New Mexico Register / Volume XXXV,
Issue 12 / June 25, 2024
TITLE 18 TRANSPORTATION AND HIGHWAYS
CHAPTER 3 MOTOR CARRIER GENERAL
PROVISIONS
PART 14 AMBULANCE SERVICES
18.3.14.1 ISSUING AGENCY: New Mexico Department of Transportation.
[18.3.14.1
NMAC - Rp, 18.3.14.1 NMAC, 7/1/2024]
18.3.14.2 SCOPE:
A. This rule
applies to all ambulance
services subject to the jurisdiction of the department.
B. In addition
to the exemptions stated in 65-2A-38 and 65-6-6
NMSA 1978, this rule does not apply to:
(1) agencies of the United States government or
(2) ambulance
services authorized in another state or country that
are engaged in interstate transportation of patients into or out
of New Mexico.
[18.3.14.2
NMAC - Rp, 18.3.14.2 NMAC, 7/1/2024]
18.3.14.3 STATUTORY AUTHORITY: Sections 65-2A-4
and 65-6-4 NMSA 1978,
and 2023 N.M. Laws, Chapter 100, Section 81.
[18.3.14.3 NMAC - Rp, 18.3.14.3 NMAC, 7/1/2024]
18.3.14.4 DURATION: Permanent.
[18.3.14.4
NMAC - Rp, 18.3.14.4 NMAC, 7/1/2024]
18.3.14.5 EFFECTIVE
DATE:
July 1,
2024, unless a later date is cited within a section.
[18.3.14.5
NMAC - Rp, 18.3.14.5 NMAC, 7/1/2024]
18.3.14.6 OBJECTIVE: The purpose
of this rule is to establish requirements for ambulance
vehicles, equipment, operations, drivers and attendant services.
[18.3.14.6
NMAC - Rp, 18.3.14.6 NMAC, 7/1/2024]
18.3.14.7 DEFINITIONS:
In addition to the definitions in 7.27.2
NMAC, as used in this rule:
A. advanced level
means emergency
medical services above the New
Mexico Emergency Medical Technician (EMT) basic level including EMT intermediate, EMT paramedic, and special
skills which include
enhanced emergency
medical
services and critical care transport;
B. critical care transport (CCT) means
the inter-facility ambulance
transportation of patients requiring critical care and medical interventions or
equipment ordered by a licensed physician.
CCT may be provided only by an ambulance agency that has received
special skill approval by the department of health (DOH) emergency medical services
(EMS) bureau and EMS medical direction committee for CCT. Critical care includes the use of specialized
ventilators, multiple medications being monitored via intravenous (IV) pumps,
intra-aortic balloon pumps, and external pacemakers.
C. emergency medical technician basic (EMT
basic) means
the pre-hospital
and
inter-facility care and treatment identified in the EMS scope of practice rules issued by the department of
health for application by all licensed emergency
medical technicians;
D. emergency medical technician intermediate (EMT intermediate) means certain advanced pre-hospital
and
inter-facility care and treatment
identified in the EMS scope of practice rules issued by the department of
health for application by licensed EMT intermediates
operating pursuant to physician directives;
E. emergency medical technician paramedic (EMT paramedic) means advanced pre-hospital assessment, and inter-facility care
and
treatment identified in the EMS scope of practice rules issued by
the department of health for application by a
licensed EMT paramedic operating pursuant to physician directive;
F. emergency means the sudden occurrence or onset of what reasonably
appears to be a traumatic or medical
condition that manifests itself by symptoms of sufficient severity,
which may include
severe pain, that the
absence
of immediate medical
attention could reasonably be expected by a lay person to result in;
(1) jeopardy
of the person’s physical and or mental health;
(2) serious impairment of bodily
functions;
(3) serious dysfunction of any
bodily organ or part; or
(4) disfigurement to the person.
G. EMS means emergency
medical services.
H. EMS bureau is the emergency medical systems bureau in the New Mexico department of
health.
I. inter-facility transport means
the transportation of a person between health care
facilities under the directive of a sending and a receiving
physician;
J. mutual aid agreement means a written
agreement between
one municipality, county or emergency medical
service and other municipalities, counties or emergency medical
services for the purpose of ensuring
adequate coverage of emergency medical services in their respective authorized territories;
K. NEMSIS
means the national emergency medical services information system, the
federal EMS data collection system administered by the United State department
of transportation national highway traffic safety administration (NHTSA).
L. NMEMSTARS
means the New Mexico EMS tracking and reporting system of pre-hospital data, and includes any subsequent contractor of these
services by the department of health’s EMS bureau.
M. patient catchment area means an area outside the territory
authorized by the operating
authority
issued by the commission that an ambulance service
is permitted to serve
in emergencies
or
pursuant to mutual aid agreements;
N. pre-hospital response time means the period in minutes that measures from the
time a dispatch agency has the
necessary information to dispatch an ambulance
service until the time an EMS
crew arrives at the scene
of
the emergency;
O. special event ambulance means an ambulance staffed with a minimum of two
licensed EMT’s, working under agreement or contract within its authorized
territory or pursuant to a grant of
temporary authority in dedicated stand-by status at a special event such as a football
game, concert, wildland fire event,
rodeo, community festival or movie set..
[18.3.14.7
NMAC - Rp, 18.3.14.7 NMAC, 7/1/2024]
18.3.14.8 DUTY TO PROVIDE
SERVICE:
A. It
shall be unlawful for an ambulance
service, or any of its
personnel or agents, to refuse to provide service to a willing
person in need of emergency
medical treatment or transportation, or to require
advance payment prior to rendering such service. A responding ambulance service may comply
with a written refusal of treatment or transport from a patient or guardian who
has been informed of the potential medical consequences of such a refusal. All written refusals must be maintained as an
ambulance service record.
B. When ambulance transport is requested and is determined
to be necessary upon review by an ambulance
service, the patient shall be delivered to the closest
appropriate
facility capable of providing definitive care and treatment, as determined by the
service’s medical director through
local EMS system protocol.
C. An ambulance service
shall give priority to
emergency response calls.
D. An ambulance service
shall be available24 hours a
day, every day of the year.
[18.3.14.8
NMAC - Rp, 18.3.14.8 NMAC, 7/1/2024]
18.3.14.9 MUTUAL
AID: Ambulance services
shall develop mutual aid agreements
with all appropriate entities
that may be implemented anytime an ambulance
service cannot respond to a call or if a disaster
or mass casualty situation occurs. Mutual
aid may
be provided pursuant to an
established written agreement or when requested by state or local authorities, including
law enforcement.
[18.3.14.9
NMAC - Rp, 18.3.14.9 NMAC, 7/1/2024]
18.3.14.10 OPERATIONS PLAN: Each ambulance
service shall have a written operations plan setting forth
its policies and procedures. The plan shall be periodically
updated and shall be available for inspection
by the department at all times. The
plan shall include:
A. all
operational guidelines and medical
protocols;
B. a
quality assurance plan;
C. personnel policies for drug and alcohol testing of
employees who present as impaired while on duty or are suspected of impairment
related to a work related accident or event;
D. all
mutual
aid agreements;
E. a
disaster and mass casualty plan;
F. infection
control procedures;
G. a
description of emergency medical dispatch capabilities;
H. work schedule standards to ensure staff
are rested and fit-for-duty; and
I. anticipated pre-hospital
response times in the ambulance service’s
territory or patient catchment area, and a description of factors that
could cause delays to those
response times.
Factors
may include:
(1) topography
of service territory;
(2) staffing issues (ex. volunteers, remote
residency, high turnover);
(3) density or specific challenges presented by
population served (ex. industrial risk, socio-economic factors, behavioral
health needs, language barriers);
(4) stationing points for ambulances and crews;
and
(5) variance in weather conditions.
[18.3.14.10
NMAC - Rp, 18.3.14.10 NMAC, 7/1/2024]
18.3.14.11 MINIMUM PERSONNEL
REQUIREMENTS:
A. Ambulances:
(1) A minimum of two licensed EMTs from the
ambulance service shall be present at the scene of the emergency, except that two EMTs need not be present
at the scene for prearranged transfers
of a stable patient or in those
situations where there are overlapping calls, disasters, or similar circumstances which result
in
an insufficient
number of EMTs being available.
(2) A
minimum of one EMT shall
be in the patient
compartment during patient care and transport.
B. Exceptions:
(1) An EMT is required to be aboard the ambulance
but is not required in the patient compartment, when a member
of
a neonatal intensive
care team is attending a patient in a
self- contained newborn intensive care
isolette.
(2) Subject
to the policies
of the service, additional non-EMT medical personnel, functioning within the scope of their licensure
and the scope of skills and medications approved for the service by the EMS
Bureau and EMS medical direction committee,
may accompany
a patient in an ambulance patient compartment, as long as one EMT is also present
in the
patient compartment.
(3) For
ambulances with approval as critical care units, one special skill critical
care certified paramedic must be in the patient compartment along with at least
one advanced provider who is:
(a) a
special skill critical care paramedic; or
(b) a
nurse trained and approved by the EMS agency medical director for the scope of
skills and medications listed in the critical care special skills application;
or
(c) other
advanced care provider, such as a physician, certified nurse practitioner, physician
assistant, respiratory therapist, or other specially trained caregiver
appropriate for the advanced care needed, as determined by the ambulance
service’s medical director.
(4) For
EMS bureau approved community EMS or advanced paramedic practice programs, at
least one caregiver trained and certified as required by the EMS bureau, and
approved by the ambulance service’s medical director, must attend and assess
the patient.
C. Training coordinator required: Each ambulance service
shall designate a coordinator
of
appropriate training and continuing education required
for all ambulance service personnel.
D. Medical director required: Each
ambulance service shall designate a medical
director, working under agreement
or contract, who meets the department
of health requirements prescribed in 7.27.3 NMAC.
If an ambulance service is temporarily without a medical director, it shall establish temporary medical direction services with a local,
regional or state EMS medical
director.
[18.3.14.11
NMAC - Rp, 18.3.14.11 NMAC, 7/1/2024]
18.3.14.12 VEHICLE
LIST:
A. Each ambulance
service shall maintain a current
list of ambulances
used in its authorized
operations. The list shall identify each ambulance by type (I, II, III), manufacturer, serial number, registration number, and other descriptive
information sufficient for
identification, and shall state whether the ambulance
is leased or owned.
B. An
ambulance service may only use ambulances on the vehicle
list, unless the service is temporarily utilizing a borrowed vehicle from
another EMS agency due to unusual and unforeseen circumstances (repair of
vehicles or other situations). The
department shall be notified in writing if this temporary situation persists
longer than seven consecutive days.
C. An ambulance service
shall submit an updated vehicle list to the department within 10 days of the date an ambulance unit
is either put into service or taken out
of service.
[18.3.14.12
NMAC - Rp, 18.3.14.12 NMAC, 7/1/2024]
18.3.14.13 VEHICLE STANDARDS: All ambulances
purchased, acquired, or placed into service
by an authorized EMS service shall meet or exceed
the general services administration (GSA) standards for operation, crash performance and safety.
[18.3.14.13
NMAC - Rp, 18.3.14.13 NMAC, 7/1/2024]
18.3.14.14 REQUIRED EQUIPMENT:
When an ambulance is dispatched, it shall carry and have readily available equipment in good working order, including:
A. one semi-automatic
defibrillator for
EMT basic and EMT intermediate use or
one semi-automatic/manual defibrillator monitor for paramedic use, as specified
in the EMS scopes of practice and local medical
protocol;
B. suction
systems, which include:
(1) on-board suction
unit that meets GSA standards;
(2) portable,
manual
or
battery powered suction unit;
C. oxygen delivery and patient ventilation devices, which include:
(1) fixed, on-board
oxygen supply which meets GSA specifications;
(2) portable oxygen devices
which are capable of delivering at least 60 minutes of oxygen at a flow rate of 10 liters per minute or, at a minimum, two D
cylinders; at least one cylinder
shall be designated as primary and configured with a yoke type regulator, liter control
and contents supply gauge;
(3) ventilation devices
including manual, self-filling, bag-valve-mask (BVM) ventilation devices,
in adult, child, infant and
neonatal sizes; the BVM shall be equipped with a sufficient supply of see through adult, child, infant, and neonatal masks; electronic or colormetric end
tidal carbon dioxide detection equipment for adults and pediatric patients are
also required;
D. Splints, including
as a minimum:
(1) one adult traction splint with limb
supporting slings, padded ankle hitch and traction device;
(2) two sets of rigid
splinting devises, or equivalents, suitable for the immobilization of upper or
lower extremities, in adult, child and infant sizes;
E. spine immobilization devices, one half-body device and two full-body devices, with suitable strapping, and head immobilization devices; commercial devices that
stabilize head, neck, and back as one unit,
may be
substituted;
F. one commercially available obstetrical kit, or equivalent;
G. one sphygmomanometer in adult, child and infant sizes, or one sphygmomanometer capable of accepting various
sizes of cuffs (adult, child, and
infant); in the latter case, a sufficient supply of cuffs in each of the identified
sizes shall be available;
H. one stethoscope;
I. two double D-cell, or equivalent, functioning flashlights;
J. one all-purpose multi-level
ambulance stretcher,
with safety straps and crash-resistant locking/securing mechanism; the locking
mechanism in the vehicle shall be the mechanism
designed for the
stretcher being used; locking mechanisms for other stretchers or locally produced
mechanisms are not allowed; in addition, the mattress
shall be fluid impervious;
K. one minimum
10-pound, or two minimum five-pound 1A20BC,
or equivalent, fire extinguisher; a current inspection
tag will be displayed on all fire extinguishers;
L. one two-way mobile
radio capable of direct communication between
the EMT and the receiving medical facility, on ultra-high frequency, on federal communications commission-designated
emergency medical radio service
(EMRS) frequencies, and which is
compatible
with the state emergency
medical services radio communications system (EMSCOM), and is
approved by the emergency medical services bureau (EMSB) and a copy
of the EMSB/DOH “EMS communications
system (EMSCOM) manual;”
M. scene safety protective equipment including:
(1) six highly visible lighted electric or chemical warning devices
suitable for nighttime use;
(2) reflective apparel
meeting American National standards
institute standards for all
personnel;
(3) a current edition of the “North American emergency response guidebook,” a guidebook for first
responders during the initial phase of a hazardous materials/dangerous goods incident;
N. uniforms or other apparel
or means of identification of a distinct
design or fashion to be worn
by ambulance service personnel when on duty
to identify
them
as EMS providers and to identify
the
level of EMS care for which the providers are licensed.
[18.3.14.14
NMAC - Rp, 18.3.14.14 NMAC, 7/1/2024]
18.3.14.15 REQUIRED SUPPLIES: When an ambulance is dispatched, it shall
carry adequate quantities of readily available supplies to ensure the level of
care described in the ambulance service protocols signed by the physician
medical director, including but not limited to:
A. 12 sterile bandages, soft roller, self-adhering type,
or equivalent to a total length of 24 yards;
B. six triangular bandages or equivalent product or substitute;
C. one box adhesive bandages;
D. one pair
trauma
shears and one penlight (either in the ambulance or on the EMT’s person);
E. one pair sterile
scissors used for cutting the umbilical
cord during a delivery;
commercially available sterile cutting devices
may be
substituted;
F. six sterile trauma dressings
in large and small
sizes;
G. 50,
or adequate supply, sterile 4" x 4", or larger, sponges;
H. four rolls of
adhesive tape;
I. four cold packs and four heat packs;
J. two sterile burn sheets,
individually wrapped;
K. four sterile burn dressings;
L. two sets of oropharyngeal airways in sizes zero through five (infant through adult),
and one set of nasopharyngeal airways (28FR, 32FR, 34FR, and 36FR, all for
adult use);
M. three sterile suitable
occlusive dressings;
N. two sets of rigid cervical collars of plastic, not foam, construction in various sizes for
adult, child and infant;
commercially
available immobilization devices
are allowed;
O. a sufficient quantity of appropriate airborne and blood-borne infection control supplies, as recommended by
the
centers for disease
control and prevention, including gloves,
masks, gowns, caps, eye protection, sharps containers, and
other equipment to protect all patient care providers
dispatched with the ambulance;
in addition, appropriate hand-washing supplies and disinfectant
shall be available on the vehicle;
P. at least two disposable high-concentration oxygen masks and two disposable
nasal cannulas in adult and
child sizes and at
least two packages of oxygen supply
tubing;
Q. appropriate large and small bore
tip suction catheters
(6f-14f), rigid tip suction catheter, and hoses;
R. one bulb suction device;
S. one emesis basin or large plastic bag;
T. two liters of sterile water, normal saline, or other
appropriate irrigation solution; and
U. two clean sets of linen,
including at least two blankets and pillows (or
suitable pillow substitutes) at all times.
[18.3.14.15
NMAC - Rp, 18.3.14.15 NMAC, 7/1/2024]
18.3.14.16 MEDICATIONS:
An ambulance
service shall adhere to the appropriate
EMS
scopes of practice for EMS personnel
regarding approved medications, provided the medications are
listed in the service’s treatment guidelines or protocols and approved by the
physician medical director for use by the ambulance service. In some
cases the medical direction committee may authorize
special skills that allow unique medications not found in the scopes of practice. In such cases, these medications are allowed on the vehicle
for use by the authorized personnel, as specified
by the special skills approval
letter provided by the
EMS medical direction committee
or the
EMS bureau. In all
cases, medications shall only be administered under medical direction, as specified in the scopes of practice and any
special skills approval letters.
[18.3.14.16
NMAC - Rp, 18.3.14.16 NMAC, 7/1/2024]
18.3.14.17 PORTABLE
MEDICAL KITS: In addition
to the required equipment and
supplies, every ambulance
shall carry at least one portable medical
kit containing the following items, or their appropriate
equivalent:
A. one sphygmomanometer in
adult, child and infant sizes, or one sphygmomanometer capable of accepting various
sizes of cuffs (adult, child, and infant).
In the latter case, a sufficient supply of cuff in each of the identified sizes shall be available.
B. one stethoscope;
C. four soft roller, self-adhering type bandages;
D. three triangular bandages or equivalent product/substitute;
E. two trauma dressings;
F. 10 size 4" x 4"
gauze sponges;
G. one roll adhesive tape;
H. one pair of trauma shears
(either in the ambulance or on the EMT’s person);
I. one penlight (either in the ambulance or on the EMT’s person);
J. two
sterile burn dressings;
K. one adult-size bag-valve-mask (BVM) ventilation device.
Neonate, infant and child BVM
must be incorporated in the kit
or
readily available aboard the vehicle;
L. one set of oropharyngeal airways, sizes 0 through 6 (neonatal through adult);
M. two sterile, petroleum gel-impregnated gauze dressings, or other suitable
occlusive dressings;
N. multiple pairs of disposable treatment
gloves;
[18.3.14.17
NMAC - Rp, 18.3.14.17 NMAC, 7/1/2024]
18.3.14.18 ADVANCED LEVEL AMBULANCE
SERVICES:
A. Service requirements: An ambulance
service shall meet the following
requirements before
it provides any advanced level treatments
or
procedures, including special
skills:
(1) If an ambulance
service represents itself or labels
its vehicles as a provider of service at any level above EMT basic, that advanced level of care and treatment
shall be provided 24 hours a
day, every day of the year, except in
those unusual situations where there are overlapping calls, disasters, or similar unforeseen circumstances.
(2) At
least one trained and licensed
advanced provider must respond to a call
and accompany the patient in the patient compartment of the ambulance.
B. Additional supplies and equipment
requirements: The following additional items are required for advanced level ambulance services:
(1) one semi-automatic monitor-defibrillator for
EMT intermediate or manual/semi automatic monitor
- defibrillator for EMT paramedic,
as specified in the EMS scopes
of
practice and local
medical
protocol;
(note: these devices require
specific training and medical director approval prior to use);
(2) assorted arm boards in infant,
child and adult
sizes;
(3) assorted intravenous catheters
in sizes 14-24 gauge;
(4) assorted macro-drip IV devices to infuse intravenous
fluids into adults
(15 drops per cc or better);
(5) assorted micro-drip IV devices to manage IV administration to infants and children;
thesemay be burettes, micro-drip tubing or in-line volume controllers;
(6) two intra-osseous
access devices;
(7) one pediatric
drug dosage chart or
tape; this may include charts listing the drug dosages
in milliliters
or
milligrams per kilogram,
pre-calculated doses based on weight,
or
a tape that generates appropriate equipment sizes and drug
doses based on the patient's height or weight;
(8) assorted intravenous (IV) fluids that
comply
with the EMS scopes of practice;
these fluids shall be stored within the manufacturers recommended temperature range at
all times until use;
(9) one laryngoscope with straight
or curved blades in infant, child and adult sizes; spare bulbs and batteries shall be
readily available;
(10) two adult
stylets for endotracheal tubes; if service has special skill approval for
pediatric (under age 12) intubation, two pediatric stylets must be in stock;
(11) one each pediatric and adult magill forceps;
(12) assorted endotracheal tubes in sizes: uncuffed
2.5-6.0 if service has special skill approval for pediatric (under age
12) intubation and cuffed 6.0-8.0;
(13) assorted medications and resuscitation medications that
are allowed in the EMS scopes of
practice and local medical protocol; these medications shall be stored within the manufacturer's recommended temperature range at
all times;
(14) adult and pediatric
sized supraglottic/laryngeal airways, and multi-lumen airways as approved by the
service’s medical director.
[18.3.14.18
NMAC - Rp, 18.3.14.19 NMAC, 7/1/2024]
18.3.14.19 NON-EMERGENCY
AND INTERFACILITY TRANSPORT: An ambulance service
may provide scheduled pre-hospital
or
inter-facility transport
of
patients, including physically or mentally impaired patients or non-ambulatory patients, who require the attending care and
monitoring of qualified medical personnel. Only certified ambulances shall
transport recumbent patients requiring medical monitoring. An ambulance
service providing such service shall:
A. provide at least
one EMT of the appropriate service
level and one qualified driver; the EMT shall
be in the patient compartment attending the patient whenever a patient
is being cared for or transported.
B. Stretcher
or wheelchair vans:
A stretcher or wheelchair van may be
used to transport a person who is:
(1) Non-ambulatory and requires non-emergency
medical transportation
and does not require medical monitoring or
treatment during transport.
(2) An
inpatient who requires transportation to another facility for diagnostic tests and a physician
authorizes the use of a stretcher van.
C. A stretcher van or wheelchair van shall not
transport a person who:
(1) Is being administered intravenous
fluids;
(2) Needs
oxygen, unless that person’s physician has prescribed oxygen as a
self-administered therapy;
(3) Needs suctioning;
(4) Has
a visible injury not yet evaluated by a medical
professional;
(5) Is
experiencing an acute condition or the exacerbation of a chronic condition;
(6) Needs
to be transported from one hospital to another hospital if the destination
hospital is
the
same level or a higher level as the hospital of origin.
(7) Is
being medically monitored at the sending facility and will continue to be
medically
monitored
at the destination facility.
[18.3.14.19
NMAC - Rp, 18.3.14.20 NMAC, 7/1/2024]
18.3.14.20 SPECIAL
EVENT AMBULANCE: Emergency transports for special events are not
inter-facility transfers unless that definition is met. Dedicated stand-by status ambulances shall not
respond to emergency calls off site of the event except in cases of disaster,
mass casualty or other unusual medical circumstance.
[18.3.14.20
NMAC - Rp, 18.3.14.21 NMAC, 7/1/2024]
18.3.14.21 MAINTENANCE, PRESERVATION, AND RETENTION OF RECORDS:
In addition to the record
requirements for motor carriers, every ambulance
service shall maintain accurate and separate
records of its services in New Mexico, including:
A. driver records with current licenses, history of department of transportation (DOT) physical examinations, approved firefighter fitness exam certification
or other approved physician
certifications, and emergency
vehicle operator training history;
B. EMS personnel
licensure;
C. statement of employment or volunteer status,
including start and stop dates;
D. records of equipment to
include inspection, repair and maintenance
records, equipment lists, vehicle title and registration certificates;
E. organized records of all ambulance runs, including
a copy of the patient care record.
[18.3.14.21 NMAC -
Rp, 18.3.14.23 NMAC, 7/1/2024]
18.3.14.22 QUALITY ASSURANCE: Each ambulance service
shall have a written quality assurance program, which shall provide for.
A. patient care records retention: an ambulance
service shall retain pre-hospital patient care records for seven years, as approved by local
medical protocol;
B. reporting: ambulance services
shall complete a patient run report for each patient contacted during an emergency response
or inter-facility transport;
the minimum data elements
from these reports, as identified
by the EMS bureau,
shall be compiled to the extent possible and submitted to the
pre- hospital data collection system at the EMS bureau as prescribed in 7.27.4 NMAC,
Emergency Medical Services Fund Act;
C. minimum patient information required upon patient delivery to the destination facility:
pursuant to ambulance
service protocol, an ambulance
service shall communicate,
electronically or in writing, clinical patient information to the intercepting ambulance or receiving facility at the time of patient transfer
or delivery, if available:
(1) ambulance
unit number, EMT name
and level of licensure;
(2) patient
age and sex;
(3) patient's
chief complaint
or EMT’s primary impression;
(4) a
brief history of the present illness,
including scene assessment and mechanism of injury;
(5) major
past illnesses;
(6) patient's mental
status;
(7) patient's
baseline vital signs;
(8) pertinent findings of the physical examination;
(9) description of emergency medical
care that has been provided
for the patient, including that
provided by any first response units; and
(10) the
patient's response to the emergency medical
care received.
D. completed patient care records: an ambulance service
shall deliver an electronic or written copy of the completed
pre-hospital patient care record to the
receiving facility emergency department
for inclusion in the patient's permanent
medical record upon delivery of the patient
to the hospital; in the event
the
unit is dispatched on another call, the patient
care record shall be delivered as soon as possible
after that call, but not later than the
end of a shift or twenty four
(24) hours after the transportation and treatment of the patient;
E. medical protocols and operational
guidelines: the ambulance service medical director shall develop
and approve medical
protocols and operational
guidelines which should include procedures for obtaining on-line medical direction; service medical
protocols shall not exceed the New Mexico EMS scope of practice, unless a
special skill has been granted; medical protocols and operational guidelines
should be developed in collaboration with receiving hospitals and EMS agencies
within the territory or patient catchment area; adult and pediatric patient protocols
shall be on the unit at all times, in electronic or hard copy form;
F. medical
director review of patient care: an
ambulance service medical director shall review patient care records at least quarterly to determine whether appropriate medical care is being provided; the medical director shall document the
steps taken during the review;
subsequent reviews will include an evaluation of whether appropriate follow-up has been accomplished; receiving hospitals and
other EMS agencies within the patient catchment area should be invited to
participate in these reviews when appropriate;
G. confidentiality of medical records: an ambulance service may
only release patient care records as provided
by state and federal law, including but not limited to the Health
Insurance Portability and Accountability Act (HIPAA).
[18.3.14.22
NMAC - Rp, 18.13.14.24 NMAC, 7/1/2024]
18.3.14.23 - 18.3.14.26 [RESERVED]
HISTORY OF 18.3.14
NMAC:
Pre-NMAC history: The material
in this
rule was previously filed with the state records center as: SCC 68-16, NM Motor Carrier
Act, Rules and Regulations, Effective Sept. 1, 1967, filed 3-14-68; SCC 68-50, General Order No. 38, filed 6/13/1968;
SCC 71-3, General
Order No. 40, Docket No. 532, filed 5/24/1971;
SCC 71-5, General
Suspension Order No. 41, Docket No. 540, filed 8/20/1971;
SCC 71-6, NM Motor Carrier Act, Rules and Regulations, Effective July 1,
1971, filed 9/21/1971; SCC-72-13, NM Ambulance Tariff No. 3-B Issued May 8, 1972, filed 10/2/1972;
SCC 73-1, NM Motor Carrier Act, Rules and Regulations, filed 6/14/1973;
SCC 74-1, NM Motor Carrier Act, Rules and Regulations, Effective July 1,
1973, filed 2-5-74; SCC 75-1, NM Motor Carrier
Act, Rules and Regulations, Effective Jan. 1, 1975, filed 4/17/1975;
SCC 75-2, Second Revised
General Order No. 35, In the Matter
of Standards for Ambulance
Operators, filed 7/11/1975;
SCC 75-3, NM Motor Carrier Act, Rules and Regulations (Rev.), Effective Jan. 1, 1975, filed 9/19/1975;
SCC 76-1, NM Motor Carrier Act, Rules and Regulations, Effective April 1,
1976, filed 4/15/1976;
SCC 77-1, NM Motor Carrier Act, Rules and Regulations, Effective Jan. 1, 1977, filed 1/25/1977; SCC-77-4, NM Ambulance Tariff No. 3-B Issued May 8, 1972, (Reissue), filed 6/6/1977;
SCC 78-1, Third Revised
General Order No. 35, In the Matter of Standards for Ambulance
Operators, filed 9/5/1978;
SCCMC Rule No. 45, Ambulance Operators
are Authorized to Provide the Following Service
Notwithstanding
Territorial
Restrictions Contained in their Certificates, filed 3/5/1982;
SCCMC Rule No. 49, Ambulance Services
- Duty to Provide
Service, filed 3/5/1982;
SCC 84-5-TD, Standards for Ambulance
Operators - Seventh
Revised General Order No. 35, filed 6/28/1984;
SCC 92-5-TR, Ambulance Standards Rule, filed 8/18/1992;
SCC Rule 252, Ambulance Standard,
filed 1/5/1993; SCC Rule 252,
Ambulance Standards, filed 10/27/1993.
HISTORY OF REPEALED MATERIAL:
SCC 68-16, NM Motor Carrier Act, Rules and Regulations, Effective Sept. 1, 1967 (filed 3/14/1968); SCC 68-50, General Order No. 38(filed 6/13/1968);
SCC 71-3, General
Order No. 40, Docket No. 532 (filed 5/24/1971);
SCC 71-5, General
Suspension Order No. 41, Docket No. 540 (filed 8/20/1971);
SCC 71-6, NM Motor Carrier Act, Rules and Regulations, Effective July 1,
1971 (filed 9/21/1971); SCC-72-13, NM Ambulance Tariff No. 3-B Issued May 8, 1972 (filed 10/2/1972);
SCC 73-1, NM Motor Carrier Act, Rules and Regulations (filed 6/14/1973);
SCC 74-1, NM Motor Carrier Act, Rules and Regulations, Effective July 1,
1973 (filed 2/5/1974); SCC 75-1, NM Motor Carrier
Act, Rules and Regulations, Effective Jan. 1, 1975 (filed 4/17/1975);
SCC 75-2, Second Revised
General Order No. 35, In the Matter of Standards
for Ambulance Operators (filed
7/11/1975);
SCC 75-3, NM Motor Carrier Act, Rules and Regulations (Rev.), Effective Jan. 1, 1975 (filed 9/19/1975);
SCC 76-1, NM Motor Carrier Act, Rules and Regulations, Effective April 1,
1976 (filed 4/15/1976);
SCC 77-1, NM Motor Carrier Act, Rules and Regulations, Effective Jan. 1, 1977 (filed 1/25/1977); SCC-77-4, NM Ambulance Tariff No. 3-B Issued May 8, 1972, (Reissue) (filed 6/6/1977);
SCC 78-1, Third Revised
General Order No. 35, In the Matter of Standards for Ambulance
Operators (filed 9/5/1978);
SCCMC Rule No. 45, Ambulance Operators
are Authorized to Provide the Following Service
Notwithstanding
Territorial
Restrictions Contained in their Certificates (filed 3/5/1982);
SCCMC Rule No. 49, Ambulance Services
- Duty to Provide
Service (filed 3/5/1982);
SCC 84-5-TD, Standards for Ambulance
Operators - Seventh Revised
General Order No. 35 (filed 6/28/1984); SCC 92-5-TR, Ambulance Standards
Rule (filed 8/18/1992);
SCC Rule 252, Ambulance Standard
(filed 1-5-93); SCC Rule 252,
Ambulance Standards
(filed 10/27/1993);
18 NMAC 4.2,
Ambulance and Medical Rescue Services (filed 12/16/1997) repealed 1/5/2005.
18.3.14
NMAC, Motor Carrier General Provisions - Ambulance Services, filed 12/16/2004,
repealed 2/13/2015.
18.3.14
NMAC, Motor Carrier General Provisions - Ambulance Services, filed 1/28/2015,
repealed 7/1/2024.
Other history:
SCC Rule 252, Ambulance
Standards (filed 10/27/1993) renumbered, reformatted and replaced by 18 NMAC 4.2, Ambulance and Medical Rescue Services, effective
1/1/1998;
18 NMAC 4.2,
Ambulance and Medical Rescue Services (filed 12/16/1997) renumbered, reformatted and replaced by 18.3.14 NMAC, Ambulance Services,
effective 1/1/2005.
18.3.14 NMAC, Ambulance
and Medical Rescue Services (filed 1/28/2015) replaced by 18.3.14
NMAC, Ambulance Services,
effective 7/1/2024.