Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0023 - Emergency Medical Services - General
Chapter 15 - ASSESSMENT, TRIAGE, TREATMENT AND TRANSPORT OF TIME SENSITIVE EMERGENCIES
Section 15-2 - Definitions

(i) "Advanced Life Support personnel" or "ALS personnel" means EMS providers licensed to function with a scope of practice that exceeds that of an Advanced Emergency Medical Technician as defined in chapter 5 of these rules and functioning as a crew member assigned to an EMS agency that maintains the equipment and medications allowable to these scopes of practice.

(ii) "Acute stroke patient" means a patient who has been exhibiting the signs and symptoms of stroke for less than six (6) hours and is not hypoglycemic.

(iii) "Decisional boundary" means a geographical point at which the clinical benefits to the patient of transport to one facility outweigh the benefits of transport to another facility.

(iv) "Effective treatment window" means that period of time in which a patient may experience a better clinical outcome if they receive appropriate treatment. Effective treatment windows vary by treatment and pathophysiology.

(v) "Evidence-based prehospital care protocols" means those treatment modalities that reflect the most current and recommended standards of medical practice based on significant clinical evidence.

(vi) "EMS agency" means an EMS agency as defined in chapter 4 of these rules.

(vii) "Emergency medical service providers" or "EMS providers" means an employee of an EMS agency or a person acting as an agent or otherwise on behalf of an EMS agency.

(viii) "FAST" means the acronym developed by the American Stroke Association (ASA) for the rapid identification of an acute stroke patient and activation of the 911 system. FAST stands for: Facial droop; Arm droop; Slurred speech; and Time to call for help.

(ix) "High index of suspicion" means the provider has sufficient or significant cause to believe that the patient is or may soon be acutely ill or injured.

(x) "Index of suspicion" means the degree to which a healthcare provider suspects that a patient may be suffering from a particular illness or injury based on the provider's training and experience, the patient's clinical presentation of signs and symptoms, and the mechanism of injury if applicable.

(xi) "Local system design" means the interrelation of the structure, hierarchy, and relationship of all of the components of the comprehensive EMS and trauma system within a specific community. In well-designed local systems of care, hospitals, TSE facilities, EMS agencies, dispatch organizations, and other healthcare and public health providers work cooperatively to ensure that patients are receiving care that is based on current clinical evidence and recommended practice, and are transported to a facility best suited for providing optimal care in the shortest time possible.

(xii) "Operational procedures" means those policies and procedures adopted by an EMS agency under these rules that direct the administrative and operational practices affecting the decision making process of the individual.

(xiii) "Scene time" means that portion of time between when an ambulance arrives at the location of the patient and when the ambulance departs the scene.

(xiv) "Stroke Alert" means a notification given by EMS providers to a Stroke Center that will be receiving a patient that has a positive FAST assessment.

(xv) "System design" means the structure, hierarchy, and relationship of all of the components of the comprehensive EMS and trauma system.

(xvi) "Time sensitive emergency" or "TSE" means a condition for which there is substantial clinical evidence demonstrating that minimal time delays in the provision of correct treatment and transport to the most appropriate facility results in improved clinical outcomes. For the purposes of these rules time sensitive emergencies are limited to traumatic injuries, heart attacks, and strokes.

(xvii) "Trauma Center" means a hospital designated as a "Regional Trauma Center" under Rules Wyoming Department of Health, Trauma Program, Chapter 4 or a hospital verified by the American College of Surgeons as a Level I or Level II Trauma Center.

(xviii) "Triage" means the process of assessing a patient or patients to determine the priority of patient treatment or transport based on the severity of injury or illness. In the case of a single patient, triage is utilized to determine the need for transport to a TSE facility. In the case of multiple patients, triage is used to determine the need for transport to a TSE facility, as well as the priority of needs of all of the patients.

(xix) "TSE facility" means: