[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 [Repealed.]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 [Repealed.]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.
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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)