N.J. Admin. Code § 8:41-10.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:41-10.6 - Medical command

(a) The provision of advanced life support care by ALS EMT-P crewmembers staffing an SCTU is deemed a delegated medical practice. The medical command physician provides the authority for the ALS EMT-P crewmembers to act.

(b) Physician medical command may be accomplished in one of four ways:

1. Direct control: Direct observation and voice orders, which may be given by a physician who is physically present on the vehicle during the transfer.

i. In the case where a physician accompanies a patient during the actual transfer, that physician shall be deemed the medical command physician;

2. Written orders, which shall be prepared by the sending physician and shall include the information and material in (b)2i through vi below. The ALS crewmember(s) shall review all orders with the sending physician or his or her nurse and indicate a thorough understanding of those orders prior to the transfer of the patient. All orders given to the registered nurse staffing the SCTU shall be specific with regard to treatments ordered or medications and dosages to be given and the sequence in which the treatment is to be performed.

i. Authorization to transfer the patient to a receiving facility which has agreed to accept the patient;

ii. Identification of the method of transportation to be utilized;

iii. A list of medical personnel who shall accompany the patient during the transfer;

iv. Medical treatment and drug orders for the duration of the transfer;

v. Documentation of any foreseeable complications which might occur during transfer; and

vi. The sending and receiving physicians' names and telephone numbers. In the event that an ALS crewmember needs immediate and/or emergent medical direction, and where it is impractical or impossible to make contact with the sending or receiving physicians, the ALS crewmember shall contact the medical command physician at the closest available mobile intensive care hospital;

3. Patient care transfer protocols.

i. Each specialty care transport service shall develop and maintain written patient care transfer protocols that cover most common medical emergencies for patients of all ages. These protocols shall be kept on file at each provider's principal place of business and shall be immediately accessible to all crewmembers and physicians. These protocols shall serve as a guide to the physicians, but shall not be deemed to restrict the treatment ordered in the best judgment of the physicians and within the scope of the practice of the crewmembers. There shall be patient care transfer protocols for the ALS crewmember(s) to start treatment until the medical command physician can be contacted for additional orders. The patient care transfer protocols shall be reviewed and signed off by the medical director at least once every 12 months;

ii. When in service, each specialty care transport service shall keep a copy of the patient care transfer protocols in each specialty care ambulance that is licensed as an SCTU; or

4. Direct on-line contact by means of radio or cellular technology.

N.J. Admin. Code § 8:41-10.6