§ 1001.2. Definitions.

 The following words and terms, when used in this subpart, have the following meanings, unless the context clearly indicates otherwise:

   ACLS course—Advanced cardiac life support course—A course in advanced cardiac life support sanctioned by the American Heart Association.

   ALS ambulance service—Advanced life support ambulance service—An entity licensed by the Department to provide ALS services by ambulance to seriously ill or injured patients. The term includes mobile ALS ambulance services that may or may not transport patients.

   ALS service medical director—Advanced life support service medical director—A medical command physician or a physician meeting the equivalent qualifications in §  1003.5 (relating to ALS service medical director) who is employed by, contracts with or volunteers with, either directly, or through an intermediary, an ALS ambulance service to make medical command authorization decisions, provide medical guidance and advice to the ALS ambulance service, and evaluate the quality of patient care provided by the prehospital personnel utilized by the ALS ambulance service.


   ALS services—Advanced life support services—The advanced prehospital and interhospital emergency medical care of serious illness or injury by appropriately trained health professionals and EMT-paramedics.

   APLS course—Advanced pediatric life support course—A course in advanced pediatric life support sanctioned by the American Academy of Pediatrics and the American College of Emergency Physicians.

   ATLS course—Advanced trauma life support course—A course in advanced trauma life support sanctioned by the American College of Surgeons Committee on Trauma.

   Act—The Emergency Medical Services Act (35 P. S. § §  6921—6938).

   Air ambulance—A rotorcraft specifically designed, constructed or modified and equipped, used or intended to be used, and maintained or operated for the purpose of providing emergency medical care to, and air transportation of, patients.

   Air ambulance medical director—A medical command physician or a physician meeting the minimum qualifications in §  1003.5 who is employed by, or contracts with, or volunteers with, either directly, or through an intermediary, an air ambulance service to make medical command authorization decisions, provide medical guidance and advice to the air ambulance service, and evaluate the quality of patient care provided by the prehospital personnel utilized by the air ambulance service.

   Air ambulance service—An agency or entity licensed by the Department to provide transportation and ALS care of patients by air ambulance.

   Aircraft operator—The person, company or agency, certified by the FAA, under 14 CFR Part 135 (relating to air taxi operators and commercial operators), to conduct air taxi operations.

   Ambulance—A vehicle specifically designed, constructed or modified and equipped, used or intended to be used, and maintained or operated for the purpose of providing emergency medical care to patients, and the transportation of patients if used for that purpose. The term includes ALS or BLS vehicles that may or may not transport patients.

   Ambulance attendant—An individual who possesses the qualifications in §  1003.21(b) (relating to ambulance attendant).

   Ambulance identification number—A number issued by the Department to each ambulance operated by an ambulance service.

   Ambulance service—An entity which regularly engages in the business or service of providing emergency medical care and transportation of patients in this Commonwealth. The term includes ALS ambulance services that may or may not transport patients.

   Ambulance service affiliate number—A unique number assigned by the Department to an ambulance service, the first two digits of which designate the county in which the ambulance service maintains its primary headquarters.

   BLS ambulance service—Basic life support ambulance service—An entity licensed by the Department to provide BLS services and transportation by ambulance to patients.

   BLS services—Basic life support services—The basic prehospital or interhospital emergency medical care and management of illness or injury performed by specially trained, certified or licensed personnel.

   Basic rescue practices technician—An individual who is certified by the Department to possess the training and skills to perform a rescue operation as taught in a basic rescue practices technician program approved by the Department.

   Basic vehicle rescue technician—An individual who is certified by the Department to possess the training and skills to perform a rescue from a vehicle as taught in a basic vehicle rescue technician program approved by the Department.

   Board certification—Current certification in a medical specialty or subspecialty recognized by either the American Board of Medical Specialties or the American Osteopathic Association.

   CPR—Cardiopulmonary resuscitation—The combination of artificial respiration and circulation which is started immediately as an emergency procedure when cardiac arrest or respiratory arrest occurs.

   CPR course—Cardiopulmonary resuscitation course—A course of instruction in CPR, meeting the Emergency Cardiac Care Committee National Conference on CPR and Emergency Cardiac Care standards. The course shall encompass one and two-rescuer adult, infant and child CPR, and obstructed airway methods.

   Commonwealth Emergency Medical Director—A medical command physician or a physician meeting the equivalent qualifications in §  1003.1 (relating to Commonwealth Emergency Medical Director) and approved by the Department to advise, formulate and direct policy on matters pertaining to EMS.

   Continuing education—Learning activities intended to build upon the education and experiential basis of prehospital personnel for the enhancement of practice, education, administration, research or theory development, to strengthen the quality of care provided.

   Continuing education sponsor—An entity or institution that is accredited by the Department as a sponsor of continuing education courses.

   Council—The Board of Directors of the Pennsylvania Emergency Health Services Council.

   Critical care specialty receiving facility—A facility identified by its capability of providing specialized emergency and continuing care to patients, including, in one of the following medical areas: poisoning, neonatal, spinal cord injury, behavioral, burns, cardiac and trauma.

   Department—The Department of Health of the Commonwealth or a designee.

   Department identification number—A number issued by the Department that identifies an individual who participates in the Statewide EMS system and who has been certified, recognized or otherwise assigned an identification number by the Department.

   Direct support of EMS systems—Activities, equipment and supplies that are involved in the planning, initiation, maintenance, expansion or improvement of EMS systems.

   EMSOF—Emergency Medical Services Operating Fund—Moneys appropriated to the Department under section 14(c) of the act (35 P. S. §  6934(c)) and which are not assigned to the Catastrophic Medical and Rehabilitation Fund.

   EMS—Emergency medical services—The services utilized in responding to the needs of an individual for immediate medical care to prevent loss of life or aggravation of physiological or psychological illness or injury.

   EMS patient care report—A report that provides standardized data and information relating to patient assessment and care.

   EMS system—The arrangement of personnel, facilities and equipment for the effective and coordinated delivery of EMS required in the prevention and management of incidents which occur either as a result of a medical emergency or of an accident, natural disaster or similar situation.

   EMS training institute—Emergency medical services training institute—An institute accredited by the Department to provide a course required for the certification or recognition of a prehospital practitioner.

   EMS training manual—Emergency medical services training manual—A manual adopted by the Department and reviewed biennially by the Council to aid ALS service medical directors in determining whether EMT-paramedics and prehospital registered nurses have demonstrated competency in the knowledge and skills necessary to be granted or maintain medical command authorization.

   EMT—Emergency medical technician—An individual trained to provide prehospital emergency medical treatment and certified as such by the Department in accordance with the current EMT-NSC, as set forth in this part.

   EMT-NSC—Emergency medical technician-National standard curriculum— An outline of knowledge and skills recommended for the education and training of EMTs, as adopted by the United States Department of Transportation.

   EMT-paramedic—Emergency medical technician-paramedic—An individual who is trained to provide prehospital emergency medical treatment at an advanced level and certified as such by the Department in accordance with the current EMT-paramedic NSC, as set forth in this part.

   EMT-paramedic NSC—Emergency medical technician-paramedic National standard curriculum—An outline of knowledge and skills recommended for the education and training of EMT-paramedics, as adopted by the United States Department of Transportation.

   Emergency—A combination of circumstances resulting in a need for immediate medical intervention.

   Emergency department—An area of the hospital dedicated to offering emergency medical evaluation and initial treatment to individuals in need of emergency care.

   FAA—The Federal Aviation Administration.

   FAA certification number—An air taxi/commercial operator operating certificate number assigned by the FAA, authorizing the certificate holder to operate aircraft as required by 14 CFR Part 135.

   Facility—A hospital.

   Federal KKK standards—The minimum standards and specifications for ambulance vehicles adopted by the United States Department of Transportation.

   Federally declared emergency—A state of emergency declared by the President of the United States, upon the request of a governor. Once the President declares the situation a ‘‘major disaster,’’ the Federal government supplements State and local efforts to meet the crisis.

   First responder—An individual who is certified by the Department as a first responder.

   Health professional—A physician who has education and continuing education in ALS services and prehospital care or a prehospital registered nurse.

   Hospital—An institution having an organized medical staff which is primarily engaged in providing to inpatients by or under the supervision of physicians, diagnostic and therapeutic services or rehabilitation services for the care or rehabilitation of injured, disabled, pregnant, diseased, sick or mentally ill persons. The term includes a facility for the diagnosis and treatment of disorders within the scope of specific medical specialties, but not a facility caring exclusively for the mentally ill.

   Invalid coach—A vehicle primarily maintained, operated and intended to be used for routine transport of persons who are convalescent or otherwise nonambulatory and do not ordinarily require emergency medical treatment while in transit. The term does not include an ambulance or another EMS vehicle.

   Medical advisory committee—An advisory body, composed of a majority of physicians, to advise a regional EMS council or the Council on issues that have potential impact on the delivery of emergency medical care.

   Medical audit—A mechanism to evaluate patient care.

   Medical command—An order given by a medical command physician to a prehospital practitioner in a prehospital, interfacility, or emergency care setting in a hospital, to provide immediate medical care to prevent loss of life or aggravation of physiological or psychological illness or injury, or to withdraw or withhold treatment.

   Medical command authorization—Permission given by the ALS service medical director, including an air ambulance medical director, to an EMT-paramedic or a prehospital registered nurse under §  1003.28 (relating to medical command authorization) to perform, on behalf of an ALS ambulance service, ALS services under medical command or in accordance with Department approved regional EMS council transfer and medical treatment protocols when medical command cannot be secured, is disrupted or is not required under the approved regional EMS council transfer and medical treatment protocols.

   Medical Command Course—The course adopted by the Department for medical command physicians and ALS service medical directors which provides an overview of the medical command system.

   Medical command facility—The distinct unit within a facility that contains the necessary equipment and personnel, as prescribed in §  1009.1 (relating to operational criteria) for providing medical command to and control over prehospital personnel when providing medical command.

   Medical command facility medical director—A medical command physician who meets the criteria established by the Department to assume responsibility for the direction and control of the equipment and personnel at a medical command facility.

   Medical command physician—A physician who is approved by a regional EMS council to provide medical command.

   Medical coordination—A system which involves the medical community in all phases of the regional EMS system and consists of the following elements:

     (i)   Designation of a regional medical director.

     (ii)   Responsibility for oversight to assure implementation of all medical requirements, with special emphasis on patient triage and medical treatment protocol.

     (iii)   Effective emergency medical planning and recommendation for Department recognition of online command facilities with medical command physicians who give orders to prehospital patient care providers.

     (iv)   Transfer and medical treatment protocols.

     (v)   Technologic innovations which support the training and operations of the physicians giving orders to prehospital patient care providers.

     (vi)   Technologic innovations which support the training and operations of the EMS program and an effective process for accountability—for example, records, case review and audits.

   Medical record—Documentation of the course of a patient’s condition and treatment, maintained to provide communication among health care providers for current and future patient care.

   Medical treatment protocols—Written prescribed medical procedures.

 NSC—National Standard Curriculum.

   PALS course—Pediatric advanced life support course—A course in advanced pediatric life support sanctioned by the American Heart Association and the American Academy of Pediatrics.

   PSAP—Public safety answering point—A communications center established to serve as the first point at which calls by or on behalf of patients are received requesting emergency medical assistance.

   Patient—An individual who is believed to be sick, injured, wounded or otherwise incapacitated and helpless and in need of immediate medical attention.

   Pennsylvania Trauma Systems Foundation—A nonprofit Pennsylvania corporation whose function is to accredit trauma centers in this Commonwealth.

   Physician—An individual who has a currently registered license to practice medicine or osteopathic medicine in this Commonwealth.

   Prehospital personnel—The term includes any of the following prehospital practitioners:

     (i)   Ambulance attendants.

     (ii)   First responders.

     (iii)   EMTs.

     (iv)   EMT-paramedics.

     (v)   Prehospital registered nurses.

     (vi)   Health professional physicians.

   Prehospital registered nurse—An individual who is recognized by the Department as such under §  1003.25b (relating to prehospital registered nurse).

   Providers of EMS—A facility, BLS ambulance service or ALS ambulance service, or a QRS.

   QRS—Quick response service—An entity recognized by the Department to respond to an emergency and to provide EMS to patients pending the arrival of the prehospital personnel of an ambulance service.

   Receiving facility—A fixed facility that provides an organized emergency department, with a physician who is trained to manage cardiac, trauma, pediatric, medical and behavioral emergencies, and is present in the facility and available to the emergency department 24 hours-a-day, 7 days-a-week, and a registered nurse who is present in the emergency department 24 hours-a-day, 7 days-a-week. The facility shall also comply with Chapter 117 (relating to emergency services).

   Regional EMS council—A nonprofit incorporated entity or appropriate equivalent whose function is to plan, develop, maintain, expand and improve EMS systems within a specific geographical area of this Commonwealth and which is deemed by the Department as being representative of health professions and major private and public and voluntary agencies, organizations and institutions concerned with providing EMS in the region.

   Registered nurse—An individual who has a current original or renewed license to practice nursing in this Commonwealth as a registered nurse.

   Rescue vehicle—A vehicle which is designed or modified and equipped for rescue operations to release persons from entrapment and which is not routinely used for emergency medical care or transport of patients.

   Residency program—Training approved or recognized by the State Board of Medicine or the State Board of Osteopathic Medicine as a program of graduate medical training for physicians.

   Rural area—An area outside urbanized areas as defined by the United States Bureau of the Census.

   Scope of practice—Those emergency medical services that an individual who is certified or recognized by the Department is permitted to perform under the certification or recognition, provided the individual has medical command authorization, if required.

   Secretary—The Secretary of the Department.

   Service area—The area in which an ambulance service routinely provides services.

   Special care unit—An appropriately equipped area of the hospital where provision has been made for a concentration of physicians, registered nurses and others who have special skills and experiences to provide medical care for critically ill patients.

   Special event—A planned and organized activity or contest, which will place participants or attendees, or both, in a defined geographic area in which the potential need for EMS exceeds local EMS capabilities, or where access by emergency vehicles might be delayed due to crowd or traffic congestion at or near the event.

   Special vehicle rescue technician—An individual who is certified by the Department to possess the training and skills to perform special rescue operations as taught in the special vehicle rescue training program approved by the Department.

   State declared emergency—An emergency declared by the Governor.

   Statewide BLS medical treatment protocols—Written medical treatment protocols adopted by the Department that have Statewide application to the delivery of BLS services by prehospital personnel.

   Trauma center—A facility accredited as a trauma center by the Pennsylvania Trauma Systems Foundation.

   Volunteer ambulance service—A nonprofit chartered corporation, association or organization located in this Commonwealth and which is regularly engaged in the service of providing emergency medical care and transportation of patients as an ambulance service.

   The provisions of this §  1001.2 amended under the Do-Not-Resuscitate Act, 20 Pa.C.S. Chapter 54.

   The provisions of this §  1001.2 amended September 1, 1995, effective September 2, 1995, 25 Pa.B. 3685; amended October 13, 2000, effective October 14, 2000, 30 Pa.B. 5363; amended December 13, 2002, effective March 1, 2003, 32 Pa.B. 6117; amended February 6, 2004, effective February 7, 2004, 34 Pa.B. 677. Immediately preceding text appears at serial pages (297022) to (297023), (269307) to (269312) and (293991).

   This section cited in 28 Pa. Code §  1051.2 (relating to definitions).