Guam § 84102 - Definitions.

§ 84102. Definitions.

Unless the context otherwise requires, the definitions

contained in this Chapter shall govern the provisions of this

Commission:

(a) Administrator means the Administrator or his/her

designee of the DPHSS Office of EMS Administrative Office

created under this Chapter.

(b) Advanced Cardiac Life Support (ACLS) is a course

of instruction designed to prepare students in the practice of

advanced emergency cardiac care.

(c) Advance Emergency Medical Technician (AEMT)

provides basic and limited advanced emergency medical care

and transportation for critical and emergent patients who

access the emergency medical system. This individual

possesses the basic knowledge and skills necessary to

provide patient care and transportation. Advanced

Emergency Medical Technicians function as part of a

comprehensive EMS response, under medical oversight.

Advanced Emergency Medical Technicians perform

interventions with the basic and advanced equipment

typically found on an ambulance. The Advanced Emergency

Medical Technician is a link from the scene to the emergency

health care system.

(d) Ambulance is any conveyance on land, sea or air

used or is intended to be used for the purpose of responding

to emergency life-threatening situations and providing

emergency transportation services.

(e) Basic Cardiac Life Support (BLS/CPR) is a course

of instruction designed to prepare students in

cardiopulmonary resuscitation techniques.

(f) Certificate or Certification means authorization in

written form issued by the Administrator to provide

emergency medical assistance on the scene, enroute, and at

designated emergency medical facilities.

(g) Commission means the Guam Emergency Medical

Services Commission created under this Chapter.

(h) Continuing Education means education required

for the renewal of a certificate or registration.

(i) Department of Transportation (DOT) is a federal

agency mandated to establish minimum standards for

provisions of care for victims.

(j) Department (DPHSS OEMS) is the Guam

Department of Public Health and Social Services (DPHSS)

Office of EMS.

(k) E-911 means “Enhanced” 911.

(l) Education Program Standards means DOT and

NHTSA approved National EMS Educational Standards that

shall be met by state-recognized EMS education programs.

(m) Emergency means any actual or self-perceived

event which threatens the life, limb, or well-being of an

individual in such a manner that immediate medical or public

safety care is needed.

(n) Emergency Ambulance Service means the

transportation of injured/ill patients by ambulance and the

administration of emergency medical services to injured/ill

patients before or during such transportation.

(o) Emergency Medical Dispatcher (EMD) - An

emergency medical dispatcher is a professional

telecommunicator tasked with the gathering of information

related to medical emergencies, the provision of assistance

and instructions by voice prior to the arrival of emergency

medical services (EMS), and the dispatching and support of

EMS resources responding to an emergency call. The term

“emergency medical dispatcher” is also a certification level

and a professional designation, certified through the

Association of Public-Safety Communications Officials-

International (APSCOI) or the National Academies of

Emergency Dispatch.

(p) Emergency Medical Responder (EMR) provides

immediate lifesaving care to critical patients who access the

emergency medical services system. EMRs have the

knowledge and skills necessary to provide immediate

lifesaving interventions while awaiting additional EMS

resources to arrive. EMRs also provide assistance to higher-

level personnel at the scene of emergencies and during

transport. Emergency Medical Responders are a vital part of

the comprehensive EMS response. Under medical oversight,

Emergency Medical Responders perform basic interventions

with minimal equipment.

(q) Emergency Medical Service Facility is a facility

that is certified and operated under the Government Code of

Guam, and is equipped, prepared, and staffed to provide

medical care for emergency patients appropriate to its

classification that evaluates and stabilizes a medical

condition of a recent onset and severity, including severe

pain, psychiatric disturbances, or symptoms of substance

abuse, that would lead a prudent layperson possessing an

average knowledge of medicine and health to believe that the

person’s condition, sickness, or injury is of such a nature that

failure to get immediate medical care could result in death or

dismemberment.

(r) Emergency Medical Technician (EMT) provides

out of hospital emergency medical care and transportation for

critical and emergent patients who access the emergency

medical services (EMS) system. EMTs have the basic

knowledge and skills necessary to stabilize and safely

transport patients ranging from non-emergency and routine

medical transports to life threatening emergencies.

Emergency Medical Technicians function as part of a

comprehensive EMS response system, under medical

oversight. Emergency Medical Technicians perform

interventions with the basic equipment typically found on an

ambulance. Emergency Medical Technicians are a critical

link between the scene of an emergency and the health care

system.

(s) Emergency Medical Services (EMS) means

services designated by the Commission as providing

emergency medical assistance on the scene, enroute, and at

designated EMS facilities.

(t) Emergency Medical Services Commission is the

Guam Emergency Medical Services Commission as created

under Article 1, Public Law 14-11.

(u) Emergency Medical Services Coordinator is an

individual designated to serve as a liaison officer for EMS

inter-agencies, i.e., Guam Memorial Hospital Authority,

Department of Public Works – Office of Highway Safety,

Guam Community College, Civil Defense, and EMS/Rescue

Bureau of the Guam Fire Department. The person shall

coordinate didactyl and clinical instructions and oversee the

student clinical activities

(v) EMS Education Center is a state-recognized

provider of initial courses, EMS continuing education topics,

and/or refresher courses that qualify individuals for state

and/or National Registry EMR, EMT, AEMT, and

Paramedic or EMD provider certification.

(w) EMS Education Group is a state-recognized

provider of EMS continuing education topics and/or

refresher courses that qualify individuals for initial or

renewal of a state and/or National Registry EMR, EMT,

AEMT, and Paramedic or EMD certification.

(x) EMS Medical Director, for the purposes of these

rules, is a Guam licensed physician in good standing who

authorizes and directs, through protocols and standing orders,

the performance of students-in-training enrolled in a DOT

and NHTSA National EMS Education Standard recognized

program and/or EMS license holders who perform medical

acts, and who is specifically identified as being responsible

to assure the performance competency of those EMS

Providers as described in the DOT and NHTSA National

EMS Educational Standards.

(y) EMSC Program means the Emergency Medical

Services for Children Program.

(z) EMS Provider means an individual who holds a

valid emergency medical service provider certificate issued

by the state and/ or NREMT, and includes Emergency

Medical Responder, Emergency Medical Technician,

Advanced Emergency Medical Technician, and Paramedic.

(aa) First Responder Homeland Security Act of 2002

refers to “emergency response providers” that includes,

federal, state, and local government emergency public safety,

law enforcement, emergency response, emergency medical,

and related personnel, agencies, and authorities.

(bb) First Responder means those individuals who in

the early stages of an incident are responsible for the

protection and preservation of life, property, evidence, and

the environment, including emergency response providers as

defined in Section 2 of the Homeland Security Act of 2002

(6 U.S.C. 101), as well as emergency management, public

health, clinical care, public works, and other skilled support

personnel (such as equipment operators) that provide

immediate support services during prevention, response, and

recovery operations.

(cc) Initial Certification means a first time application

for and issuance by the state and/or NREMT of a certificate

at any level as an EMS provider. This shall include

applications received from persons holding any level of EMS

certification issued by the NREMT who are applying for

either a higher or lower-level certificate.

(dd) Initial Course is a course of study based on the

DOT and NHSTA approved curriculum that meets the

National EMS Education Standard requirements for issuance

of a certificate or registration for the first time.

(ee) Initial Registration means a first time application

for and issuance by the DPHSS Office of EMS of a

registration as an EMD, EMR, EMT, AEMT or Paramedic.

This shall include applications received from persons holding

any level of EMS certification issued by the state and/or

NREMT who are applying for registration.

(ff) Letter of Admonition is a form of disciplinary

sanction that is placed in an EMS provider’s file, and

represents an adverse action against the certificate holder.

(gg) License or Licensure is an authorization in written

form issued by the Administrator to a person to furnish,

operate, conduct, maintain, advertise, or otherwise engage in

providing EMS Services.

(hh) License means certificate or certification.

(ii) Mass Casualty Incident is defined as an incident in

which EMS resources, such as personnel and equipment, are

overwhelmed by the number and severity of casualties.

(jj) Medical Direction On-Line means advice,

assistance, supervision, and control provided from a state

designated regional medical facility staffed by emergency

physicians supplying professional support through radio,

telephonic, or any written or oral communication for on-site

and in-transit basic and advanced life support services given

by prehospital field personnel.

(kk) National Registry Emergency Medical Technician

(NREMT) is an individual who has a current and valid EMT

license issued by the DPHSS Office of EMS who meets the

requirements established under Chapter 84, Public Law 14-

11, who is authorized to provide basic emergency medical

care in accordance with the rules pertaining to EMS Practice

and Medical Director Oversight, and meets the specialized

training requirements as established by the U.S. DOT and

NHTSA in the National EMS Educational Standards EMT

Level. For the purposes of these rules, EMT includes the

historic EMS Provider level of EMT. This definition will

apply to this term or any future changes established by the

U.S. DOT.

(ll) National Continued Competency Program (NCCP)

is constructed using methodology similar to that of the

American Board of Medical Specialties.

(mm) National Highway Traffic Safety

Administration (NHTSA) is a U.S. DOT agency leading the

federal role in the creation of national standard curricula for

EMRs, EMT-Bs, AEMTs and Paramedics defining the

necessary components and training of an EMS System.

(nn) National Registry Advance Emergency Medical

Technician (NRAEMT) is an individual who has a current

and valid AEMT license issued by the DPHSS Office of EMS

who meets the requirements established under Chapter 84,

Public Law 14-11, who is authorized to provide advance

emergency medical care in accordance with the rules

pertaining to EMS Practice and Medical Director Oversight,

and meets the specialized training requirements as

established by the U.S. DOT and NHTSA in the National

EMS Educational Standards for the AEMT Level. This

definition will apply to this term or any future changes

established by the U.S. DOT.

(oo) National Registry Emergency Medical Responder

(NREMR) is an individual who has successfully completed

the training and examination requirements for emergency

medical responders and who provides assistance to the

injured or ill until more highly trained and qualified

personnel arrive.

(pp) National Registry of Emergency Medical

Technicians (NREMT) is a national non-governmental

organization that certifies entry-level (EMR, EMT, AEMT

and Paramedic) and ongoing competency of EMS providers.

(qq) National Registry Paramedic (NRP) is an

individual who has a current and valid Paramedic license

issued by the DPHSS Office of EMS who meets the

requirements established under Chapter 84, Public Law 14-

11, who is authorized to provide critical advance emergency

medical care in accordance with the rules pertaining to EMS

Practice and Medical Director Oversight, and meets the

specialized training requirements as established by the U.S.

DOT and NHTSA in the National EMS Educational

Standards for the Paramedic Level. This definition will apply

to this term or any future changes established by the U.S.

DOT.

(rr) Non-Emergency Medical Transport - Non-

emergency medical transportation is a form of medical

transportation which is provided in non-emergency situations

to people who require special medical attention, e.g., para-

transits, vans w/ wheelchair access and passenger service

vehicles.

(ss) Office of Emergency Medical Services is the

Administrative Office of EMS within the Department of

Public Health and Social Services.

(tt) Paramedic is an allied health professional whose

primary focus is to provide advanced emergency medical

care for critical and emergent patients who access the

emergency medical system. This individual possesses the

complex knowledge and skills necessary to provide patient

care and transportation. Paramedics function as part of a

comprehensive EMS response, under medical oversight.

Paramedics perform interventions with the basic and

advanced equipment typically found on an ambulance. The

Paramedic is a link from the scene into the health care

system.

(uu) Pediatric Advance Life Support (PALS) is a course

instruction designed to prepare students in the practice of

advance pediatric emergency cardiac care.

(vv) Practical or Psychomotor Skills Examination is a

skills test conducted at the end of an initial course and prior

to application for national certification or state licensure.

(ww) Provisional Certification is a certification, valid

for not more than one (1) year, that may be issued by the state

and/or NREMT to an EMS PROVIDER applicant seeking

certification.

(xx) Provisional Registration is a registration, valid for

not more than one (1) year, that may be issued by the state

and/or NREMT to an EMT applicant seeking registration.

(yy) Refresher Course is a course of study based on the

U.S. Department of Transportation approved curriculum that

contributes in part to the education requirements for renewal

of a license or registration.

(zz) Registered Emergency Medical Responder

(REMR) is an individual who has successfully completed the

training and examination requirements for EMRs based on a

U.S. DOT and NHSTA National EMS Education Standard

recognized program who provides assistance to the injured or

ill until more highly trained and qualified personnel arrive,

and who is registered with the DPHSS Office of EMS.

(aaa) Rules Pertaining to EMS Practice and Medical

Director Oversight means rules adopted by the EMS

Administrator and/or Medical Director of DPHSS and the

Office of EMS upon the advice of the EMS Commission that

establishes the responsibilities of Medical Directors and all

authorized acts of EMS license holders.

(bbb) Shall means compliance is mandatory.

(ccc) Tele-Communicator operates communication

equipment to receive incoming calls for assistance, and

dispatches personnel and equipment to the scene of an

emergency; and operates a telephone console to receive

incoming calls for assistance.

(ddd) Treatment Protocol means written guidelines (also

known as Off-line Medical Direction) approved by the EMS

Medical Director providing pre-hospital personnel with a

standardized approach to commonly encountered patient problems

that is related to medical or trauma, thus encountering immediate

care.