Ariz. Admin. Code § 9-25-706

Current through Register Vol. 30, No. 25, June 21, 2024

Section R9-25-706 - Minimum Standards for Mission Staffing (Authorized by A.R.S. Sections 36-2202(A)(3) and (4), 36-2209(A)(2), and 36-2213)

A. A licensee shall ensure that, except as provided in subsection (B):

1. Each critical care mission is staffed by a medical team of at least two individuals with the following qualifications:

a. For a critical care interfacility transport mission:

i. A physician or registered nurse; and

ii. Another physician, Another registered nurse, a Paramedic, or a licensed respiratory care practitioner; and

b. For a critical care mission that is an emergency medical services transport:

i. A physician or registered nurse; and

ii. A Paramedic or another registered nurse;

2. Each interfacility maternal transport mission is staffed by a medical team that:

a. Complies with the requirements for a critical care mission medical team in subsection (A)(1); and

b. Has the following additional qualifications:

i. Proficiency in advanced emergency cardiac life support that includes didactic instruction and a practical skills test, consistent with training recognized by the American Heart Association;

ii. Proficiency in neonatal resuscitation; and

iii. Proficiency in stabilization and transport of the pregnant patient;

3. Each interfacility neonatal transport mission is staffed by a medical team that:

a. Complies with the requirements for a critical care mission medical team in subsection (A)(1); and

b. Has the following additional qualifications:

i. Proficiency in pediatric advanced emergency life support that includes didactic instruction and a practical skills test, consistent with training recognized by the American Heart Association; and

ii. Proficiency in neonatal resuscitation and stabilization of the neonatal patient; and

4. Each advanced life support mission is staffed by a medical team of at least two individuals with the following qualifications:

a. For an advanced life support mission that is an emergency medical services transport:

i. A physician, registered nurse, or Paramedic; and

ii. Another Paramedic or another registered nurse;

b. For an advanced life support interfacility transport mission:

i. A physician, registered nurse, or Paramedic; and

ii. Another Paramedic , a licensed respiratory care practitioner, or another registered nurse.

B. If the pilot on a mission using a rotor-wing air ambulance determines, in accordance with the air ambulance service's written guidelines required under subsection (C)(1), that the weight of a second medical team member could potentially compromise the performance of the rotor-wing air ambulance and the safety of the mission, and the use of a single-member medical team is consistent with the on-line medical direction or on-line medical guidance received as required under subsection (C)(2), an air ambulance service may use a single-member medical team consisting of an individual with the following qualification:

1. For a critical care mission, a physician or registered nurse; and

2. For an advanced life support mission, a physician, registered nurse, or Paramedic.

C. A licensee shall ensure that:

1. Each air ambulance service rotor-wing pilot is provided with written guidelines to use in determining when the weight of a second medical team member could potentially compromise the performance of a rotor-wing air ambulance and the safety of a mission, including the conditions of density altitude and weight that warrant the use of a single-member medical team;

2. The following are done, without delay, after an air ambulance service rotor-wing pilot determines that the weight of a second medical team member could potentially compromise the performance of a rotor-wing air ambulance and the safety of a mission:

a. The pilot communicates that information to the medical team,

b. The medical team obtains on-line medical direction or on-line medical guidance regarding the use of a single-member medical team, and

c. The medical team proceeds in compliance with the on-line medical direction or on-line medical guidance;

3. A single-member medical team has the knowledge and medical equipment to perform one-person cardiopulmonary resuscitation;

4. The patient care provided by each single-member medical team, including consideration of each patient's status upon arrival at the destination health care institution, is reviewed through the quality improvement processes in R9-25-705(A)(11)(b) and (c); and

5. A single-member medical team is used only when no other transport team is available that would be more appropriate for delivering the level of care that a patient requires.

D. A licensee shall ensure that the air ambulance service creates and maintains for each personnel member a file containing documentation of the personnel member's qualifications, including, as applicable, licenses, certifications, and training records.

Ariz. Admin. Code § R9-25-706

New Section made by final rulemaking at 12 A.A.R. 656, effective April 8, 2006 (Supp. 06-1). Renumbered from R9-25-711 and amended by final rulemaking at 28 A.A.R. 842, effective 6/5/2022. Amended by exempt rulemaking at 28 A.A.R. 3681, effective 11/8/2022.