Life Support:
(A) oropharyngeal airways;
(B) portable and vehicle mounted suction;
(C) bag valve mask units, oxygen capable;
(D) portable and vehicle mounted oxygen;
(E) oxygen delivery devices;
(F) dressing and bandaging materials;
(G) rigid cervical immobilization devices;
(H) spinal immobilization devices;
(I) extremity splints;
(J) equipment to meet special patient needs;
(K) equipment for determining and monitoring patient
vital signs, condition or response to treatment;
(L) pharmaceuticals, as required by medical director
protocols;
(M) An External Cardiac Defibrillator appropriate to
the staffing level;
(N) A patient-transport device capable of being secured
to the vehicle; and
(O) An epinephrine auto injector or similar device
capable of treating anaphylaxis.
(2) Advanced Life Support:
(A) all required BLS equipment;
(B) advanced airway equipment;
(C) IV equipment and supplies; and
(D) pharmaceuticals as required by medical director
protocols.
(3) MICU:
(A) all required BLS and ALS equipment;
(B) cardiac monitor/defibrillator; and
(C) pharmaceuticals as required by medical director
protocols.
(4) BLS with ALS Capability:
(A) all required BLS equipment, even when in service
or response ready at the ALS level; and
(B) all required ALS equipment, when in service or
response ready at the ALS level.
(5) BLS with MICU Capability:
(A) all required BLS equipment, even when in service
or response ready at the MICU level; and
(B) all required MICU equipment, when in service or
response ready at the either the MICU level.
(6) ALS with MICU Capability:
(A) all required ALS equipment, even when in service
or response ready at the MICU level; and
(B) all MICU equipment, when in service or response
ready at the MICU level.
(7) In addition to medical supplies and equipment:
(A) a complete and current copy of written protocols
approved by the medical director; with a current and complete equipment,
supply, and medication list;
(B) operable emergency warning devices;
(C) personal protective equipment for the crew to include
at least:
(i) protective, non-porous gloves;
(ii) medical eye protection;
(iii) medical respiratory protection;
(iv) medical protective gowns or equivalent; and
(v) personal cleansing supplies;
(D) sharps container;
(E) biohazard bags;
(F) portable, battery-powered flashlight (not a pen-light);
(G) a mounted fire extinguisher;
(H) "No Smoking" signs posted in the patient compartment
and cab of vehicle; and
(I) emergency response guide book (for hazardous materials).
(8) As justified by specific patient needs, and when
qualified personnel are available, providers may appropriately utilize
equipment in addition to that which is required by their designation
levels. Equipment used must be consistent with protocols and/or patient-specific
orders and must correspond to personnel qualifications.
(k) National accreditation. If a provider has been
accredited through a national accrediting organization approved by
the department and adheres to Texas staffing level requirements, the
department may exempt the provider from portions of the license process.
In addition to other licensing requirements, accredited providers
shall submit:
(1) an accreditation self-study;
(2) a copy of formal accreditation certificate; and
(3) any correspondence or updates to or from the accrediting
organization which impact the provider's status.
(l) Subscription or Membership Services. An EMS provider
who operates or intends to operate a subscription or membership program
for the provision of EMS within the provider service area shall meet
all the requirements for an EMS provider license as established by
the Health and Safety Code, Chapter 773, and the rules adopted thereunder,
and shall obtain department approval prior to soliciting, advertising
or collecting subscription or membership fees. In order to obtain
department approval for a subscription or membership program, the
EMS provider shall:
(1) Obtain written authorization from the highest elected
official (County Judge or Mayor) of the political subdivision(s) where
subscriptions will be sold. Written authorization must be obtained
from each County Judge if subscriptions are to be sold in multiple
counties.
(A) The County Judge must provider written authorizations
if subscriptions sold across an entire county.
(B) The Mayor may provide written authorization if
subscriptions are sold exclusively within the boundaries of an incorporated
town or city.
(2) Submit a copy of the contract used to enroll participants.
(3) The EMS provider shall maintain a current file
of all advertising for the service. Submit a copy of all advertising
used to promote the subscription service within ten days after the
beginning of any enrollment period.
(4) Comply with all state and federal regulations regarding
billing and reimbursement for participants in the subscription service.
(5) Provide evidence of financial responsibility by:
(A) obtaining a surety bond payable to the department
in an amount equal to the funds to be subscribed. The surety bond
must be on a department bond form and be issued by a company licensed
by or eligible to do business in the State of Texas; or
(B) submitting satisfactory evidence of self-insurance
an amount equal to the funds to be subscribed if the provider is a
function of a governmental entity.
(6) Not deny emergency medical services to non-subscribers
or subscribers of non-current status.
(7) Be reviewed at least every year; and the subscription
program may be reviewed by the department at any time.
(8) Furnish a list after each enrollment period with
the names, addresses, dates of enrollment of each subscriber, and
subscription fee paid by each subscriber.
Cont'd... |
