Definitions in
RCW
18.71.200,
18.71.205,
18.73.030, and
70.168.015 and the definitions in
this section apply throughout this chapter unless the context clearly requires
otherwise.
(1) "Activation of the
trauma system" means mobilizing resources to care for a trauma patient in
accordance with regional patient care procedures.
(2) "Adolescence" means the period of
physical and psychological development from the onset of puberty to maturity,
approximately twelve to eighteen years of age.
(3) "Advanced cardiac life support (ACLS)"
means a course that includes the education and clinical interventions used to
treat cardiac arrest and other acute cardiac related problems.
(4) "Advanced emergency medical technician
(AEMT)" means a person who has been examined and certified by the secretary as
an intermediate life support technician as defined in
RCW
18.71.200 and
18.71.205.
(5) "Advanced first aid" means an advanced
first-aid course prescribed by the American Red Cross or its
equivalent.
(6) "Advanced life
support (ALS)" means invasive emergency medical services requiring the advanced
medical treatment skills of a paramedic.
(7) "Agency" means an aid or ambulance
service licensed by the secretary to provide prehospital care or interfacility
ambulance transport.
(8) "Agency
response time" means the interval from dispatch to arrival on the
scene.
(9) "Aid service" means an
agency licensed by the secretary to operate one or more aid vehicles,
consistent with regional and state plans.
(10) "Ambulance service" means an agency
licensed by the secretary to operate one or more ground or air
ambulances.
(11) "Approved" means
approved by the department of health.
(12) "ATLS" means advanced trauma life
support, a course developed by the American College of Surgeons.
(13) "Attending surgeon" means a physician
who is board-certified or board-qualified in general surgery, and who has
surgical privileges delineated by the facility's medical staff. The attending
surgeon is responsible for care of the trauma patient, participates in all
major therapeutic decisions, and is present during operative
procedures.
(14) "Available" for
designated trauma services described in WAC
246-976-485 through
246-976-890 means physically
present in the facility and able to deliver care to the patient within the time
specified. If no time is specified, the equipment or personnel must be
available as reasonable and appropriate for the needs of the patient.
(15) "Basic life support (BLS)" means
emergency medical services requiring basic medical treatment skills as defined
in chapter 18.73
RCW.
(16) "Board certified" or
"board-certified" means that a physician has been certified by the appropriate
specialty board recognized by the American Board of Medical Specialties. For
the purposes of this chapter, references to "board certified" include
physicians who are board-qualified.
(17) "Board-qualified" means physicians who
have graduated less than five years previously from a residency program
accredited for the appropriate specialty by the accreditation council for
graduate medical education.
(18)
"BP" means blood pressure.
(19)
"Certification" means the secretary recognizes that an individual has proof of
meeting predetermined qualifications, and authorizes the individual to perform
certain procedures.
(20) "Consumer"
means an individual who is not associated with the EMS/TC system, either for
pay or as a volunteer, except for service on the steering committee, or
regional or local EMS/TC councils.
(21) "Continuing medical education method" or
(CME method) means prehospital EMS recertification education required after
initial EMS certification to maintain and enhance skill and knowledge. The CME
method requires the successful completion of department-approved knowledge and
practical skill certification examinations to recertify.
(22) "County operating procedures" or "COPS"
means the written operational procedures adopted by the county MPD and the
local EMS council specific to county needs.
(23) "CPR" means cardiopulmonary
resuscitation.
(24) "Critical care
transport" means the interfacility transport of a patient whose condition
requires care by a physician, RN or a paramedic who has received special
training and approval by the MPD.
(25) "Department" means the Washington state
department of health.
(26)
"Dispatch" means to identify and direct an emergency response unit to an
incident location.
(27) "Diversion"
means the EMS transport of a patient past the usual receiving facility to
another facility due to temporary unavailability of care resources at the usual
receiving facility.
(28) "E-code"
means external cause code, an etiology included in the International
Classification of Diseases (ICD).
(29) "ED" means emergency
department.
(30) "Emergency medical
procedures" means the skills that are performed within the scope of practice of
EMS personnel certified by the secretary under
chapters
18.71 and
18.73 RCW.
(31) "Emergency medical services and trauma
care (EMS/TC) system" means an organized approach to providing personnel,
facilities, and equipment for effective and coordinated medical treatment of
patients with a medical emergency or injury requiring immediate medical or
surgical intervention to prevent death or disability. The emergency medical
services and trauma care system includes prevention activities, prehospital
care, hospital care, and rehabilitation.
(32) "Emergency medical responder (EMR)"
means a person who has been examined and certified by the secretary as a first
responder to render prehospital EMS care as defined in
RCW
18.73.081.
(33) "Emergency medical technician (EMT)"
means a person who has been examined and certified by the secretary as an EMT
to render prehospital EMS care as defined in
RCW
18.73.081.
(34) "EMS" means emergency medical
services.
(35) "EMS provider" means
an individual certified by the secretary or the University of Washington School
of Medicine under
chapters
18.71 and
18.73 RCW to provide prehospital
emergency response, patient care, and transport.
(36) "EMS/TC" means emergency medical
services and trauma care.
(37)
"General surgeon" means a licensed physician who has completed a residency
program in surgery and who has surgical privileges delineated by the
facility.
(38) "ICD" means the
international classification of diseases, a coding system developed by the
World Health Organization.
(39)
"Injury prevention" means any combination of educational, legislative,
enforcement, engineering and emergency response initiatives used to reduce the
number and severity of injuries.
(40) "Interfacility transport" means medical
transport of a patient between recognized medical treatment facilities
requested by a licensed health care provider.
(41) "Intermediate life support (ILS)" means
invasive emergency medical services requiring the advanced medical treatment
skills of an advanced EMT (AEMT).
(42) "IV" means a fluid or medication
administered directly into the venous system.
(43) "Local council" means a local EMS/TC
council authorized by
RCW
70.168.120(1).
(44) "Medical control" means oral or written
direction of medical care that certified prehospital EMS personnel provide to
patients of all age groups. The oral or written direction is provided by the
MPD or MPD delegate.
(45) "Medical
control agreement" means a written agreement between two or more MPDs, using
similar protocols that are consistent with regional plans, to assure continuity
of patient care between counties, and to facilitate assistance.
(46) "Medical program director (MPD)" means a
person who meets the requirements of
chapters
18.71 and
18.73 RCW and is certified by the
secretary. The MPD is responsible for both the supervision of training and
medical control of EMS providers.
(47) "MPD delegate" means a physician
appointed by the MPD and recognized and approved by the department. An MPD
delegate may be:
(a) A prehospital training
physician who supervises specified aspects of training EMS personnel;
or
(b) A prehospital supervising
physician who provides on-line medical control of EMS personnel.
(48) "Ongoing training and
evaluation program (OTEP)" means a continuous program of prehospital EMS
education for EMS personnel after completion of initial training. An OTEP is
approved by the MPD and the department. An OTEP must meet the EMS education
requirements and core topic content required for recertification. The OTEP
method includes evaluations of the knowledge and skills covered in the topic
content following each topic presentation.
(49) "PALS" means a pediatric advanced life
support course.
(50) "Paramedic" or
"physician's trained emergency medical service paramedic" means a person who
has been trained in an approved program to perform all phases of prehospital
emergency medical care, including advanced life support, under written or oral
authorization of an MPD or approved physician delegate, examined and certified
by the secretary under
chapter
18.71 RCW.
(51) "Pediatric education requirement (PER)"
means the pediatric education and training standards required for certain
specialty physicians and nurses who care for pediatric patients in designated
trauma services as identified in WAC
246-976-886 and
246-976-887.
(52) "PEPP" means pediatric education for
prehospital professionals.
(53)
"PHTLS" means a prehospital trauma life support course.
(54) "Physician" means an individual licensed
under the provisions of
chapters
18.71 or
18.57 RCW.
(55) "Physician with specific delineation of
surgical privileges" means a physician with surgical privileges delineated for
emergency/life-saving surgical intervention and stabilization of a trauma
patient prior to transfer to a higher level of care. Surgery privileges are
awarded by the facility's credentialing process.
(56) "Postgraduate year" means the
classification system for residents who are undergoing postgraduate training.
The number indicates the year the resident is in during his/her postmedical
school residency program.
(57)
"Practical skills examination" means a test conducted in an initial course, or
a test conducted during a recertification period, to determine competence in
each of the practical skills or group of skills specified by the
department.
(58) "Prehospital index
(PHI)" means a scoring system used to trigger activation of a hospital trauma
resuscitation team.
(59)
"Prehospital patient care protocols" means the department-approved, written
orders adopted by the MPD under
RCW
18.73.030(15) and
70.168.015(27)
which direct the out-of-hospital care of patients. These protocols are related
only to delivery and documentation of direct patient treatment. The protocols
meet or exceed statewide minimum standards developed by the department in rule
as authorized in chapter 70.168 RCW.
(60) "Prehospital provider" means EMS
provider.
(61) "Prehospital trauma
care service" means an agency that is verified by the secretary to provide
prehospital trauma care.
(62)
"Prehospital trauma triage procedure" means the method used by prehospital
providers to evaluate injured patients and determine whether to activate the
trauma system from the field. It is described in WAC
246-976-930(2).
(63) "Public education" means education of
the population at large, targeted groups, or individuals, in preventive
measures and efforts to alter specific injury, trauma, and medical-related
behaviors.
(64) "Quality
improvement (QI)" or "quality assurance (QA)" means a process/program to
monitor and evaluate care provided in the EMS/TC system.
(65) "Regional council" means the regional
EMS/TC council established by
RCW
70.168.100.
(66) "Regional patient care procedures" means
department-approved written operating guidelines adopted by the regional
emergency medical services and trauma care council, in consultation with the
local emergency medical services and trauma care councils, emergency
communication centers, and the emergency medical services medical program
director, in accordance with statewide minimum standards. The patient care
procedures identify the level of medical care personnel to be dispatched to an
emergency scene, procedures for triage of patients, the level of trauma care
facility to first receive the patient, and the name and location of other
trauma care facilities to receive the patient should an interfacility transfer
be necessary. Procedures on interfacility transfer of patients are consistent
with the transfer procedures in
chapter
70.170 RCW. Patient care
procedures do not relate to direct patient care.
(67) "Regional plan" means the plan defined
in WAC
246-976-960(1)(b)
that has been approved by the
department.
(68) "Registered nurse"
means an individual licensed under the provisions of chapter 18.79
RCW.
(69) "Rural" means an
unincorporated or incorporated area with a total population of less than ten
thousand people, or with a population density of less than one thousand people
per square mile.
(70) "Secretary"
means the secretary of the department of health.
(71) "Senior EMS instructor (SEI)" means an
individual approved by the department to be responsible for the administration,
quality of instruction and the conduct of initial emergency medical responder
(EMR) and emergency medical technician (EMT) training courses.
(72) "Special competence" means that an
individual has been deemed competent and committed to a medical specialty area
with documented training, board certification and/or experience, which has been
reviewed and accepted as evidence of a practitioner's expertise:
(a) For physicians, by the facility's medical
staff;
(b) For registered nurses,
by the facility's department of nursing;
(c) For physician assistants and advanced
registered nurse practitioners, as defined in the facility's bylaws.
(73) "State plan" means the
emergency medical services and trauma care system plan described in
RCW
70.168.015(7), adopted by
the department under
RCW
70.168.060(10).
(74) "Steering committee" means the EMS/TC
steering committee created by
RCW
70.168.020.
(75) "Suburban" means an incorporated or
unincorporated area with a population of ten thousand to twenty-nine thousand
nine hundred ninety-nine or any area with a population density of between one
thousand and two thousand people per square mile.
(76) "System response time" for trauma means
the interval from discovery of an injury until the patient arrives at a
designated trauma facility.
(77)
"Training program" means an organization that is approved by the department to
be responsible for specified aspects of training EMS personnel.
(78) "Trauma rehabilitation coordinator"
means a person designated to facilitate early rehabilitation interventions and
the trauma patient's access to a designated rehabilitation center.
(79) "Trauma response area" means a service
coverage zone identified in an approved regional plan.
(80) "Trauma service" means the clinical
service within a hospital or clinic that is designated by the department to
provide care to trauma patients.
(81) "Urban" means:
(a) An incorporated area over thirty
thousand; or
(b) An incorporated or
unincorporated area of at least ten thousand people and a population density
over two thousand people per square mile.
(82) "Verification" means a prehospital
agency is capable of providing verified trauma care services and is
credentialed under
chapters
18.73 and 70.168
RCW.
(83) "Wilderness" means any
rural area not readily accessible by public or private maintained
road.