SUBCHAPTER 7 CERTIFYING
EMERGENCY MEDICAL SERVICE PERSONNEL
§16-85-53 Authority
and purpose. The purpose of this subchapter is to
implement section 453-33, HRS, which delegates to the board the
authority to adopt rules regarding certification of individuals
as qualified in emergency medical services. [Eff. 12/17/82; am
and comp 7/27/87; comp 10/28/89; comp 8/25/90: am and comp
12/22/97] (Auth: HRS §453-33) (Imp: HRS §453-33)
§16-85-53.5 Definitions. As
used in this subchapter:
"Advanced life support" shall be defined as provided in
chapter 321, HRS, and its subsequent amendments which are
incorporated into and made a part of this subchapter.
"Basic life support" shall be as provided in chapter 321,
HRS, and its subsequent amendments which are incorporated into
and made a part of this subchapter.
"Designated MEDICOM base station hospital" means a state
department of health designated acute care hospital emergency
department from which authorized physicians provide medical
direction and assistance to emergency medical personnel in the
delivery of prehospital emergency medical services.
"Emergency medical technician-basic" or "EMT-Basic" or
"EMT-B" means an individual certified by the board to perform
basic life support services to a patient at the site of an
emergency and in transit to, or between, a medical facility or
facilities.
"Emergency medical technician-paramedic" or "EMT-Paramedic"
or "EMT-P" or "paramedic" means an individual certified by the
board to perform basic and advanced life support services to a
patient at the site of an emergency and in transit to, or
between, a medical facility or facilities.
"MEDICOM" means the State department of health two-way
radio communications system between dispatch centers, ambulances,
and medical facilities.
"Mobile intensive care technician" or "MICT" means an
individual certified by the board as an EMT-Paramedic. [Eff. and
comp 7/27/87; comp 10/28/89; comp 8/25/90 am and comp 12/22/97]
(Auth: HRS §453-33) (Imp: HRS §§321-222,
453-33)
§16-85-54 Certification
application. (a) There shall be two classes of
emergency medical service personnel: EMT-B and EMT-P.
(b) An application for certification shall be made
under oath on a form to be provided by the board and shall
require the applicant to provide:
(1) For EMT-B certification:
(A) The appropriate fees including the application fee which
shall not be refunded;
(B) The applicant's full name;
(C) Evidence of completion of an EMT-Basic course of training
which equals or exceeds the curriculum listed in section
16-85-56;
(D) Evidence of passage of the National Registry Emergency
Medical Technicians (National Registry) EMT-Basic
examination;
(E) Evidence of current certification from the National Registry
of Emergency Medical Technicians;
(F) Information regarding any conviction of any crime which has
not been annulled or expunged; and
(G) If applicable, evidence of any certifications held or once
held in other jurisdictions indicating the status of the
certification and documenting any disciplinary action;
(H) Any other information the board may require to investigate
the applicant's qualifications for certification.
(2) For EMT-P certification:
(A) All items listed in subparagraphs (1) (A), (B), (E), (F),
(G) and (H);
(B) Evidence of completion of an EMT-Paramedic course of training
which equals or exceeds the curriculum listed in section
16-85-56; and
(C) Evidence of passage of the National Registry's EMT-Paramedic
examination.
(c) An application for temporary certification shall be
made under oath on a form to be provided by the board and shall
require the applicant to provide:
(1) All items listed in subparagraphs (1) (A), (B), and
(H);
(2) Evidence of completion of the appropriate training program
within the past twelve months from the date of application;
(3) The name of the applicant's employer for whom the applicant
will be performing services; and
(4) Application to take the first available examination after the
date of application. Temporary certification may be issued only
once to an applicant.
(d) It shall be the applicant's responsibility to
furnish any information requested by the board. In the event of
any change of information provided, the board shall be notified
within thirty days of any change.
(e) Every application and all references shall be
signed by the applicant or the person attesting to the
applicant's education, experience, and reputation. [Eff 12/17/82;
am and comp 7/27/87; comp 10/28/89; comp 8/25/90; am and comp DEC
22 1997 ] (Auth: HRS §453-33) (Imp: HRS §§453-33,
453-32.5)
§16-85-55 Recertification requirements.
(a) Certificate holders may comply with recertification
requirements by having a current certificate from the National
Registry of Emergency Medical Technicians (NREMT).
(b) Certificate holders who do not have a current
certificate from the NREMT shall submit evidence of continuing
education (CE) requirements that includes:
(1) For EMT-Basic:
(A) State approved EMT refresher training - twenty-four hour
minimum;
(B) Annual cardiopulmonary resuscitation (CPR) certification;
and
(C) Forty-eight hours of additional continuing education in any
of the subjects listed in section 16-85-56(a).
(2) For EMT-Paramedic:
(A) Forty-eight hours of paramedic refresher training, which
shall include advanced cardiac life support (ACLS) certification
or training deemed to be equivalent to that required for ACLS
certification by the medical director of the training
program;
(B) Annual CPR certification;
(C) Twenty-four hours of additional continuing education in any
of the subjects listed in section 16-85-56(b); and
(D) Documentation of skill maintenance.
(c) There shall be no CE requirement at the time of a
certificate holder's first recertification if the certificate
holder was initially licensed in the twelve- month period prior
to the January 31 recertification date.
(d) Certificate holders who were certified in the first
calendar year of the previous biennial registration period, shall
provide evidence of one-half of the CE requirements noted
above.
(e)Temporary certification shall be valid from the date
of issuance of temporary certification to the date of release of
results of the first examination following issuance of
certification and the temporary certification shall not be
extended.
(f) At the time of recertification each certificate
holder shall certify on a form provided by the board that the
licensee has complied with the CE requirements. The certification
shall be under oath if required by the board. The board may
require any certificate holder to submit, in addition to the
certification, further evidence demonstrating compliance with the
CE requirement set forth in this section.
(g) A false certification to the board by a certificate
holder shall be deemed a violation of section 453-8(a)(15), HRS,
and subject the certificate holder to disciplinary
proceedings.
(h) Failure to recertify and present such CE evidence
as required shall constitute a forfeiture of certification, which
may be restored within two years from the date of forfeiture
provided the applicant pays all applicable fees, including
renewal fees as applicable, and provides evidence of meeting the
CE requirements.
(i)The board may, when reviewing application for
restoration, deny or reject the application in accordance with
section 16-85-107. [Eff. 12/17/82; am and comp 7/27/87; comp
10/28/89; comp 8/25/90; am and comp 12/22/97] (Auth: HRS
§453-33) (Imp: HRS §§ 453-32, 453.32.1,
453-32.5)
§16-85-56 Courses of
training. (a) The EMT-Basic course of training shall
be as follows:
(1) The course of training shall be based on, but not limited
to, the national Emergency Medical Technician Ambulance (EMT-A)
curriculum of the United States department of
transportation;
(2) The course shall include the minimum theoretical knowledge
necessary to provide for the application of basic life support
skills in the delivery of prehospital emergency services in the
following subjects for a minimum of one hundred eighty
hours:
(A) Standards and policies of the emergency medical services
system;
(B) Human systems and patient assessment;
(C) Respiratory emergencies;
(D) Cardiovascular emergencies;
(E) Neurological emergencies;
(F) Musculoskeletal injuries;
(G) Obstetrical and gynecological emergencies;
(H) Pediatric emergencies;
(I) Medical emergencies;
(J) Trauma;
(K) Shock;
(L) Basic knowledge of behavioral disorders;
(M) Extrication and rescue techniques; and
(N) Introduction to communications;
(3) The course shall include both hospital and emergency
ambulance clinical experience to enable the student to
demonstrate competency in basic life support skills required for
certification. The course of clinical experience shall be for a
minimum of one hundred thirty-five hours; and
(4) The course of training shall include the following
skills:
(A) Perform cardiopulmonary resuscitation;
(B) Obtain basic patient history and physical examination;
(C) Obtain and monitor vital signs;
(D) Establish and maintain airways;
(E) Administer free-flow one hundred percent oxygen;
(F) Ventilate with bag-mask;
(G) Apply and use mechanical automatic heart and lung
resuscitator;
(H) Control hemorrhage;
(I) Apply bandages;
(J) Immobilize or splint fractures, dislocations, and
sprains;
(K) Immobilize and extricate automobile injury victims;
(L) Perform light rescue and triage;
(M) Perform emergency delivery of baby, and provide newborn
care;
(N) Initiate intervention with behavioral disorders;
(O) Apply antishock trousers (MAST);
(P) Operate a medical communications system;
(Q) Operate an emergency medical vehicle; and
(R) Perform twelve-lead electrocardiogram (EKG);
(b) The EMT-Paramedic course of training shall be as
follows:
(1) The course of training shall be based on, but not limited to,
the national Emergency Medical Technician-Paramedic (EMT-P)
curriculum of the United States department of
transportation;
(2) The course shall include all knowledge and skills required at
the EMT-Basic level in addition to the minimum theoretical
knowledge necessary to provide advanced life support skills in
the delivery of prehospital emergency medical services in the
following subjects, for a minimum of four hundred hours:
(A) Standards and policies of the emergency medical services
system;
(B) Human systems and detailed patient assessment;
(C) Respiratory emergencies;
(D) Cardiovascular emergencies;
(E) Neurological emergencies;
(F) Musculoskeletal injuries;
(G) Obstetrical and gynecological emergencies;
(H) Neonatal and pediatric emergencies;
(I) Medical emergencies;
(J) Trauma;
(K) Shock and fluid therapy;
(L) Behavioral disorders;
(M) Extrication and rescue techniques;
(N) Communication with base station and physicians; and
(O) Pharmacology;
(3) The course shall include a hospital and an emergency
ambulance clinical internship to enable the student to
demonstrate competency in advanced life support skills required
for certification. The course of clinical internship shall be for
a minimum of eight hundred fifteen hours; and
(4) The course of training shall include the following
skills:
(A) Perform all skills included in EMT basic life support
skills in subsection (a)(4);
(B) Perform adult and pediatric advanced cardiac life
support;
(C) Perform history taking and physical exam assessing illness or
degree of injury of patient;
(D) Communicate with emergency physicians at designated MEDICOM
hospitals;
(E) Perform procedures, and administer medications included in
board-approved EMT-Paramedic course of training and as published
in protocols, via the following routes:
(i) Oral;
(ii) Sublingual;
(iii) Subcutaneous;
(iv) lntramuscular;
(v) Intravenous;
(vi) Endotracheal; and
(vii) Intraosseous;
(F) Perform tracheal intubation;
(G) Perform intravenous therapy to include:
(i) Intravenous fluids; and
(ii) lntravenous medications;
(H) Perform twelve-lead electrocardiogram (EKG), interpret
life-threatening arrhythmias and recognize abnormalities;
(I) Perform defibrillation and cardioversion;
(J) Administer appropriate medications to treat:
(K) Apply and use rotating tourniquets;
(L) Insert nasogastric tubes;
(M) Perform gastric lavage;
(N) Perform closed chest needle thoracostomy;
(O) Perform pericardiocentesis;
(P) Perform cricothyroid needle insertion;
(Q) Perform direct laryngoscopy for McGill forcep removal of
foreign body;
(R) Perform techniques for reflex vagocardiac stimulation;
and
(S) Operate medical communications system. [Eff. 12/17/82, am and
comp 7/27/87; am and comp 10/28/89; comp 8/25/90; am and comp
12/22/97] (Auth: HRS §453-33) (Imp: §§ 453-31,
453-32)
§16-85-59 Scope of
practice. (a) The scope of practice of an
EMT-Basic shall be restricted to the performance of the basic
life support services.
(b) The scope of practice of an EMT-Paramedic shall be
restricted to the performance of the basic and advanced life
support services. [Eff. 4/27/83; am and comp 7/27/87; comp
10/28/89; comp 8/25/90; am and comp 12/22/97] (Auth: HRS
§453- 33) (Imp: HRS §453-31)
§16-85-60
Supervision; responsibility. (a) Supervision of
certified EMT-Paramedics providing services within the practice
of medicine shall be by:
(1) Standing orders for life-threatening situations where
morbidity or mortality may be increased without immediate medical
intervention approved:
(A) By the department of health for emergencies requiring
immediate life-saving medical care; and
(B) By the chief of the emergency department of a designated
MEDICOM hospital; and
(2) Emergency physicians at a State-designated MEDICOM base
station hospital who communicate with emergency medical services
personnel via radio or telephone and provide medical direction
on-site and in-transit to a medical facility in accordance with
the knowledge and skills required for State-certified treatment,
transfer, and triage protocols approved by the State department
of health.
(b) Responsibility of EMT-Paramedics. Advance
life-support treatment shall rest with the EMT-Paramedic and the
physician and:
(1) Recognition is to be made that the designated emergency
physician's communications are dependent on accurate and precise
description of medical assessment by EMT-Paramedics, since the
physician is not physically present at the scene;
(2) Recognition is to be made that the emergency physician
communicating with EMT-Paramedics is dependent upon the skills of
the EMT-Paramedic in performing procedures as directed, since the
physician is not physically present at the scene; and
(3) If the emergency physician is not compensated for the
communication by the patient, the ambulance service, or the
hospital, the emergency physician is deemed to be acting in good
faith as a good samaritan and is to be protected by Hawaii State
law as performing a good samaritan act. [ Eff. 4/27/83; am and
comp 7/27/87; comp 10/28/89; comp 8/25/90; am and comp 12/22/97]
(Auth: HRS § 453-33) (Imp: HRS §§453-32,
663-1.5)
§16-85-61 Repealed. [R
12/22/97]
§16-85-62 Revocation, limitation, suspension, or
denial of certification. Any certification granted
pursuant to this subchapter, may be revoked, limited, suspended,
or denied by the board at any time in accordance with section
16-85-120 for any one or more of the acts listed in chapter 453,
HRS or this chapter. [Eff. and comp 7/27/87; comp 10/28/89; comp
8/25/90; am and comp 12/22/97] (Auth: HRS §453-33) (Imp: HRS
§453-32)
Notice: The above is
an excerpt from State of Hawaii Administrative Rules, Title 16,
Department of Commerce and Consumer Affairs and is
presented for general informational purposes only. Content is as
that which may be found in the original, however, formatting of
the text is not identical. Copies of the
official text of the Hawaii Administrative Rules
are available at the Office of the Lieutenant Governor, law
libraries throughout the State of Hawaii, and select law
libraries throughout the world. Some of the branches of the
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please call in advance to see if the particular Chapter of the
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