Current through Register Vol. 54, No. 44, November 2, 2024
(a)
Generally. A special
operations EMS service provides EMS in austere environments that require
specialized knowledge, equipment or vehicles to access a patient or it
addresses patient care situations that differ from the routine situations that
can be handled by a QRS, ambulance service or squad service, or some
combination thereof. Depending upon the type of special operations EMS service
and the circumstances presented, a special operations EMS service may be able
to meet the EMS needs of the patient by itself, or may need to work with other
EMS services to meet the EMS needs of the patient.
(b)
Special provisions. The
following apply to special operations EMS services:
(1) When providing EMS through a special
operations EMS service, an EMS provider's scope of practice is expanded to
include EMS skills and the use of equipment in addition to those included in
the EMS provider's general scope of practice if the EMS provider has received
education to perform those skills and use that equipment by having successfully
completed a course approved by the Department for that type of special
operations EMS service. The EMS provider is required to be able to document
having received that education and to demonstrate competency in the performance
of those skills and use of that equipment to the EMS agency medical director.
Performance of those skills and use of that equipment by that level of EMS
provider will be authorized by the Department as published in a notice in the
Pennsylvania Bulletin. An EMS provider shall perform these
skills as directed by the Statewide EMS protocols applicable to that type of
special operations EMS service or as otherwise directed by a medical command
physician.
(2) Notwithstanding
§
1021.41(a)
(relating to EMS patient care reports), when an EMS agency is providing EMS
exclusively through a special operations EMS service it shall document patient
encounters as follows:
(i) It shall document
every patient encounter on a log that includes the minimum information required
by the Department as published in a notice in the Pennsylvania
Bulletin pertaining to EMS PCR form elements, including documentation
required by the Statewide EMS protocols for any patient refusing
treatment.
(ii) For any patient
transported by ambulance from a special operations EMS incident, it shall
complete a written transfer of care form that contains the patient information
that is essential for immediate transmission for patient care required under
§
1021.41(c), and
provide it to the EMS provider on the ambulance who accepts responsibility for
the patient.
(iii) For any patient
transported by ambulance from a special operations EMS incident who receives
EMS from the special operations EMS service exceeding the scope of practice of
an EMT, it shall complete an EMS PCR and otherwise comply with §
1021.41.
(iv) For any patient not
transported by ambulance who refuses EMS or dies while under the care of a
special operations EMS service, the special operations EMS service shall
complete an EMS PCR and otherwise comply with §
1021.41.
(3)
Notwithstanding §
1027.31(8)
(relating to general standards for providing EMS), when an EMS provider at or
above the AEMT level is responding as part of a special operations EMS service
in a vehicle other than an EMS vehicle, the EMS provider may transport in that
vehicle EMS equipment and supplies that an EMT is not authorized to use,
provided the EMS agency has adopted policies approved by its EMS agency medical
director to ensure the proper storage and security of the equipment and
medications, and the EMS provider abides by those policies.
(4) To facilitate the ability of EMS
providers to access and move patients, a special operations EMS service may use
modes of transportation at the special operations EMS incident site, such as a
bike, golf cart or other motorized vehicle, to transport EMS providers and
patients.
(c)
Tactical EMS service.
(1)
Purpose. An EMS agency that provides a tactical EMS service
provides EMS support to a law enforcement service to afford a rapid and safe
EMS response if a person becomes ill or injured during a tactical law
enforcement operation.
(2)
Affiliation. To secure and maintain an EMS agency license that
authorizes the EMS agency to operate a tactical EMS service, an EMS agency
shall demonstrate that it is affiliated with a law enforcement service operated
by a government law enforcement agency or a consortium of government law
enforcement agencies.
(3)
Staffing. An EMS agency that provides a tactical EMS service
shall be staffed by at least six EMS providers who are above the AEMT level
with a minimum of 2 years of experience as an EMS provider above the AEMT
level, and who have completed an educational program approved by the Department
on tactical EMS operations. The minimum staff when providing EMS support as a
tactical EMS service is two EMS providers who meet these standards. All EMS
providers who provide EMS for an EMS agency's tactical EMS service shall be 21
years of age or older.
(4)
Weapons. Notwithstanding §
1027.3(j)
(relating to licensure and general operating standards), when an EMS provider
is responding to a tactical law enforcement operation as part of a tactical EMS
service, the EMS provider may carry weapons and other tactical items as
otherwise permitted by law and approved by the affiliated law enforcement
agency.
(5)
Reporting. The EMS agency shall provide a summary report of a
tactical EMS operation response to the regional EMS council assigned to the
region in which the tactical EMS service was provided, within 30 days of the
tactical EMS operation, on a form or through an electronic process as
prescribed by the Department.
(d)
Wilderness EMS service.
(1)
Purpose. An EMS agency
that provides a wilderness EMS service provides EMS in the wilderness,
backcountry or other wild and uncultivated area to afford an EMS response
should a person become ill or injured in that setting.
(2)
Coordination. To secure
and maintain an EMS agency license that authorizes the EMS agency to operate a
wilderness EMS service, an EMS agency shall demonstrate that it has coordinated
with a local, county or State emergency service or services and responds at
their request.
(3)
Staffing. An EMS agency that provides a wilderness EMS service
shall be staffed by at least six EMS providers who have completed an
educational program approved by the Department on wilderness EMS operations.
The minimum staff when providing EMS as a wilderness EMS service is two EMS
providers at or above the EMT level who meet these standards. EMS providers who
provide EMS for a wilderness EMS service shall be 18 years of age or
older.
(4)
Reporting. The EMS agency shall provide a summary report of a
wilderness EMS operation response to the regional EMS council assigned to the
region in which the wilderness EMS service was provided, within 30 days of the
wilderness EMS operation, on a form or through an electronic process, as
prescribed by the Department.
(e)
Mass-gathering EMS
service.
(1)
Purpose. An EMS agency that provides a mass-gathering EMS
service provides EMS when there is a large gathering of persons under
circumstances such as the following:
(i) The
number of anticipated participants or spectators would overwhelm normal EMS
capabilities for the area or local hospital capabilities.
(ii) The nature of the activity occurring at
the mass-gathering site may result in increased risk of injury or illness to
spectators or participants.
(iii)
Areas where access to normal EMS operations are limited due to factors such as
physical/logistical restrictions in access routes, gathering areas and the
number of spectators.
(iv) Risk
analysis has determined that the site of the mass-gathering could be considered
a target of opportunity for terrorist activity.
(2)
Coordination. To secure
and maintain an EMS agency license that authorizes the EMS agency to operate a
mass-gathering EMS service, an EMS agency shall demonstrate that it has
coordinated with an EMS agency that operates an ambulance service and other
local, county or State emergency services.
(3)
Staffing. An EMS agency
that provides mass-gathering EMS service shall be staffed by at least six EMS
providers. The minimum staff when providing EMS support as a mass-gathering EMS
service is two EMS providers with at least one EMS provider at or above the EMT
level.
(4)
Reporting. The EMS agency shall provide a summary report of a
mass-gathering event at which it provides EMS to the regional EMS council
assigned to the region in which the mass-gathering EMS service was provided,
within 30 days of the event, on a form or through an electronic process, as
prescribed by the Department.
(f)
Urban search and rescue EMS
service.
(1)
Purpose. An EMS agency that provides an urban search and
rescue (USAR) EMS service provides EMS at an incident in which patients are
entrapped by a structural collapse or other entrapment for an extended period
of time.
(2)
Coordination. To secure and maintain an EMS agency license
that authorizes the EMS agency to operate a USAR EMS service, an EMS agency
shall demonstrate that it has coordinated with a local, county or State
emergency service or services and responds at their request.
(3)
Staffing. An EMS agency
that provides a USAR EMS service shall be staffed by at least six EMS providers
above the level of AEMT who have completed an educational program approved by
the Department on USAR EMS operations. The minimum staff when providing EMS as
a USAR EMS service is two EMS providers above the AEMT level who meet these
standards. EMS providers who provide EMS for a USAR EMS service shall be 18
years of age or older.
(4)
Reporting. The EMS agency shall provide a summary report of a
USAR EMS operation response to the regional EMS council assigned to the region
in which the USAR EMS service was provided, within 30 days of the USAR EMS
operation, on a form or through an electronic process, as prescribed by the
Department.
(g)
Extraordinary applications. An EMS agency or an applicant for
an EMS agency license may apply to operate under its license a type of special
operations EMS service that is not addressed in this chapter. The Department
will address each request on an individual basis. It will grant, conditionally
grant or deny the request as it deems appropriate to protect the public
interest. An EMS agency granted authorization to conduct a special operations
EMS service under this subsection shall be subject to any later adopted
regulations that apply to that type of special operations EMS
service.
(h)
Construction. This section enables an EMS agency that has been
licensed to provide a special operations EMS service to hold itself out as
being licensed to provide that service and to provide that service in
accordance with the requirements in this section. It does not require an EMS
agency to be licensed to conduct a special operations EMS service to respond to
a call requesting EMS under circumstances in which a special operations EMS
service would be appropriate.