(A) Each ambulance service shall have written
policies and procedures consistent with
105 CMR
170.000, the accepted standards of care for EMTs and
applicable laws. These policies shall set out guidelines for operating and
maintaining the service and ambulances, and shall be provided to EMTs. These
policies shall be comprehensive, reflect current day-to-day operations, and
address at minimum the following:
(1)
Certification and recertification of EMTs;
(2) Orientation of all ambulance service
employees;
(3) Responsibility to
dispatch, treat and transport in accordance with
105
CMR 170.355;
(4) Duties of transportation and policies
relating to delivery of patients to appropriate health care facilities in
accordance with
105
CMR 170.020;
(5) Nondiscrimination;
(6) Backup services including provisions for
when such services are to be used and timely dispatch in accordance with
standards set out in the applicable Department-approved service zone plan, to
backup services when needed;
(7)
Arrangements for securing additional EMS personnel at appropriate certification
levels, in order to staff ambulances in accordance with
105
CMR 170.305;
(8) Dispatch;
(9) Communications;
(10) Stocking of supplies;
(11) Use of lights and warning
signals;
(12) Staffing of
ambulances;
(13) Conduct of
personnel;
(14) Acquisition,
security and disposal of controlled substances and other drugs, in accordance
with 105 CMR
700.000: Implementation of M.G.L. c.
94C;
(15) Maintenance of
biomedical equipment and devices according to manufacturers'
recommendations;
(16) Ensuring
timely leaving/transmission of patient care reports at receiving
hospitals;
(17) Arrangements for
securing additional appropriately trained personnel to assist EMTs, whether in
providing ALS services in accordance with
105
CMR 170.305(C) or for other
purposes;
(18) For ALS services,
the hours during which ALS service will be provided, if the service is not yet
operating 24 hours per day, seven days per week, in accordance with
105
CMR 170.385(C);
(19) For ALS-Paramedic services that staff
with one paramedic and one other certified EMT, all policies required by
105
CMR 170.305(C)(2);
(20) Mechanical failures;
(21) Inspection authorities;
(22) Infection control procedures including
designated infection control officer;
(23) Compliance with the Statewide Treatment
Protocols;
(24) Training and skill
competency assurance of EMS personnel for new or updated equipment; changes and
updates to
105 CMR
170.000, the Statewide Treatment Protocols;
administrative requirements, advisories and memoranda issued by the Department;
and as otherwise required by any provision of
105 CMR
170.000 or the Statewide Treatment
Protocols;
(25) Rights of parents
of patients who are minors, including the right to accompany the patient in the
ambulance in accordance with M.G.L. c. 111C, § 17;
(26) Mandated reporting;
(27) EMT use of patient restraints in
accordance with
105
CMR 170.373 and the Statewide Treatment
Protocols;
(28) Sanitary practices;
and
(29) Disposal of hazardous
waste.
(B) Each EFR
service shall have written policies and procedures consistent with
105 CMR
170.000 and
105 CMR
171.000: Massachusetts First Responder
Training, the accepted standards of care for EMTs and EFRs and
applicable laws. The policies shall establish guidelines for operating and
maintaining the EFR service and shall be made available to all EMTs and EFRs
working for or with the service. These policies shall address the following:
(1) Certification and recertification of
EMTs;
(2) Orientation of all EMTs
and EFRs;
(3) Service's
responsibility for its EFRs meeting certification and recertification
requirements;
(4) Transfer of
patient care and patient care information from the EFR service to the
transporting ambulance service;
(5)
Dispatch;
(6)
Communications;
(7) Stocking of
supplies;
(8) Conduct of EMS
personnel;
(9) EMS inspection
authorities;
(10) Infection control
procedures;
(11) EMT compliance
with the Statewide Treatment Protocols;
(12) Maintenance of biomedical equipment and
devices according to manufacturers' recommendations; and
(13) Use of visible and audible warning
signals.
(C) In addition
to the policies and procedures required under
105
CMR 170.330(A), each service
licensed at the critical care services level must maintain comprehensive
critical care services policies, procedures, protocols and standing orders for
patient care, as required by CAMTS or an accreditation program the Department
approves as substantially equivalent to CAMTS. All clinical policies,
procedures, protocols and standing orders must be:
(1) Developed in conjunction with, and
approved by, the affiliate hospital medical director providing oversight for
the critical care services provided by the service;
(2) Reviewed and updated as appropriate, with
at minimum an annual review and approval of the affiliate hospital medical
director, and
(3) Submitted to the
Department on an annual basis.
(D) Standards for the contents of the
procedures and policies are established separately by the Department as
administrative requirements.
