California Code of Regulations
Title 22 - Social Security
Division 9 - Prehospital Emergency Medical Services
Chapter 4 - Emergency Medical Technician-Paramedic
Article 7 - System Requirements
Section 100170 - Medical Control

Universal Citation: 22 CA Code of Regs 100170

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

The medical director of the LEMSA shall establish and maintain medical control in the following manner:

(a) Prospectively, by assuring the development of written medical policies and procedures, to include at a minimum:

(1) Treatment protocols that encompass the paramedic scope of practice.

(2) Local medical control policies and procedures as they pertain to the paramedic base hospitals, alternative base stations, paramedic service providers, paramedic personnel, patient destination, and the LEMSA.

(3) Criteria for initiating specified emergency treatments on standing orders or for use in the event of communication failure that is consistent with this Chapter.

(4) Criteria for initiating specified emergency treatments, prior to voice contact, that are consistent with this Chapter.

(5) Requirements to be followed when it is determined that the patient will not require transport to the hospital by ambulance, is treated on scene without transport, or when the patient refuses care or transport.

(6) Requirements for the initiation, completion, review, evaluation, and retention of an electronic health record (EHR) as specified in this Chapter. These requirements shall address but not be limited to:
(A) Initiation of an electronic health record for every patient response.

(B) Responsibilities for record completion.

(C) Record distribution to include LEMSA, receiving hospital, paramedic base hospital, alternative base station, and paramedic service provider.

(D) Responsibilities for record review and evaluation.

(E) Responsibilities for record retention.

(b) Establish policies which provide for direct voice communication between a paramedic and a base hospital physician, authorized registered nurse, or MICN, as needed.

(c) Retrospectively, by providing for organized evaluation and CE for paramedic personnel. This shall include, but not be limited to:

(1) Review by a base hospital physician, authorized registered nurse, or MICN of the appropriateness and adequacy of paramedic procedures initiated and decisions regarding transport.

(2) Maintenance of records of communications between the service provider(s) and the base hospital through tape recordings and through emergency department communication logs sufficient to allow for medical control and CE of the paramedic.

(3) Organized field care audit(s).

(4) Organized opportunities for CE including maintenance and proficiency of skills as specified in this Chapter.

(5) Ensuring the EMSQIP methods of evaluation are composed of structure, process, and outcome evaluations which focus on improvement efforts to identify root causes of problems, intervene to reduce or eliminate these causes, and take steps to correct the process and recognize excellence in performance and delivery of care, pursuant to the provisions of Chapter 12 of this Division.

(d) In circumstances where use of a base hospital as defined in Section 100169 is precluded, alternative arrangements for complying with the requirements of this Section may be instituted by the medical director of the LEMSA if approved by the Authority.

1. Renumbering of former section 100169 to section 100170 and amendment of subsection (d) and renumbering of former section 100170 to section 100171 filed 11-29-93 as an emergency; operative 12/1/93 (Register 93, No. 49). A Certificate of Compliance must be transmitted to OAL by 3-30-94 or emergency language will be repealed by operation of law on the following day. For prior history, see Register 92, No. 10.
2. Certificate of Compliance as to 11-29-93 order transmitted to OAL 3-30-94; disapproved by OAL and order of repeal as to 11-29-93 order filed on 5-11-94 (Register 94, No. 19).
3. 11-29-93 order including amendment of section refiled 5-12-94 as an emergency; operative 5-12-94 (Register 94, No. 19). A Certificate of Compliance must be transmitted to OAL by 9-9-94 or emergency language will be repealed by operation of law on the following day.
4. Editorial correction of HISTORY 3 (Register 94, No. 21).
5. Certificate of Compliance as to 5-12-94 order transmitted to OAL 9-9-94 and filed 10-24-94 (Register 94, No. 43).
6. Renumbering of former section 100170 to section 100175 and renumbering of former section 100165.3 to section 100170, including amendment of section heading, repealer and new section, and amendment of NOTE, filed 3-15-99; operative 4-14-99 (Register 99, No. 12).
7. Repealer of former section 100170, relocation and renumbering of former article 9 to article 8 and renumbering of former section 100176 to section 100170 filed 9-10-2004; operative 10-10-2004 (Register 2004, No. 37).
8. Relocation of article 8 heading to precede section 100171, renumbering of former section 100170 to section 100171 and renumbering and amendment of former section 100169 to section 100170 filed 2-11-2013; operative 4-1-2013 (Register 2013, No. 7).
9. Amendment of subsections (a)(5)-(a)(6)(A), (b) and (c)(1) and new subsection (c)(5) and amendment of NOTE filed 1-24-2020; operative 4-1-2020 (Register 2020, No. 4).

Note: Authority cited: Sections 1797.106, 1797.107, 1797.172 and 1797.176, Health and Safety Code. Reference: Sections 1204, 1206, 1797.56, 1797.90, 1797.114, 1797.172, 1797.202, 1797.220, 1797.227, 1798, 1798.2, 1798.3, 1798.101 and 1798.105, Health and Safety Code; and Section 5404, Welfare and Institutions Code.

The amended version of this section by Register 2024, No. 38, effective 1/1/2025 is not yet available.

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