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COMMONWEALTH OF PENNSYLVANIA

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28 Pa. Code § 1051.2. Definitions.

§ 1051.2. Definitions.

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

   Advance directive—A directive for health care in a declaration issued under 20 Pa.C.S. Chapter 54 (relating to the Advance Directive for Health Care Act).

   Attending physician—A physician who has primary responsibility for the medical care and treatment of a patient. A patient may have more than one attending physician.

   CPR—Cardiopulmonary resuscitation—Cardiac compression, invasive airway techniques, artificial ventilation, defibrillation and other related procedures used to resuscitate a patient or to prolong the life of a patient.

   DNR—Do not resuscitate.

   Declarant—As defined in 20 Pa.C.S. §  5403 (relating to definitions).

   Declaration—As defined in 20 Pa.C.S. §  5403.

   Department—The Department of Health of the Commonwealth.

   EMS personnel—Emergency medical services personnel—Prehospital personnel and individuals given good Samaritan civil immunity protection when using an automated external defibrillator under 42 Pa.C.S. §  8331.2 (relating to good Samaritan civil immunity for use of automated external defibrillators).

   EMS provider—Emergency medical services provider—EMS personnel, a medical command physician and, as defined in §  1001.2 (relating to definitions), an advance life support service medical director, medical command facility medical director, medical command facility, ambulance service and quick response service.

   Health care provider—A person who is licensed, certified or otherwise authorized to administer health care in the ordinary course of a business or practice of a profession. The term includes EMS providers.

   Invasive airway technique—Any advanced airway technique, including endotracheal intubation.

   Life-sustaining treatment

     (i)   A medical procedure or intervention that, when administered to a patient, will serve only to prolong the process of dying or to maintain the patient in a state of permanent unconsciousness.

     (ii)   The term includes nutrition and hydration administered by gastric tube or intravenously or any other artificial or invasive means if the order of the patient so specifically provides.

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

   Out-of-hospital DNR bracelet—A bracelet which signifies that an out-of-hospital DNR order has been issued.

   Out-of-hospital DNR necklace—A necklace which signifies that an out-of-hospital DNR order has been issued.

   Out-of-hospital DNR order—A written order, the form for which is supplied by the Department or its designee under this chapter, that is issued by an attending physician and directs EMS providers to withhold CPR from the patient in the event of cardiac or respiratory arrest.

   Out-of-hospital DNR patient—A patient for whom an attending physician has issued an out-of-hospital DNR order.

   Patient—One of the following:

     (i)   An individual who is in a terminal condition.

     (ii)   A declarant whose declaration has become operative under 20 Pa.C.S. §  5405(2) (relating to when declaration becomes operative) and which provides that CPR may not be provided in the event of the declarant’s cardiac or respiratory arrest if the declarant becomes permanently unconscious, or designates a surrogate to make that decision under those circumstances.

   Permanently unconscious

     (i)   A medical condition that has been diagnosed in accordance with currently accepted medical standards and with reasonable medical certainty as total and irreversible loss of consciousness and capacity for interaction with the environment.

     (ii)   The term includes, without limitation, a persistent vegetative state or irreversible coma.

   Person—An individual, corporation, partnership, association or Federal, State or local government or governmental agency.

   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)   Emergency medical technicians (EMTs).

     (iv)   EMT-paramedics.

     (v)   Prehospital registered nurses.

     (vi)   Health professional physicians.

   Surrogate—An individual who has, or individuals who collectively have, legal authority to request an out-of-hospital DNR order for another individual or to revoke that order.

   Terminal condition—An incurable and irreversible medical condition in an advanced state caused by injury, disease or physical illness which will, in the opinion of the attending physician, to a reasonable degree of medical certainty, result in death regardless of the continued application of life-sustaining treatment.

Source

   The provisions of this §  1051.2 amended February 6, 2004, effective February 7, 2004, 34 Pa.B. 677. Immediately preceeding text appears at serial pages (294014) to (294016).



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