Section 7 AAC 26.999 - DefinitionsIn this chapter,
(1) "acute care hospital" means a state licensed hospital or federal hospital that provides medical and surgical outpatient and inpatient services to persons with injuries or illnesses;(2) "advanced life support" has the meaning given in AS 18.08.200;(3) "AED" means automated external defibrillation;(4) "AEMT" means a person who has been certified or licensed in a state or territory as an Advanced Emergency Medical Technician (AEMT) certified by the National Registry of Emergency Medical Technicians (NREMT);(5) "aeromedical service" means a medevac service, an air ambulance service, a critical care air ambulance service, or a specialty aeromedical transport team; (6) "aeromedical transport team" means a team of two or more health care workers who are trained and equipped to provide care to a patient being transported in an aircraft;(7) "air medevacs" means transporting emergency patients by fixed or rotary wing aircraft with at least one certified or licensed emergency medical responder in attendance; (8) "appropriate equipment to perform basic and advanced life-support emergency procedures" means the basic and advanced life-support equipment carried on an ambulance that meets department approval and the needs of local EMS patient care guidelines;(9) "area trauma center" means a health care facility that is designated by the department as having met the essential standards for area trauma hospitals as specified in the Committee on Trauma Level III Trauma Center Designation Criteria, located in the American College of Surgeons' Resources for Optimal Care of the Injured Patient, adopted by reference in 7 AAC 26.740, unless a specific exception is granted by the department;(10) "automated defibrillator" (A) means a defibrillator that is capable of automated rhythm analysis, and that will charge and deliver a defibrillation, with minimal operator intervention, after electronically detecting the presence of ventricular fibrillation or rapid ventricular tachycardia; (B) does not include a semi-automatic defibrillator;(11) "basic life support" means those emergency care skills set out in the goals and objectives of the United States Department of Transportation, National Highway Traffic Safety Administration's National Emergency Medical Services Education Standards, January 2009, adopted by reference in 7 AAC 26.050(1)(A); (12)"certified or licensed medical personnel" means EMT-I's, EMT-ll's, EMT-lll's, AEMTs, paramedics, physician assistants, advanced practice registered nurses, registered nurses, or physicians authorized by law to provide medical care in this state or in the state in which the certified or licensed service is based;(13) "certifying officer" means a person designated (A) by the department to ensure the security of the examinations for state certification or licensure;(B) to ensure that the security of examinations for certification meets testing requirements by the National Registry of Emergency Medical Technicians (NREMT);(14) "commissioner" means the commissioner of health and social services;(15) "continuing medical education" or "CME" means ongoing education in (A) topics included in the initial training course objectives for certified EMD, emergency medical responder (EMR), EMT-I, EMT-II, EMT-III, or AEMT or continuing education requirements of cognitive and psychomotor learning for which the provider is certified; (B) other department-approved educational subjects required for maintenance of professional organization certification; (C) college courses in anatomy, physiology, biology, chemistry, pharmacology, psychology, sociology, injury prevention, or statistics, or department-accepted courses;(D) content presented using critiques, didactic sessions, practical drills, workshops, seminars, commercial educational systems, distributed learning, or other department-approved educational methods;(E) professional EMS education systems such as the National Continued Competency Program (NCCP) by the National Registry of Emergency Medical Technicianss (NREMT) or accredited education by the Commission on Accreditation for Pre-Hospital Education (CAPCE);(16) "CPR" means cardiopulmonary resuscitation; (17) "critical care air ambulance service" means an organization or entity that is, or that uses by contractual arrangement, an aircraft operator or operators, with appropriate aircraft, and that provides or advertises to provide emergency medical care that includes advanced hfe support services and air transportation under the direct or indirect supervision of a medical director, through personnel trained at least to the paramedic, physician assistant, advanced practice registered nurse, registered nurse, or physician level; generally, a critical care air ambulance service has the expertise to provide a higher level of medical care than does a medevac service and usually provides transportation from the initial treatment hospital to a referral hospital;(18) "curriculum" means a collection of objectives, educational standards, or course materials;(19) "department" means the Department of Health and Social Services; (20) "department-approved aeromedical training" means a course, approved by the department, that includes training in the following, as appropriate to meet the needs of the applicant: (A) physiological aspects of pressure and the atmosphere, including composition, layers and physiological divisions of the atmosphere, atmospheric pressure, the circulation system, basic respiratory physiology, hypoxia and shock, cabin pressurization and decompression, gas expansion disorders, evolved gas problems, and acceleration or deceleration forces on the body;(B) specific medical situations, such as escort responsibilities and self-care, patient stress and prolonged immobility, medication problems and side effects, motion sickness, nosebleed, hearing problems, flying across time zones and international borders, patient preparation for transportation, enplaning and deplaning, stages of flight, oxygen administration, intravenous therapy, tracheal suction, CPR, chest tubes, retention balloons, and dressing change;(C) specific medical situations, such as patient assessment, head injuries, chest, abdominal, neck or spinal injuries, orthopedic disorders, facial wounds and injuries, eye problems, ear and throat problems, respiratory problems, cardiac problems, gastrointestinal problems, poisoning and overdose, hematologic disorders, urological disorders, behavioral states, maternal transport, infant and pediatric transport, burns, hypothermia and cold water near-drowning, and diving injuries;(D) responsibilities during preflight, inflight, and postflight phases of an air ambulance mission;(E) legal considerations of air ambulance service and recordkeeping for air ambulance services;(F) lifting and moving patients, and general inflight patient care, including care of patients who require special considerations in the airborne environment;(G) medications, including the times that medications are administered and adjustments that are required when changing time zones; (H) medical equipment used aboard aircraft;(I) changes in barometric pressure, decompression sickness and air embolism, and changes in partial pressure of oxygen;(J) other environmental factors affecting patient care, including humidity, temperature, ventilation, and noise;(K) aircraft systems, including electrical, pressurization, lighting, and ventilation; and(L) aircraft emergencies, such as electrical failure, rapid decompression, emergency landings, and principles of survival;(21) "department-approved medevac training" means a course, approved by the department, that includes training in the following, as appropriate to meet the needs of the applicant: (A) decision to medevac, planning and systems coordination, and escort training objectives;(B) aircraft and equipment considerations, such as types of aircraft, patient care, selection of aircraft and air carriers, minimum and special needs, effects of the environment, safety factors, and transferring and retrieving equipment;(C) physiological aspects of pressure and the atmosphere, including composition, layers and physiological divisions of the atmosphere, atmospheric pressure, the circulation system, basic respiratory physiology, hypoxia and shock, cabin pressurization and decompression, gas expansion disorders, evolved gas problems, and acceleration or deceleration forces on the body;(D) supporting activities, such as recordkeeping and the role of protocols and standing orders; (E) lifting and moving patients, survival during inflight emergencies, and general inflight patient care, including care of patients who require special considerations in the airborne environment;(F) medical equipment used aboard aircraft;(G) changes in barometric pressure, decompression sickness and air embolism, and changes in partial pressure of oxygen;(H) other environmental factors affecting patient care, including humidity, temperature, ventilation, and noise;(I) aircraft systems, including electrical, pressurization, lighting, and ventilation; and(J) aircraft emergencies such as electrical failure, rapid decompression, emergency landings, and principles of survival;(22) "direct or indirect supervision" means direct voice contact or by written standing orders;(23) "distance delivery education" means educational activities in which the student and the instructor are not in the same physical location; "distance delivery education" includes videoconference or teleconference, performing directed studies, distributed learning, and virtual instructor lead training;(24) "EMD" means an emergency medical dispatcher;(25) "EMD medical director" means a physician who is authorized to practice medicine in this state who assumes medical oversight of emergency medical dispatch services, including the approval of systematized caller interrogation questions, systematized pre-arrival instructions, and protocols to match the dispatcher's evaluation of injury or illness severity and the number of victims with vehicle response modes and configurations; (26) "emergency medical dispatcher" means a person certified by the department who has successfully completed a department-approved emergency medical dispatcher course and has met all other department requirements for certification;(27) "emergency medical dispatch priority reference system" means a protocol system approved by the EMD medical director, used by a dispatch agency to dispatch aid to medical emergencies, and must include(A) systematized caller interrogation questions;(B) systematized pre-arrival instructions; and(C) protocols matching the dispatcher's evaluation of injury or illness severity and numbers of victims with vehicle response modes and configurations;(28) "emergency medical service" means an organization that provides basic or advanced life support medical services outside a hospital;(29) "emergency medical services" means the provision of emergency medical care and transportation of the sick or injured;(30) "emergency medical technician" has the meaning given in AS 18.08.200;(31) "emergency trauma technician" means a person who has successfully completed an emergency trauma technician training course approved by the department under 7 AAC 26.450;(32) "EMS" means emergency medical services;(33) "EMS bridge" means a specialized curriculum designed between two EMS courses for which the course is designed;(34) "EMS communications capability" means point-to-point voice communications between EMS responders in the field and a higher-level medical facility, such as a clinic with mid-level practitioners, or a hospital;(35) "EMS provider" means an individual that is certified, licensed or trained to provide emergency medical services;(36) "EMS training" means the didactic, clinical, and psychomotor education, or instruction, provided to an emergency medical student or responder;(37) "EMT" (A) means an emergency medical technician;(B) includes a person who has been certified or licensed as an EMT in a state or territory or by the National Registry of Emergency Medical Technicians (NREMT);(38) "EMT-Paramedic" or "National Registry Paramedic" means a person who has been certified or licensed as a paramedic in a state or territory, or who has been certified as a paramedic by the National Registry of Emergency Medical Technicians (NREMT);(39) "ETT" means emergency trauma technician;(40) "ETT card" means documentation of successful completion of an ETT training course approved by the department under 7 AAC 26.450;(41) "gross misconduct" means the knowing violation of AS 18.08 or this chapter;(42) "high-risk maternal transport team" means a team of two or more health care workers who are trained and equipped to provide care to women with potentially serious complications of pregnancy during transport;(43) "high-risk newborn transport team" means a team of two or more health care workers who are trained and equipped to provide care to newborns during transport;(44) "hours of instruction" means hours devoted to the didactic, clinical, and psychomotor training of the course participants, but does not include hours used for the certification testing of students;(45) "inflight patient care form" means a preprinted form that includes spaces for recording information, including the patient's name; date of flight; name of air carrier; diagnosis; originating and terminating points and patient's condition upon departure and arrival; an inflight medical attendant's report of the patient's status, including vital signs, level of consciousness, drugs administered, and details of therapeutic intervention; unusual circumstances encountered during the flight, including inordinate altitudes flown, turbulence, and times associated with these abnormal conditions; and other information, such as billing information for medical and transportation expenses;(46) "intervener physician" means a physician who has not previously established a doctor-patient relationship with the emergency patient, but who is willing to accept responsibility for a medical emergency, and who can provide proof of a valid medical license;(47) "local trauma stabilization center" means a health care facility that is designated by the department as having met the essential standards for area trauma hospitals as specified in the department's level IV trauma center designation criteria, contained in Level IV/V Trauma Center Applicants, Essential or Desirable Resources/Services Available, adopted by reference in 7 AAC 26.720; (48) "local trauma stabilization clinic" means a clinic that(A) provides advanced trauma life support before a patient is transferred to a higher level of care; and(B) is designated by the department as having met the essential standards for Level V trauma centers as specified in the department's level V trauma center designation criteria, contained in Level IV/V Trauma Center Applicants, Essential or Desirable Resources/Services Available, adopted by reference in 7 AAC 26.720;(49) "medevac service" means an organization or entity that provides aeromedical evacuation or medically assisted transportation and usually provides transportation from the scene of the emergency, or a remote village or occupation site, to the initial treatment hospital;(50) "medical director" means, except in 7 AAC 26.620, an individual who meets the applicable qualifications in 7 AAC 26.630 and who agrees to perform the responsibilities specified in this chapter for supervision of an EMT-I, EMT-II, EMT-III, AEMT, emergency medical dispatcher, EMD or EMS instructor education course, emergency medical service, medevac service, critical care air ambulance service, or specialty aeromedical transport team;(52) "paramedic course coordinator" means an individual who is certified in accordance with 7 AAC 26.174 to fulfill the responsibilities set out in 7 AAC 26.176;(53) "mid-level practitioner" means a person certified or licensed by the state as an advanced practice registered nurse or as a physician assistant; (55) "mutual aid agreement" means a written agreement that permits an emergency medical service to go to the aid of another emergency medical service within or outside the local service area, and to receive aid from another emergency medical service within or outside of the local service area, during multiple casualty incidents or other situations as defined in the agreement;(56) "objectives" means instructional content or learning outcomes as part of the curriculum, course lesson, activity, cognitive knowledge, or demonstrated skill;(57) "on-line physician" means a physician immediately available in person or by radio or telephone, when medically appropriate, for communication of medical direction to non-physician prehospital care-givers;(58) "organization that provides basic or advanced life-support emergency medical services outside a hospital" (A) means an organization, such as an ambulance service, rescue squad, fire department, or medevac service that, as one of its primary functions, provides basic or advanced life-support emergency medical services;(B) does not include other organizations having ancillary emergency health or patient care responsibilities;(59) "other organization having ancillary emergency health or patient care responsibilities" means an organization such as the community health aide program, the uniformed services, the National Park Service, the United States Forest Service, a logging camp, the Alaska Marine Highway System, the Alaska Railroad, or private corporation, that must provide services to individuals needing immediate medical care in order to prevent loss of life or aggravation of psychological or physiological illness or injury;(60) "patient contact" means a contact by an EMT with a person who is sick or injured in which the EMT performs at least one of the following: (B) obtaining vital signs;(61) "pediatric transport provider" means a health care worker who is trained and equipped to provide care to children during transport;(62) "pediatric transport team" means a team of two or more health care workers who are trained and equipped to provide care to children during transport;(63) "pre-arrival instructions" means telephone rendered, medically approved, written instructions given by trained EMD's through callers that help to provide aid to the victim and control of the situation before the arrival of prehospital EMS personnel; "pre-arrival instructions" are part of an instruction given by a certified emergency medical dispatcher and are used as close to word-for-word as possible;(64)"primary instructor" means an EMS instructor, EMS instructor coordinator, ETT instructor, or paramedic course coordinator who (A) requested course approval under this chapter; or(B) coordinated a training program approved by the department under this chapter, or taught more hours in that program than any other instructor; (65) "protocols" mean written clinical standards for EMS practice in a variety of situations within the EMS system;(66) "reasonable period of time" means that period of time in which the medical attendant with the patient, or the supervising physician, feels that the patient's condition will not deteriorate significantly;(67) "refresher course" means a course, of at least 24 hours in length, that includes cognitive and psychomotor skills appropriate for an EMT-I, EMT-II, EMT-III, AEMT, or paramedic;(68) "regional trauma center" means a health care facility that is designated by the department as having met the essential standards for area trauma hospitals as specified in the Committee on Trauma Level II Trauma Center Designation Criteria, located in the American College of Surgeons' Resources for Optimal Care of the Injured Patient, adopted by reference in 7 AAC 26.740;(69)Resources for Optimal Care of the Injured Patient means a publication of the Committee on Trauma, American College of Surgeons, and is adopted by reference in 7 AAC 26.740; (70) "responsible official" means a person who has administrative responsibility for the operations of an emergency medical service, and includes the chief of a fire department or ambulance service;(71) "reverification" means the (A) process used by the American College of Surgeons' Committee on Trauma to re-evaluate the trauma care capabilities and performance of a center previously verified as meeting the criteria of a level I, level II, or level III trauma center using the current guidelines set out in Resources for Optimal Care of the Injured Patient, adopted by reference in 7 AAC 26.740; or(B) process used by a physician and nurse from the state trauma system review committee under AS 18.23.070(5)(A) with expertise in trauma care, and additional licensed physicians or nurses with that expertise as needed, to re-evaluate the trauma care capabilities and performance of a hospital or clinic previously verified as meeting the criteria of a level IV or level V trauma center using the current guidelines set out in Level IV/V Trauma Center Applicants, Essential or Desirable Resources/Services Available, adopted by reference in 7 AAC 26.720;(72) "semi-automatic defibrillator" means a defibrillator that is capable of electronically detecting ventricular fibrillation and rapid ventricular tachycardia, but requires user interaction in order to deliver a countershock;(73) "skill sheets" means the forms containing frequently used and critical psychomotor skills;(74) "specialty aeromedical transport team" means an aeromedical transport team that provides advanced life support services and can accommodate the special medical needs of the category of patient the applicant is certified to serve, including a high-risk newborn transport team, high-risk maternal transport team, or pediatric transport team; generally, a specialty air medical transport team transports a certain category of patient to a specialty hospital referral center capable of meeting the particular needs of the patient;(75) "specialty trauma referral center" means a health care facility that is designated by the department as having met the essential standards for area trauma hospitals as specified in the Committee on Trauma Level I Trauma Center Designation Criteria, located in the American College of Surgeons' Resources for Optimal Care of the Injured Patient, adopted by reference in 7 AAC 26.740;(76) "standing orders" means strictly defined written orders for actions, techniques, or drug administration, to be used when communication contact has not been made with a base station physician;(77) "state-approved EMS training agency" means a regional nonprofit EMS agency, a regional native corporation that provides EMS training, a university in this state providing EMS training, a state agency providing EMS training, or an organization that employs emergency medical technician instructors;(78) "successful course completion" means verification on forms provided by the department, that the student has met all the cognitive and learning objectives, and psychomotor skill competencies of the course, in the training course classroom setting;(79) "trauma center" means an acute care hospital, clinic, or other entity that has met minimum standards for staffing, equipment, and organizational commitment to manage the care and treatment of traumatic injury victims, and is certified by the department as a level I, level II, level III, level IV, or level V trauma center under 7 AAC 26.720 or recertified under 7 AAC 26.730; (80) "trauma patient" means a victim of an external cause of injury that results in major or minor tissue damage or destruction caused by intentional or unintentional exposure to thermal, mechanical, electrical, or chemical energy, or by the absence of heat or oxygen (International Classification of Diseases, ICD-10 codes) or other categories of injuries as defined by the department; (81) "trauma registry" means a statewide database on traumatic injury victims, whose injuries are of sufficient severity to result in hospitalization or death, to assess the appropriateness and quality of care and treatment in the prehospital and hospital setting and to study the epidemiology of serious injuries;(82) "under the direct supervision of a physician or paramedic" means that the physician or paramedic is physically present and able to view, provide patient care, and provide recommendations regarding the assessment and treatment provided by the paramedic intern from the time of arrival at the scene to the time the patient care is transferred to another medical provider;(83) "vehicle response configuration" means the specific vehicles of varied types, capabilities, and numbers responding to render assistance;(84) "vehicle response mode" means the use of driving techniques, such as red lights-and-siren, to respond to an emergency medical situation;(85) "verification" means the (A) process used by the Committee on Trauma, American College of Surgeons, to assess the trauma care capabilities and performance of a trauma center as a level I, level II, or level III trauma center; or(B) process used by a physician and nurse from the state trauma system review committee under AS 18.23.070(5)(A) with expertise in trauma care, and additional licensed physicians or nurses with that expertise as needed, to evaluate the trauma care capabilities and performance of a hospital or clinic as meeting the criteria of a level IV or level V trauma center using the current guidelines set out in Level IV/V Trauma Center Applicants, Essential or Desirable Resources/Services Available, adopted by reference in 7 AAC 26.720; (86) "voice recorder" means a device capable of continuous recording of the voice communications at the scene;(87) "working day" means a day other than Saturday, Sunday, or a state holiday.(88) "license" means a license or certificate issued as evidence of authority to practice as an EMS provider;(89) "paramedic" has the meaning given to "mobile intensive care paramedic" in AS 18.08.200.Eff. 4/7/96, Register 138; am 5/22/96, Register 138; am 3/11/98, Register 145; am 7/4/99, Register 151; am 6/23/2001, Register 158; am 8/16/2002, Register 163; am 12/26/2014, Register 212, January 2015; am 11/1/2018, Register 228, January 2019; am 8/21/2019, Register 231, July 2019; am 1/1/2022, Register 241, April 2022Authority:AS 18.08.010
AS 18.08.080
AS 18.08.082
AS 18.08.084