The following words and terms, when used in these sections, shall have
the following meanings, unless the context clearly indicates otherwise:
(1) Abandonment - Leaving a patient without medical care once
patient contact has been established, unless emergency medical services personnel
are following a physician directive or the patient signs a release; turning
the care of a patient over to an individual of lesser training when advanced
treatment modalities have been initiated to include, but not limited to, IVs,
intubation, and drug therapy.
(2) Accreditation - Formal recognition by a national association
of a provider's service or an education program based on voluntarily met standards
established by that association.
(3) Act - Emergency Medical Services Act, Health and Safety
Code, Chapter 773.
(4) Advanced life support (ALS) - Emergency prehospital
or interfacility care that uses invasive medical acts. The provision of advanced
life support shall be under the medical supervision and control of a licensed
physician.
(5) Advanced life support (ALS) vehicle - A vehicle that
is designed for transporting the sick and injured and that meets the requirements
of a basic life support vehicle and has sufficient equipment and supplies
for providing intravenous therapy and endotracheal or esophageal intubation
or both.
(6) Air ambulance provider - A person who operates/leases
a fixed-wing or rotor-wing air ambulance aircraft, equipped and staffed to
provide a medical care environment on-board appropriate to the patient's needs.
The term air ambulance provider is not synonymous with and does not refer
to the Federal Aviation Administration (FAA) air carrier certificate holder
unless they also maintain and control the medical aspects that are consistent
with EMS provider licensure.
(7) Basic life support (BLS) - Emergency prehospital or
interfacility care that uses noninvasive medical acts. The provision of basic
life support shall be under the medical supervision and control of a licensed
physician.
(8) Basic life support (BLS) vehicle - A vehicle that
is designed for transporting the sick or injured and that has sufficient equipment
and supplies for providing basic life support.
(9) Basic trauma facility - A hospital designated by the
department as having met the criteria for a Level IV trauma facility as described
in §157.125 of this title (relating to Requirements for Trauma Facility
Designation). Basic trauma facilities provide resuscitation, stabilization,
and arrange for appropriate transfer of major and severe trauma patients to
a higher level trauma facility, provide ongoing educational opportunities
in trauma related topics for health care professionals and the public, and
implement targeted injury prevention programs.
(10) Board - The Texas Board of Health.
(11) Bureau - The Bureau of Emergency Management of the
Texas Department of Health.
(12) Bureau chief - The chief of the Bureau of Emergency
Management.
(13) Bypass - Direction given to a prehospital emergency
medical services unit, by direct/on-line medical control or predetermined
triage criteria, to pass the nearest hospital for the most appropriate hospital/trauma
facility. Bypass protocols should have local physician input into their development
and should be reviewed through the regional performance improvement process.
(14) Candidate - An individual who is requesting emergency
medical services personnel certification or licensure, recertification or
relicensure from the Texas Department of Health.
(15) Certificant - Emergency medical services personnel
with current certification from the Texas Department of Health.
(16) Comprehensive trauma facility - A hospital designated
by the department as having met the criteria for a Level I trauma facility
as described in §157.125 of this title. Comprehensive trauma facilities
manage major and severe trauma patients, provide ongoing educational opportunities
in trauma related topics for health care professionals and the public, implement
targeted injury prevention programs, and conduct trauma research.
(17) Course medical director - A licensed physician approved
by the department with experience in and current knowledge of emergency care
who shall provide direction over all instruction and clinical practice required
in EMS training courses.
(18) Credit hour - Continuing education credit unit awarded
for successful completion of a unit of learning activity as defined in §157.32
of this title (relating to EMS Education Program and Course Approval).
(19) Critically injured person - A person suffering major
or severe trauma, with severe multi system injuries or major unisystem injury;
the extent of the injury may be difficult to ascertain, but which has the
potential of producing mortality or major disability.
(20) Department - The Texas Department of Health.
(21) Designation - A formal recognition by the department
of a hospital's trauma care capabilities and commitment.
(22) Diversion - A procedure put into effect by a trauma
facility to insure appropriate patient care when that facility is unable to
provide the level of care demanded by a trauma patient's injuries or when
the facility has temporarily exhausted its resources.
(23) Emergency call - a telephone call or other similar
communication from a member of the public, as part of a 9-1-1 system or other
emergency access communication system, made to obtain emergency medical services.
(24) Emergency care attendant (ECA) - An individual who
is certified by the department as minimally proficient to provide emergency
prehospital care by providing initial aid that promotes comfort and avoids
aggravation of an injury or illness.
(25) Emergency medical services (EMS) - Services used
to respond to an individual's perceived need for immediate medical care and
to prevent death or aggravation of physiological or psychological illness
or injury.
(26) Emergency medical services (EMS) operator - a person
who, as an employee of a public agency, as that term is defined by Health
and Safety Code, §771.001, receives emergency calls.
(27) Emergency Medical Service Administrator - The principal
executive manager of an emergency medical service organization who is responsible
for the non-medical operations, staffing, policies and procedures, and overall
management of the service.
(28) Emergency medical services and trauma care system
- An arrangement of available resources that are coordinated for the effective
delivery of emergency health care services in geographical regions consistent
with planning and management standards.
(29) Emergency medical services personnel -
(A) emergency care attendant (ECA);
(B) emergency medical technician (EMT);
(C) emergency medical technician-intermediate (EMT-I); or
(D) emergency medical technician-paramedic (EMT-P).
(30) Emergency medical services (EMS) provider -
A person who uses, operates or maintains EMS vehicles and EMS personnel to
provide EMS. See §157.11 of this title (relating to Requirements for
an EMS Provider License) regarding fee exemption.
(31) Emergency medical services (EMS) volunteer provider
- An EMS which has at least 75% of the total personnel as volunteers and is
a nonprofit organization. See §157.11 of this title regarding fee exemption.
(32) Emergency medical services (EMS) volunteer - EMS
personnel who provide emergency prehospital or interfacility care in affiliation
with a licensed EMS provider or a registered First Responder organization
without remuneration, except for reimbursement for expenses.
(33) Emergency medical technician (EMT) - An individual
who is certified by the department as minimally proficient to perform emergency
prehospital care that is necessary for basic life support and that includes
the control of hemorrhaging and cardiopulmonary resuscitation.
(34) Emergency medical technician-intermediate (EMT-I)
- An individual who is certified by the department as minimally proficient
in performing skills required to provide emergency prehospital or interfacility
care by initiating and maintaining under medical supervision certain procedures,
including intravenous therapy and endotracheal or esophageal intubation or
both.
(35) Emergency medical technician-paramedic (EMT-P) -
An individual who is certified by the department as minimally proficient to
provide emergency prehospital or interfacility care by providing advanced
life support that includes initiation and maintenance under medical supervision
of certain procedures, including intravenous therapy, endotracheal or esophageal
intubation or both, electrical cardiac defibrillation or cardioversion, and
drug therapy.
(36) Emergency medical services vehicle-
(A) basic life support vehicle;
(B) advanced life support vehicle;
(C) mobile intensive care unit (MICU);
(D) MICU rotor wing and MICU fixed wing air medical vehicles;
or
(E) specialized emergency medical service vehicle.
(37) Emergency prehospital care - Care provided to
the sick and injured before or during transportation to a medical facility,
including any necessary stabilization of the sick or injured in connection
with that transportation.
(38) Facility triage - The process of assigning patients
to an appropriate trauma facility based on injury severity and facility availability.
(39) General trauma facility - A hospital designated by
the department as having met the criteria for a Level III trauma facility
as described in §157.125 of this title. General trauma facilities provide
resuscitation, stabilization, and assessment of injury victims and either
provide treatment or arrange for appropriate transfer to a higher level trauma
facility, provide ongoing educational opportunities in trauma related topics
for health care professionals and the public, and implement targeted injury
prevention programs.
(40) Governmental entity - A county, a city or town, a
school district, or a special district or authority created in accordance
with the Texas Constitution, including a rural fire prevention district, an
emergency services district, a water district, a municipal utility district,
and a hospital district.
(41) Health care entity - A first responder, EMS provider,
physician, nurse, hospital, designated trauma facility, or a rehabilitation
program.
(42) Industrial ambulance - Any vehicle owned and operated
by an industrial facility as defined in the Texas Transportation Code, Chapter
541, §201, and used for initial transport or transfer of company employees
who become urgently ill or injured on company premises to an appropriate medical
facility.
(43) Interfacility care - Care provided while transporting
a patient between medical facilities.
(44) Lead trauma facility - A trauma facility that has
made an additional commitment to its trauma service area. This commitment,
which usually is offered by the highest level of trauma facility in a given
trauma service area, includes receipt of major and severe trauma patients
transferred from lower level trauma facilities. It also includes on-going
support of the regional advisory council and the provision of regional outreach,
prevention, and trauma educational activities to all trauma care providers
in the trauma service area regardless of health care system affiliation.
(45) Licensee - An individual who holds a current paramedic
license from the Texas Department of Health (department); an individual who
uses, maintains or operates EMS vehicles and EMS personnel to provide EMS
and who holds an EMS provider license from the department.
(46) Major trauma facility - A hospital designated by
the department as having met the criteria for a Level II trauma facility as
described in §157.125 of this title. Major trauma facilities provide
similar services to the Level I trauma facility although research and some
medical specialty areas are not required for Level II facilities, provide
ongoing educational opportunities in trauma related topics for health care
professionals and the public, and implement targeted injury prevention programs.
(47) Major trauma patient - A person with injuries, or
potential injuries, severe enough to benefit from treatment at a trauma facility.
These patients may or may not present with alterations in vital signs or level
of consciousness or obvious significant injuries (see severe trauma patient),
but have been involved in an incident which results in a high index of suspicion
for significant injury and/or disability. Co-morbid factors such as age and/or
the presence of significant medical problems should also be considered. These
patients should initiate a system's or health care entity's trauma response,
including prehospital triage to a designated trauma facility. For performance
improvement purposes, these patients are also identified retrospectively by
an injury severity score of 9 or above.
(48) Medical control - The supervision of prehospital
emergency medical service providers by a licensed physician. This encompasses
on-line (direct voice contact) and off-line (written protocol and procedural
review).
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