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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 157EMERGENCY MEDICAL CARE
SUBCHAPTER AEMERGENCY MEDICAL SERVICES - PART A
RULE §157.2Definitions

The following words and terms, when used in these sections, shall have the following meanings, unless the context clearly indicates otherwise:

  (1) Abandonment - Leaving a patient without appropriate medical care once patient contact has been established, unless emergency medical services personnel are following medical director's protocols, a physician directive or the patient signs a release; turning the care of a patient over to an individual of lesser education when advanced treatment modalities have been initiated.

  (2) Accreditation - Formal recognition by a national association of a provider's service or an education program based on standards established by that association.

  (3) Act - Emergency Medical Services Act, Health and Safety Code, Chapter 773.

  (4) Administrator of Record (AOR) - The administrator for an EMS provider who meets the requirements of Health and Safety Code, §773.05712 and §773.0415.

  (5) Advanced Emergency Medical Technician (AEMT) - An individual who is certified by the department and is minimally proficient in performing the basic life support skills required to provide emergency prehospital or interfacility care and initiating and maintaining under medical supervision certain advanced life support procedures, including intravenous therapy and endotracheal or esophageal intubation.

  (6) Advanced life support (ALS) - Emergency prehospital or interfacility care that uses invasive medical acts and which would include ALS assessment. The provision of advanced life support shall be under the medical supervision and control of a licensed physician.

  (7) Advanced life support (ALS) vehicle - A vehicle that is designed for transporting the sick and injured and that meets the requirements of §157.11(j)(2) of this title (relating to Requirements for an EMS Provider License) as an advanced life support vehicle and has sufficient equipment and supplies for providing advanced level of care based on national standards and the EMS provider's medical director approved treatment protocols.

  (8) Advanced Life Support assessment - Assessment performed by an AEMT or paramedic that qualify as advanced life support based upon initial dispatch information, when it could reasonably be believed that the patient was suffering from an acute condition that may require advanced skills.

  (9) Air ambulance provider - A person who operates/leases a fixed-wing or rotor-wing air ambulance aircraft, equipped and staffed to provide a medical care environment on-board appropriate to the patient's needs. The term air ambulance provider is not synonymous with and does not refer to the Federal Aviation Administration (FAA) air carrier certificate holder unless they also maintain and control the medical aspects that are consistent with EMS provider licensure.

  (10) Ambulance - A vehicle for transportation of sick or injured person to, from or between places of treatment for an illness or injury, and provide out of hospital medical care to the patient.

  (11) Authorized ambulance vehicle - A vehicle authorized to be operated by the licensed provider and that meets all criteria for approval as listed in §157.11(e) of this title.

  (12) Basic life support (BLS) - Emergency prehospital or interfacility care that uses noninvasive medical acts. The provision of basic life support will have sufficient equipment and supplies for providing basic level care based on national standards and the EMS provider's medical director approved treatment protocols.

  (13) Basic life support (BLS) vehicle - A vehicle that is designed for transporting the sick or injured and that has sufficient equipment and supplies for providing basic life support based on national standards and the EMS provider's medical director approved treatment protocols.

  (14) Basic trauma facility - A hospital designated by the department as having met the criteria for a Level IV trauma facility as described in §157.125 of this title (relating to Requirements for Trauma Facility Designation). Basic trauma facilities provide resuscitation, stabilization, and arrange for appropriate transfer of major and severe trauma patients to a higher level trauma facility, provide ongoing educational opportunities in trauma related topics for health care professionals and the public, and implement targeted injury prevention programs.

  (15) Bypass - Direction given to a prehospital emergency medical services unit, by direct/on-line medical control or predetermined triage criteria, to pass the nearest hospital for the most appropriate hospital/trauma facility. Bypass protocols should have local physician input into their development and should be reviewed through the regional performance improvement process.

  (16) Candidate - An individual who is requesting emergency medical services personnel certification or licensure, recertification or relicensure from the Texas Department of State Health Services.

  (17) Certificant - Emergency medical services personnel with current certification from the Texas Department of State Health Services.

  (18) Comprehensive trauma facility - A hospital designated by the department as having met the criteria for a Level I trauma facility as described in §157.125 of this title. Comprehensive trauma facilities manage major and severe trauma patients, provide ongoing educational opportunities in trauma related topics for health care professionals and the public, implement targeted injury prevention programs, and conduct trauma research.

  (19) Course medical director - A Texas licensed physician approved by the department with experience in and current knowledge of emergency care who shall provide direction over all instruction and clinical practice required in EMS training courses.

  (20) Credit hour - Continuing education credit unit awarded for successful completion of a unit of learning activity as defined in §157.32 of this title (relating to EMS Education Program and Course Approval).

  (21) Critically injured person - A person suffering major or severe trauma, with severe multi system injuries or major unisystem injury; the extent of the injury may be difficult to ascertain, but which has the potential of producing mortality or major disability.

  (22) Current - Within active certification or licensure period of time.

  (23) Department - The Texas Department of State Health Services.

  (24) Designated infection control officer - A designated officer who serves as a liaison between the employer's employees who have been or believe they have been exposed to a potentially life-threatening infectious disease, through a person who was treated and/or transported, by the EMS provider.

  (25) Designation - A formal recognition by the department of a hospital's trauma care capabilities and commitment.

  (26) Distance learning - A method of learning remotely without being in regular face-to-face contact with an instructor in the classroom.

  (27) Diversion - A procedure put into effect by a trauma facility to ensure appropriate patient care when that facility is unable to provide the level of care demanded by a trauma patient's injuries or when the facility has temporarily exhausted its resources.

  (28) Emergency call - A new call or other similar communication from a member of the public, as part of a 9-1-1 system or other emergency access communication system, made to obtain emergency medical services.

  (29) Emergency care attendant (ECA) - An individual who is certified by the department as minimally proficient to provide emergency prehospital care by providing initial aid that promotes comfort and avoids aggravation of an injury or illness.

  (30) Emergency medical services (EMS) - Services used to respond to an individual's perceived need for medical care and to prevent death or aggravation of physiological or psychological illness or injury.

  (31) Emergency medical services (EMS) operator - A person who, as an employee of a public agency, as that term is defined by Health and Safety Code, §771.001, receives emergency calls.

  (32) Emergency medical services and trauma care system - An arrangement of available resources that are coordinated for the effective delivery of emergency health care services in geographical regions consistent with planning and management standards.

  (33) Emergency medical services (EMS) personnel -

    (A) emergency care attendant (ECA);

    (B) emergency medical technician (EMT);

    (C) advanced emergency medical technician (AEMT);

    (D) emergency medical technician intermediate (EMT-I); or

    (E) emergency medical technician-paramedic (EMT-P); or

    (F) licensed paramedic.

  (34) Emergency medical services (EMS) provider - A person who uses, operates or maintains EMS vehicles and EMS personnel to provide EMS. See §157.11 of this title regarding fee exemption.

  (35) Emergency medical services (EMS) volunteer provider - An EMS provider that has at least 75% of the total personnel as volunteers and is a nonprofit organization. See §157.11 of this title regarding fee exemption.

  (36) Emergency medical services (EMS) volunteer - EMS personnel who provide emergency prehospital or interfacility care in affiliation with a licensed EMS provider or a registered First Responder organization without remuneration, except for reimbursement for expenses.

  (37) Emergency medical technician (EMT) - An individual who is certified by the department as minimally proficient to perform emergency prehospital care that is necessary for basic life support and that includes the control of hemorrhaging and cardiopulmonary resuscitation.

  (38) Emergency medical technician-paramedic (EMT-P) - An individual who is certified by the department as minimally proficient to provide emergency prehospital or interfacility care in health care facility's emergency or urgent care clinical setting, including a hospital emergency room and a freestanding emergency medical care facility by providing advanced life support that includes initiation and maintenance under medical supervision of certain procedures, including intravenous therapy, endotracheal or esophageal intubation or both, electrical cardiac defibrillation or cardioversion, and drug therapy.

  (39) Emergency medical services vehicle -

    (A) basic life support (BLS) vehicle;

    (B) advanced life support (ALS) vehicle;

    (C) mobile intensive care unit (MICU);

    (D) MICU rotor wing and MICU fixed wing air medical vehicles; or

    (E) specialized emergency medical service vehicle.

  (40) Emergency Medical Task Force (EMTF) - A unit specially organized to provide coordinated emergency medical response operation systems during large scale EMS incidents.

  (41) Emergency prehospital care - Care provided to the sick and injured within a health care facility's emergency or urgent care clinical setting, including a hospital emergency room and a freestanding emergency medical care facility, before or during transportation to a medical facility, including any necessary stabilization of the sick or injured in connection with that transportation.

  (42) Facility triage - The process of assigning patients to an appropriate trauma facility based on injury severity and facility availability.

  (43) Fixed location - The address as it appears on the initial and/or renewal EMS provider license application in which the patient care records and administrative offices will be located.

  (44) General trauma facility - A hospital designated by the department as having met the criteria for a Level III and Level IV trauma facility as described in §157.125 of this title. General trauma facilities provide resuscitation, stabilization, and assessment of injury victims and either provide treatment or arrange for appropriate transfer to a higher level trauma facility, provide ongoing educational opportunities in trauma related topics for health care professionals and the public, and implement targeted injury prevention programs.

  (45) Governmental entity - A county, a city or town, a school district, or a special district or authority created in accordance with the Texas Constitution, including a rural fire prevention district, an emergency services district, a water district, a municipal utility district, and a hospital district.

  (46) Health care entity - A first responder, EMS provider, physician, nurse, hospital, designated trauma facility, or a rehabilitation program.

  (47) Inactive EMS provider status - The period when a licensed EMS provider is not able to respond or response ready to an emergency or non-emergency medical dispatch.

  (48) Industrial ambulance - Any vehicle owned and operated by an industrial facility as defined in the Texas Transportation Code, §541.201, and used for initial transport or transfer of company employees who become urgently ill or injured on company premises to an appropriate medical facility.

  (49) Interfacility care - Care provided while transporting a patient between medical facilities.

Cont'd...

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