6 Colo. Code Regs. § 1015-3-2-16
Current through Register Vol. 47, No. 11, June 10, 2024
Section 6 CCR 1015-3-2-16 - Interfacility Transport16.1 The EMS agency medical director shall have protocols in place to ensure the appropriate level of care is available during interfacility transport.16.2 The transporting EMS provider may decline to transport any patient he or she believes requires a level of care beyond his or her capabilities.16.3 The interfacility transport typically involves three types of patients:16.3.1 Those patients whose safe transport can be accomplished by ambulance, under the care of an EMT, EMT-IV, AEMT, EMT-I, or Paramedic, within the medical acts allowed under these rules.16.3.2 Those patients whose safe transport can be accomplished by ambulance, under the care of a Paramedic, but may require medical acts that are outside the medical acts allowed under these rules, but which acts have been approved through waiver granted by the Department.16.3.3 Those patients whose safe transport requires the skills and expertise of a Critical Care transport team under the care of an experienced Critical Care practitioner.16.4 The hemodynamically unstable patient or patient who may require Intensive Care Unit level of treatment, regardless if coming from an Intensive Care Unit, who requires special monitoring (e.g. central venous pressure, intracranial pressure), multiple cardioactive/vasoactive medications, or specialized critical care equipment (i.e. intra-aortic balloon pump) should remain under the care of an experienced Critical Care practitioner, and every attempt should be made to transport that patient while maintaining the appropriate level of care. The capabilities of the institution, the capabilities of the transporting agency and, most importantly, the safety of the patient should be considered when making transport decisions.16.5 Unless otherwise noted, the following Appendices C and D indicate hospital/facility initiated interventions and/or medications.16.5.1 Additions to these medical acts are not allowed unless a waiver has been granted as described in Section 12 of these rules.16.5.2 The following medical acts are approved for interfacility transport of patients, with the requirements that the medical acts allowed must have been initiated in a medical facility under the direct order and supervision of licensed medical providers and are not authorized for field initiation. EMS continuation and monitoring of these interventions is to be allowed with any alterations in the therapy requiring direct verbal order. The EMS provider should continue the same medical standards of care with regard to patient monitoring that were initiated in the facility.16.5.3 It is understood that these medical acts may not be addressed in the National EMS Education Standards for EMT, AEMT, EMT-I, or Paramedic. As such, it is the joint responsibility of the EMS agency medical director and individuals performing these medical acts to obtain appropriate additional training needed to safely and effectively utilize and monitor these interventions in the interfacility transport environment.16.6 Any of the medical acts and medications allowed in interfacility transport in Appendices C and D may be performed in the clinical setting under the medical direction of a clinical medical director and under medical supervision.37 CR 12, June 25, 2014, effective 5/21/201437 CR 12, June 25, 2014, effective 7/15/201437 CR 22, November 25, 2014, effective 12/15/201438 CR 24, December 25, 2015, effective 1/14/201640 CR 10, May 25, 2017, effective 7/1/201740 CR 20, October 25, 2017, effective 1/1/201840 CR 21, November 10, 2017, effective 1/1/201841 CR 23, December 10, 2018, effective 1/14/201943 CR 22, November 25, 2020, effective 1/1/202144 CR 23, December 10, 2021, effective 12/30/202145 CR 10, May 25, 2022, effective 6/14/2022