16 Del. Admin. Code § 4301-10.0
Current through Register Vol. 28, No. 7, January 1, 2025
Section 4301-10.0 - Operations10.1 Designation 10.1.1 An agency must be designated13 as an ALS Interfacility Transport Organization by the Delaware Department of Health and Social Services, Division of Public Health in order to: 10.1.1.1 Provide ALS services during any medical transport originating in Delaware.10.1.1.2 Advertise as a Delaware Advanced Life Support Organization.1410.1.1.2.1 All advertisements and invoices shall contain the legal name and the phrase "A Designated Delaware ALS Interfacility Transport Organization". 10.1.1.2.1.1 Advertisements may also include the words "Mobile Intensive Care Service", "Critical Care Transport Service", or "Advanced Life Support".10.1.1.2.1.2 An ALS-ITO utilizing paramedics shall not include the words "Paramedics" or "Paramedic Service" on any of their advertisements.10.1.1.2.2 Advertisements include but are not limited to business cards, letterhead, newsletters, brochures, flyers, etc.10.2 Scope of Services 10.2.1 ALS Interfacility Transportation is defined as the medically necessary transportation of a patient requiring the provision of medical care that exceeds the scope of practice of an EMT-Basic that originates at a Delaware medical facility with a destination at another medical facility.10.2.2 Operations as an ALS Interfacility Transport Organization are limited to 'non-911' emergency and non-emergency transports with the following exceptions: 10.2.2.1 As a component of a disaster plan.10.2.2.2 As part of a 'mutual aid' agreement approved by the OEMS. 10.2.2.2.1 The agreement must specifically address: 10.2.2.2.1.1 Remuneration for services rendered,10.2.2.2.1.2 Response time performance.10.2.2.3 At an incident where the ALS-IFT unit coincidentally arrived before the jurisdiction 911 organization.10.2.3 In instances where the crew of an uncommitted ALS-ITO ambulance chooses to render care at a '911' incident before the jurisdictional '911' ALS agency is present on scene, the following procedures shall apply: 10.2.3.1 The ALS-ITO unit shall immediately contact the jurisdictional PSAP and report the nature and location of the incident.10.2.3.2 The ALS-ITO personnel shall provide medical care within their scope of practice to any persons in need of it until a jurisdictional EMS unit arrives at the scene.10.2.3.3 Patient care responsibilities and scene control shall be deferred to the jurisdictional authorities as they arrive or as they request.10.2.3.4 The ALS-ITO unit may, but will not be required to, provide transportation services if a request is made by the Incident Commander and this request is approved by a representative of the jurisdictional ALS agency. 10.2.3.4.1 The responsibility for providing the service remains with the jurisdictional ALS agency until it is accepted by the ALS-ITO.10.2.3.5 Documentation of the patient contact must be completed using the appropriate EDIN form at the time of transfer to the receiving medical facility.10.2.4 A 911-ALS organization or PSAP may not direct emergency calls to an ALS-ITO unless a mutual aid agreement, approved by the OEMS, exists between the jurisdictional 911 ALS service and the ALS-ITO. 10.2.4.1 The agreement must specifically address: 10.2.4.1.1 Remuneration for services rendered,10.2.4.1.2 Response time performance requirements.10.3 Standing Orders 10.3.1 Use 10.3.1.1 The scope of practice for paramedics providing ALS Interfacility Transport services is defined by the Delaware Paramedic Standing Orders. 10.3.1.1.1 The State Medical Director and the Board of Medical Practice (BOMP) must approve any changes to the paramedic scope of practice (Refer to Section XII of these regulations).10.3.2 Protocol Variances 10.3.2.1 If a paramedic performs a function that is outside of the scope of practice as defined by the Delaware Paramedic Standing Orders, the following activity must occur: 10.3.2.1.1 The Organization Medical Director must be notified of the violation immediately.10.3.2.1.2 The paramedic must submit a written report of the incident to the Organization Medical Director within twenty-four (24) hours of the incident.10.3.2.1.3 The Organization Medical Director shall notify the State Medical Director's Office of any and all incidents of potential protocol violations within five (5) working days of receiving the incident report.10.3.2.2 The Organization Medical Director and/ or the company shall investigate the incident and provide a written report of the investigation and its conclusions to the State Medical Director through the Organization Medical Director within fourteen calendar days of the incident.10.3.2.3 The State Medical Director will review the incident based on the reports and issue a recommendation for action if appropriate. 10.3.2.3.1 The State Medical Director reserves the right to initiate an independent investigation.10.3.2.3.2 The State Medical Director may immediately suspend the paramedic's certification for a period of thirty days in order to prevent a clear and imminent danger to public health15.10.3.2.4 A review may also be initiated by a written complaint to the Division of Public Health - Office of Emergency Medical Services.10.4 Crew Configuration 10.4.1 The crew shall consist of at least two providers. 10.4.1.1 At least one provider must be a certified Delaware paramedic.10.4.1.2 The other provider must at least be a Delaware EMT-B. 10.4.1.2.1 The EMT-B may not function as a primary care provider.10.4.2 An ALS-ITO may not transport patients requiring care that is beyond the scope of practice of a Delaware paramedic unless the patient is accompanied by a healthcare provider authorized under Delaware law to provide the required level of care in compliance with federal medical transport/transfer regulations.10.5 Personnel Identification 10.5.1 All personnel shall display identification that includes their photograph, last name, and position/ certification level.10.5.2 All EMTs and paramedics must carry a Delaware issued certification card at all times while on duty.10.5.3 Identification must be visible on the front of the outermost garment.10.5.4 All personnel shall only display insignia for valid certification and personal identification.10.5.5 Agencies shall provide assurance that their personnel do not wear or display identification that suggests affiliation with another agency, service, organization, department, or company other than the ALS-ITO or a healthcare facility that is involved in the patient's care.10.6 Ambulance Operation 10.6.1 Ambulances are to be operated in accordance with 21Del.C.§ 4106 by licensed operators possessing a Delaware emergency vehicle operator (EVO) card or an equivalent as determined by the Delaware State Fire Prevention Commission.1610.6.2 Lights and sirens are to be used by ALS-IFT vehicles only in the following situations: 10.6.2.1 Enroute to an emergency call as determined and documented by the transferring physician,10.6.2.2 Transporting a Priority 1 patient as determined and documented by the transferring physician.10.6.2.3 Transporting a patient meeting the criteria determined by the Organization Medical Director as requiring emergency transportation.10.7 Medical Control 10.7.1 Authority 10.7.1.1 The transferring physician is responsible for providing medical control for the patient transfer until the patient reaches the destination facility.16 Del. Admin. Code § 4301-10.0