Section 641.131.3. Emergency medical care providers—authority.

         131.3(1) Authority of emergency medical care personnel. An emergency medical care provider who holds an active certification issued by the department may:

            a.                Render, via on-line medical direction, emergency and nonemergency medical care in those areas for which the emergency medical care provider is certified as part of an authorized service program:

             (1)              At the scene of an emergency;

             (2)              During transportation to a hospital;

             (3)              While in the hospital emergency department;

             (4)              Until patient care is directly assumed by a physician or by authorized hospital personnel; and

             (5)              During transfer from one medical care facility to another or to a private home.

            b.                Function in any hospital or any other entity in which health care is ordinarily provided only when under the direct supervision of a physician when:

             (1)              Enrolled as a student in, and approved by, a training program;

             (2)              Fulfilling continuing education requirements;

             (3)              Employed by or assigned to a hospital or other entity in which health care is ordinarily provided only when under the direct supervision of a physician as a member of an authorized service program, or in an individual capacity, by rendering lifesaving services in the facility in which employed or assigned pursuant to the emergency medical care provider’s certification and under direct supervision of a physician, physician assistant, or registered nurse. An emergency medical care provider shall not routinely function without the direct supervision of a physician, physician assistant, or registered nurse. However, when the physician, physician assistant, or registered nurse cannot directly assume emergency care of the patient, the emergency medical care provider may perform, without direct supervision, emergency medical care procedures for which certified, if the life of the patient is in immediate danger and such care is required to preserve the patient’s life;

             (4)              Employed by or assigned to a hospital or other entity in which health care is ordinarily provided only under the direct supervision of a physician, as a member of an authorized service program, or in an individual capacity, to perform nonlifesaving procedures for which certified and designated in a written job description. Such procedures may be performed after the patient is observed by and when the emergency medical care provider is under the supervision of the physician, physician assistant, or registered nurse, including when the registered nurse is not acting in the capacity of a physician designee, and where the procedure may be immediately abandoned without risk to the patient.

         131.3(2) When emergency medical care personnel are functioning in a capacity identified in 131.3(1)“a,” they may perform emergency and nonemergency medical care without contacting a supervising physician or physician designee if written protocols have been approved by the service program medical director which clearly identify when the protocols may be used in lieu of voice contact.

         131.3(3) Scope of practice.

            a.                Emergency medical care providers shall provide only those services and procedures that are authorized within the scope of practice for which they are certified.

            b.                Scope of Practice for Iowa EMS Providers (June 2016) is hereby incorporated and adopted by reference for emergency medical care providers. For any differences that may occur between the Scope of Practice adopted by reference and these administrative rules, the administrative rules shall prevail.

            c.                The department may grant a variance for changes to the Scope of Practice that have not yet been adopted by reference in these rules. A variance to these rules may be granted by the department pursuant to 641—subrule 132.14(1).

            d.                Scope of Practice for Iowa EMS Providers is available through the Iowa Department of Public Health, Bureau of EMS, Lucas State Office Building, Des Moines, Iowa 50319-0075, or the bureau of EMS Web site ( www.idph.state.ia.us/ems ).

         131.3(4) The department may approve emergency medical pilot project(s) on a limited basis. Requests for a pilot project application shall be made to the department.

         131.3(5) An emergency medical care provider who has knowledge of an emergency medical care provider, service program or training program that has violated Iowa Code chapter 147A or these rules shall report such information to the department within 30 days.

[ ARC 9443B , IAB 4/6/11, effective 8/1/11;    ARC 0062C , IAB 4/4/12, effective 5/9/12;    ARC 0480C , IAB 12/12/12, effective 1/16/13;    ARC 1404C , IAB 4/2/14, effective 5/7/14;    ARC 2277C , IAB 12/9/15, effective 1/13/16;    ARC 2767C , IAB 10/12/16, effective 11/16/16]