Nrs: Chapter 450B - Emergency Medical Services

Link to law: https://www.leg.state.nv.us/NRS/NRS-450B.html
Published: 2015

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[Rev. 2/10/2015 5:33:39

PM--2014R2]

CHAPTER 450B - EMERGENCY MEDICAL SERVICES

GENERAL PROVISIONS

NRS 450B.015        Legislative

declaration.



NRS 450B.020        Definitions.

NRS 450B.025        “Advanced

emergency medical technician” defined.

NRS 450B.030        “Air

ambulance” defined.

NRS 450B.040        “Ambulance”

defined.

NRS 450B.050        “Attendant”

defined.

NRS 450B.0505      “Automated

external defibrillator” and “defibrillator” defined.

NRS 450B.060        “Board”

defined.

NRS 450B.0605      “Certificate”

defined.

NRS 450B.061        “Committee”

defined.

NRS 450B.062        “Designated

officer” defined.

NRS 450B.0625      “Division”

defined.

NRS 450B.063        “Emergency

medical dispatcher” defined.

NRS 450B.065        “Emergency

medical technician” defined.

NRS 450B.070        “Emergency

medical technician certificate” defined. [Repealed.]

NRS 450B.0703      “Emergency

response employee” defined.

NRS 450B.0707      “Exposed”

and “exposure” defined.

NRS 450B.071        “Firefighter”

defined.

NRS 450B.072        “Fire-fighting

agency” defined.

NRS 450B.077        “Health

authority” defined.

NRS 450B.080        “Health

Division” defined. [Repealed.]

NRS 450B.082        “Health

officer” defined.

NRS 450B.083        “Infectious

disease” defined.

NRS 450B.085        “Intermediate

emergency medical technician” defined. [Replaced in revision by NRS 450B.095.]

NRS 450B.090        “License”

defined.

NRS 450B.095        “Paramedic”

defined.

NRS 450B.100        “Permit”

defined.

NRS 450B.105        “Trauma”

defined.

NRS 450B.110        “Volunteer

attendant” defined.

NRS 450B.120        Regulations,

standards and procedures of board.

NRS 450B.130        Establishment

of minimum standards and additional requirements.

NRS 450B.140        Sources

for standards and regulations; standards may differ for different categories.

NRS 450B.150        Administration

and enforcement; inspections.

NRS 450B.1505      Certain

money received by Division to be used for training program for certain

emergency medical services personnel.

COMMITTEE ON EMERGENCY MEDICAL SERVICES

NRS 450B.151        Creation;

membership; terms of members; alternate members; vacancies.

NRS 450B.152        Chair;

meetings; rules for management; compensation of members.

NRS 450B.153        Duties.

NRS 450B.154        Administrative

support.

EMERGENCY MEDICAL DISPATCHERS

NRS 450B.155        Training

and certification.

AMBULANCE ATTENDANTS, EMERGENCY MEDICAL TECHNICIANS AND

FIREFIGHTERS

NRS 450B.160        Licensing

of attendants and firefighters; regulations; certification of physicians,

nurses and physician assistants serving as attendants.

NRS 450B.165        Attendant,

firefighter and emergency medical technician to attest to knowledge of and

compliance with certain guidelines concerning safe and appropriate injection

practices.

NRS 450B.171        Relative

of patient or other person may ride with attendants.

NRS 450B.180        Certification

and authority of emergency medical technicians, advanced emergency medical

technicians and paramedics; maintenance of central registry of certificates

issued; regulations. [Effective until the date of the repeal of 42 U.S.C. § 666,

the federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]

NRS 450B.180        Certification

and authority of emergency medical technicians, advanced emergency medical

technicians and paramedics; maintenance of central registry of certificates

issued; regulations. [Effective on the date of the repeal of 42 U.S.C. § 666,

the federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]

NRS 450B.183        Payment

of child support: Statement by applicant for license or certificate; grounds

for denial of license or certificate; duty of health authority. [Effective

until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each

state to establish procedures for withholding, suspending and restricting the

professional, occupational and recreational licenses for child support

arrearages and for noncompliance with certain processes relating to paternity

or child support proceedings.]

NRS 450B.185        Suspension

of license or certificate for failure to pay child support or comply with

certain subpoenas or warrants; reinstatement of license or certificate.

[Effective until the date of the repeal of 42 U.S.C. § 666, the federal law

requiring each state to establish procedures for withholding, suspending and

restricting the professional, occupational and recreational licenses for child

support arrearages and for noncompliance with certain processes relating to

paternity or child support proceedings.]

NRS 450B.187        Application

for license or certificate to include social security number. [Effective until

the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state

to establish procedures for withholding, suspending and restricting the professional,

occupational and recreational licenses for child support arrearages and for

noncompliance with certain processes relating to paternity or child support

proceedings.]

NRS 450B.190        Provisional

licensing of attendants.

EMERGENCY MEDICAL TECHNICIANS

NRS 450B.1905      Program

of training for certification; maintenance of certification.

ADVANCED EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS;

ENDORSEMENT TO ADMINISTER IMMUNIZATIONS AND DISPENSE MEDICATION

NRS 450B.191        Program

of training for certification as advanced emergency medical technician;

maintenance of certification.

NRS 450B.1915      Authorized

activities of advanced emergency medical technician.

NRS 450B.195        Program

of training for certification as paramedic; maintenance of certification.

NRS 450B.197        Authorized

activities of paramedic.

NRS 450B.1975      Endorsement

to administer immunizations, dispense medication and respond to public health

needs.

PERMIT AUTHORIZING FIRE-FIGHTING AGENCY TO PROVIDE CERTAIN

LEVEL OF MEDICAL CARE

NRS 450B.1985      Exclusive

method of issuance; authority of district board of health in certain larger

counties to issue; situations in which certain medical care may be provided.

AMBULANCES, AIR AMBULANCES AND VEHICLES OF FIRE-FIGHTING

AGENCIES

NRS 450B.200        Permit

for operation; fees; renewal; disciplinary or legal action for violations;

maintenance of central registry of permits issued; regulations.

NRS 450B.210        Provisional

permit.

NRS 450B.220        Periodic

inspections.

NRS 450B.230        Owner

not to allow operation without required equipment; exception.

NRS 450B.235        Filing

and maintenance of schedule of rates of ambulance.

TREATMENT OF TRAUMA

NRS 450B.236        Approval

required for operation of center for treatment of trauma.

NRS 450B.237        Establishment

of program for treatment of trauma; regulations; proposal to designate hospital

as trauma center; approval by Administrator of Division; standards; compliance.

NRS 450B.238        Regulations

requiring hospital to record and maintain information.

NRS 450B.239        Division

to cooperate with American College of Surgeons.

PROHIBITED ACTS

NRS 450B.240        Engaging

in operation of services relating to ambulances or air ambulances without

permit prohibited; provision of certain medical care by fire-fighting agency

without permit prohibited.

NRS 450B.250        Service

as attendant for ambulance or air ambulance without license prohibited;

provision of certain medical care by firefighter without license prohibited.

NRS 450B.255        Representation

as emergency medical technician, advanced emergency medical technician or

paramedic without certificate prohibited.

NRS 450B.260        Operation

of ambulance, air ambulance or fire-fighting vehicle used to provide certain

medical care without licensed driver and attendant prohibited; exceptions.

NRS 450B.265        Offering

level of emergency care provided by paramedic without permit prohibited;

exception.

SAFETY OF EMERGENCY RESPONSE EMPLOYEES CONCERNING EXPOSURE TO

INFECTIOUS DISEASES

NRS 450B.340        Designation

of officer to receive notifications and responses and make requests on behalf

of emergency response employees.

NRS 450B.350        Duty

of medical facility or county coroner or medical examiner to notify designated

officer if victim transported has infectious disease; time and contents for

notification.

NRS 450B.360        Determination

of possible exposure of emergency response employee to infectious disease;

request for response from medical facility or county coroner or medical

examiner.

NRS 450B.370        Response

of medical facility or county coroner or medical examiner.

NRS 450B.375        Procedure

upon notification that insufficient information exists to determine whether

emergency response employee was exposed to infectious disease; request for

further evaluation; duties of health officer.

NRS 450B.380        Notice

to emergency response employee of possible exposure to infectious disease.

NRS 450B.390        Limitations

on effect of NRS 450B.340 to 450B.390, inclusive.

WITHHOLDING LIFE-SUSTAINING TREATMENT

NRS 450B.400        Definitions.

NRS 450B.405        “Attending

physician” defined.

NRS 450B.410        “Do-not-resuscitate

identification” defined.

NRS 450B.420        “Do-not-resuscitate

order” defined.

NRS 450B.430        “Do-not-resuscitate

protocol” defined.

NRS 450B.440        “Health

care facility” defined.

NRS 450B.450        “Life-resuscitating

treatment” defined.

NRS 450B.460        “Person

who administers emergency medical services” defined.

NRS 450B.470        “Qualified

patient” defined.

NRS 450B.475        “Terminal

condition” defined.

NRS 450B.480        Applicability.

NRS 450B.490        Adoption

of regulations; fee for do-not-resuscitate identification.

NRS 450B.500        Do-not-resuscitate

identification: Contents.

NRS 450B.505        Do-not-resuscitate

identification: Manufacture and issuance of bracelet or medallion.

NRS 450B.510        Written

do-not-resuscitate orders: Issued only to qualified patients; physician

authorized to apply for identification.

NRS 450B.520        Application

for do-not-resuscitate identification: Form; requirements.

NRS 450B.525        Application

for do-not-resuscitate identification on behalf of minor: Requirements; form;

revocation by parent or legal guardian of authorization to withhold

life-resuscitating treatment; effect when minor is of sufficient maturity.

NRS 450B.530        Revocation

of authorization to withhold life-resuscitating treatment.

NRS 450B.540        Person

not guilty of unprofessional conduct or subject to liability for withholding or

providing life-resuscitating treatment under certain circumstances.

NRS 450B.550        Person

who administers emergency medical services required to comply with

do-not-resuscitate protocol; exception.

NRS 450B.560        Assumption

that do-not-resuscitate identification is valid.

NRS 450B.570        Resulting

death not suicide or homicide; life insurance or annuity not affected by

possession of do-not-resuscitate identification or issuance of

do-not-resuscitate order; prohibition or requirement of possession of do-not-resuscitate

identification or issuance of do-not-resuscitate order not allowed in

connection with health care.

NRS 450B.580        Unlawful

acts; penalty.

NRS 450B.590        Limitations

on effect of provisions.

AUTOMATED EXTERNAL DEFIBRILLATORS

NRS 450B.595        “Automated

external defibrillator” and “defibrillator” defined. [Repealed.]

NRS 450B.600        Required

to be placed in certain public buildings and locations; inspection and

maintenance; training on operation and use.

NRS 450B.610        Maintenance

of database by Division; disclosure of information in database; duties of

manufacturer; registration of defibrillator; civil penalty for violation.

NRS 450B.620        Placement

and maintenance by school districts, health clubs and medical facilities;

training of employees.

EMERGENCY MEDICAL SERVICES AT SPECIAL EVENTS

NRS 450B.650        Definitions.

NRS 450B.655        “Dedicated

advanced life support ambulance” defined.

NRS 450B.660        “First-aid

station” defined.

NRS 450B.665        “Host

organization” defined.

NRS 450B.670        “Roving

emergency medical technician team” defined.

NRS 450B.675        “Roving

intermediate emergency medical technician team” defined.

NRS 450B.680        “Significant

number” defined.

NRS 450B.685        “Special

event” defined.

NRS 450B.690        Host

organization of certain special events held in certain larger counties required

to provide certain emergency medical services.

NRS 450B.695        Host

organization of certain special events held in certain larger counties required

to provide certain number of dedicated advanced life support ambulances.

NRS 450B.700        Host

organization of special event at which 50,000 or more persons are projected to

be in attendance required to provide certain emergency medical services.

MISCELLANEOUS PROVISIONS

NRS 450B.790        Hospital

required to ensure that certain persons in need of emergency services are

transferred to appropriate places in hospital within 30 minutes after arrival;

civil and criminal liability.

NRS 450B.795        State

Board of Health to collect data concerning waiting times for provision of

emergency services to certain persons; hospitals and providers of emergency

services in certain counties required to participate in collection of data;

development of system of collecting data; advisory committees; quarterly report

to Legislative Committee on Health Care; expenses; regulations; written request

for repeal of section.

NRS 450B.800        Fingerprints

of applicant.

NRS 450B.810        Maintenance,

inspection and compilation of information.

NRS 450B.820        Local

requirements for franchise or permit are not superseded.

NRS 450B.830        Exemptions

from chapter.

NRS 450B.840        Operation

of ambulance or fire-fighting agency by county or city subject to provisions of

chapter.

NRS 450B.850        Programs

for training.

NRS 450B.860        Volunteer

ambulance drivers and attendants: Discharge from employment; civil action;

disclosure to employer.

NRS 450B.870        Medical

review committee entitled to autopsy records concerning death under review;

sharing of information concerning subject of review; autopsy records are

privileged.

PENALTIES

NRS 450B.900        Penalties

for violation.

_________

_________

 

GENERAL PROVISIONS

      NRS 450B.015  Legislative declaration.  The

Legislature hereby declares that prompt and efficient emergency medical care

and transportation is necessary for the health and safety of the people of

Nevada, and that minimum standards for such care and all persons providing it

must be established.

      (Added to NRS by 1981, 1599; A 1993, 2828)

      NRS 450B.020  Definitions.  As

used in this chapter, unless the context otherwise requires, the words and

terms defined in NRS 450B.025 to 450B.110, inclusive, have the meanings ascribed to

them in those sections.

      (Added to NRS by 1973, 1141; A 1985, 1693; 1987, 1043, 2207; 1993, 2118, 2828; 1995, 725; 1999, 1172; 2009, 913; 2013, 937, 1872, 3061)

      NRS 450B.025  “Advanced emergency medical technician” defined.  “Advanced emergency medical technician” means

a person certified by the health officer as having satisfactorily completed a

program of training for certification as an advanced emergency medical

technician pursuant to NRS 450B.191.

      (Added to NRS by 1987, 2206; A 1993, 2828; 2013, 937)

      NRS 450B.030  “Air ambulance” defined.  “Air

ambulance” means an aircraft especially designed, constructed, modified or

equipped to be used for the transportation of injured or sick persons. “Air

ambulance” does not include any commercial aircraft carrying passengers on regularly

scheduled flights.

      (Added to NRS by 1973, 1141)

      NRS 450B.040  “Ambulance” defined.  “Ambulance”

means a motor vehicle which is specially designed, constructed, equipped and

staffed to provide emergency medical care for one or more:

      1.  Sick or injured persons; or

      2.  Persons whose medical condition may

require special observation during transportation or transfer,

Ê including,

without limitation, such a vehicle of a fire-fighting agency.

      (Added to NRS by 1973, 1141; A 1985, 1726, 2117; 2001, 998; 2013, 937)

      NRS 450B.050  “Attendant” defined.  “Attendant”

means a person responsible for the care of a sick or injured person in an

ambulance or air ambulance, and includes the driver of an ambulance but not the

pilot of an air ambulance.

      (Added to NRS by 1973, 1141)

      NRS 450B.0505  “Automated external defibrillator” and “defibrillator” defined.  “Automated external defibrillator” or

“defibrillator” means a medical device that:

      1.  Has been approved by the United States Food

and Drug Administration;

      2.  Is capable of recognizing the presence

or absence of ventricular fibrillation and rapid ventricular tachycardia in a

patient;

      3.  Is capable of determining, without

intervention by the operator of the device, whether defibrillation should be

performed on a patient;

      4.  Upon determining that defibrillation

should be performed on a patient, automatically charges and requests delivery

of an electrical impulse to the patient’s heart; and

      5.  Upon appropriate action by the operator

of the device, delivers an appropriate electrical impulse to the patient’s

heart.

      (Added to NRS by 2013, 1869)

      NRS 450B.060  “Board” defined.  “Board”

means:

      1.  In a county whose population is less

than 700,000, the State Board of Health.

      2.  In a county whose population is 700,000

or more, the district board of health.

      (Added to NRS by 1973, 1141; A 1993, 2828; 1995, 2547; 2005, 2471; 2011, 1269)

      NRS 450B.0605  “Certificate” defined.  “Certificate”

means a certificate issued by a health authority acknowledging the successful

completion of a program of training as an emergency medical technician,

advanced emergency medical technician or paramedic as identified on the

certificate.

      (Added to NRS by 2013, 937)

      NRS 450B.061  “Committee” defined.  “Committee”

means the Committee on Emergency Medical Services.

      (Added to NRS by 1999, 1170)

      NRS 450B.062  “Designated officer” defined.  “Designated

officer” means a person designated by an employer to serve as a designated

officer for its emergency response employees pursuant to NRS 450B.340.

      (Added to NRS by 2009, 910)

      NRS 450B.0625  “Division” defined.  “Division”

means the Division of Public and Behavioral Health of the Department of Health

and Human Services.

      (Added to NRS by 2013, 3061)

      NRS 450B.063  “Emergency medical dispatcher” defined.  “Emergency

medical dispatcher” means a person who:

      1.  Has completed a training program in

emergency medical dispatching which has been approved by the board; and

      2.  Has been certified as having

satisfactorily completed such a training program by an entity approved by the

board to provide such training.

      (Added to NRS by 1993, 2117)

      NRS 450B.065  “Emergency medical technician” defined.  “Emergency

medical technician” means a person certified by the health officer as having

satisfactorily completed a program of training for certification as an

emergency medical technician pursuant to NRS

450B.1905.

      (Added to NRS by 1987, 2206; A 1993, 2828; 2013, 938)

      NRS 450B.070  “Emergency medical technician certificate” defined.  Repealed. (See chapter 226, Statutes of Nevada 2013, at page 969.)

 

      NRS 450B.0703  “Emergency response employee” defined.  “Emergency

response employee” means a firefighter, attendant, volunteer attendant,

emergency medical technician, advanced emergency medical technician, paramedic,

law enforcement officer, correctional officer, other peace officer or person

who is employed by an agency of criminal justice, county coroner or medical

examiner or any of their employees, any other public employee whose duties may

require him or her to come into contact with human blood or bodily fluids or

any other person who, in the course of his or her professional duties, responds

to emergencies in this State.

      (Added to NRS by 2009, 911;

A 2013, 938)

      NRS 450B.0707  “Exposed” and “exposure” defined.  “Exposed”

or “exposure” means any circumstances which create a significant risk of a

person becoming infected with an infectious disease.

      (Added to NRS by 2009, 911)

      NRS 450B.071  “Firefighter” defined.  “Firefighter”

means a person who holds a license and is employed by or serving as a volunteer

with a fire-fighting agency.

      (Added to NRS by 1985, 1692; A 2005, 330)—(Substituted

in revision for NRS 450B.073)

      NRS 450B.072  “Fire-fighting agency” defined.  “Fire-fighting

agency” means a fire department or fire protection district of the State or a

political subdivision which holds a permit issued pursuant to this chapter. The

term does not include a person or governmental entity, other than a

governmental entity to whom a permit is issued in accordance with the

provisions of NRS 450B.1985, which provides

transportation of sick or injured persons to a medical facility.

      (Added to NRS by 1985, 1692; A 1987, 718; 2001, 998)

      NRS 450B.077  “Health authority” defined.  “Health

authority” means:

      1.  In a county whose population is less

than 700,000, the Division.

      2.  In a county whose population is 700,000

or more, the district board of health.

      (Added to NRS by 1993, 2827; A 1995, 2547; 2005, 2471; 2011, 1269)

      NRS 450B.080  “Health Division” defined.  Repealed.

(See chapter 489, Statutes of Nevada 2013, at page 3071.)

 

      NRS 450B.082  “Health officer” defined.  “Health

officer” means:

      1.  In a county whose population is less than

700,000, the Chief Medical Officer.

      2.  In a county whose population is 700,000

or more, the district health officer.

      (Added to NRS by 1993, 2827; A 1995, 2547; 2005, 2471; 2011, 1269)

      NRS 450B.083  “Infectious disease” defined.  “Infectious

disease” means a disease caused by a living organism or other pathogen,

including, without limitation, a fungus, bacillus, parasite, protozoan or

virus.

      (Added to NRS by 2009, 911)

      NRS 450B.085  “Intermediate emergency medical technician” defined.  [Replaced in revision by NRS 450B.095.]

 

      NRS 450B.090  “License” defined.  “License”

means the license issued by the health authority under the provisions of this

chapter to an attendant of an ambulance or an air ambulance or to a firefighter

employed by or serving as a volunteer with a fire-fighting agency.

      (Added to NRS by 1973, 1141; A 1985, 1693; 1993, 2828; 2005, 330)

      NRS 450B.095  “Paramedic” defined.  “Paramedic”

means a person certified by the health officer as having satisfactorily

completed a program of training for certification as a paramedic pursuant to NRS 450B.195.

      (Added to NRS by 1981, 277; A 1993, 2828; 2013, 938)—(Substituted

in revision for NRS 450B.085)

      NRS 450B.100  “Permit” defined.  “Permit”

means the permit issued by the health authority under the provisions of this

chapter to:

      1.  A person, agency of the State or

political subdivision to own or operate an ambulance or air ambulance in the

State of Nevada; or

      2.  A fire-fighting agency to provide

medical care by emergency medical technicians, advanced emergency medical

technicians or paramedics to sick or injured persons:

      (a) At the scene of an emergency; or

      (b) At the scene of an emergency and while

transporting those persons to a medical facility.

      (Added to NRS by 1973, 1141; A 1985, 1693; 1993, 2829; 2001, 998; 2013, 938)

      NRS 450B.105  “Trauma” defined.  “Trauma”

means any acute injury which, according to standardized criteria for triage in

the field, involves a significant risk of death or the precipitation of

complications or disabilities.

      (Added to NRS by 1987, 1042)

      NRS 450B.110  “Volunteer attendant” defined.  “Volunteer

attendant” means a person who does not receive the majority of his or her

annual employment income from employment as an attendant, and who is not

employed by a commercial ambulance firm or corporation.

      (Added to NRS by 1973, 1141)

      NRS 450B.120  Regulations, standards and procedures of board.  The board shall establish and promulgate such

rules, regulations, standards and procedures as it determines are necessary to

administer the provisions of this chapter.

      (Added to NRS by 1973, 1141)

      NRS 450B.130  Establishment of minimum standards and additional requirements.

      1.  The board shall adopt regulations

establishing reasonable minimum standards for:

      (a) Sanitation in ambulances and air ambulances;

      (b) Medical and nonmedical equipment and supplies

to be carried in ambulances and medical equipment and supplies to be carried in

air ambulances and vehicles of a fire-fighting agency;

      (c) Interior configuration, design and dimensions

of ambulances placed in service after July 1, 1979;

      (d) Permits for operation of ambulances, air

ambulances and vehicles of a fire-fighting agency;

      (e) Records to be maintained by an operator of an

ambulance or air ambulance or by a fire-fighting agency; and

      (f) Treatment of patients who are critically ill

or in urgent need of treatment.

      2.  Any regulations adopted by the board

pursuant to subsection 1 establishing reasonable minimum standards for a permit

for the operation of an air ambulance or records to be maintained by an

operator of an air ambulance must:

      (a) Except as otherwise provided in paragraph

(b), be based on the medical aspects of the operation of an air ambulance,

including, without limitation, aspects related to patient care; and

      (b) Not be based on economic factors, including,

without limitation, factors related to the prices, routes or nonmedical

services of an air ambulance.

      3.  The health officers of this state shall

jointly adopt regulations to establish the minimum standards for the

certification or licensure of persons who provide emergency medical care. Upon

adoption of the regulations, each health authority shall adopt the regulations

for its jurisdiction. After each health authority adopts the regulations, the

standards established constitute the minimum standards for certification or

licensure of persons who provide emergency medical care in this state. Any

changes to the minimum standards must be adopted jointly by the health officers

and by each health authority in the manner set forth in this subsection. Any

changes in the minimum standards which are not adopted in the manner set forth

in this subsection are void.

      4.  A health officer may adopt regulations

that impose additional requirements for the certification or licensure of

persons who provide emergency medical care in the jurisdiction of the health

officer, but the health officer must accept the certification or licensure of a

person who provides emergency medical care from the jurisdiction of another

health officer as proof that the person who provides emergency medical care has

met the minimum requirements for certification or licensure.

      5.  As used in this section, “person who

provides emergency medical care” means an emergency medical technician,

advanced emergency medical technician, paramedic, attendant of an ambulance or

air ambulance or firefighter employed by or serving with a fire-fighting

agency.

      (Added to NRS by 1973, 1142; A 1979, 69; 1981, 1553; 1985, 1693; 1993, 2829; 2013, 617, 938)

      NRS 450B.140  Sources for standards and regulations; standards may differ for

different categories.

      1.  In adopting regulations under NRS 450B.120 and 450B.130,

the board may use standards and regulations proposed by:

      (a) The Committee on Trauma of the American

College of Surgeons;

      (b) The United States Department of

Transportation;

      (c) The United States Public Health Service;

      (d) The Bureau of Health Insurance of the Social

Security Administration;

      (e) The American Academy of Orthopaedic Surgeons;

      (f) The National Academy of Sciences—National

Research Council;

      (g) The American Heart Association; and

      (h) Regional, state and local emergency medical

services committees and councils.

      2.  The board may establish different

standards for commercial, volunteer, industrial and other categories of

ambulances and fire-fighting agencies to reflect different circumstances and in

the public interest.

      (Added to NRS by 1973, 1142; A 1985, 1693; 1993, 2829)

      NRS 450B.150  Administration and enforcement; inspections.

      1.  The health authority shall administer

and enforce the provisions of this chapter.

      2.  The health authority and its authorized

agents shall enter upon and inspect, in a reasonable manner and during

reasonable business hours, the premises and vehicles of persons and

governmental entities providing services regulated pursuant to the provisions

of this chapter.

      3.  If, pursuant to subsection 2, the

health authority or its authorized agents conduct an inspection of the premises

or aircraft of persons or governmental entities providing air ambulance

services, the inspection must be related only to the medical aspects of the

operation of the air ambulance.

      (Added to NRS by 1973, 1142; A 1985, 1694; 1987, 2207; 1989, 1505, 1928; 1993, 2830; 2013, 618)

      NRS 450B.1505  Certain money received by Division to be used for training

program for certain emergency medical services personnel.

      1.  Any money the Division receives from a

fee set by the State Board of Health pursuant to NRS 439.150 for the issuance or renewal of

a license pursuant to NRS 450B.160, an

administrative penalty imposed pursuant to NRS

450B.900 or an appropriation made by the Legislature for the purposes of

training related to emergency medical services:

      (a) Must be deposited in the State Treasury and

accounted for separately in the State General Fund;

      (b) May be used only to carry out a training

program for emergency medical services personnel who work for a volunteer

ambulance service or firefighting agency, including, without limitation,

equipment for use in the training; and

      (c) Does not revert to the State General Fund at

the end of any fiscal year.

      2.  Any interest or income earned on the

money in the account must be credited to the account. Any claims against the

account must be paid in the manner that other claims against the State are

paid.

      3.  The Administrator of the Division shall

administer the account.

      (Added to NRS by 2011, 2513;

A 2013,

3061)

COMMITTEE ON EMERGENCY MEDICAL SERVICES

      NRS 450B.151  Creation; membership; terms of members; alternate members;

vacancies.

      1.  The Committee on Emergency Medical

Services, consisting of nine members appointed by the State Board of Health, is

hereby created.

      2.  Upon request of the State Board of

Health, employee associations that represent persons that provide emergency

medical services, including, without limitation, physicians and nurses that

provide emergency medical services, emergency medical technicians, ambulance

attendants, firefighters, fire chiefs and employees of rural hospitals, shall

submit to the State Board of Health written nominations for appointments to the

Committee.

      3.  After considering the nominations

submitted pursuant to subsection 2, the State Board of Health shall appoint to

the Committee:

      (a) One member who is a physician licensed

pursuant to chapter 630 or 633 of NRS and who has experience providing

emergency medical services;

      (b) One member who is a registered nurse and who

has experience providing emergency medical services;

      (c) One member who is a volunteer firefighter;

      (d) One member who is employed by a fire-fighting

agency at which some of the firefighters are employed and some serve as

volunteers;

      (e) One member who is employed by an urban

fire-fighting agency;

      (f) One member who is employed by or serves as a

volunteer with a medical facility that is located in a rural area and that

provides emergency medical services;

      (g) One member who is employed by an organization

that provides emergency medical services in an air ambulance and whose duties

are closely related to such emergency medical services;

      (h) One member who is employed by a privately

owned entity that provides emergency medical services; and

      (i) One member who is employed by an operator of

a service which is:

             (1) Provided for the benefit of the

employees of an industry who become sick or are injured at the industrial site;

and

             (2) Staffed by employees who are licensed

attendants and perform emergency medical services primarily for the industry.

      4.  In addition to the members set forth in

subsection 3, the following persons are ex officio members of the Committee:

      (a) An employee of the Division, appointed by the

Administrator of the Division, whose duties relate to administration and

enforcement of the provisions of this chapter;

      (b) The county health officer appointed pursuant

to NRS 439.290 in each county whose

population is 100,000 or more, or the county health officer’s designee;

      (c) A physician who is a member of a committee

which consists of directors of trauma centers in this State and who is

nominated by that committee; and

      (d) A representative of a committee or group

which focuses on the provision of emergency medical services to children in this

State and who is nominated by that committee or group.

      5.  The term of each member appointed by

the State Board of Health is 2 years. A member may not serve more than two

consecutive terms but may serve more than two terms if there is a break in

service of not less than 2 years.

      6.  The State Board of Health shall not

appoint to the Committee two persons who are employed by or volunteer with the

same organization, except the State Board of Health may appoint a person who is

employed by or volunteers with the same organization of which a member who

serves ex officio is an employee.

      7.  Each member of the Committee shall

appoint an alternate to serve in the member’s place if the member is

temporarily unable to perform the duties required of him or her pursuant to NRS 450B.151 to 450B.154,

inclusive.

      8.  A position on the Committee that

becomes vacant before the end of the term of the member must be filled in the

same manner as the original appointment.

      (Added to NRS by 1999, 1170; A 2005, 330; 2009, 666)

      NRS 450B.152  Chair; meetings; rules for management; compensation of members.

      1.  The Committee shall elect a Chair from

among its members. The term of the Chair is 1 year.

      2.  The Committee shall meet at the call of

the Chair at least four times each year.

      3.  The Committee shall adopt rules for its

own management.

      4.  A member of the Committee serves

without compensation, except that, for each day or portion of a day during

which a member attends a meeting of the Committee or is otherwise engaged in

the business of the Committee, the member of the Committee is entitled to

receive the per diem allowance and travel expenses provided for state officers

and employees generally. The per diem allowance and travel expenses must be

paid by the Division from money not allocated by specific statute for another

use.

      (Added to NRS by 1999, 1171)

      NRS 450B.153  Duties.  The

Committee shall:

      1.  Review and advise the Division

regarding the management and performance of emergency medical services in this

State and regarding statewide emergency medical protocols;

      2.  Advise the Division on matters of policy

relating to emergency care, including, without limitation, the qualifications

of persons who provide emergency medical services;

      3.  Advise the board and Division with

respect to the preparation and adoption of regulations regarding emergency

care;

      4.  Review periodically the budget of the

Division that relates to emergency medical services;

      5.  Encourage the training and education of

emergency medical service personnel to improve the system of public safety in

this State; and

      6.  Perform such other duties as may be

required by law or regulation.

      (Added to NRS by 1999, 1171)

      NRS 450B.154  Administrative support.  The

Division shall provide administrative support and assistance to the Committee.

      (Added to NRS by 1999, 1172)

EMERGENCY MEDICAL DISPATCHERS

      NRS 450B.155  Training and certification.

      1.  An educational institution, public or

private agency or other entity may provide a training program for emergency

medical dispatchers and issue certificates of completion if the program meets

the requirements set forth in the regulations of the board and is approved by

the board.

      2.  The board shall adopt regulations:

      (a) Prescribing the requirements for a program

for training and certifying an emergency medical dispatcher;

      (b) Prescribing the procedures for an educational

institution, public or private agency or other entity to obtain the approval of

the board to provide such a program; and

      (c) Establishing such fees as are necessary to

cover the cost of administering the provisions of this section.

      (Added to NRS by 1993, 2117)

AMBULANCE ATTENDANTS, EMERGENCY MEDICAL TECHNICIANS AND

FIREFIGHTERS

      NRS 450B.160  Licensing of attendants and firefighters; regulations;

certification of physicians, nurses and physician assistants serving as

attendants.

      1.  The health authority may issue licenses

to attendants and to firefighters employed by or serving as volunteers with a

fire-fighting agency.

      2.  Each license must be evidenced by a

card issued to the holder of the license, is valid for a period not to exceed 2

years and is renewable.

      3.  An applicant for a license must file

with the health authority:

      (a) A current, valid certificate evidencing the

applicant’s successful completion of a program of training as an emergency

medical technician, advanced emergency medical technician or paramedic, if the

applicant is applying for a license as an attendant, or, if a volunteer

attendant, at a level of skill determined by the board.

      (b) A current valid certificate evidencing the

applicant’s successful completion of a program of training as an emergency

medical technician, advanced emergency medical technician or paramedic, if the

applicant is applying for a license as a firefighter with a fire-fighting

agency.

      (c) A signed statement showing:

             (1) The name and address of the applicant;

             (2) The name and address of the employer

of the applicant; and

             (3) A description of the applicant’s

duties.

      (d) Such other certificates for training and such

other items as the board may specify.

      4.  The board shall adopt such regulations

as it determines are necessary for the issuance, suspension, revocation and

renewal of licenses.

      5.  Each operator of an ambulance or air

ambulance and each fire-fighting agency shall annually file with the health

authority a complete list of the licensed persons in its service.

      6.  Licensed physicians, registered nurses

and licensed physician assistants may serve as attendants without being

licensed under the provisions of this section. A registered nurse who performs

emergency care in an ambulance or air ambulance shall perform the care in

accordance with the regulations of the State Board of Nursing. A licensed

physician assistant who performs emergency care in an ambulance or air

ambulance shall perform the care in accordance with the regulations of the

Board of Medical Examiners.

      7.  Each licensed physician, registered

nurse and licensed physician assistant who serves as an attendant must have

current certification of completion of training in:

      (a) Advanced life-support procedures for patients

who require cardiac care;

      (b) Life-support procedures for pediatric

patients who require cardiac care; or

      (c) Life-support procedures for patients with

trauma that are administered before the arrival of those patients at a

hospital.

Ê The

certification must be issued by the Board of Medical Examiners for a physician

or licensed physician assistant or by the State Board of Nursing for a

registered nurse.

      8.  The Board of Medical Examiners and the

State Board of Nursing shall issue a certificate pursuant to subsection 7 if

the licensed physician, licensed physician assistant or registered nurse

attends:

      (a) A course offered by a national organization

which is nationally recognized for issuing such certification;

      (b) Training conducted by the operator of an

ambulance or air ambulance; or

      (c) Any other course or training,

Ê approved by

the Board of Medical Examiners or the State Board of Nursing, whichever is

issuing the certification. The Board of Medical Examiners and the State Board

of Nursing may require certification of training in all three areas set forth

in subsection 7 for a licensed physician, licensed physician assistant or

registered nurse who primarily serves as an attendant in a county whose

population is 700,000 or more.

      (Added to NRS by 1973, 1142; A 1977, 962; 1979, 70; 1981, 278, 1554; 1985, 1694, 2118; 1987, 2207; 1993, 317, 2830; 1995, 725; 1997, 690; 2001, 782; 2005, 331; 2011, 1269;

2013, 939)

      NRS 450B.165  Attendant, firefighter and emergency medical technician to

attest to knowledge of and compliance with certain guidelines concerning safe

and appropriate injection practices.  The

health authority shall not issue or renew:

      1.  A license to an attendant or

firefighter; or

      2.  A certificate,

Ê unless the

applicant for issuance or renewal of the license or certificate attests to

knowledge of and compliance with the guidelines of the Centers for Disease

Control and Prevention concerning the prevention of transmission of infectious

agents through safe and appropriate injection practices.

      (Added to NRS by 2011, 2053;

A 2013, 940)

      NRS 450B.171  Relative of patient or other person may ride with attendants.  Except as otherwise provided in this chapter,

unlicensed relatives of a sick or injured patient and other persons may ride in

an ambulance if there are two attendants in the ambulance, each of whom is

licensed pursuant to this chapter or exempt from licensing pursuant to

subsection 6 of NRS 450B.160.

      (Added to NRS by 1989, 286; A 1993, 318)

      NRS 450B.180  Certification and authority of emergency medical technicians,

advanced emergency medical technicians and paramedics; maintenance of central

registry of certificates issued; regulations. [Effective until the date of the

repeal of 42 U.S.C. § 666, the federal law requiring each state to establish

procedures for withholding, suspending and restricting the professional,

occupational and recreational licenses for child support arrearages and for

noncompliance with certain processes relating to paternity or child support

proceedings.]

      1.  Any person desiring certification as an

emergency medical technician, advanced emergency medical technician or

paramedic must apply to the health authority using forms prescribed by the

health authority.

      2.  The health authority, pursuant to

regulations and procedures adopted by the board, shall make a determination of

the applicant’s qualifications to be certified as an emergency medical

technician, advanced emergency medical technician or paramedic and shall issue

the appropriate certificate to each qualified applicant.

      3.  A certificate is valid for a period not

exceeding 2 years and may be renewed if the holder of the certificate complies

with the provisions of this chapter and meets the qualifications set forth in

the regulations and standards established by the board pursuant to this

chapter. The regulations and standards established by the board must provide

for the completion of a course of instruction, within 2 years after initial

licensure, relating to the medical consequences of an act of terrorism that

involves the use of a weapon of mass destruction. The course must provide at

least 4 hours of instruction that includes instruction in the following

subjects:

      (a) An overview of acts of terrorism and weapons

of mass destruction;

      (b) Personal protective equipment required for

acts of terrorism;

      (c) Common symptoms and methods of treatment

associated with exposure to, or injuries caused by, chemical, biological, radioactive

and nuclear agents;

      (d) Syndromic surveillance and reporting

procedures for acts of terrorism that involve biological agents; and

      (e) An overview of the information available on,

and the use of, the Health Alert Network.

Ê The board

may thereafter determine whether to establish regulations and standards

requiring additional courses of instruction relating to the medical

consequences of an act of terrorism that involves the use of a weapon of mass

destruction.

      4.  The health authority may suspend or

revoke a certificate if it finds that the holder of the certificate no longer

meets the prescribed qualifications. Unless the certificate is suspended by the

district court pursuant to NRS 425.540,

the holder of the certificate may appeal the suspension or revocation of his or

her certificate pursuant to regulations adopted by the board.

      5.  The board shall determine the

procedures and techniques which may be performed by an emergency medical

technician, advanced emergency medical technician or paramedic.

      6.  A certificate issued pursuant to this

section is valid throughout the State, whether issued by the Division or a

district board of health.

      7.  The Division shall maintain a central

registry of all certificates issued pursuant to this section, whether issued by

the Division or a district board of health.

      8.  The board shall adopt such regulations

as are necessary to carry out the provisions of this section.

      9.  As used in this section:

      (a) “Act of terrorism” has the meaning ascribed

to it in NRS 202.4415.

      (b) “Biological agent” has the meaning ascribed

to it in NRS 202.442.

      (c) “Chemical agent” has the meaning ascribed to

it in NRS 202.4425.

      (d) “Radioactive agent” has the meaning ascribed

to it in NRS 202.4437.

      (e) “Weapon of mass destruction” has the meaning

ascribed to it in NRS 202.4445.

      (Added to NRS by 1973, 1143; A 1977, 70; 1981, 279, 1555; 1991, 1916; 1993, 2831; 1995, 2548; 1997, 2056; 2003, 2953; 2005, 2471; 2013, 940)

      NRS 450B.180  Certification and

authority of emergency medical technicians, advanced emergency medical

technicians and paramedics; maintenance of central registry of certificates

issued; regulations. [Effective on the date of the repeal of 42 U.S.C. § 666,

the federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]

      1.  Any person desiring certification as an

emergency medical technician, advanced emergency medical technician or

paramedic must apply to the health authority using forms prescribed by the

health authority.

      2.  The health authority, pursuant to

regulations and procedures adopted by the board, shall make a determination of

the applicant’s qualifications to be certified as an emergency medical

technician, advanced emergency medical technician or paramedic, and shall issue

the appropriate certificate to each qualified applicant.

      3.  A certificate is valid for a period not

exceeding 2 years and may be renewed if the holder of the certificate meets the

qualifications set forth in the regulations and standards established by the

board pursuant to this chapter. The regulations and standards established by

the board must provide for the completion of a course of instruction, within 2

years after initial licensure, relating to the medical consequences of an act

of terrorism that involves the use of a weapon of mass destruction. The course must

provide at least 4 hours of instruction that includes instruction in the

following subjects:

      (a) An overview of acts of terrorism and weapons

of mass destruction;

      (b) Personal protective equipment required for

acts of terrorism;

      (c) Common symptoms and methods of treatment

associated with exposure to, or injuries caused by, chemical, biological, radioactive

and nuclear agents;

      (d) Syndromic surveillance and reporting

procedures for acts of terrorism that involve biological agents; and

      (e) An overview of the information available on,

and the use of, the Health Alert Network.

Ê The board

may thereafter determine whether to establish regulations and standards

requiring additional courses of instruction relating to the medical

consequences of an act of terrorism that involves the use of a weapon of mass

destruction.

      4.  The health authority may suspend or

revoke a certificate if it finds that the holder of the certificate no longer

meets the prescribed qualifications. The holder of the certificate may appeal

the suspension or revocation of his or her certificate pursuant to regulations

adopted by the board.

      5.  The board shall determine the

procedures and techniques which may be performed by an emergency medical

technician, advanced emergency medical technician or paramedic.

      6.  A certificate issued pursuant to this

section is valid throughout the State, whether issued by the Division or a

district board of health.

      7.  The Division shall maintain a central

registry of all certificates issued pursuant to this section, whether issued by

the Division or a district board of health.

      8.  The board shall adopt such regulations

as are necessary to carry out the provisions of this section.

      9.  As used in this section:

      (a) “Act of terrorism” has the meaning ascribed

to it in NRS 202.4415.

      (b) “Biological agent” has the meaning ascribed

to it in NRS 202.442.

      (c) “Chemical agent” has the meaning ascribed to

it NRS 202.4425.

      (d) “Radioactive agent” has the meaning ascribed

to it in NRS 202.4437.

      (e) “Weapon of mass destruction” has the meaning

ascribed to it in NRS 202.4445.

      (Added to NRS by 1973, 1143; A 1977, 70; 1981, 279, 1555; 1991, 1916; 1993, 2831; 1995, 2548; 1997, 2056; 2003, 2953; 2005, 2471, 2472; 2013, 940,

effective on the date of the repeal of 42 U.S.C. § 666, the federal law

requiring each state to establish procedures for withholding, suspending and

restricting the professional, occupational and recreational licenses for child

support arrearages and for noncompliance with certain processes relating to

paternity or child support proceedings)

      NRS 450B.183  Payment of child support: Statement by applicant for license or

certificate; grounds for denial of license or certificate; duty of health

authority. [Effective until the date of the repeal of 42 U.S.C. § 666, the

federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]

      1.  An applicant for the issuance or

renewal of a license as an attendant or firefighter employed by a fire-fighting

agency or a certificate shall submit to the health authority the statement

prescribed by the Division of Welfare and Supportive Services of the Department

of Health and Human Services pursuant to NRS

425.520. The statement must be completed and signed by the applicant.

      2.  The health authority shall include the

statement required pursuant to subsection 1 in:

      (a) The application or any other forms that must

be submitted for the issuance or renewal of the license or certificate; or

      (b) A separate form prescribed by the health

authority.

      3.  A license or certificate described in subsection

1 may not be issued or renewed by the health authority if the applicant:

      (a) Fails to submit the statement required

pursuant to subsection 1; or

      (b) Indicates on the statement submitted pursuant

to subsection 1 that the applicant is subject to a court order for the support

of a child and is not in compliance with the order or a plan approved by the

district attorney or other public agency enforcing the order for the repayment

of the amount owed pursuant to the order.

      4.  If an applicant indicates on the

statement submitted pursuant to subsection 1 that the applicant is subject to a

court order for the support of a child and is not in compliance with the order

or a plan approved by the district attorney or other public agency enforcing

the order for the repayment of the amount owed pursuant to the order, the

health authority shall advise the applicant to contact the district attorney or

other public agency enforcing the order to determine the actions that the

applicant may take to satisfy the arrearage.

      (Added to NRS by 1997, 2055; A 2005, 332; 2013, 941)

      NRS 450B.185  Suspension of license or certificate for failure to pay child

support or comply with certain subpoenas or warrants; reinstatement of license

or certificate. [Effective until the date of the repeal of 42 U.S.C. § 666, the

federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]

      1.  If the health authority receives a copy

of a court order issued pursuant to NRS

425.540 that provides for the suspension of all professional, occupational

and recreational licenses, certificates and permits issued to a person who is

the holder of a license as an attendant or firefighter employed by a

fire-fighting agency or a certificate, the health authority shall deem the

license or certificate issued to that person to be suspended at the end of the

30th day after the date on which the court order was issued unless the health

authority receives a letter issued to the holder of the license or certificate

by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the

license or certificate has complied with the subpoena or warrant or has

satisfied the arrearage pursuant to NRS

425.560.

      2.  The health authority shall reinstate a

license as an attendant or firefighter employed by a fire-fighting agency or a

certificate that has been suspended by a district court pursuant to NRS 425.540 if:

      (a) The health authority receives a letter issued

by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license or

certificate was suspended stating that the person whose license or certificate

was suspended has complied with the subpoena or warrant or has satisfied the

arrearage pursuant to NRS 425.560; and

      (b) The person whose license or certificate was

suspended pays any fees imposed by the health authority for the reinstatement

of a suspended license or certificate.

      (Added to NRS by 1997, 2056; A 2005, 333; 2013, 942)

      NRS 450B.187  Application for license or certificate to include social

security number. [Effective until the date of the repeal of 42 U.S.C. § 666,

the federal law requiring each state to establish procedures for withholding,

suspending and restricting the professional, occupational and recreational

licenses for child support arrearages and for noncompliance with certain

processes relating to paternity or child support proceedings.]  An application for the issuance or renewal of

a license as an attendant or firefighter employed by a fire-fighting agency or

a certificate must include the social security number of the applicant.

      (Added to NRS by 1997, 2056; A 2005, 333; 2013, 943)

      NRS 450B.190  Provisional licensing of attendants.

      1.  The health authority may, at its

discretion, issue a provisional license as an attendant to a person who does

not meet the qualifications established pursuant to this chapter, if the health

authority determines that such issuance will be in the public interest.

      2.  A provisional license as an attendant

must not be made valid for more than 1 year from the date of issuance and is

not renewable.

      (Added to NRS by 1973, 1144; A 1987, 2208; 1993, 2832)

EMERGENCY MEDICAL TECHNICIANS

      NRS 450B.1905  Program of training for certification; maintenance of

certification.

      1.  A program of training for certification

as an emergency medical technician must be:

      (a) Supervised by a physician and approved by the

health authority; or

      (b) Presented by a national organization which is

nationally recognized for providing such training and approved by the board.

      2.  A program of training for certification

as an emergency medical technician must follow the curriculum or educational

standards prepared by the United States Department of Transportation as a

national standard for emergency medical technicians.

      3.  The board may adopt regulations which

prescribe other requirements of training for certification as an emergency

medical technician.

      4.  An owner of an ambulance shall not

offer emergency medical care to a patient in urgent need of medical care or

observation unless the attendant has successfully completed a program of

training for certification as an emergency medical technician or is exempt, pursuant

to subsection 6 of NRS 450B.160, from the

requirement to obtain that training.

      5.  The board may by regulation prescribe

additional requirements for receiving and maintaining certification as an

emergency medical technician. The curriculum or educational standards for

training must be:

      (a) At the level of advanced first aid; or

      (b) At least equivalent to any curriculum or

educational standards prepared by the Department of Transportation as a

national standard for emergency medical technicians.

      (Added to NRS by 1985, 2117; A 1987, 2208; 1993, 318, 2832; 2013, 943)

ADVANCED EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS;

ENDORSEMENT TO ADMINISTER IMMUNIZATIONS AND DISPENSE MEDICATION

      NRS 450B.191  Program of training for certification as advanced emergency

medical technician; maintenance of certification.

      1.  A program of training for certification

as an advanced emergency medical technician must be supervised by a licensed physician

and approved by the health authority.

      2.  A program of training for certification

as an advanced emergency medical technician must include an approved curriculum

in intravenous therapy and the management of a passage for air to the lungs.

Only a certified emergency medical technician with experience as established by

the board is eligible for this training.

      3.  In order to maintain certification,

each advanced emergency medical technician must annually:

      (a) Comply with the requirements established by

the board for continuing medical education; and

      (b) Demonstrate his or her skills as required by

regulation of the board.

      4.  The board may by regulation prescribe

the curriculum and other requirements for training and maintaining

certification as an advanced emergency medical technician. The curriculum must

be at least equivalent to any curriculum or educational standards prepared by

the United States Department of Transportation as a national standard for

advanced emergency medical technicians.

      5.  A person shall not represent himself or

herself to be an advanced emergency medical technician unless the person has on

file with the health authority a currently valid certificate demonstrating

successful completion of the program of training required by this section.

      6.  Except as authorized by subsection 6 of

NRS 450B.160, an attendant or firefighter shall

not perform, and the owner, operator, director or chief officer of an ambulance

or a fire-fighting agency shall not offer, emergency care as an advanced

emergency medical technician without fulfilling the requirements established by

the board.

      (Added to NRS by 1981, 277; A 1981, 1557; 1985, 1695; 1987, 2209; 1993, 319, 2833; 1995, 725; 2005, 333; 2013, 943)

      NRS 450B.1915  Authorized activities of advanced emergency medical technician.  An advanced emergency medical technician may

perform any procedure and administer any drug:

      1.  Approved by regulation of the board; or

      2.  Authorized pursuant to NRS 450B.1975, if the advanced emergency medical

technician has obtained an endorsement pursuant to that section.

      (Added to NRS by 1981, 278; A 1987, 2210; 2009, 1533;

2013, 944)

      NRS 450B.195  Program of training for certification as paramedic; maintenance

of certification.

      1.  Only a certified emergency medical

technician with experience as established by the board is eligible for training

as a paramedic.

      2.  A program of training for certification

as a paramedic must be supervised by a licensed physician and approved by the

health authority.

      3.  To maintain certification, each

paramedic must annually:

      (a) Comply with the requirements established by

the board for continuing medical education; and

      (b) Demonstrate his or her skills as required by

regulation of the board.

      4.  The board may by regulation prescribe

the curriculum and other requirements for training and maintaining

certification as a paramedic. The curriculum must be at least equivalent to any

curriculum or educational standards prepared by the United States Department of

Transportation as a national standard for paramedics.

      5.  A person shall not represent himself or

herself to be a paramedic unless the person has on file with the health

authority a currently valid certificate evidencing the person’s successful

completion of the program of training required by this section.

      6.  Except as authorized by subsection 6 of

NRS 450B.160, an attendant or firefighter shall

not perform, and the owner, operator, director or chief officer of an ambulance

or a fire-fighting agency shall not offer, emergency care as a paramedic

without fulfilling the requirements established by the board.

      (Added to NRS by 1973, 610; A 1975, 38; 1979, 71; 1981, 1555; 1985, 1696; 1987, 2210; 1993, 319, 2833; 1995, 725; 2005, 334; 2013, 944)

      NRS 450B.197  Authorized activities of paramedic.  An

attendant or a firefighter who is a paramedic may perform any procedure and

administer any drug:

      1.  Approved by regulation of the board; or

      2.  Authorized pursuant to NRS 450B.1975, if the attendant or firefighter who

is a paramedic has obtained an endorsement pursuant to that section.

      (Added to NRS by 1973, 610; A 1975, 38; 1981, 1556; 1985, 1696; 1987, 2211; 2005, 334; 2009, 1534;

2013, 945)

      NRS 450B.1975  Endorsement to administer immunizations, dispense medication and

respond to public health needs.

      1.  An advanced emergency medical

technician or a paramedic who holds an endorsement to administer immunizations,

dispense medication and prepare and respond to certain public health needs

issued in accordance with the regulations adopted pursuant to this section may:

      (a) Administer immunizations and dispense

medications;

      (b) Participate in activities designed to prepare

the community to meet anticipated health needs, including, without limitation,

participation in public vaccination clinics; and

      (c) Respond to an actual epidemic or other

emergency in the community,

Ê under the

direct supervision of the local health officer, or a designee of the local

health officer, of the jurisdiction in which the immunization is administered

or the medication is dispensed or in which the emergency or need exists.

      2.  The district board of health, in a

county whose population is 700,000 or more, may adopt regulations for the

endorsement of advanced emergency medical technicians and paramedics pursuant

to this section. The regulations must:

      (a) Prescribe the minimum training required to

obtain such an endorsement;

      (b) Prescribe the continuing education requirements

or other evidence of continued competency for renewal of the endorsement;

      (c) Prescribe the fee for the issuance and

renewal of the endorsement, which must not exceed $5; and

      (d) Not require licensure as an attendant as a

condition of eligibility for an endorsement pursuant to this section.

      3.  The State Board of Health shall, for

counties whose population is less than 700,000, adopt regulations for the

endorsement of advanced emergency medical technicians and paramedics pursuant

to this section. The regulations must:

      (a) Prescribe the minimum training required to

obtain such an endorsement;

      (b) Prescribe the continuing education

requirements or other evidence of continued competency for renewal of the

endorsement;

      (c) Prescribe the fee for the issuance and

renewal of the endorsement, which must not exceed $5;

      (d) To the extent practicable, authorize local

health officers to provide the training and continuing education required to

obtain and renew an endorsement; and

      (e) Not require licensure as an attendant as a

condition of eligibility for an endorsement pursuant to this section.

      4.  As used in this section:

      (a) “Emergency” means an occurrence or threatened

occurrence for which, in the determination of the Governor, the assistance of

state agencies is needed to supplement the efforts and capabilities of

political subdivisions to save lives, protect property and protect the health

and safety of persons in this State, or to avert the threat of damage to

property or injury to or the death of persons in this State.

      (b) “Local health officer” means a city health

officer appointed pursuant to NRS 439.430,

county health officer appointed pursuant to NRS

439.290 or district health officer appointed pursuant to NRS 439.368 or 439.400.

      (Added to NRS by 2009, 1532;

A 2011,

1270; 2013,

945)

PERMIT AUTHORIZING FIRE-FIGHTING AGENCY TO PROVIDE CERTAIN

LEVEL OF MEDICAL CARE

      NRS 450B.1985  Exclusive method of issuance; authority of district board of

health in certain larger counties to issue; situations in which certain medical

care may be provided.

      1.  Except as otherwise provided in

subsection 2, no permit may be issued pursuant to this chapter authorizing a

fire-fighting agency to provide the level of medical care provided by an

advanced emergency medical technician or paramedic to sick or injured persons

while transporting those persons to a medical facility.

      2.  Except as otherwise provided in

subsection 10 of NRS 450B.200, the district board

of health in a county whose population is 700,000 or more may issue a permit

pursuant to NRS 450B.200 or 450B.210 authorizing a fire-fighting agency to

provide the level of medical care provided by an advanced emergency medical

technician or paramedic to sick or injured persons at the scene of an emergency

and while transporting those persons to a medical facility.

      (Added to NRS by 2001, 998; A 2005, 2473; 2011, 1271;

2013, 618,

946)

AMBULANCES, AIR AMBULANCES AND VEHICLES OF FIRE-FIGHTING

AGENCIES

      NRS 450B.200  Permit for operation; fees; renewal; disciplinary or legal

action for violations; maintenance of central registry of permits issued;

regulations.

      1.  The health authority may issue a permit

for the operation of an ambulance, an air ambulance or a vehicle of a

fire-fighting agency at the scene of an emergency.

      2.  Each permit must be evidenced by a card

issued to the holder of the permit.

      3.  No permit may be issued unless the

applicant is qualified pursuant to the regulations of the board.

      4.  An application for a permit must be

made upon forms prescribed by the board and in accordance with procedures

established by the board, and must contain the following:

      (a) The name and address of the owner of the

ambulance or air ambulance or of the fire-fighting agency;

      (b) The name under which the applicant is doing

business or proposes to do business, if applicable;

      (c) A description of each ambulance, air

ambulance or vehicle of a fire-fighting agency, including the make, year of

manufacture and chassis number, and the color scheme, insigne, name, monogram

or other distinguishing characteristics to be used to designate the applicant’s

ambulance, air ambulance or vehicle;

      (d) The location and description of the places

from which the ambulance, air ambulance or fire-fighting agency intends to

operate; and

      (e) Such other information as the board deems

reasonable and necessary to a fair determination of compliance with the

provisions of this chapter.

      5.  The board shall establish a reasonable

fee for annual permits.

      6.  All permits expire on July 1 following

the date of issue, and are renewable annually thereafter upon payment of the

fee required by subsection 5 at least 30 days before the expiration date.

      7.  The health authority shall:

      (a) Revoke, suspend or refuse to renew any permit

issued pursuant to this section for violation of any provision of this chapter

or of any regulation adopted by the board; or

      (b) Bring an action in any court for violation of

this chapter or the regulations adopted pursuant to this chapter,

Ê only after

the holder of a permit is afforded an opportunity for a public hearing pursuant

to regulations adopted by the board.

      8.  The health authority may suspend a

permit if the holder is using an ambulance, air ambulance or vehicle of a

fire-fighting agency which does not meet the minimum requirements for equipment

as established by the board pursuant to this chapter.

      9.  In determining whether to issue a

permit for the operation of an air ambulance pursuant to this section, the

health authority:

      (a) Except as otherwise provided in paragraph

(b), may consider the medical aspects of the operation of an air ambulance,

including, without limitation, aspects related to patient care; and

      (b) Shall not consider economic factors, including,

without limitation, factors related to the prices, routes or nonmedical

services of an air ambulance.

      10.  The issuance of a permit pursuant to

this section or NRS 450B.210 does not authorize

any person or governmental entity to provide those services or to operate any

ambulance, air ambulance or vehicle of a fire-fighting agency not in conformity

with any ordinance or regulation enacted by any county, municipality or special

purpose district.

      11.  A permit issued pursuant to this

section is valid throughout the State, whether issued by the Division or a

district board of health. An ambulance, air ambulance or vehicle of a

fire-fighting agency which has received a permit from the district board of health

in a county whose population is 700,000 or more is not required to obtain a

permit from the Division, even if the ambulance, air ambulance or vehicle of a

fire-fighting agency has routine operations outside the county.

      12.  The Division shall maintain a central

registry of all permits issued pursuant to this section, whether issued by the

Division or a district board of health.

      13.  The board shall adopt such regulations

as are necessary to carry out the provisions of this section.

      (Added to NRS by 1973, 1144; A 1977, 71; 1981, 279; 1985, 1697; 1987, 2212; 1991, 1916; 1993, 2834; 1995, 2548; 2005, 2473; 2011, 1271;

2013, 618)

      NRS 450B.210  Provisional permit.

      1.  The board may issue provisional permits

limited as to time, place and purpose, based on the need therefor. No

provisional permit may be issued for a period of longer than 6 months. The

board may establish a reasonable fee for such provisional permits.

      2.  Unless otherwise limited in the permit,

a provisional permit issued pursuant to this section is valid for providing

emergency services throughout the State, whether issued by the Division or a

district board of health.

      3.  In determining whether to issue a

permit for the operation of an air ambulance pursuant to this section, the

health authority:

      (a) Except as otherwise provided in paragraph

(b), may consider the medical aspects of the operation of an air ambulance, including,

without limitation, aspects related to patient care; and

      (b) Shall not consider economic factors,

including, without limitation, factors related to the prices, routes or

nonmedical services of an air ambulance.

      (Added to NRS by 1973, 1145; A 1991, 1917; 2005, 2474; 2013, 619)

      NRS 450B.220  Periodic inspections.

      1.  Subsequent to issuance of any permit

under NRS 450B.200 and 450B.210,

the health authority shall cause to be inspected the ambulances, aircraft,

vehicles, medical supplies, equipment, personnel, records, premises and

operational procedures of a holder of a permit whenever that inspection is

deemed necessary, but no less frequently than once each year. The periodic

inspection required by this section is in addition to any other state or local

inspections required for ambulances, aircraft or motor vehicles under statute

or ordinances.

      2.  Any inspection conducted pursuant to

subsection 1 of the aircraft, equipment, personnel, records, premises or

operational procedures of a holder of a permit to operate an air ambulance must

be related only to the medical aspects of the operation of the air ambulance.

      (Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2835; 2013, 620)

      NRS 450B.230  Owner not to allow operation without required equipment;

exception.

      1.  The public or private owner of an

ambulance or air ambulance or the fire-fighting agency who owns a vehicle used

in providing emergency medical care shall not permit its operation and use

without the equipment required by regulations and standards of the board.

      2.  The provisions of this section do not

apply to the equipment in or of an air ambulance unless the equipment is

related to the medical aspects of the operation of the air ambulance.

      (Added to NRS by 1973, 1145; A 1985, 1699; 2013, 620)

      NRS 450B.235  Filing and maintenance of schedule of rates of ambulance.

      1.  Each public and private owner of an

ambulance shall file his or her schedule of rates with the health authority.

Any change in a schedule of an ambulance must be filed before the change

becomes effective.

      2.  The health authority shall keep each

schedule of rates or changes filed with it for at least 3 years after the

schedule has been superseded or otherwise become ineffective.

      (Added to NRS by 1979, 726; A 1993, 2835; 2013, 620)

TREATMENT OF TRAUMA

      NRS 450B.236  Approval required for operation of center for treatment of

trauma.  A person shall not operate

a center for the treatment of trauma without first applying for and obtaining

the written approval of the Administrator of the Division.

      (Added to NRS by 1987, 1042)

      NRS 450B.237  Establishment of program for treatment of trauma; regulations;

proposal to designate hospital as trauma center; approval by Administrator of

Division; standards; compliance.

      1.  The board shall establish a program for

treating persons who require treatment for trauma and for transporting and

admitting such persons to centers for the treatment of trauma. The program must

provide for the development, operation and maintenance of a system of

communication to be used in transporting such persons to the appropriate

centers.

      2.  The State Board of Health shall adopt

regulations which establish the standards for the designation of hospitals as

centers for the treatment of trauma. The State Board of Health shall consider

the standards adopted by the American College of Surgeons for a center for the

treatment of trauma as a guide for such regulations. The Administrator of the

Division shall not approve a proposal to designate a hospital as a center for

the treatment of trauma unless the hospital meets the standards established

pursuant to this subsection.

      3.  Each district board of health in a

county whose population is 700,000 or more shall adopt regulations which

establish the standards for the designation of hospitals in the county as

centers for the treatment of trauma which are consistent with the regulations

adopted by the State Board of Health pursuant to subsection 2. A district board

of health shall not approve a proposal to designate a hospital as a center for

the treatment of trauma unless the hospital meets the standards established

pursuant to this subsection.

      4.  A proposal to designate a hospital

located in a county whose population is 700,000 or more as a center for the

treatment of trauma:

      (a) Must be approved by the Administrator of the

Division and by the district board of health of the county in which the hospital

is located; and

      (b) May not be approved unless the district board

of health of the county in which the hospital is located has established and

adopted a comprehensive trauma system plan concerning the treatment of trauma

in the county, which includes, without limitation, consideration of the future

trauma needs of the county, consideration of and plans for the development and

designation of new centers for the treatment of trauma in the county based on

the demographics of the county and the manner in which the county may most

effectively provide trauma services to persons in the county.

      5.  Upon approval by the Administrator of

the Division and, if the hospital is located in a county whose population is

700,000 or more, the district board of health of the county in which the

hospital is located, of a proposal to designate a hospital as a center for the

treatment of trauma, the Administrator of the Division shall issue written

approval which designates the hospital as such a center. As a condition of

continuing designation the hospital must comply with the following

requirements:

      (a) The hospital must admit any injured person

who requires medical care.

      (b) Any physician who provides treatment for

trauma must be qualified to provide that treatment.

      (c) The hospital must maintain the standards

specified in the regulations adopted pursuant to subsections 2 and 3.

      (Added to NRS by 1987, 1042; A 1993, 2835; 2005, 1349; 2011, 1273)

      NRS 450B.238  Regulations requiring hospital to record and maintain

information.  The State Board of

Health shall adopt regulations which require each hospital to record and

maintain information concerning the treatment of trauma in the hospital. The

Board shall consider the guidelines adopted by the American College of Surgeons

which concern the information which must be recorded.

      (Added to NRS by 1987, 1043; A 1993, 2836)

      NRS 450B.239  Division to cooperate with American College of Surgeons.  In addition to the education and training

required by this chapter, the Division shall cooperate with the American

College of Surgeons to provide training in the treatment of trauma.

      (Added to NRS by 1987, 1043)

PROHIBITED ACTS

      NRS 450B.240  Engaging in operation of services relating to ambulances or air

ambulances without permit prohibited; provision of certain medical care by

fire-fighting agency without permit prohibited.

      1.  A person or governmental entity shall

not engage in the operation of any ambulance or air ambulance service in this

state without a currently valid permit for that service issued by the health

authority.

      2.  A fire-fighting agency shall not

provide the level of medical care provided by an advanced emergency medical

technician or paramedic to sick or injured persons at the scene of an emergency

or while transporting those persons to a medical facility without a currently

valid permit for that care issued by the health authority.

      3.  Nothing in this section precludes the

operation of an aircraft in this state in a manner other than as an air

ambulance.

      (Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2836; 2001, 999; 2013, 620, 946)

      NRS 450B.250  Service as attendant for ambulance or air ambulance without

license prohibited; provision of certain medical care by firefighter without

license prohibited.  Except as

otherwise provided in this chapter, a person shall not serve as an attendant on

any ambulance or air ambulance and a firefighter shall not provide the level of

medical care provided by an advanced emergency medical technician or paramedic

to sick or injured persons at the scene of an emergency or while transporting

those persons to a medical facility unless the person holds a currently valid

license issued by the health authority under the provisions of this chapter.

      (Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2836; 2001, 999; 2005, 334; 2013, 946)

      NRS 450B.255  Representation as emergency medical technician, advanced

emergency medical technician or paramedic without certificate prohibited.  A person shall not represent himself or

herself to be an emergency medical technician, advanced emergency medical

technician or paramedic unless the person has been issued a currently valid

certificate by the health authority.

      (Added to NRS by 1979, 71; A 1993, 2836; 2013, 946)

      NRS 450B.260  Operation of ambulance, air ambulance or fire-fighting vehicle

used to provide certain medical care without licensed driver and attendant

prohibited; exceptions.

      1.  Except as otherwise provided in this

section, the public or private owner of an ambulance or air ambulance or a

fire-fighting agency which owns a vehicle used in providing medical care to

sick or injured persons at the scene of an emergency or while transporting

those persons to a medical facility shall not permit its operation and use by

any person not licensed under this chapter.

      2.  An ambulance carrying a sick or injured

patient must be occupied by a driver and an attendant, each of whom is licensed

as an attendant pursuant to this chapter or exempt from licensing pursuant to

subsection 6 of NRS 450B.160, except as otherwise

provided in subsection 5 or in geographic areas which may be designated by the

board and for which the board may prescribe lesser qualifications.

      3.  An air ambulance carrying a sick or

injured patient must be occupied by a licensed attendant, or a person exempt

from licensing pursuant to subsection 6 of NRS

450B.160, in addition to the pilot of the aircraft.

      4.  The pilot of an air ambulance is not

required to have a license under this chapter.

      5.  A person who operates or uses a vehicle

owned by a fire-fighting agency is not required to be licensed under this

chapter, except that such a vehicle may not be used to provide the level of

medical care provided by an advanced emergency medical technician or paramedic

to sick or injured persons:

      (a) At the scene of an emergency unless at least

one person in the vehicle is licensed to provide the care; or

      (b) While transporting those persons to a medical

facility unless at least two persons in the vehicle are licensed to provide the

care.

      6.  Nothing in this section precludes the

operation of an aircraft in this State in a manner other than as an air

ambulance.

      (Added to NRS by 1973, 1145; A 1985, 1699; 1993, 320; 2001, 999; 2013, 620, 947)

      NRS 450B.265  Offering level of emergency care provided by paramedic without

permit prohibited; exception.

      1.  Except as otherwise provided in

subsection 2, a fire-fighting agency or an owner, operator, director or chief

officer of an ambulance shall not represent, advertise or imply that it:

      (a) Is authorized to provide the level of

emergency care provided by a paramedic; or

      (b) Uses the services of a paramedic,

Ê unless the

service has a currently valid permit to provide the level of emergency care

provided by a paramedic issued by the health authority.

      2.  Any service in a county whose

population is less than 700,000, that holds a valid permit for the operation of

an ambulance but is not authorized by the health authority to provide the level

of emergency care provided by a paramedic may represent, for billing purposes,

that its ambulance provided emergency care by a paramedic if:

      (a) A registered nurse employed by a hospital

rendered the level of emergency care provided by a paramedic to a patient being

transferred from the hospital by the ambulance; and

      (b) The equipment deemed necessary by the health

authority for the provision of the level of emergency care provided by a

paramedic was on board the ambulance at the time the registered nurse rendered

the emergency care.

      3.  A hospital that employs a registered

nurse who renders the care described in subsection 2 is entitled to reasonable

reimbursement for the services rendered by the nurse.

      (Added to NRS by 1979, 71; A 1985, 1700; 1987, 2213; 1989, 286, 1936; 1993, 2836; 2011, 1274;

2013, 947)

SAFETY OF EMERGENCY RESPONSE EMPLOYEES CONCERNING EXPOSURE

TO INFECTIOUS DISEASES

      NRS 450B.340  Designation of officer to receive notifications and responses

and make requests on behalf of emergency response employees.  Each employer of emergency response employees

in this State shall designate at least one employee to serve as a designated

officer to receive notifications and responses and make requests on behalf of

its emergency response employees pursuant to NRS

450B.340 to 450B.390, inclusive.

      (Added to NRS by 2009, 911)

      NRS 450B.350  Duty of medical facility or county coroner or medical examiner

to notify designated officer if victim transported has infectious disease; time

and contents for notification.

      1.  Except as otherwise provided in NRS 441A.195, if a victim of an

emergency is transported by emergency response employees to a medical facility

and the medical facility determines that the victim has an infectious disease,

the medical facility shall notify a designated officer of the emergency

response employees of that determination.

      2.  If a victim of an emergency is

transported by emergency response employees to a medical facility, the victim

dies at or before reaching the medical facility and the county coroner or

medical examiner of the county in which the victim dies, as applicable,

determines the cause of death of the victim, the county coroner or medical

examiner shall notify a designated officer of the emergency response employees

of any determination by the county coroner or medical examiner that the victim

had an infectious disease.

      3.  The medical facility to which the

victim is transported or the county coroner or medical examiner of the county

in which the victim dies, as applicable, shall cause the notification required

by subsection 1 or 2, as appropriate, to be made as soon as practicable, but

not later than 48 hours after the determination is made.

      4.  The notification must include, without

limitation:

      (a) The name of the infectious disease to which

the emergency response employees may have been exposed; and

      (b) The date on which the victim of the emergency

was transported by the emergency response employees to the medical facility.

      (Added to NRS by 2009, 911)

      NRS 450B.360  Determination of possible exposure of emergency response

employee to infectious disease; request for response from medical facility or

county coroner or medical examiner.

      1.  Except as otherwise provided in NRS 441A.195, if an emergency response

employee believes that he or she may have been exposed to an infectious disease

by a victim of an emergency who was transported, attended, treated or assisted

by the emergency response employee, a designated officer of the employee shall,

upon the request of the employee, make an initial determination of the possible

exposure of the employee to an infectious disease by:

      (a) Collecting the facts relating to the

circumstances under which the employee may have been exposed to an infectious

disease; and

      (b) Evaluating the facts to determine whether the

victim had an infectious disease and whether the employee may have been exposed

to the disease.

      2.  If a designated officer determines that

an emergency response employee may have been exposed to an infectious disease,

the designated officer shall submit to the medical facility to which the victim

was transported or the county coroner or medical examiner of the county in

which the victim died, as applicable, a written request for a response.

      (Added to NRS by 2009, 911)

      NRS 450B.370  Response of medical facility or county coroner or medical

examiner.

      1.  If a medical facility, county coroner

or medical examiner, as applicable, receives a written request for a response

pursuant to subsection 2 of NRS 450B.360, the

medical facility, county coroner or medical examiner shall, as soon as

practicable but not later than 48 hours after receiving the request, evaluate

the facts submitted in the request and determine whether the emergency response

employee was exposed to an infectious disease.

      2.  If the medical facility, county coroner

or medical examiner, as applicable, determines that the emergency response

employee may have been exposed or was not exposed to an infectious disease or

that insufficient information exists for a determination to be made, the

medical facility, county coroner or medical examiner shall notify, in writing,

the designated officer who submitted the request.

      (Added to NRS by 2009, 912)

      NRS 450B.375  Procedure upon notification that insufficient information exists

to determine whether emergency response employee was exposed to infectious

disease; request for further evaluation; duties of health officer.

      1.  If a designated officer receives a

notice from a medical facility, county coroner or medical examiner, as

applicable, pursuant to subsection 2 of NRS 450B.370

that insufficient information exists for the medical facility, county coroner

or medical examiner to make a determination of whether an emergency response

employee was exposed to an infectious disease, the designated officer may

submit a request for further evaluation to the health officer in whose

jurisdiction the medical facility, county coroner or medical examiner is

located. A request submitted pursuant to this subsection must include the

original request for a written response submitted by the designated officer

pursuant to subsection 2 of NRS 450B.360.

      2.  If a health officer receives a request

for further evaluation pursuant to subsection 1, the health officer shall

evaluate the request and the request for a written response submitted by the

designated officer pursuant to subsection 2 of NRS

450B.360. An evaluation conducted pursuant to this subsection must be completed

as soon as practicable but not later than 48 hours after the request for

further evaluation is received.

      3.  If an evaluation conducted pursuant to

subsection 2 indicates that the facts provided to the medical facility, county

coroner or medical examiner, as applicable, were:

      (a) Sufficient to determine that an emergency

response employee was exposed to an infectious disease, the health officer

shall, on behalf of the designated officer, resubmit the request to the medical

facility, county coroner or medical examiner; or

      (b) Insufficient to determine that an emergency

response employee was exposed to an infectious disease, the health officer

shall advise the designated officer in writing regarding the collection and

description of additional facts for further evaluation by the medical facility,

county coroner or medical examiner pursuant to NRS

450B.370.

      (Added to NRS by 2009, 912)

      NRS 450B.380  Notice to emergency response employee of possible exposure to

infectious disease.

      1.  If a designated officer receives a

notice from a medical facility, county coroner or medical examiner, as

applicable, pursuant to NRS 450B.370 that an

emergency response employee may have been exposed to an infectious disease, the

designated officer shall, as soon as is practicable after receiving the notice,

notify each emergency response employee who responded to the emergency and may

have been exposed to an infectious disease.

      2.  The notification must include, without

limitation:

      (a) A statement indicating that the emergency

response employee may have been exposed to an infectious disease;

      (b) The name of the infectious disease;

      (c) The date on which the victim of the emergency

was transported by the emergency response employee to the medical facility; and

      (d) Any action that is medically appropriate for

the emergency response employee to take.

      (Added to NRS by 2009, 913)

      NRS 450B.390  Limitations on effect of NRS 450B.340 to 450B.390,

inclusive.  The provisions of NRS 450B.340 to 450B.390,

inclusive, must not be construed to:

      1.  Authorize any cause of action for

damages or any civil penalty against a medical facility, county coroner,

medical examiner or designated officer that fails to comply with any

requirement of those provisions.

      2.  Require or authorize a medical

facility, county coroner or medical examiner to test a victim of an emergency

for the presence of an infectious disease.

      3.  Require or authorize a medical

facility, county coroner, medical examiner, designated officer or emergency

response employee to disclose the identity of or identifying information about

a victim of an emergency or an emergency response employee.

      4.  Authorize an emergency response

employee to fail to respond or deny services to a victim of an emergency.

      (Added to NRS by 2009, 913)

WITHHOLDING LIFE-SUSTAINING TREATMENT

      NRS 450B.400  Definitions.  As

used in NRS 450B.400 to 450B.590,

inclusive, unless the context otherwise requires, the words and terms defined

in NRS 450B.405 to 450B.475,

inclusive, have the meanings ascribed to them in those sections.

      (Added to NRS by 1997, 287; A 2001, 815)

      NRS 450B.405  “Attending physician” defined.  “Attending

physician” has the meaning ascribed to it in NRS

449.550.

      (Added to NRS by 2001, 814)

      NRS 450B.410  “Do-not-resuscitate identification” defined.  “Do-not-resuscitate identification” means:

      1.  A form of identification approved by

the health authority, which signifies that:

      (a) A person is a qualified patient who wishes

not to be resuscitated in the event of cardiac or respiratory arrest; or

      (b) The patient’s attending physician has:

             (1) Issued a do-not-resuscitate order for

the patient;

             (2) Obtained the written approval of the

patient concerning the order; and

             (3) Documented the grounds for the order in

the patient’s medical record.

      2.  The term also includes a valid

do-not-resuscitate identification issued under the laws of another state.

      (Added to NRS by 1997, 287)

      NRS 450B.420  “Do-not-resuscitate order” defined.  “Do-not-resuscitate

order” means a written directive issued by a physician licensed in this state

that emergency life-resuscitating treatment must not be administered to a

qualified patient. The term also includes a valid do-not-resuscitate order

issued under the laws of another state.

      (Added to NRS by 1997, 288)

      NRS 450B.430  “Do-not-resuscitate protocol” defined.  “Do-not-resuscitate

protocol” means the standardized procedure and guidelines established by the

board for the withholding of emergency life-resuscitating treatment in

compliance with a do-not-resuscitate order or a do-not-resuscitate

identification.

      (Added to NRS by 1997, 288; A 1999, 45)

      NRS 450B.440  “Health care facility” defined.  “Health

care facility” has the meaning ascribed to it in NRS 162A.740.

      (Added to NRS by 1997, 288; A 2009, 210)

      NRS 450B.450  “Life-resuscitating treatment” defined.  “Life-resuscitating

treatment” means cardiopulmonary resuscitation or a component of

cardiopulmonary resuscitation, including chest compressions, defibrillation,

cardioversion, assisted ventilation, airway intubation or administration of

cardiotonic drugs.

      (Added to NRS by 1997, 288)

      NRS 450B.460  “Person who administers emergency medical services” defined.  “Person who administers emergency medical

services” means a paid or volunteer firefighter, law enforcement officer,

emergency medical technician, advanced emergency medical technician, paramedic,

ambulance attendant or other person trained to provide emergency medical

services.

      (Added to NRS by 1997, 288; A 2013, 948)

    NRS 450B.470  “Qualified patient” defined.  “Qualified

patient” means:

      1.  A patient 18 years of age or older who

has been determined by the patient’s attending physician to be in a terminal

condition and who:

      (a) Has executed a declaration in accordance with

the requirements of NRS 449.600;

      (b) Has executed a Physician Order for

Life-Sustaining Treatment form pursuant to NRS

449.691 to 449.697, inclusive, if

the form provides that the patient is not to receive life-resuscitating

treatment; or

      (c) Has been issued a do-not-resuscitate order

pursuant to NRS 450B.510.

      2.  A patient who is less than 18 years of

age and who:

      (a) Has been determined by the patient’s

attending physician to be in a terminal condition; and

      (b) Has executed a Physician Order for

Life-Sustaining Treatment form pursuant to NRS

449.691 to 449.697, inclusive, if

the form provides that the patient is not to receive life-resuscitating

treatment or has been issued a do-not-resuscitate order pursuant to NRS 450B.510.

      (Added to NRS by 1997, 288; A 2001, 815; 2013, 2290)

      NRS 450B.475  “Terminal condition” defined.  “Terminal

condition” has the meaning ascribed to it in NRS

449.590.

      (Added to NRS by 2001, 814)

      NRS 450B.480  Applicability.  The

provisions of NRS 450B.400 to 450B.590, inclusive, apply only to emergency medical

services administered to a qualified patient:

      1.  Before he or she is admitted to a

medical facility; or

      2.  While the qualified patient is being

prepared to be transferred, or is being transferred, from one health care

facility to another health care facility.

      (Added to NRS by 1997, 288; A 2001, 816)

      NRS 450B.490  Adoption of regulations; fee for do-not-resuscitate

identification.

      1.  The board

shall adopt regulations to carry out the provisions of NRS

450B.400 to 450B.590, inclusive. The

regulations must establish:

      (a) A do-not-resuscitate protocol; and

      (b) The procedure to apply for a

do-not-resuscitate identification.

      2.  The board may establish a fee for:

      (a) A do-not-resuscitate identification to be

collected by the health authority. The fee may not exceed the actual cost to

the health authority of:

             (1) Manufacturing or obtaining the

identification from a manufacturer, including the cost of shipping and

handling; and

             (2) Engraving the identification.

      (b) The issuance of a bracelet or medallion which

indicates that a do-not-resuscitate identification has been issued to a

qualified patient.

      3.  In the case of a district board of health,

such regulations take effect immediately upon approval by the State Board of

Health.

      (Added to NRS by 1997, 288; A 1999, 45; 2001, 816; 2005, 2475)

      NRS 450B.500  Do-not-resuscitate identification: Contents.  Each do-not-resuscitate identification issued

by the health authority must include, without limitation:

      1.  An identification number that is unique

to the qualified patient to whom the identification is issued;

      2.  The name and date of birth of the

patient; and

      3.  The name of the attending physician of

the patient.

      (Added to NRS by 1997, 288)

      NRS 450B.505  Do-not-resuscitate identification: Manufacture and issuance of

bracelet or medallion.  The board

may enter into an agreement for the manufacture of a bracelet or medallion to

be worn by a qualified patient which indicates that the qualified patient has

been issued a do-not-resuscitate identification. Such a bracelet or medallion

may be issued to a qualified patient in addition to, and not in lieu of, the

do-not-resuscitate identification.

      (Added to NRS by 2001, 814)

      NRS 450B.510  Written do-not-resuscitate orders: Issued only to qualified

patients; physician authorized to apply for identification.

      1.  A physician licensed in this state may

issue a written do-not-resuscitate order only to a patient who has been

determined to be in a terminal condition.

      2.  Except as otherwise provided in

subsection 3, the order is effective only if the patient has agreed to its

terms, in writing, while the patient is capable of making an informed decision.

      3.  If the patient is a minor, the order is

effective only if:

      (a) The parent or legal guardian of the minor has

agreed to its terms, in writing; and

      (b) The minor has agreed to its terms, in

writing, while the minor is capable of making an informed decision if, in the

opinion of the attending physician, the minor is of sufficient maturity to

understand the nature and effect of withholding life-resuscitating treatment.

      4.  A physician who issues a do-not-resuscitate

order may apply, on behalf of the patient, to the health authority for a

do-not-resuscitate identification for that patient.

      (Added to NRS by 1997, 289; A 2001, 816)

      NRS 450B.520  Application for do-not-resuscitate identification: Form;

requirements.  Except as otherwise

provided in NRS 450B.525:

      1.  A qualified patient may apply to the

health authority for a do-not-resuscitate identification by submitting an

application on a form provided by the health authority. To obtain a

do-not-resuscitate identification, the patient must comply with the

requirements prescribed by the board and sign a form which states that the

patient has informed each member of his or her family within the first degree

of consanguinity or affinity, whose whereabouts are known to the patient, or if

no such members are living, the patient’s legal guardian, if any, or if he or

she has no such members living and has no legal guardian, his or her caretaker,

if any, of the patient’s decision to apply for an identification.

      2.  An application must include, without

limitation:

      (a) Certification by the patient’s attending

physician that the patient suffers from a terminal condition;

      (b) Certification by the patient’s attending

physician that the patient is capable of making an informed decision or, when

the patient was capable of making an informed decision, that the patient:

             (1) Executed:

                   (I) A written directive that

life-resuscitating treatment be withheld under certain circumstances;

                   (II) A durable power of attorney for

health care pursuant to NRS 162A.700

to 162A.860, inclusive; or

                   (III) A Physician Order for

Life-Sustaining Treatment form pursuant to NRS

449.691 to 449.697, inclusive, if

the form provides that the patient is not to receive life-resuscitating

treatment; or

             (2) Was issued a do-not-resuscitate order

pursuant to NRS 450B.510;

      (c) A statement that the patient does not wish

that life-resuscitating treatment be undertaken in the event of a cardiac or

respiratory arrest;

      (d) The name, signature and telephone number of

the patient’s attending physician; and

      (e) The name and signature of the patient or the

agent who is authorized to make health care decisions on the patient’s behalf

pursuant to a durable power of attorney for health care decisions.

      (Added to NRS by 1997, 289; A 1999, 45; 2001, 817; 2009, 210; 2013, 2290)

      NRS 450B.525  Application for do-not-resuscitate identification on behalf of

minor: Requirements; form; revocation by parent or legal guardian of

authorization to withhold life-resuscitating treatment; effect when minor is of

sufficient maturity.

      1.  A parent or legal guardian of a minor

may apply to the health authority for a do-not-resuscitate identification on

behalf of the minor if the minor has been:

      (a) Determined by his or her attending physician

to be in a terminal condition; and

      (b) Issued a do-not-resuscitate order pursuant to

NRS 450B.510.

      2.  To obtain such a do-not-resuscitate

identification, the parent or legal guardian must:

      (a) Submit an application on a form provided by

the health authority; and

      (b) Comply with the requirements prescribed by

the board.

      3.  An application submitted pursuant to

subsection 2 must include, without limitation:

      (a) Certification by the minor’s attending

physician that the minor:

             (1) Suffers from a terminal condition; and

             (2) Has executed a Physician Order for

Life-Sustaining Treatment form pursuant to NRS

449.691 to 449.697, inclusive, if

the form provides that the minor is not to receive life-resuscitating treatment

or has been issued a do-not-resuscitate order pursuant to NRS 450B.510;

      (b) A statement that the parent or legal guardian

of the minor does not wish that life-resuscitating treatment be undertaken in

the event of a cardiac or respiratory arrest;

      (c) The name of the minor;

      (d) The name, signature and telephone number of

the minor’s attending physician; and

      (e) The name, signature and telephone number of

the minor’s parent or legal guardian.

      4.  The parent or legal guardian of the

minor may revoke the authorization to withhold life-resuscitating treatment by

removing or destroying or requesting the removal or destruction of the

identification or otherwise indicating to a person that he or she wishes to

have the identification removed or destroyed.

      5.  If, in the opinion of the attending

physician, the minor is of sufficient maturity to understand the nature and

effect of withholding life-resuscitating treatment:

      (a) The do-not-resuscitate identification

obtained pursuant to this section is not effective without the assent of the

minor.

      (b) The minor may revoke the authorization to

withhold life-resuscitating treatment by removing or destroying or requesting

the removal or destruction of the identification or otherwise indicating to a

person that the minor wishes to have the identification removed or destroyed.

      (Added to NRS by 2001, 815; A 2013, 2291)

      NRS 450B.530  Revocation of authorization to withhold life-resuscitating

treatment.  Except as otherwise

provided in NRS 450B.525, a qualified patient who

possesses a do-not-resuscitate identification may revoke his or her

authorization to withhold life-resuscitating treatment by removing or

destroying or requesting the removal or destruction of his or her

identification or otherwise indicating to a person that the patient wishes to

have the identification removed or destroyed.

      (Added to NRS by 1997, 289; A 2001, 817)

      NRS 450B.540  Person not guilty of unprofessional conduct or subject to

liability for withholding or providing life-resuscitating treatment under

certain circumstances.

      1.  A person is not guilty of

unprofessional conduct or subject to civil or criminal liability if the person:

      (a) Is a physician who:

             (1) Causes the withholding of

life-resuscitating treatment from a qualified patient who possesses a

do-not-resuscitate identification in accordance with the do-not-resuscitate

protocol; or

             (2) While the patient is being prepared to

be transferred, or is being transferred, from one health care facility to

another health care facility, carries out a do-not-resuscitate order that is

documented in the medical record of a qualified patient, in accordance with the

do-not-resuscitate protocol;

      (b) Pursuant to the direction of or with the

authorization of a physician, participates in:

             (1) The withholding of life-resuscitating

treatment from a qualified patient who possesses a do-not-resuscitate

identification in accordance with the do-not-resuscitate protocol; or

             (2) While the patient is being prepared to

be transferred, or is being transferred, from one health care facility to

another health care facility, carrying out a do-not-resuscitate order that is

documented in the medical record of a qualified patient, in accordance with the

do-not-resuscitate protocol; or

      (c) Administers emergency medical services and:

             (1) Causes or participates in the

withholding of life-resuscitating treatment from a qualified patient who

possesses a do-not-resuscitate identification;

             (2) Before a qualified patient is admitted

to a medical facility, carries out a do-not-resuscitate order that has been

issued in accordance with the do-not-resuscitate protocol; or

             (3) While the patient is being prepared to

be transferred, or is being transferred, from one health care facility to

another health care facility, carries out a do-not-resuscitate order that is

documented in the medical record of a qualified patient, in accordance with the

do-not-resuscitate protocol.

      2.  A health care facility, ambulance

service or fire-fighting agency that employs a person described in subsection 1

is not guilty of unprofessional conduct or subject to civil or criminal

liability for the acts or omissions of the employee carried out in accordance

with the provisions of subsection 1.

      3.  A physician, a person pursuant to the

direction or authorization of a physician, a health care facility or a person

administering emergency medical services who provides life-resuscitating

treatment pursuant to:

      (a) An oral or written request made by a

qualified patient, or the parent or legal guardian of a qualified patient, who

may revoke the authorization to withhold life-resuscitating treatment pursuant

to NRS 450B.525 or 450B.530;

or

      (b) An observation that a qualified patient, or

the parent or legal guardian of a qualified patient, has revoked or otherwise

indicated that he or she wishes to revoke the authorization to withhold

life-resuscitating treatment pursuant to NRS 450B.525

or 450B.530,

Ê is not

guilty of unprofessional conduct or subject to civil or criminal liability.

      (Added to NRS by 1997, 289; A 2001, 817)

      NRS 450B.550  Person who administers emergency medical services required to

comply with do-not-resuscitate protocol; exception.

      1.  Except as otherwise provided in

subsection 2, a person who administers emergency medical services shall comply

with do-not-resuscitate protocol when the person observes a do-not-resuscitate

identification or carries out a do-not-resuscitate order.

      2.  A person who administers emergency

medical services and who is unwilling or unable to comply with the

do-not-resuscitate protocol shall take all reasonable measures to transfer a

qualified patient who possesses a do-not-resuscitate identification or has been

issued a do-not-resuscitate order to a physician or health care facility in

which the do-not-resuscitate protocol may be followed.

      (Added to NRS by 1997, 290; A 2001, 818)

      NRS 450B.560  Assumption that do-not-resuscitate identification is valid.

      1.  Unless he or she has knowledge to the

contrary, a physician, any other provider of health care or any person who

administers emergency medical services may assume that a do-not-resuscitate

identification complies with the provisions of NRS

450B.400 to 450B.590, inclusive, and is valid.

      2.  The provisions of NRS 450B.400 to 450B.590,

inclusive, do not create a presumption concerning the intention of a:

      (a) Qualified patient or a parent or legal

guardian of a qualified patient who has revoked authorization to withhold

life-resuscitating treatment pursuant to NRS 450B.525

or 450B.530; or

      (b) Person who has not obtained a

do-not-resuscitate identification,

Ê concerning

the use or withholding of life-resuscitating treatment in a life-threatening

emergency.

      (Added to NRS by 1997, 290; A 2001, 819)

      NRS 450B.570  Resulting death not suicide or homicide; life insurance or

annuity not affected by possession of do-not-resuscitate identification or

issuance of do-not-resuscitate order; prohibition or requirement of possession

of do-not-resuscitate identification or issuance of do-not-resuscitate order

not allowed in connection with health care.

      1.  Death that results when

life-resuscitating treatment has been withheld pursuant to the

do-not-resuscitate protocol and in accordance with the provisions of NRS 450B.400 to 450B.590,

inclusive, does not constitute a suicide or homicide.

      2.  The possession of a do-not-resuscitate

identification or the issuance of a do-not-resuscitate order does not affect

the sale, procurement or issuance of a policy of life insurance or an annuity

or impair or modify the terms of a policy of life insurance or an annuity. A

policy of life insurance or an annuity is not legally impaired or invalidated

if life-resuscitating treatment has been withheld from an insured who possesses

a do-not-resuscitate identification or has been issued a do-not-resuscitate order,

notwithstanding any term in the policy or annuity to the contrary.

      3.  A person may not prohibit or require

the possession of a do-not-resuscitate identification or the issuance of a

do-not-resuscitate order as a condition of being insured for, or receiving,

health care.

      (Added to NRS by 1997, 290; A 2001, 819)

      NRS 450B.580  Unlawful acts; penalty.

      1.  It is unlawful for:

      (a) A person who administers emergency medical

services to fail willfully to transfer a qualified patient in accordance with

the provisions of NRS 450B.550.

      (b) A person purposely to conceal, cancel, deface

or obliterate a do-not-resuscitate identification of a qualified patient,

unless it is done in compliance with a request of the qualified patient or a

parent or legal guardian of the qualified patient to remove or destroy the

do-not-resuscitate identification pursuant to NRS

450B.525 or 450B.530.

      (c) A person to falsify or forge the

do-not-resuscitate identification of a qualified patient or purposely to

conceal or withhold personal knowledge of the revocation of a

do-not-resuscitate identification with the intent to cause the use, withholding

or withdrawal of life-resuscitating treatment.

      2.  A person who violates any of the

provisions of this section is guilty of a misdemeanor.

      (Added to NRS by 1997, 291; A 2001, 819)

      NRS 450B.590  Limitations on effect of provisions.  The

provisions of NRS 450B.400 to 450B.590, inclusive, do not:

      1.  Require a physician or other provider

of health care to take action contrary to reasonable medical standards;

      2.  Condone, authorize or approve mercy

killing, euthanasia or assisted suicide;

      3.  Substitute for any other legally authorized

procedure by which a person may direct that the person not be resuscitated in

the event of a cardiac or respiratory arrest;

      4.  Except as otherwise provided in NRS 449.6946, affect or impair any right

created pursuant to the provisions of NRS

449.535 to 449.690, inclusive, or 449.691 to 449.697, inclusive; or

      5.  Affect the right of a qualified patient

to make decisions concerning the use of life-resuscitating treatment, if he or

she is able to do so, or impair or supersede a right or responsibility of a

person to affect the withholding of medical care in a lawful manner.

      (Added to NRS by 1997, 291; A 2013, 2292)

AUTOMATED EXTERNAL DEFIBRILLATORS

      NRS 450B.595  “Automated external defibrillator” and “defibrillator” defined.  Repealed. (See chapter 358, Statutes of Nevada

2013, at page 1872.)

 

      NRS 450B.600  Required to be placed in certain public buildings and locations;

inspection and maintenance; training on operation and use.

      1.  Not later than July 1, 2004, and

thereafter:

      (a) The board of trustees of a school district in

a county whose population is 100,000 or more shall ensure that at least one

automated external defibrillator is placed in a central location at each high

school within the district.

      (b) The Reno-Tahoe Airport Authority shall ensure

that at least three automated external defibrillators are placed in central

locations at the largest airport within the county.

      (c) The board of county commissioners of each

county whose population is 700,000 or more shall ensure that at least seven

automated external defibrillators are placed in central locations at the

largest airport within the county.

      (d) The Board of Regents of the University of

Nevada shall ensure that at least two automated external defibrillators are

placed in central locations at each of:

             (1) The largest indoor sporting arena or

events center controlled by the University in a county whose population is

100,000 or more but less than 700,000; and

             (2) The largest indoor sporting arena or

events center controlled by the University in a county whose population is

700,000 or more.

      (e) The Division shall ensure that at least one

automated external defibrillator is placed in a central location at each of the

following state buildings:

             (1) The Capitol Building in Carson City;

             (2) The Legislative Building in Carson

City; and

             (3) The Grant Sawyer Building in Las

Vegas.

      (f) The board of county commissioners of each

county whose population is 100,000 or more shall:

             (1) Identify five county buildings or

offices in each of their respective counties which are characterized by large

amounts of pedestrian traffic or which house one or more county agencies that

provide services to large numbers of persons; and

             (2) Ensure that at least one automated

external defibrillator is placed in a central location at each county building

or office identified pursuant to subparagraph (1).

      2.  Each governmental entity that is

required to ensure the placement of one or more automated external

defibrillators pursuant to subsection 1:

      (a) May accept gifts, grants and donations for

use in obtaining, inspecting and maintaining the defibrillators;

      (b) Shall ensure that those defibrillators are

inspected and maintained on a regular basis; and

      (c) Shall encourage the entity where the

automated external defibrillator is placed to require any employee who will use

the automated external defibrillator to successfully complete the training

requirements of a course in basic emergency care of a person in cardiac arrest

that includes training in the operation and use of an automated external

defibrillator and is conducted in accordance with the standards of the American

Heart Association, the American National Red Cross or any similar organization.

      (Added to NRS by 2003, 2464; A 2009, 779; 2011, 1274)

      NRS 450B.610  Maintenance of database by Division; disclosure of information

in database; duties of manufacturer; registration of defibrillator; civil

penalty for violation.

      1.  The Division shall:

      (a) Within the limitations of available funding,

establish and maintain a database containing:

             (1) The name and address of each person

who owns an automated external defibrillator for commercial use in this State;

             (2) If the defibrillator has been

registered with the Division pursuant to subsection 4, the name, street address

and telephone number of the business or organization that has placed the

defibrillator for use on its premises, and the specific location at which the

defibrillator is stored; and

             (3) If the defibrillator has been

registered with the Division pursuant to subsection 5, the information

concerning the defibrillator that was required for registration by the

Division.

      (b) Make the information in the database

available to each agency and facility that employs an emergency medical

dispatcher in this State.

      (c) Apply for and accept any gifts, grants or

donations to establish and maintain the database.

      2.  An emergency medical dispatcher may

disclose the information in the database to any person for the purpose of

providing emergency medical care.

      3.  A manufacturer that sells an automated

external defibrillator for commercial use in this State shall:

      (a) Notify the purchaser in writing of the

opportunity to register the defibrillator pursuant to subsection 4;

      (b) On or before January 10, April 10, July 10

and October 10 of each year, notify the Division of the name and address of

each person who purchased such a defibrillator from the manufacturer during the

immediately preceding 3 calendar months; and

      (c) Provide to each person who purchases such a

defibrillator from the manufacturer information regarding the installation,

use, maintenance and operation of the defibrillator and any related training

that is available.

      4.  A person who purchases an automated

external defibrillator for commercial use in this State may register the

defibrillator with the Division by providing the Division with the person’s

name, street address and telephone number, the name, street address and

telephone number of the business or organization on whose premises the

defibrillator will be placed for use, and the specific location at which the

defibrillator will be stored.

      5.  A person who owns an automated external

defibrillator for use in a private residence may register the defibrillator

with the Division by providing such information concerning the defibrillator as

required by the Division.

      6.  The Division may impose a civil penalty

upon a manufacturer of not more than $500 for each violation of this section by

the manufacturer. All money collected from the imposition of a civil penalty

must be used for the maintenance of the database established pursuant to

subsection 1.

      (Added to NRS by 2009, 777)

      NRS 450B.620  Placement and maintenance by school districts, health clubs and

medical facilities; training of employees.

      1.  Except as otherwise provided in NRS 450B.600, the board of trustees of each school

district in this State, to the extent that money is available, may provide for

the placement of an automated external defibrillator in each public school in

the school district and at each athletic facility maintained by the school district

at a location that is separate from a public school. Each defibrillator must be

appropriate for use on children and adults and be limited to use on school

property and at school events. The board of trustees may accept:

      (a) The donation of a defibrillator that complies

with the standards established by the United States Food and Drug

Administration; and

      (b) Gifts, grants and donations for use in

obtaining, inspecting and maintaining a defibrillator.

      2.  Each medical facility and health club

in this State may provide for the placement of an automated external

defibrillator in a central location at the medical facility or health club.

      3.  Each school district, medical facility

and health club that provides for the placement of one or more automated

external defibrillators pursuant to this section shall:

      (a) Ensure that each defibrillator is inspected

and maintained on a regular basis; and

      (b) Require any employee who will use a

defibrillator to complete the training requirements of a course in basic

emergency care of a person in cardiac arrest that includes training in the

operation and use of an automated external defibrillator and is conducted in

accordance with the standards of the American Heart Association, the American

National Red Cross or any similar organization.

      4.  As used in this section:

      (a) “Health club” has the meaning ascribed to it

in NRS 598.9415.

      (b) “Medical facility” means:

             (1) A facility for hospice care as defined

in NRS 449.0033;

             (2) A facility for intermediate care as

defined in NRS 449.0038;

             (3) A facility for skilled nursing as

defined in NRS 449.0039;

             (4) A hospital as defined in NRS 449.012;

             (5) An independent center for emergency medical

care as defined in NRS 449.013; or

             (6) A surgical center for ambulatory

patients as defined in NRS 449.019.

      (c) “School property” has the meaning ascribed to

it in NRS 701B.350.

      (Added to NRS by 2009, 778)

EMERGENCY MEDICAL SERVICES AT SPECIAL EVENTS

      NRS 450B.650  Definitions.  As

used in NRS 450B.650 to 450B.700,

inclusive, unless the context otherwise requires, the words and terms defined

in NRS 450B.655 to 450B.685,

inclusive, have the meanings ascribed to them in those sections.

      (Added to NRS by 2013, 1869)

      NRS 450B.655  “Dedicated advanced life support ambulance” defined.  “Dedicated advanced life support ambulance”

means an ambulance equipped to provide advanced life support that:

      1.  Is capable of transporting a patient

from a special event to a hospital but, upon delivering the patient,

immediately returns to the site of the special event; and

      2.  Is staffed by:

      (a) At least one advanced emergency medical

technician and paramedic; or

      (b) At least two other attendants, each with an

equivalent or a higher level of skill than the levels described in paragraph

(a).

      (Added to NRS by 2013, 1869)

      NRS 450B.660  “First-aid station” defined.  “First-aid

station” means a fixed location at the site of a special event that is staffed

by at least one emergency medical technician or a person with a higher level of

skill who is capable of providing emergency medical care within his or her

scope of practice.

      (Added to NRS by 2013, 1870)

      NRS 450B.665  “Host organization” defined.  “Host

organization” means:

      1.  If a permit was obtained for a special

event, the person who obtained the permit; or

      2.  If a permit was not obtained for a

special event, the person who sponsored the special event.

      (Added to NRS by 2013, 1870)

      NRS 450B.670  “Roving emergency medical technician team” defined.  “Roving emergency medical technician team”

means a team at the site of a special event that:

      1.  Consists of two or more emergency

medical technicians, advanced emergency medical technicians or paramedics; and

      2.  Has the medical supplies necessary to

provide emergency medical care.

      (Added to NRS by 2013, 1870)

      NRS 450B.675  “Roving intermediate emergency medical technician team” defined.  “Roving intermediate emergency medical

technician team” means a roving emergency medical team that consists of two or

more advanced emergency medical technicians or paramedics.

      (Added to NRS by 2013, 1870)

      NRS 450B.680  “Significant number” defined.  “Significant

number” means, with regard to:

      1.  Contacts by emergency medical personnel

with persons who attended a special event, the number of contacts is 0.07

percent or more of the total number of persons who attended the special event;

and

      2.  Patients transported to a hospital, the

number of patients transported from the special event to the hospital by

ambulance or private vehicle is 15 percent or more of the total number of contacts

at the special event by emergency medical personnel with persons who attended

the special event.

      (Added to NRS by 2013, 1870)

      NRS 450B.685  “Special event” defined.  “Special

event” means a temporary event, including, without limitation, a concert or

sporting event, at which 2,500 or more persons are projected to be in

attendance at the same time. The term does not include a temporary event held

at a location which is designed to host concerts, sporting events, conventions,

trade shows and any other similar events and which has permanently established

methods for providing first-aid or emergency medical services at the location.

      (Added to NRS by 2013, 1870)

      NRS 450B.690  Host organization of certain special events held in certain larger

counties required to provide certain emergency medical services.

      1.  In a county whose population is 100,000

or more, if a special event at which 2,500 or more persons but less than 10,000

persons are projected to be in attendance at the same time, the host

organization shall provide at least one first-aid station at the site of the

special event if:

      (a) The special event is a concert; or

      (b) Three or more of the following factors apply

to the special event:

             (1) The special event involves a high-risk

activity, including, without limitation, sports or racing.

             (2) The special event poses environmental

hazards to persons attending the special event or is held during a period of

extreme heat or cold.

             (3) The average age of the persons

attending the special event is less than 25 years of age or more than 50 years

of age.

             (4) A large number of the persons

attending the special event have acute or chronic illnesses.

             (5) Alcohol is sold at the special event

or, if the special event has been held before, there is a history of alcohol or

drug use by the persons who attended the special event in the past.

             (6) The density of the number of persons

attending the special event increases the difficulty regarding:

                   (I) Access to the persons who are

attending the special event who require emergency medical care; or

                   (II) The transfer of those persons

who require emergency medical care to an ambulance.

      2.  In a county whose population is 100,000

or more, if the host organization meets the requirements of paragraph (a) or

(b) of subsection 1 and 10,000 or more persons but less than 15,000 persons are

projected to be in attendance at the special event at the same time, the host

organization shall:

      (a) Provide at least one first-aid station at the

site of the special event and equip the first-aid station with an automated

external defibrillator; and

      (b) Provide a roving emergency medical technician

team at the site of the special event.

      3.  In a county whose population is 100,000

or more, if the host organization meets the requirements of paragraph (a) or

(b) of subsection 1 and 15,000 or more persons but less than 50,000 persons are

projected to be in attendance at the special event at the same time, the host

organization shall:

      (a) Provide at least one first-aid station at the

site of the special event and staff the first-aid station with at least one

registered nurse, licensed practical nurse or paramedic in lieu of an emergency

medical technician; and

      (b) Provide two or more roving intermediate

emergency medical technician teams at the site of the special event.

      (Added to NRS by 2013, 1870)

      NRS 450B.695  Host organization of certain special events held in certain

larger counties required to provide certain number of dedicated advanced life

support ambulances.

      1.  In a county whose population is 100,000

or more, if a special event at which 2,500 or more persons but less than 15,000

persons are projected to be in attendance at the same time, the host

organization shall provide at least one dedicated advanced life support

ambulance at the special event if the special event:

      (a) Is located more than 5 miles from the closest

hospital; or

      (b) Has been held before and there is a history

of a significant number of:

             (1) Contacts by emergency medical

personnel with persons who attended the special event to provide emergency

medical care to those persons; or

             (2) Persons who attended the special event

who were transported as patients from the special event to a hospital.

      2.  In a county whose population is 100,000

or more, if the host organization meets the requirements of paragraph (a) or

(b) of subsection 1 and 15,000 or more persons but less than 50,000 persons are

projected to be in attendance at the special event at the same time, the host

organization shall provide at least two dedicated advanced life support

ambulances at the special event.

      (Added to NRS by 2013, 1871)

      NRS 450B.700  Host organization of special event at which 50,000 or more

persons are projected to be in attendance required to provide certain emergency

medical services.  If a special

event at which 50,000 or more persons are projected to be in attendance at the

same time, the host organization shall provide:

      1.  Two or more first-aid stations at the

site of the special event;

      2.  Two or more physicians licensed

pursuant to chapter 630 or 633 of NRS;

      3.  Two or more roving emergency medical

technician teams; and

      4.  Two or more dedicated advanced life

support ambulances.

      (Added to NRS by 2013, 1871)

MISCELLANEOUS PROVISIONS

      NRS 450B.790  Hospital required to ensure that certain persons in need of

emergency services are transferred to appropriate places in hospital within 30

minutes after arrival; civil and criminal liability.

      1.  Each hospital in this State which

receives a person in need of emergency services and care who has been

transported to the hospital by a provider of emergency medical services shall

ensure that the person is transferred to a bed, chair, gurney or other

appropriate place in the hospital to receive emergency services and care as

soon as practicable, but not later than 30 minutes after the time at which the

person arrives at the hospital.

      2.  This section does not create a duty of

care and is not a ground for civil or criminal liability.

      3.  As used in this section:

      (a) “Emergency services and care” has the meaning

ascribed to it in NRS 439B.410.

      (b) “Hospital” has the meaning ascribed to it in NRS 449.012.

      (c) “Provider of emergency medical services”

means each operator of an ambulance and each fire-fighting agency which has a

permit to operate pursuant to this chapter and which provides transportation

for persons in need of emergency services and care to hospitals.

      (Added to NRS by 2005, 1474; A 2007, 2372)

      NRS 450B.795  State Board of Health to collect data concerning waiting times

for provision of emergency services to certain persons; hospitals and providers

of emergency services in certain counties required to participate in collection

of data; development of system of collecting data; advisory committees;

quarterly report to Legislative Committee on Health Care; expenses; regulations;

written request for repeal of section.

      1.  The State Board of Health shall collect

data, in accordance with the system that is developed by the Board pursuant to

subsection 5, concerning the waiting times for the provision of emergency

services and care to each person who is in need of such services and care and

who is transported to a hospital by a provider of emergency medical services.

      2.  Each hospital and each provider of

emergency medical services in a county whose population is 700,000 or more shall

participate in the collection of data pursuant to this section by collecting

data, in accordance with the system that is developed by the State Board of

Health pursuant to subsection 5, concerning the waiting times for the provision

of emergency services and care to each person who is in need of such services

and care and who is transported to a hospital by a provider of emergency

medical services.

      3.  Except as otherwise provided in

subsection 4, the hospitals and the providers of emergency medical services in

a county whose population is less than 700,000 are not required to participate

in the collection of data pursuant to this section unless the county health

officer, each hospital and each provider of emergency medical services in the

county agree in writing that the county will participate in the collection of

data. The county health officer shall submit the written agreement to the State

Board of Health.

      4.  If the State Board of Health

determines, in a county whose population is 100,000 or more but less than

700,000, that there are excessive waiting times at one or more hospitals in the

county for the provision of emergency services and care to persons who are in

need of such services and care and who have been transported to the hospital by

a provider of emergency medical services, the State Board of Health may require

the county to implement a system of collecting data pursuant to subsection 5

concerning the extent of waiting times and the circumstances surrounding such

waiting times.

      5.  For the purpose of collecting data

pursuant to this section, the State Board of Health shall develop a system of

collecting data concerning the waiting times of persons for the provision of

emergency services and care at a hospital and the surrounding circumstances for

such waiting times each time a person is transported to a hospital by a

provider of emergency medical services. The system must include, without

limitation, an electronic method of recording and collecting the following

information:

      (a) The time at which a person arrives at the

hospital, which is the time that the person is presented to the emergency room

of the hospital;

      (b) The time at which the person is transferred

to an appropriate place in the hospital to receive emergency services and care,

which is the time that the person is physically present in the appropriate

place and the staff of the emergency room of the hospital have received a

report concerning the transfer of the person;

      (c) If a person is not transferred to an

appropriate place in the hospital to receive emergency services and care within

30 minutes after arriving at the hospital, information detailing the reason for

such delay, which may be selected from a predetermined list of possible reasons

that are available for selection in the electronic system;

      (d) A unique identifier that is assigned to each

transfer of a person to a hospital by a provider of emergency medical services

which allows the transfer to be identified and reviewed; and

      (e) The names of the personnel of the provider of

emergency medical services who transported the person to the hospital and of

the personnel of the hospital who are responsible for the care of the person

after the person arrives at the hospital.

      6.  The State Board of Health shall ensure

that:

      (a) The data collected pursuant to subsection 5

is reported to the Division on a quarterly basis;

      (b) The data collected pursuant to subsection 5

is available to any person or entity participating in the collection of data

pursuant to this section; and

      (c) The system of collecting data developed

pursuant to subsection 5 and all other aspects of the collection comply with

the Health Insurance Portability and Accountability Act of 1996, Public Law

104-191.

      7.  The State Board of Health shall appoint

for each county in which hospitals and providers of emergency medical services

are participating in the collection of data pursuant to this section an

advisory committee consisting of the health officer of the county, a

representative of each hospital in the county and a representative of each

provider of emergency medical services in the county. Each member of the

advisory committee serves without compensation and is not entitled to receive a

per diem allowance or travel expenses for the member’s service on the advisory

committee. Each advisory committee shall:

      (a) Meet not less than once each calendar

quarter;

      (b) Review the data that is collected for the

county and submitted to the State Board of Health concerning the waiting times

for the provision of emergency services and care, the manner in which such data

was collected and any circumstances surrounding such waiting times;

      (c) Review each incident in which a person was

transferred to an appropriate place in a hospital to receive emergency services

and care more than 30 minutes after arriving at the hospital; and

      (d) Submit a report of its findings to the State

Board of Health.

      8.  The State Board of Health may delegate

its duties set forth in this section to:

      (a) The district board of health in a county

whose population is 700,000 or more.

      (b) The county or district board of health in a

county whose population is less than 700,000.

      9.  The State Board of Health or any county

or district board of health that is performing the duties of the State Board of

Health pursuant to subsection 8 shall submit a quarterly report to the

Legislative Committee on Health Care, which must include a written compilation

of the data collected pursuant to this section.

      10.  The State Board of Health may require

each hospital and provider of emergency medical services located in a county

that participates in the collection of data pursuant to this section to share

in the expense of purchasing hardware, software, equipment and other resources

necessary to carry out the collection of data pursuant to this section.

      11.  The State Board of Health shall adopt

regulations to carry out the provisions of this section, including, without

limitation, regulations prescribing the duties and responsibilities of each:

      (a) County or district board of health that is

performing the duties of the State Board of Health pursuant to subsection 8;

      (b) Hospital located in a county that

participates in the collection of data pursuant to this section; and

      (c) Provider of emergency medical services

located in a county whose population is less than 700,000 that participates in

the collection of data pursuant to this section.

      12.  The district board of health in each

county whose population is 700,000 or more shall adopt regulations consistent

with subsection 11 for providers of emergency medical services located in the

county to carry out the provisions of this section.

      13.  The State Board of Health may, in

consultation with each hospital and provider of emergency medical services

located in a county that participates in the collection of data pursuant to

this section, submit a written request to the Director of the Legislative

Counsel Bureau for transmission to a regular session of the Legislature for the

repeal of this section. Such a written request must include the justifications

and reasons for requesting the termination of the collection of data pursuant

to this section.

      14.  As used in this section:

      (a) “Emergency services and care” has the meaning

ascribed to it in NRS 439B.410.

      (b) “Hospital” has the meaning ascribed to it in NRS 449.012.

      (c) “Provider of emergency medical services”

means each operator of an ambulance and each fire-fighting agency which has a

permit to operate pursuant to this chapter and which provides transportation

for persons in need of emergency services and care to hospitals.

      (Added to NRS by 2007, 2369; A 2011, 1275)

      NRS 450B.800  Fingerprints of applicant.  An

applicant for any permit, license or certificate issued pursuant to this

chapter shall furnish to the health authority a complete set of the applicant’s

fingerprints and written permission authorizing the health authority to forward

those fingerprints to the Central Repository for Nevada Records of Criminal

History for submission to the Federal Bureau of Investigation for its report.

The health authority may exchange with the Federal Bureau of Investigation any

information respecting the fingerprints of an applicant.

      (Added to NRS by 1981, 278; A 1993, 2837; 2003, 2850)

      NRS 450B.810  Maintenance, inspection and compilation of information.  Each holder of a permit shall maintain

accurate records upon such forms as may be provided by the health authority and

containing such information as may be reasonably required by the board

concerning the care or transportation of each patient, or both, within this

state and beyond its limits. These records must be available for inspection by

the health authority at any reasonable time and copies thereof must be

furnished to the health authority upon request. This record does not constitute

a diagnosis, and a legal signature is not required on forms dealing with the

type of injury sustained by a particular patient. The health authority shall

compile and provide a summary of this information.

      (Added to NRS by 1973, 1145; A 1985, 1700; 1993, 2837)

      NRS 450B.820  Local requirements for franchise or permit are not superseded.  The issuance of a permit does not authorize

any person, firm, corporation or association to provide ambulance services or

to operate an ambulance without a franchise or permit in any county or

incorporated city which has enacted an ordinance making it unlawful to do so.

      (Added to NRS by 1973, 1146)

      NRS 450B.830  Exemptions from chapter.  The

following are exempted from the provisions of this chapter:

      1.  The occasional use of a vehicle or

aircraft to transport injured or sick persons, which vehicle or aircraft is not

ordinarily used in the business of transporting persons who are sick or

injured.

      2.  A vehicle or aircraft rendering

services as an ambulance or air ambulance in case of a major catastrophe or

emergency if ambulance or air ambulance services with permits are insufficient

to render the services required.

      3.  Persons rendering service as attendants

in case of a major catastrophe or emergency if licensed attendants cannot be

secured.

      4.  Ambulances based outside this State.

      5.  Air ambulances based outside this State

which:

      (a) Deliver patients from a location outside this

State to a location within this State; and

      (b) Do not receive any patients within this

State.

      6.  Attendants based outside this State

rendering service solely on ambulances which are exempt from the provisions of

this chapter.

      7.  Attendants rendering service solely on

air ambulances which are exempt from the provisions of this chapter.

      8.  Vehicles owned and operated by search

and rescue organizations chartered by the State as corporations not for profit

or otherwise existing as nonprofit associations which are not regularly used to

transport injured or sick persons except as part of rescue operations.

      9.  Ambulances or air ambulances owned and

operated by an agency of the United States Government.

      (Added to NRS by 1973, 1146; A 1987, 2213; 1991, 1918; 2013, 621)

      NRS 450B.840  Operation of ambulance or fire-fighting agency by county or city

subject to provisions of chapter.  No

county or city may operate an ambulance or contract to have another operate an

ambulance or provide for the operation of a fire-fighting agency in violation

of this chapter or the regulations adopted under this chapter.

      (Added to NRS by 1973, 1146; A 1985, 1700)

      NRS 450B.850  Programs for training.  The

health authority may operate training programs and may contract with others to

operate training programs for ambulance attendants, ambulance service

operators, firefighters, law enforcement officers, physicians, nurses and

others in emergency first aid, emergency care and any other techniques

associated with emergency care, transportation and treatment of the sick and

injured and the proper operation of an ambulance service.

      (Added to NRS by 1973, 1146; A 1993, 2837; 2005, 334)

      NRS 450B.860  Volunteer ambulance drivers and attendants: Discharge from

employment; civil action; disclosure to employer.

      1.  Any person or other entity who is an

employer or is vested with the power to discharge or recommend the discharge of

a person who serves as a volunteer ambulance driver or attendant shall not deprive

the person performing that service of his or her employment as a consequence of

his or her action as a volunteer ambulance driver or attendant.

      2.  A person discharged in violation of

subsection 1 may commence a civil action against the person’s employer and

obtain:

      (a) Wages and benefits lost as a result of the

violation;

      (b) An order of reinstatement without loss of

position, seniority or benefits;

      (c) Damages equal to the amount of lost wages and

benefits; and

      (d) Reasonable attorney’s fees fixed by the

court.

      3.  Any applicant for employment who is,

and any employee who becomes, a volunteer ambulance driver or attendant must

disclose that fact to his or her prospective or present employer.

      4.  As used in this section, “volunteer

ambulance driver or attendant” means a person who is a driver of or attendant

on an ambulance owned or operated by:

      (a) A nonprofit organization that provides

volunteer ambulance service in any county, city or town in this State; or

      (b) A political subdivision of this State.

      (Added to NRS by 1997, 467)

      NRS 450B.870  Medical review committee entitled to autopsy records concerning

death under review; sharing of information concerning subject of review;

autopsy records are privileged.

      1.  A medical review committee is entitled

to access to any autopsy records relating to a death under review.

      2.  Each organization represented on a medical

review committee to review the medical care or death of a person shall share

with other members of the committee information in its possession concerning

the person who is the subject of the review and any other information deemed by

the organization to be pertinent to the review.

      3.  Any autopsy records provided to a

medical review committee pursuant to this section are privileged records for

the purposes of NRS 49.119 and 49.121.

      4.  As used in this section, “medical

review committee” means a medical review committee of a county or district

board of health that certifies, licenses or regulates providers of emergency

medical services pursuant to the provisions of this chapter, but only when

functioning as a peer review committee.

      (Added to NRS by 2007, 2478)

PENALTIES

      NRS 450B.900  Penalties for violation.

      1.  Any person who violates any of the

provisions of this chapter is guilty of a misdemeanor.

      2.  In addition to any criminal penalty

imposed, the Division may impose against any person who violates any of the

provisions of this chapter, an administrative penalty in an amount established

by the State Board of Health by regulation.

      (Added to NRS by 1973, 1147; A 2011, 2513)