The following words and terms, as utilized in this chapter, shall have the following meanings, unless the context in which they are utilized clearly indicates otherwise.
"Advanced life support" or "ALS" means an advanced level of pre-hospital, inter-facility or emergency medical care that includes basic life support functions, cardiac monitoring, cardiac defibrillation, telemetered electrocardiography, administration of anti-arrhythmic agents, intravenous (IV) therapy, administration of specific medications, drugs and solutions, utilization of adjunctive ventilation devices, trauma care and other techniques and procedures authorized in writing by the Commissioner.
"Advanced practice nurse" means a person who is validly licensed by the New Jersey Board of Nursing in accordance with the standards set forth at 45:11-45 et seq.
"Advertising" means any information directly or indirectly issued, distributed, hand-delivered or implied through any medium and utilized for the purpose of promoting the service of a provider.
"AHA CPR Guidelines" means the "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" as published by the American Heart Association, National Center, 7272 Greenville Avenue, Dallas, TX 75231-4596, incorporated herein by reference, as amended and supplemented. A copy of the guidelines is on file and available for inspection at the Office of Emergency Medical Services.
"Air medical unit" or "AMU" means a specially equipped helicopter that is validly licensed by the Department and operated in accordance with the standards set forth at N.J.A.C. 8:41.
"Airplane" means, as defined at 14 C.F.R. 1.1, an engine-driven fixed-wing aircraft heavier than air, which is supported in flight by the dynamic reaction of the air against its wings.
"ALS inter-facility transfer" means the transportation of a patient in need of advanced life support care from one health care facility to another via a specialty care transport unit or an air medical unit. Mobile intensive care units shall not be utilized to perform ALS inter-facility transfers.
"AMD Standard" means the standards and amendments thereto published by the Ambulance Manufacturers Division of the Truck Body and Equipment Association, as reported by the Federal Specification for the Star-of-Life Ambulance, KKK-A-1822E, Edition E, June 1, 2002. Copies of the standards may be obtained from the General Services Administration, Centralized Mailing List Service (7CAFL), P.O. Box 6477, Fort Worth, Texas, 76115.
"Automated external defibrillator" or "AED" means a device that can be attached to a patient in cardiopulmonary arrest, analyze an electrocardiogram for the presence of potentially lethal dysrhythmias (specifically, ventricular fibrillation and fast ventricular tachycardia), deliver an electrical defibrillation to the patient in accordance with the requirements of standard treatment protocols, and produce an event summary that documents significant events in the utilization of the device, specifically events prior to and after an electrical defibrillation.
"Available" means ready for immediate utilization (pertaining to equipment, vehicles and personnel) or immediately accessible (pertaining to records).
"Basic life support" or "BLS" means a basic level of pre-hospital care that includes patient stabilization, airway clearance and maintenance, cardiopulmonary resuscitation (CPR) (to the level of the Professional Rescuer or Health Care Provider as issued by either the American Heart Association, the American Red Cross, the National Safety Council or other entity determined by the Department to comply with AHA CPR Guidelines), hemorrhage control, initial wound care, fracture stabilization, victim extrication and other techniques and procedures as defined in the United States Department of Transportation (U.S.D.O.T.) EMT-Basic National Standards Curriculum (obtainable from The National Highway Traffic Safety Administration, 400 7th Street S.W., Washington, D.C., 20590, by accessing their website at http://www.nhtsa.dot.gov/people/injury/ems or by calling (888) 327-4236).
"Basic life support ambulance" or "BLS ambulance" means an emergency medical services vehicle that is validly licensed by the Department and operated in accordance with the standards set forth in this chapter.
"Basic life support ambulance service" or "BLS ambulance service" means an entity that is validly licensed by the Department to provide pre-hospital basic life support care and/or BLS inter-facility transfers.
"BLS inter-facility transfer" means the transportation of a patient not in need of advanced life support care from one health care facility to another via a basic life support ambulance.
"Cardiac defibrillation" means the discharge of electrical current through the fibrillating myocardium for the purpose of restoring a perfusing cardiac rhythm.
"Certified" or "certification" means official documentation that a person has completed all the requirements of an approved training program and has demonstrated competence in the subject matter to the satisfaction of the certifying agency.
"Commissioner" means the Commissioner of the New Jersey Department of Health and Senior Services.
"Communicable disease" means an illness due to a specific infectious agent or its toxic products, specifically including, but not limited to, those pathogens defined in the Federal bloodborne pathogen standards found at 29 C.F.R. 1910.1030(b), and which occurs through transmission of that agent or its toxic products from a reservoir to a susceptible host.
"Contaminated" means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
"Controlled dangerous substance" means a drug, substance or immediate precursor identified in Schedules I through V of the New Jersey Controlled Dangerous Substances Act (24:21-5 through 24:21-8.1 ). The term shall not include distilled spirits, wine or malt beverages, as those terms are defined or utilized in 33:1-1 et seq., or tobacco and tobacco products.
"Convicted" or "conviction" means a finding of guilt by a judge or jury, a guilty plea, a plea of nolo contendere or non-vult or entry into a pre-trial intervention program, or other diversionary program authorized under the statutes of the State of New Jersey or under any other state's statutes.
"CPR certification" means valid certification in cardiopulmonary resuscitation to the level of the Professional Rescuer or Health Care Provider as issued by the American Heart Association, the American Red Cross, the National Safety Council or other entity determined by the Department to comply with AHA CPR Guidelines.
"Crashworthy" means that all supplies, equipment, oxygen systems, patient litters and wheelchairs carried on the vehicle shall remain firmly in place and shall not present a hazard to any vehicle occupant in the event of an accident or sudden change in vehicle speed or direction. Crashworthy retention systems shall not incorporate rubber straps, "shock cords" or Velcro (R) -type closures. Crashworthy retention systems for some items are covered by specific Federal standards. The Department's test for crashworthiness of other retention systems is whether the item can be removed from place without unlatching or unbuckling the retention system.
"Crewmember" means any person (including, but not limited to a PAT Technician, MAV Technician or EMT-Basic) who staffs a mobility assistance vehicle or basic life support ambulance.
"Crime" means, in accordance with the New Jersey Code of Criminal Justice, specifically 2C:1-4, any offense for which a sentence of imprisonment in excess of six months is authorized.
"Department" means the New Jersey Department of Health and Senior Services.
"Department-Initiated-Out-of-Service" or "DIOOS" means the immediate removal from service of a vehicle by Department staff, such that the vehicle may not be utilized for the provision of any basic and/or advanced life support care. Vehicles removed from service in this manner shall be identified by the placement of an official Department "Out-of-Service" sticker on at least one of the vehicle's windows.
"Disorderly persons offense" or "petty disorderly persons offense" shall have the same meaning as the definition provided by the New Jersey Code of Criminal Justice at N.J.S.A. 2C:1-4, incorporated herein by reference, as amended and supplemented. Generally, such offenses are under the jurisdiction of municipal courts, carry a maximum jail term of six months or less, and are characterized by being minor in nature, not giving rise to the rights of trial by jury or indictment by grand jury. Examples of these offenses include harassment, obstructing a public passage, and fighting in a public place.
"Emergency" means a person's perceived need for immediate medical care in order to prevent death or aggravation of physiological or psychological illness or injury.
"Emergency medical services" or "EMS" means a system for the provision of emergency care and transportation of persons who are sick or injured and in need of immediate medical care.
"Emergency Medical Technician-Basic" or "EMT-Basic" means a person trained in basic life support care and validly certified or recognized by the Commissioner in accordance with the standards for Emergency Medical Technician-Basic certification as set forth at N.J.A.C. 8:40A.
"Emergency Medical Technician-Paramedic" or "EMT-Paramedic" means a person trained in advanced life support care and validly certified or recognized by the Commissioner in accordance with the standards for Emergency Medical Technician-Paramedic certification as set forth at N.J.A.C. 8:41A.
"Emergency response" means the provision of pre-hospital basic life support care by crewmembers staffing a basic life support ambulance, and includes those services that are provided after a call has been received by a 9-1-1 dispatcher requiring an immediate response (for example, automobile accidents, mass gatherings, special events and stadium/arena EMS services) as well as emergent responses to long-term care facilities that may or may not be routed through a 9-1-1 dispatcher.
"Federal Specification, KKK-A-1822," means the most current specification and amendments thereto, currently entitled: "Federal Specification for the Star-of-Life Ambulance KKK-A-1822E," Edition E, June 1, 2002, incorporated herein by reference, as amended and supplemented. Copies of the standards may be obtained from the General Services Administration, Centralized Mailing List Service (7CAFL), P.O. Box 6477, Forth Worth, Texas 76115.
"FMVSS" means Federal Motor Vehicle Safety Standards, as set forth at 49 C.F.R. 571, incorporated herein by reference. Copies of the standards may be obtained from the Superintendent of Documents, Washington, D.C.
"General hospital" shall have the meaning provided at 8:43G-1.3(b) 1, as amended and supplemented.
"Health care facility" means a facility so defined in the Health Care Facilities Planning Act, N.J.S.A. 26:2H-1.1 et seq.
"Helicopter" means a heavier-than-air aircraft that depends principally for its support in flight on the lift generated by one or more rotors.
"Impervious" means not allowing liquids or dirt to penetrate the surface of the material. For the purposes of this chapter, impervious surfaces do not include coverings made of or containing carpet, velour or cloth.
"In-service" means the presence of a mobility assistance vehicle or basic life support ambulance at a sending or receiving health care facility; the picking up, transporting or discharging of any patient; or any instance where the mobility assistance vehicle or basic life support ambulance is ready to accept patients and perform mobility assistance or basic life support care.
"JEMS (Jersey Emergency Medical Services) Communications Plan" means the authorized communications plan for emergency medical services, as issued by the Department. Copies of the plan are available, for a fee, from the Office of Emergency Medical Services.
"License" or "licensed" means validly licensed by the Commissioner in accordance with the standards for licensure as set forth in this chapter.
"MAV crewmember" means any person identified at 8:40-5.3 as being necessary to meet the minimum personnel requirements for a mobility assistance vehicle.
"Medical director" means the physician responsible for the medical oversight of the operations of a basic life support ambulance service that provides emergency response. The specific criteria required of a medical director are set forth at 8:40-6.15.
"Medical record" means any information and/or reports (including, but not limited to, patient care reports) that describe a person's physical condition and/or medical history.
"Mobile intensive care unit" or "MICU" means a specialized emergency medical services vehicle that is validly licensed by the Department and operated in accordance with the standards set forth at N.J.A.C. 8:41.
"Mobility assistance vehicle" or "MAV" means a specialized transport vehicle that is validly licensed by the Department and operated in accordance with the standards set forth in this chapter.
"Mobility assistance vehicle service" or "MAV service" means an entity that is validly licensed by the Department to provide non-emergency health care transportation of sick, infirm or otherwise disabled persons who are under the care or supervision of a physician or other recognized health care provider and whose medical condition is not of sufficient magnitude or gravity to require transportation in a basic life support ambulance, but does require transportation from place to place for medical care, and whose utilization of an alternate form of transportation, such as taxicab, bus, other public conveyance or private vehicle, might create a serious risk to life and health. This service was formerly known as invalid coach service prior to the enactment of 30:4D-3a.
"Mobility assistance vehicle technician" or "MAVT" means an individual who has successfully completed the requirements of the mobility assistance vehicle technician's course standards as listed in chapter Appendix B, incorporated herein by reference, and established by the mobility assistance vehicle technician course faculty.
"Non volunteer" means a non volunteer basic life support ambulance service. Includes those agencies that bill patients or insurers for services, hospital-operated services, proprietary services, municipally-operated ambulance services, services operated by a paid municipal fire department, services operated by a paid municipal police department, industrial first aid squads or State-operated ambulances.
"Office of Emergency Management" means the Office of Emergency Management of the New Jersey State Police, Division Headquarters, PO Box 7068, West Trenton, New Jersey, 08625. The telephone number for the Office of Emergency Management is (609) 882-2000.
"Office of Emergency Medical Services" or "OEMS" means the Office of Emergency Medical Services in the New Jersey Department of Health and Senior Services, PO Box 360, Trenton, New Jersey, 08625. The telephone number for OEMS is (609) 633-7777.
"Passenger assistance techniques" or "PAT" means a training program developed by the Transportation Management Associates, Fort Worth Texas. The training program is designed to provide drivers of mobility assistance vehicles the necessary basic skills to safely and effectively assist and transport ambulatory and wheelchair bound patients in their care.
"Patient" means any person who is ill or injured, living or deceased and with whom a crewmember has established physical or verbal contact.
"Patient care report" means the written documentation completed each time a crewmember makes physical or verbal contact with a patient.
"Pediatric" means the period of time beginning with the 29th day following birth up to, but not including, a person's thirteenth birthday.
"Petty disorderly persons offense" means an offense as defined at 2C:1-4.
"Physician" means a person who is validly licensed by the New Jersey State Board of Medical Examiners in accordance with the standards set forth at 45:9-6.
"Physician assistant" means a person who is validly licensed by the New Jersey State Board of Medical Examiners in accordance with the standards set forth at N.J.S.A. 45:9-27.1 3.
"Positive latching mechanism" means a latching mechanism that requires the manual release of the latching device. This does not include magnetic or friction-type latches.
"Pre-hospital" means the period of time prior to the delivery of a patient to a physician or registered nurse at a general hospital or satellite emergency department.
"Provider" means a mobility assistance vehicle service or basic life support ambulance service. By virtue of such status, the provider shall assume full legal responsibility for the delivery of services and shall be held accountable for the actions of its crewmembers in the event that there are violations of any State or Federal licensing standards.
"Provider-Initiated-Out-of-Service" or "PIOOS" means the temporary removal from service of a vehicle by the provider. A provider may choose to remove a vehicle from service for various reasons including, but not limited to, when the vehicle is in transit for repairs, when being utilized for official administrative duties or when being utilized in a parade or similar ceremony. Vehicles removed from service in this manner shall be identified by the placement of a placard in one of the vehicle's windows.
"Receiving health care facility" means a general hospital, nursing home, physician's office, outpatient facility or rehabilitation facility to which a patient is transferred following evaluation and/or treatment.
"Registered nurse" means a person who is validly licensed by the New Jersey State Board of Nursing in accordance with the standards set forth at 45:11-26.
"Regulated medical waste" means, as defined at 7:26-3A.5, those medical wastes that have been listed or meet the waste characteristic classification criteria described at 7:26-3A.6 and that must be managed in accordance with the requirements of N.J.A.C. 7:26-3A.
"Revocation" or "revoked" means the permanent voiding, withdrawal and/or cancellation of a license or certification.
"Satellite emergency department" means a facility that is owned and operated by a general hospital, which provides emergency care and treatment.
"Specialty care transport unit" or "SCTU" means a specialized transport medical service vehicle that is validly licensed by the Department and operated in accordance with the standards set forth at N.J.A.C. 8:41.
"Star of Life" means the symbol described in certification of registration number 1,058,022, which the United States Commissioner of Patents and Trademarks has issued to the National Highway Traffic Safety Administration.
"Untreated regulated medical waste" means regulated medical waste, as defined in this subchapter, which has not been treated to substantially reduce or eliminate its potential for causing disease.
"Valid" or "validly" means original (not a photo copy), current, up-to-date, not expired, in effect and/or not past the renewal date required by the issuer.
"Vehicle" means a mobility assistance vehicle or basic life support ambulance, as defined in this subchapter.
"Volunteer ambulance, first aid or rescue squad" means, in accordance with 27:5F-20, an ambulance, first aid or rescue squad that provides emergency medical services without receiving payment for those services. Whether the members of a squad provide their services for free or are compensated by the squad is irrelevant to a squad's volunteer status.
N.J. Admin. Code § 8:40-1.3