NAC450B.505. Permit required; appointment, powers and duties of medical director.

     1. Each service or fire-fighting agency providing emergency care must:

     (a) Apply for and receive a permit from the Health Division; and

     (b) Have a medical director who is responsible for developing, carrying out and evaluating standards for the provision of emergency care by the service or fire-fighting agency.

     2. The medical director of a service or fire-fighting agency shall:

     (a) Establish medical standards which:

          (1) Are consistent with standards approved by the board;

          (2) Are equal to or more restrictive than the standards of the state emergency medical system; and

          (3) Must be approved by the Health Division or a physician active in providing emergency care who is designated by the Health Division to review and make recommendations to the Health Division.

     (b) Direct the emergency care provided by any licensed attendant who is actively employed by or a volunteer with the service or fire-fighting agency.

     3. The appointment of a medical director must be approved by the Health Division or a physician with experience in emergency care who is designated by the Health Division to approve those appointments. The medical director must:

     (a) Be a physician;

     (b) Have experience in and current knowledge of the emergency care of patients who are acutely ill or injured;

     (c) Have knowledge of and access to local plans for responding to emergencies;

     (d) Be familiar with the operations of a base hospital, including communication with, and direction of, personnel who provide emergency care;

     (e) Be actively involved in the training of personnel who provide emergency care;

     (f) Be actively involved in the audit, review and critique of emergency care provided by personnel;

     (g) Have knowledge of administrative and legislative processes affecting local, regional and state systems that provide emergency medical services;

     (h) Have knowledge of laws and regulations affecting local, regional and state systems that provide emergency medical services; and

     (i) Have knowledge of procedures and treatment for advanced cardiac and trauma life support.

     4. A medical director of a service or fire-fighting agency may:

     (a) In consultation with appropriate specialists and consistent with the protocols of regional and statewide systems, establish medical protocols and policies for the service or fire-fighting agency;

     (b) Recommend to the Health Division the revocation of licensure of personnel who provide emergency care;

     (c) Approve educational requirements and proficiency levels for instructors and personnel of the service or fire-fighting agency;

     (d) Approve educational programs within the service that are consistent with accepted local, regional and state medical practice;

     (e) Suspend an emergency medical technician within that service or fire-fighting agency pending review and evaluation by the Health Division;

     (f) Establish medical standards for dispatch procedures to ensure that the appropriate response units are dispatched to the scene of a medical emergency when requested;

     (g) Establish criteria and procedures to be used when a patient refuses transportation;

     (h) Establish medical criteria for the level of care and type of transportation to be used for emergency care;

     (i) Establish standing orders and procedures and the criteria under which the providers of emergency care may operate before initiating contact with a physician at a base station; and

     (j) Conduct an audit to ensure the quality of the medical system of the service or fire-fighting agency in conjunction with the activities of the designated base hospital or health facility.

     5. The medical director of the service or fire-fighting agency may delegate his or her duties to any other qualified physician.

     6. If a medical director of a service or fire-fighting agency wishes to resign, he or she:

     (a) Shall provide written notification of such intentions to the Health Division and the service or fire-fighting agency not less than 30 days before the effective date of the resignation; and

     (b) May provide recommendations for an interim replacement.

     7. If the medical director of a service or fire-fighting agency is unable to carry out his or her responsibilities, he or she shall designate an alternate physician to assume the duties of the medical director.

     (Added to NAC by Bd. of Health, eff. 8-1-91; A by R045-97, 10-30-97; R182-01, 3-5-2002)