Section 836IAC1-1-1. Definitions

   The following definitions apply throughout this title unless the context clearly denotes otherwise:

(1) "14 CFR 135 and 14 CFR 119" means air carriers with reference to F.A.R. 135 and 119, and holding a current F.A.A. air carrier certificate, with approved air ambulance operations-helicopter or air ambulance operation-airplane operations specifications.

(2) "Advanced life support", for purposes of IC 16-31, means the following:

(A) Care given:

(i) at the scene of an:

(AA) accident;

(BB) act of terrorism (as defined in IC 35-41-1-26.5 [IC 35-41-1-26.5 was repealed by P.L.114-2012, SECTION 132, effective July 1, 2012.]), if the governor has declared a disaster emergency under IC 10-14-3-12 in response to the act of terrorism; or

(CC) illness;

(ii) during transport; or

(iii) at a hospital;

by a paramedic, emergency medical technician-intermediate, and that is more advanced than the care usually provided by an emergency medical technician or an emergency medical technician-basic advanced.

(B) The term may include any of the following:

(i) Defibrillation.

(ii) Endotracheal intubation.

(iii) Parenteral injection of appropriate medications.

(iv) Electrocardiogram interpretation.

(v) Emergency management of trauma and illness.

(3) "Advanced life support fixed-wing ambulance service provider organization" means a service provider that utilizes fixed-wing aircraft to provide airport to airport transports where the patients involved require a stretcher or cot and are being transported to or from a definite care medical setting.

(4) "Advanced life support nontransport vehicle" means a motor vehicle other than an ambulance, owned or leased by a certified emergency medical service provider organization, that provides advanced life support but does not supply patient transport from the scene of the emergency. The term does not include an employer-owned or employer-operated vehicle used for first aid purposes within or upon the employer's premises.

(5) "Advanced life support rotorcraft ambulance service provider organization" means a service provider that utilizes rotorcraft aircraft to respond directly to the scene of a medical emergency either as an initial first responder or as a secondary responder and are utilized to airlift critically ill or injured patients directly to or between definitive care facilities or to a point of transfer with another more appropriate form of transportation.

(6) "Agency" means the state emergency management agency emergency medical services division.

(7) "Air-medical director" means a physician with an unlimited license to practice medicine in Indiana and who has an active role in the delivery of emergency care. The licensed physician shall be ultimately responsible for patient care during each transport. The air-medical director is responsible for directly overseeing and assuring that appropriate aircraft, air-medical personnel, and equipment are provided for each patient transported by the air ambulances within the air-medical services as well as the performance of air-medical personnel.

(8) "Air-medical personnel" means a person who is certified by the commission as a paramedic or is a registered nurse or physician.

(9) "Ambulance" means any conveyance on land, sea, or air that is used, or is intended to be used, for the purpose of responding to emergency life-threatening situations and providing transportation of an emergency patient.

(10) "Ambulance service provider organization" means any person certified by the commission who engages in or seeks to furnish, operate, conduct, maintain, advertise, or otherwise engage in services for the transportation and care of emergency patients as a part of a regular course of doing business, either paid or voluntary.

(11) "Auto-injector" means a spring-loaded needle and syringe that:

(A) contains a single dose of medication; and

(B) automatically releases and injects the medication.

(12) "Basic life support" means the following:

(A) Assessment of emergency patients.

(B) Administration of oxygen.

(C) Use of mechanical breathing devices.

(D) Application of antishock trousers.

(E) Performance of cardiopulmonary resuscitation.

(F) Application of dressings and bandage materials.

(G) Application of splinting and immobilization devices.

(H) Use of lifting and moving devices to ensure safe transport.

(I) Use of an automatic or a semiautomatic defibrillator if the defibrillator is used in accordance with training procedures established by the commission.

(J) Administration by an emergency medical technician or emergency medical technician-basic advanced of epinephrine through an auto-injector.

(K) For an emergency medical technician-basic advanced, the following:

(i) Electrocardiogram interpretation.

(ii) Manual external defibrillation.

(iii) Intravenous fluid therapy.

(L) Other procedures authorized by the commission, including procedures contained in the revised national emergency medical technician-basic training curriculum guide.

(M) Except as provided by:

(i) clause (J) and the training and certifications standards established under IC 16-31-2-9(4);

(ii) clause (K)(iii); and

(iii) the training standards established under IC 16-31-2-9(5);

the term does not include invasive medical care techniques or advanced life support.

(13) "Basic life support nontransport provider organization" means an organization, certified by the commission, that provides first response patient care at an emergency that includes defibrillation but does not supply patient transport from the scene of the emergency.

(14) "Certificate" or "certification" means authorization in written form issued by the commission to a person to furnish, operate, conduct, maintain, advertise, or otherwise engage in providing emergency medical services as a part of a regular course of doing business, either paid or voluntary.

(15) "Commission" means the Indiana emergency medical services commission.

(16) "Director" means the director of the state emergency management agency.

(17) "Emergency ambulance services" means the transportation of emergency patients by ambulance and the administration of basic life support to emergency patients before or during such transportation.

(18) "Emergency management of trauma and illness" means the following:

(A) For a paramedic, those procedures for which the paramedic has been specifically trained and:

(i) that are a part of the curriculum prescribed by the commission; or

(ii) are a part of the continuing education program and approved by the supervising hospital and the paramedic provider organization's medical director.

(B) For an emergency medical technician-intermediate, those procedures for which the emergency medical technician-intermediate has been specifically trained:

(i) in the Indiana basic emergency medical technician and Indiana emergency medical technician-intermediate curriculums; and

(ii) that have been approved by the administrative and medical staff of the supervising hospital, the emergency medical technician-intermediate provider organization medical director, and the commission as being within the scope and responsibility of the emergency medical technician-intermediate.

(19) "Emergency medical services" means the provision of emergency ambulance services or other services, including extrication and rescue services, utilized in serving an individual's need for immediate medical care in order to prevent loss of life or aggravation of physiological or psychological illness or injury.

(20) "Emergency medical services driver" means an individual who has a certificate of completion of a commission-approved driver training course.

(21) "Emergency medical services provider organization" means any person certified by the commission who engages in or seeks to furnish, operate, conduct, maintain, advertise, or otherwise engage in services for the care of emergency patients as part of a regular course of doing business, either paid or voluntary.

(22) "Emergency medical services vehicle" means the following:

(A) An ambulance.

(B) An emergency medical service nontransport vehicle.

(23) "Emergency medical technician" means an individual who is certified under this article to provide basic life support at the scene of an accident or an illness or during transport.

(24) "Emergency medical technician-basic advanced" means an individual who is certified under IC 16-31 to provide basic life support at the scene of an accident or an illness or during transport and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement.

(25) "Emergency medical technician-basic advanced provider organization" means an ambulance service provider or other provider organization certified by the commission to provide basic life support services administered by emergency medical technicians-basic advanced and has been certified to perform manual or automated defibrillation, rhythm interpretation, and intravenous line placement in conjunction with a supervising hospital.

(26) "Emergency medical technician-intermediate" means an individual who can perform at least one (1) but not all of the procedures of a paramedic and who:

(A) has completed a prescribed course in advanced life support;

(B) has been certified by the commission;

(C) is associated with a single supervising hospital; and

(D) is affiliated with a provider organization.

(27) "Emergency medical technician-intermediate provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by emergency medical technician-intermediates in conjunction with a supervising hospital.

(28) "Emergency patient" means an individual who is acutely ill, injured, or otherwise incapacitated or helpless and who requires emergency care. The term includes an individual who requires transportation on a litter or cot or is transported in a vehicle certified as an ambulance under IC 16-31-3.

(29) "Extrication service" means any actions that disentangle and frees [sic., free] from entrapment.

(30) "F.A.A." means the Federal Aviation Administration.

(31) "F.A.R." means the federal aviation regulations, including, but not limited to, 14 CFR.

(32) "First responder" means an individual who is:

(A) certified under IC 16-31 and who meets the commission's standards for first responder certification; and

(B) the first individual to respond to an incident requiring emergency medical services.

(33) "Fixed-wing ambulance" means a propeller or jet airplane.

(34) "Flight physiology" means the physiological stress of flight encountered during air medical operations to include, but not be limited to:

(A) temperature;

(B) pressure;

(C) stresses of barometric pressure changes;

(D) hypoxia;

(E) thermal and humidity changes;

(F) gravitational forces;

(G) noise;

(H) vibration;

(I) fatigue; and

(J) volume and mass of gases.

(35) "Medical director" means a physician with an unlimited license to practice medicine in Indiana and who has an active role in the delivery of emergency care.

(36) "Nontransporting emergency medical services vehicle" or "emergency medical service nontransport vehicle" means a motor vehicle, other than an ambulance, used for emergency medical services. The term does not include an employer-owned or employer-operated vehicle used for first aid purposes within or upon the employer's premises.

(37) "Paramedic" means an individual who:

(A) is:

(i) affiliated with a certified paramedic provider organization;

(ii) employed by a sponsoring hospital approved by the commission; or

(iii) employed by a supervising hospital with a contract for inservice education with a sponsoring hospital approved by the commission;

(B) has completed a prescribed course in advanced life support; and

(C) has been certified by the commission.

(38) "Paramedic provider organization" means an ambulance service provider organization or other provider organization certified by the commission to provide advanced life support services administered by paramedics or physicians with an unlimited license to practice medicine in Indiana in conjunction with supervising hospitals.

(39) "Person" means any:

(A) natural person or persons;

(B) partnership;

(C) corporation;

(D) association;

(E) joint stock association; or

(F) governmental entity other than an agency or instrumentality of the United States. "Agency or instrumentality of the United States" does not include a person operating under a contract with the government of the United States.

(40) "Physician" means an individual who currently holds a valid unlimited license to practice medicine in Indiana under IC 25-22.5-1-1.1.

(41) "Program director" means a person employed by a certified training institution to coordinate the emergency medical services training programs.

(42) "Provider organization" means an ambulance service or other emergency care organization certified by the commission to provide emergency medical services.

(43) "Provider organization operating area" means the geographic area in which an emergency medical technician-basic advanced, affiliated with a specific emergency medical technician-basic advanced provider organization, is able to maintain two-way voice communication with the provider organization's supervising hospitals.

(44) "Registered nurse" means a person licensed under IC 25-23-1-1.1.

(45) "Rescue services" means the provision of basic life support except it does not include the following:

(A) Administration of oxygen.

(B) Use of mechanical breathing devices.

(C) Application of antishock trousers.

(D) Application of splinting devices.

(E) Use of an automatic or a semiautomatic defibrillator.

(F) Electrocardiogram interpretation.

(G) Manual external defibrillation.

(H) Intravenous fluid therapy.

(I) Invasive medical care techniques.

(46) "Rescue squad organization" means an organization that holds a voluntary certification to provide extrication, rescue, or emergency medical services.

(47) "Supervising hospital" means a hospital licensed under IC 16-21-2 or under the licensing laws of another state that has been certified by the commission to supervise paramedics, emergency medical technicians-intermediate, emergency medical technician-basic advanced, and provider organizations in providing emergency medical care.

(48) "Training institution" means an institution certified by the commission to administer emergency medical services training programs.

(Indiana Emergency Medical Services Commission; Emergency Medical Services Preliminary; filed Jun 5, 1975, 11:57 a.m.: Rules and Regs. 1976, p. 84; filed Nov 3, 1980, 3:55 p.m.: 3 IR 2191; filed Dec 13, 1985, 9:13 a.m.: 9 IR 1035; filed Aug 18, 1986, 1:00 p.m.: 10 IR 23; filed May 15, 1998, 10:25 a.m.: 21 IR 3865; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2718; filed Feb 20, 2003, 8:00 a.m.: 26 IR 2333; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3507; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR-836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA)