Ariz. Admin. Code § 9-25-202

Current through Register Vol. 30, No. 40, October 4, 2024

Section R9-25-202 - On-line Medical Direction (Authorized by A.R.S. sections 36-2201, 36-2202(A)(3) and (A)(4), 36-2204(5), (6), and (7), 36-2204.01, and 36-2205(A) and (D)) licensed:

A. In this Section, "physician" means an individual

1. According to A.R.S. Title 32, Chapter 13 or 17; or

2. When working in a health care institution operating under federal or tribal law as an administrative unit of the U.S. government or a sovereign tribal nation, by a similar licensing board in another state.

B. An emergency medical services provider or ambulance service shall:

1. Except as provided in R9-25-203(C)(3), ensure that a physician provides on-line medical direction to EMCTs on behalf of the emergency medical services provider or ambulance service only if the physician meets one of the following:

a. Has emergency medicine certification issued by a member board of the American Board of Medical Specialties;

b. Has emergency medical services certification issued by the American Board of Emergency Medicine;

c. Has emergency medicine certification issued by the American Osteopathic Board of Emergency Medicine;

d. Has emergency medicine certification issued by the American Board of Physician Specialties;

e. Has completed an emergency medicine residency training program accredited by the Accreditation Council for Graduate Medical Education or approved by the American Osteopathic Association; or

f. Is an emergency medicine physician in an emergency department located in Arizona and has current certification that meets the requirements in R9-25-201(A)(1)(f)(i) through (iii);

2. For each physician providing on-line medical direction on behalf of the emergency medical services provider or ambulance service, maintain for Department review either:

a. The name, e-mail address, telephone number, and qualifications of the physician providing on-line medical direction on behalf of the emergency medical services provider or ambulance service; or

b. If the emergency medical services provider or ambulance service provides on-line medical direction through an ALS base hospital or a centralized medical direction communications center, a copy of a written agreement with the ALS base hospital or centralized medical direction communications center documenting that the physician providing on-line medical direction is qualified under subsection (B)(1);

3. Ensure that the on-line medical direction provided to an EMCT on behalf of the emergency medical services provider or ambulance service is consistent with:

a. The EMCT's scope of practice, as specified in Table 5.1; and

b. Communication protocols, triage protocols, treatment protocols, and protocols for prehospital incident history reports, specified in R9-25-201(E)(2); and

4. Ensures that a physician providing on-line medical direction on behalf of the emergency medical services provider or ambulance service relays on-line medical direction only through one of the following individuals, under the supervision of the physician and consistent with the individual's scope of practice:

a. Another physician,

b. A physician assistant,

c. A registered nurse practitioner,

d. A registered nurse,

e. A Paramedic, or

f. An EMT-I(99).

C. An emergency medical services provider or ambulance service may provide on-line medical direction through an ALS base hospital certified according to R9-25-203(C), if the emergency medical services provider or ambulance service:

1. Uses the ALS base hospital for on-line medical direction only for patients who are children, and

2. Has an additional written agreement for the provision of on-line medical direction with an ALS base hospital that meets the requirements in R9-25-203(B)(1) or a centralized medical direction communications center.

D. An emergency medical services provider or ambulance service shall ensure that the emergency medical services provider or ambulance service, or an ALS base hospital or a centralized medical direction communications center providing on-line medical direction on behalf of the emergency medical services provider or ambulance service, has:

1. Operational and accessible communication equipment that will allow on-line medical direction to be given to an EMCT;

2. A written plan for alternative communications with an EMCT in the event of a disaster, communication equipment breakdown or repair, power outage, or malfunction; and

3. A physician qualified under subsection (B)(1) available to give on-line medical direction to an EMCT 24 hours a day, seven days a week.

Ariz. Admin. Code § R9-25-202

Adopted effective October 15, 1996 (Supp. 96-4). Former R9-25-202 renumbered to R9-25-208; new R9-25-202 made by final rulemaking at 9 A.A.R. 5372, effective January 3, 2004 (Supp. 03-4). Amended by final rulemaking at 25 A.A.R. 953, effective 7/1/2019.