(1) The secretary verifies prehospital EMS services. Verification is a higher form of licensure that requires twenty-four-hour, seven day a week compliance with the standards outlined in chapter
70.168 RCW and this chapter. Verification will expire with the prehospital EMS service's period of licensure.
(2) To qualify for trauma verification, an agency must be a licensed ambulance or aid service as specified in WAC
246-976-260.
(3) The following EMS services may be verified:
(a) Aid service: Basic, intermediate (AEMT), and advanced (paramedic) life support;
(b) Ground ambulance service: Basic, intermediate (AEMT), and advanced (paramedic) life support;
(c) Air ambulance service.
(4) Personnel requirements:
(a) Verified aid services must provide personnel on each trauma response including:
(i) Basic life support: At least one individual who is an EMR or above;
(ii) Intermediate life support: At least one AEMT;
(iii) Advanced life support - Pramedic: At least one paramedic;
(b) Verified ambulance services must provide personnel on each trauma response including:
(i) Basic life support: At least two certified individuals - one EMT plus one EMR;
(ii) Intermediate life support: One AEMT, plus one EMT;
(iii) Advanced life support - Paramedic: At least two certified individuals - One paramedic and one EMT;
(c) Verified air ambulance services must provide personnel as identified in WAC
246-976-320.
(5) Equipment requirements:
(a) Verified BLS vehicles must carry equipment identified in WAC
246-976-300, Table A;
(b) Verified ILS and paramedic vehicles must provide equipment identified in Table A of this section, in addition to meeting the requirements of WAC
246-976-300;
(c) Verified air ambulance services must meet patient care equipment requirements described in WAC
246-976-320.
table a: equipment for verified trauma services (note: "asst" means assortments. "x" indicates required.) | ambulance | aid vehicle |
par | ils | par | ils |
airway management |
| Airway adjuncts | | | | |
| | Adjunctive airways, assorted per protocol | X | X | X | X |
| | Laryngoscope handle, spare batteries | 1 | 1 | 1 | 1 |
| | | Adult blades, set | 1 | 1 | 1 | 1 |
| | | Pediatric blades, straight (0, 1, 2) | 1 ea | 1 ea | 1 ea | 1 ea |
| | | Pediatric blades, curved (2) | 1 ea | 1 ea | 1 ea | 1 ea |
| | McGill forceps, adult & pediatric | 1 | 1 | 1 | 1 |
| | ET tubes, adult and pediatric | asst | 0 | asst | 0 |
| Supraglottic airways per MPD protocol | X | X | X | X |
| End-tidal CO2 detector | 1 ea | 1 ea | 1 ea | 1 ea |
| Oxygen saturation monitor | 1 ea | 1 ea | 1 ea | 1 ea |
trauma emergencies |
| IV access | | | | |
| | Administration sets and intravenous fluids per protocol: | | | | |
| | | Adult | 4 | 4 | 2 | 2 |
| | | Pediatric volume control device | 2 | 2 | 1 | 1 |
| | Catheters, intravenous (14-24 ga) | asst | asst | asst | asst |
| | | Needles | | | | |
| | | | Hypodermic | asst | asst | asst | asst |
| | | | Intraosseous, per protocol | 2 | 2 | 1 | 1 |
| | Sharps container | 1 | 1 | 1 | 1 |
| | Syringes | asst | asst | asst | asst |
| Glucose measuring supplies | Yes | Yes | Yes | Yes |
| Pressure infusion device | 1 | 1 | | |
| Length based tool for estimating pediatric medication and equipment sizes | 1 | 1 | 1 | 1 |
| Medications according to local patient care protocols |
(6) Aid service response time requirements: Verified aid services must meet the following minimum agency response times as defined by the department and identified in the regional plan:
(a) To urban response areas: Eight minutes or less, eighty percent of the time;
(b) To suburban response areas: Fifteen minutes or less, eighty percent of the time;
(c) To rural response areas: Forty-five minutes or less, eighty percent of the time;
(d) To wilderness response areas: As soon as possible.
(7) Ground ambulance service response time requirements: Verified ground ambulance services must meet the following minimum agency response times for all EMS and trauma responses to response areas as defined by the department and identified in the regional plan:
(a) To urban response areas: Ten minutes or less, eighty percent of the time;
(b) To suburban response areas: Twenty minutes or less, eighty percent of the time;
(c) To rural response areas: Forty-five minutes or less, eighty percent of the time;
(d) To wilderness response areas: As soon as possible.
(8) Verified air ambulance services must meet minimum agency response times as identified in the state plan.
(9) Verified ambulance and aid services must comply with the approved prehospital trauma triage procedures defined in WAC
246-976-010.
(10) The department will:
(a) Identify minimum and maximum numbers of prehospital services, based on:
(i) The approved regional EMS and trauma plans, including: Distribution and level of service identified for each response area; and
(ii) The Washington state EMS and trauma plan;
(b) With the advice of the steering committee, consider all available data in reviewing response time standards for verified prehospital trauma services at least biennially;
(c) Administer the BLS/ILS/ALS verification application and evaluation process;
(d) Approve an applicant to provide verified prehospital trauma care, based on satisfactory evaluations as described in this section;
(e) Obtain comments from the regional council as to whether the application(s) appears to be consistent with the approved regional plan;
(f) Provide written notification to the applicant(s) of the final decision in the verification award;
(g) Notify the regional council and the MPD in writing of the name, location, and level of verified services;
(h) Approve renewal of a verified service upon reapplication, if the service continues to meet standards established in this chapter and verification remains consistent with the regional plan.
(11) The department may:
(a) Conduct a preverification site visit; and
(b) Grant a provisional verification not to exceed one hundred twenty days. The secretary may withdraw the provisional verification status if provisions of the service's proposal are not implemented within the one hundred twenty-day period, or as otherwise provided in chapter
70.168 RCW and this chapter.