H-0924.1 _______________________________________________
HOUSE BILL 1427
_______________________________________________
State of Washington 54th Legislature 1995 Regular Session
By Representatives Dyer, Dellwo, Backlund, Thibaudeau and Skinner
Read first time 01/25/95. Referred to Committee on Health Care.
AN ACT Relating to emergency medical service professionals; and amending RCW 18.71.030, 18.71.200, 18.71.205, and 18.71.210.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 18.71.030 and 1994 sp.s. c 9 s 306 are each amended to read as follows:
Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer; nor shall anything in this chapter be construed to prohibit:
(1) The furnishing of medical assistance in cases of emergency requiring immediate attention;
(2) The domestic administration of family remedies;
(3) The administration of oral medication of any nature to students by public school district employees or private elementary or secondary school employees as provided for in chapter 28A.210 RCW;
(4) The practice of dentistry, osteopathy, osteopathy and surgery, nursing, chiropractic, podiatric medicine and surgery, optometry, naturopathy, or any other healing art licensed under the methods or means permitted by such license;
(5) The practice of medicine in this state by any commissioned medical officer serving in the armed forces of the United States or public health service or any medical officer on duty with the United States veterans administration while such medical officer is engaged in the performance of the duties prescribed for him or her by the laws and regulations of the United States;
(6) The practice of medicine by any practitioner licensed by another state or territory in which he or she resides, provided that such practitioner shall not open an office or appoint a place of meeting patients or receiving calls within this state;
(7) The practice of medicine by a person who is a regular student in a school of medicine approved and accredited by the commission, however, the performance of such services be only pursuant to a regular course of instruction or assignments from his or her instructor, or that such services are performed only under the supervision and control of a person licensed pursuant to this chapter;
(8) The practice of medicine by a person serving a period of postgraduate medical training in a program of clinical medical training sponsored by a college or university in this state or by a hospital accredited in this state, however, the performance of such services shall be only pursuant to his or her duties as a trainee;
(9) The practice of medicine by a person who is regularly enrolled in a physician assistant program approved by the commission, however, the performance of such services shall be only pursuant to a regular course of instruction in said program and such services are performed only under the supervision and control of a person licensed pursuant to this chapter;
(10) The practice of medicine by a licensed physician assistant which practice is performed under the supervision and control of a physician licensed pursuant to this chapter;
(11) The practice of medicine, in any part of this state which shares a common border with Canada and which is surrounded on three sides by water, by a physician licensed to practice medicine and surgery in Canada or any province or territory thereof;
(12) The administration of nondental anesthesia by a dentist who has completed a residency in anesthesiology at a school of medicine approved by the commission, however, a dentist allowed to administer nondental anesthesia shall do so only under authorization of the patient's attending surgeon, obstetrician, or psychiatrist, and the commission has jurisdiction to discipline a dentist practicing under this exemption and enjoin or suspend such dentist from the practice of nondental anesthesia according to this chapter and chapter 18.130 RCW;
(13) Emergency
lifesaving service rendered by a physician's trained ((mobile intravenous
therapy technician, by a physician's trained mobile airway management
technician, or by a physician's trained mobile intensive care paramedic)) emergency
medical service advanced life support technician, as defined in RCW
18.71.200, if the emergency lifesaving service is rendered under the
responsible supervision and control of a licensed physician;
(14) The provision of clean, intermittent bladder catheterization for students by public school district employees or private school employees as provided for in RCW 18.79.290 and 28A.210.280.
Sec. 2. RCW 18.71.200 and 1991 c 3 s 165 are each amended to read as follows:
(((1))) As used
in this chapter, a "physician's trained ((mobile intravenous therapy))
emergency medical service advanced life support technician" means a
person who:
(((a))) (1)
Has successfully completed an emergency medical technician course as described
in chapter 18.73 RCW;
(((b))) (2)
Is trained under the supervision of an approved medical program director ((to
administer intravenous solutions)) according to training standards
prescribed in rule to perform specific phases of advanced cardiac and trauma
life support under written or oral authorization of an approved licensed
physician; and
(((c))) (3)
Has been examined and certified as a physician's trained ((mobile
intravenous therapy)) emergency medical service advanced life support
technician, by level, by the University of Washington's school of
medicine or the department of health((;
(2) As used in this
chapter, a "physician's trained mobile airway management technician"
means a person who:
(a) Has successfully
completed an emergency medical technician course as described in chapter 18.73
RCW;
(b) Is trained under
the supervision of an approved medical program director to perform endotracheal
airway management and other authorized aids to ventilation under written or
oral authorization of an approved licensed physician; and
(c) Has been
examined and certified as a physician's trained mobile airway management
technician by the University of Washington's school of medicine or the
department of health; and
(3) As used in this
chapter, a "physician's trained mobile intensive care paramedic"
means a person who:
(a) Has successfully
completed an emergency medical technician course as described in chapter 18.73
RCW;
(b) Is trained under
the supervision of an approved medical program director:
(i) To carry out all
phases of advanced cardiac life support;
(ii) To administer
drugs under written or oral authorization of an approved licensed physician;
and
(iii) To administer
intravenous solutions under written or oral authorization of an approved
licensed physician; and
(iv) To perform
endotracheal airway management and other authorized aids to ventilation; and
(c) Has been
examined and certified as a physician's trained mobile intensive care paramedic
by the University of Washington's school of medicine or by the department of
health)).
Sec. 3. RCW 18.71.205 and 1994 sp.s. c 9 s 316 are each amended to read as follows:
(1) The secretary of the department of health, in conjunction with the advice and assistance of the emergency medical services licensing and certification advisory committee as prescribed in RCW 18.73.050, and the commission, shall prescribe:
(a) Practice parameters, training standards for, and levels of, physician trained emergency medical service advanced life support technicians;
(b) Minimum
standards and performance requirements for the certification and
recertification of physician's trained ((intravenous therapy technicians,
airway management technicians, and mobile intensive care paramedics)) emergency
medical service advanced life support technicians; and
(((b))) (c)
Procedures for certification, recertification, and decertification of
physician's trained ((intravenous therapy technicians, airway management
technicians, and mobile intensive care paramedics)) emergency medical
service advanced life support technicians.
(2) Initial certification shall be for a period of three years.
(3) Recertification shall be granted upon proof of continuing satisfactory performance and education, and shall be for a period of three years.
(4) As used in chapters 18.71 and 18.73 RCW, "approved medical program director" means a person who:
(a) Is licensed to practice medicine and surgery pursuant to chapter 18.71 RCW or osteopathy and surgery pursuant to chapter 18.57 RCW; and
(b) Is qualified and knowledgeable in the administration and management of emergency care and services; and
(c) Is so certified by the department of health for a county, group of counties, or cities with populations over four hundred thousand in coordination with the recommendations of the local medical community and local emergency medical services and trauma care council.
(5) The Uniform Disciplinary Act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of certificates, and the disciplining of certificate holders under this section. The secretary shall be the disciplining authority under this section. Disciplinary action shall be initiated against a person credentialed under this chapter in a manner consistent with the responsibilities and duties of the medical program director under whom such person is responsible.
(6) Such activities of physician trained emergency medical service advanced life support technicians shall be limited to actions taken under the express written or oral order of medical program directors and shall not be construed at any time to include free standing or nondirected actions, for actions not presenting an emergency or life-threatening condition.
Sec. 4. RCW 18.71.210 and 1989 c 260 s 4 are each amended to read as follows:
No act or omission of
any physician's trained ((mobile intensive care paramedic, intravenous
therapy)) emergency medical service advanced life support
technician, ((or airway management technician,)) as defined in RCW
18.71.200 ((as now or hereafter amended)), any emergency medical
technician or first responder as defined in RCW 18.73.030, done or omitted in
good faith while rendering emergency medical service under the responsible
supervision and control of a licensed physician or an approved medical program
director or delegate(s) to a person who has suffered illness or bodily injury
shall impose any liability upon:
(1) The physician's
trained ((mobile intensive care paramedic, intravenous therapy technician,
airway management technician,)) emergency medical service advanced life
support technician, or first responder;
(2) The medical program director;
(3) The supervising physician(s);
(4) Any hospital, the officers, members of the staff, nurses, or other employees of a hospital;
(5) Any training agency or training physician(s);
(6) Any licensed ambulance service; or
(7) Any federal, state, county, city or other local governmental unit or employees of such a governmental unit.
This section shall apply
to an act or omission committed or omitted in the performance of the actual
emergency medical procedures and not in the commission or omission of an act
which is not within the field of medical expertise of the physician's trained
((mobile intensive care paramedic, intravenous therapy technician, airway
management)) emergency medical service advanced life support
technician, emergency medical technician, or first responder, as the case may
be.
This section shall not
relieve a physician or a hospital of any duty otherwise imposed by law upon
such physician or hospital for the designation or training of a physician's
trained ((mobile intensive care paramedic, intravenous therapy technician,
airway management)) emergency medical service advanced life support
technician, emergency medical technician, or first responder, nor shall this
section relieve any individual or other entity listed in this section of any
duty otherwise imposed by law for the provision or maintenance of equipment to
be used by the physician's trained ((mobile intensive care paramedics,
intravenous therapy technicians, airway management)) emergency medical
service advanced life support technicians, emergency medical technicians,
or first responders.
This section shall not apply to any act or omission which constitutes either gross negligence or willful or wanton misconduct.
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