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WACs > Title 246 > Chapter 246-976 > Section 246-976-390











246-976-340    

246-976-395







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WAC 246-976-390









Trauma verification of prehospital EMS services.









(1) The secretary verifies prehospital EMS services. Verification is a higher form of licensure that requires twenty-four-hour, seven day a week compliance with the standards outlined in chapter 70.168 RCW and this chapter. Verification will expire with the prehospital EMS service's period of licensure.
(2) To qualify for trauma verification, an agency must be a licensed ambulance or aid service as specified in WAC 246-976-260.
(3) The following EMS services may be verified:
(a) Aid service: Basic, intermediate (AEMT), and advanced (paramedic) life support;
(b) Ground ambulance service: Basic, intermediate (AEMT), and advanced (paramedic) life support;
(c) Air ambulance service.
(4) Personnel requirements:
(a) Verified aid services must provide personnel on each trauma response including:
(i) Basic life support: At least one individual who is an EMR or above;
(ii) Intermediate life support: At least one AEMT;
(iii) Advanced life support - Pramedic: At least one paramedic;
(b) Verified ambulance services must provide personnel on each trauma response including:
(i) Basic life support: At least two certified individuals - one EMT plus one EMR;
(ii) Intermediate life support: One AEMT, plus one EMT;
(iii) Advanced life support - Paramedic: At least two certified individuals - One paramedic and one EMT;
(c) Verified air ambulance services must provide personnel as identified in WAC 246-976-320.
(5) Equipment requirements:
(a) Verified BLS vehicles must carry equipment identified in WAC 246-976-300, Table A;
(b) Verified ILS and paramedic vehicles must provide equipment identified in Table A of this section, in addition to meeting the requirements of WAC 246-976-300;
(c) Verified air ambulance services must meet patient care equipment requirements described in WAC 246-976-320.

TABLE A: EQUIPMENT FOR VERIFIED TRAUMA SERVICES
(NOTE: "ASST" MEANS ASSORTMENTS. "X" INDICATES REQUIRED.)
AMBULANCE AID VEHICLE

PAR ILS PAR ILS

AIRWAY MANAGEMENT

  Airway adjuncts        

    Adjunctive airways, assorted per protocol X X X X

    Laryngoscope handle, spare batteries 1 1 1 1

      Adult blades, set 1 1 1 1

      Pediatric blades, straight (0, 1, 2) 1 ea 1 ea 1 ea 1 ea

      Pediatric blades, curved (2) 1 ea 1 ea 1 ea 1 ea

    McGill forceps, adult & pediatric 1 1 1 1

    ET tubes, adult and pediatric asst 0 asst 0

  Supraglottic airways per MPD protocol X X X X

  End-tidal CO2 detector 1 ea 1 ea 1 ea 1 ea

  Oxygen saturation monitor 1 ea 1 ea 1 ea 1 ea

TRAUMA EMERGENCIES

  IV access        

    Administration sets and intravenous fluids per protocol:        

      Adult 4 4 2 2

      Pediatric volume control device 2 2 1 1

    Catheters, intravenous (14-24 ga) asst asst asst asst

      Needles        

        Hypodermic asst asst asst asst

        Intraosseous, per protocol 2 2 1 1

    Sharps container 1 1 1 1

    Syringes asst asst asst asst

  Glucose measuring supplies Yes Yes Yes Yes

  Pressure infusion device 1 1    

  Length based tool for estimating pediatric medication and equipment sizes 1 1 1 1

  Medications according to local patient care protocols

(6) Aid service response time requirements: Verified aid services must meet the following minimum agency response times as defined by the department and identified in the regional plan:
(a) To urban response areas: Eight minutes or less, eighty percent of the time;
(b) To suburban response areas: Fifteen minutes or less, eighty percent of the time;
(c) To rural response areas: Forty-five minutes or less, eighty percent of the time;
(d) To wilderness response areas: As soon as possible.
(7) Ground ambulance service response time requirements: Verified ground ambulance services must meet the following minimum agency response times for all EMS and trauma responses to response areas as defined by the department and identified in the regional plan:
(a) To urban response areas: Ten minutes or less, eighty percent of the time;
(b) To suburban response areas: Twenty minutes or less, eighty percent of the time;
(c) To rural response areas: Forty-five minutes or less, eighty percent of the time;
(d) To wilderness response areas: As soon as possible.
(8) Verified air ambulance services must meet minimum agency response times as identified in the state plan.
(9) Verified ambulance and aid services must comply with the approved prehospital trauma triage procedures defined in WAC 246-976-010.
(10) The department will:
(a) Identify minimum and maximum numbers of prehospital services, based on:
(i) The approved regional EMS and trauma plans, including: Distribution and level of service identified for each response area; and
(ii) The Washington state EMS and trauma plan;
(b) With the advice of the steering committee, consider all available data in reviewing response time standards for verified prehospital trauma services at least biennially;
(c) Administer the BLS/ILS/ALS verification application and evaluation process;
(d) Approve an applicant to provide verified prehospital trauma care, based on satisfactory evaluations as described in this section;
(e) Obtain comments from the regional council as to whether the application(s) appears to be consistent with the approved regional plan;
(f) Provide written notification to the applicant(s) of the final decision in the verification award;
(g) Notify the regional council and the MPD in writing of the name, location, and level of verified services;
(h) Approve renewal of a verified service upon reapplication, if the service continues to meet standards established in this chapter and verification remains consistent with the regional plan.
(11) The department may:
(a) Conduct a preverification site visit; and
(b) Grant a provisional verification not to exceed one hundred twenty days. The secretary may withdraw the provisional verification status if provisions of the service's proposal are not implemented within the one hundred twenty-day period, or as otherwise provided in chapter 70.168 RCW and this chapter.
[Statutory Authority: Chapters 18.71, 18.73, and 70.168 RCW. WSR 11-07-078, § 246-976-390, filed 3/22/11, effective 5/15/11. Statutory Authority: RCW 18.73.140. WSR 00-22-124, § 246-976-390, filed 11/1/00, effective 12/2/00. Statutory Authority: Chapters 18.71, 18.73, and 70.168 RCW. WSR 00-08-102, § 246-976-390, filed 4/5/00, effective 5/6/00. Statutory Authority: RCW 43.70.040 and chapters 18.71, 18.73 and 70.168 RCW. WSR 93-01-148 (Order 323), § 246-976-390, filed 12/23/92, effective 1/23/93.]