Guam § 84110 - Certification.

§ 84110. Certification.

Pursuant to this Chapter, all persons who furnish, operate,

conduct, maintain, advertise, or otherwise engaged in providing

emergency medical services as a part of the regular course of

doing business, either paid or voluntary, shall hold a current valid

certification issued by the Administrator of the Office of EMS to

provide emergency medical services.

In order to be certified, such providers of emergency medical

services shall meet the following minimum standards:

(a) Emergency Medical Services Personnel Training

Programs and Courses of Training.

(1) The Guam Community College School of

Allied Health, the Guam Fire Department, the

University of Guam, and other EMS training service

providers approved by the DPHSS Office of EMS shall

provide training courses in emergency medical

responder, emergency medical technician-basic,

emergency medical technician-intermediate, emergency

medical technician-paramedic, and advanced life

support for emergency medical services personnel. The

curricula and syllabi of these courses shall be approved

in advance by the Office of EMS. The curricula and

syllabi of the courses of ambulance personnel shall be

consistent with the scope and level of the practice of

emergency medical services associated with emergency

ambulance personnel certification, and the Department

of Transportation, National Highway Traffic Safety

Administration, and the National Emergency Medical

Services Advisory Council.

(2) The Guam Community College School of

Allied Health, the Guam Fire Department, the

University of Guam, and other EMS training service

providers approved by the DPHSS Office of EMS shall

consult with and get approval of the Office of EMS to

determine the number and type of emergency medical

services courses necessary to support the staffing

requirements for emergency medical services. The

basic life support training programs shall be relevant to

and consistent with the training course required for

certification.

(3) The Office of EMS shall develop standards

for emergency medical services course instructors, and

standards for emergency medical services training

facilities for all basic life support personnel, advanced

life support personnel, users of the automatic external

defibrillator, and emergency medical dispatch personnel

that shall be at least equivalent to or exceed the

standards necessary to meet the requirements stated in

either of the following areas: the Department of

Transportation, National Highway Traffic Safety

Administration or the National Emergency Medical

Services Advisory Council, for the certification of basic

life support personnel and advanced life support

personnel.

(4) The Office of EMS will conduct annual

inspections of the training facilities and evaluate the

qualifications of course instructors to ensure that the

standards and qualifications are consistent with the

medical standards for emergency medical technician-

basic, emergency medical technician-intermediate,

emergency medical technician-paramedic and advanced

life support emergency medical services personnel,

users of the automatic external defibrillators, and

emergency medical dispatch/E911 call taker personnel.

(5) Course requirements for pre-hospital

emergency services training for National Registry

Emergency Medical Responder (NREMR), National

Registry Emergency Medical Technician (NREMT),

National Registry Advance Emergency Medical

Technician (NRAEMT), and National Registry

Paramedic (NRP) shall be listed in the Guam EMS rules

and regulations, as prescribed by the United States

Department of Transportation, National Highway

Traffic Safety Administration, and/or the National

Emergency Medical Services Advisory Council.

(b) The personnel shall meet the standards for

education and training established by the Administrator of

the Office of EMS for certification and re-certification.

(c) Ambulances, emergency medical services

facilities, private non-emergent transport vehicles, and

private ambulance services primarily provide BLS transport

services utilizing NREMR, NREMT, NAEMT, and NRP

personnel. Private ambulance services and private non-

emergent transport vehicles shall not normally respond to

emergency incidents (E911 dispatches by Guam Fire

Department) as first responder units, except in the following

instances:

(1) When specifically requested by the EMS

agency (Guam Fire Department E911 Dispatch) having

jurisdiction.

(2) When the private service receives a direct

request for service from a person or facility other than

dispatch, in which the patient may be transported to an

emergency department. In these instances, the service

may respond but shall contact the appropriate

emergency dispatch agency (Guam Fire Department

E911 Dispatch). When a direct request is made to a

private ambulance service from a location outside of a

medical facility or private ambulance during non-

emergency transport, the request shall be routed to E911

via instruction or call transfer for the purpose of

dispatching of GFD resources or mutual aid (military or

private ambulance service), as determined by

established policies and procedures.

(3) Transfer of care by a Guam Fire Department

EMT- Paramedic of an ALS patient to a private EMT-

Paramedic ambulance service for transport shall only

occur with Guam EMS Medical Director direct on-line

medical control approval.

(4) Transfer of care by a Guam Fire Department

EMT-Basic to a private EMT-Basic ambulance service.

(d) Ambulances, emergency medical services

facilities, private non-emergent transport vehicles, and

private companies offering ambulance services, and related

equipment, shall conform to the requirements of the

Administrator of the Office of EMS for certification and re-

certification.

(e) Ambulances, private companies offering

ambulance services and private non-emergent transport

vehicles shall be operated in Guam with insurance coverage,

issued by an insurance company licensed to do business in

Guam, for each and every ambulance, private non-emergent

transport vehicle, and private ambulance service owned or

operated by or for the licensee, providing for the payment of

benefits and including, but not limited to, the following:

(1) No-fault insurance policy (motor vehicle):

(A) No-fault benefits with respect to any

accidental harm arising out of a motor vehicle

accident;

(B) Liability coverage for all damages arising

out of bodily injury to or death of any person as a

result of any one (1) motor vehicle accident;

(C) Liability coverage for all damages arising

out of injury to or destruction of property,

including motor vehicles and including the loss of

use, thereof, as a result of any one (1) motor vehicle

accident;.

(D) Professional or Occupational Liability or

Bodily Injury Insurance (other than motor vehicle)

in an amount of not less than that specified by the

Guam EMS Administrator as may be required in

the regulations adopted by the Office of EMS.

(E) Ambulances, private companies offering

ambulance services, and private non-emergent

transport vehicles shall be equipped with

communications equipment approved by the

Administrator.

(f) Eligibility, Training and Skill Requirements for

Emergency Medical Responders, Emergency Medical

Technicians, Advanced Emergency Medical Technicians,

and Paramedics:

(1) Student Eligibility:

(A) Emergency Medical Responder (EMR):

(i) eighteen (18) years of age.

(B) Emergency Medical Technician

(EMT/Basic Life Support):

(i) eighteen (18) years of age.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) eighteen (18) years of age;

(ii) high school diploma or equivalent;

(iii) EMT Certificate;

(iv) BLS, ACLS and PALS

Certification.

(D) Paramedic (Advanced Life Support):

(i) eighteen (18) years of age;

(ii) high school diploma or equivalent;

(iii) EMT Certificate;

(iv) BLS, ACLS and PALS

Certification.

(2) Minimum Training Requirements:

(A) Emergency Medical Responder (EMR):

(i) 96 hours (total minimum);

(ii) 80 hours Didactic;

(iii) 16 hours Hospital Clinicals.

(B) Emergency Medical Technician (EMT/

Basic Life Support):

(i) 120 hours (total minimum);

(ii) 110 hours Didactic & Skills Lab;

(iii) 10 hours Hospital Clinicals;

(iv) Field Internship: 10 Patient

Contacts.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) 306 hours (total minimum);

(ii) 208 hours Didactic & Skills Lab;

(iii) 16 hours Clinical;

(iv) 24 hours Field Internship and 10

ALS Team Lead Contacts.

(D) Paramedic (Advanced Life Support):

(i) 1120 hours (total minimum);

(ii) 450 hours Didactic & Skills lab;

(iii) 150 hours Hospital Clinicals;

(iv) 480 hours Field Internship and 40

ALS Team Lead Contacts.

(3) Minimum Scope of Practice:

(A) Emergency Medical Responder (EMR):

(i) Patient Assessment;

(ii) Advance First Aid;

(iii) Use of adjunctive breathing aid and

administration of oxygen;

(iv) Automated External Defibrillator;

(v) Cardiopulmonary Resuscitation.

(B) Emergency Medical Technician (EMT/

Basic Life Support):

(i) Patient Assessment;

(ii) Advance First Aid;

(iii) Use of adjunctive breathing aid and

administration of oxygen;

(iv) Automated External Defibrillator;

(v) Cardiopulmonary Resuscitation;

(vi) Transport of Ill and Injured Persons.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) All EMT Skills;

(ii) Perilaryngeal Airways;

(iii) Laryngoscope;

(iv) Endotracheal (ET) Intubations

(Adults, Orally);

(v) Valsalva’s Maneuvers;

(vi) Intravenous Infusion;

(vii) Obtain Venous Blood;

(viii) Glucose Measuring and

Administration;

(ix) Medications: (Approved by Medical

Director).

(D) Paramedic (Advanced Life Support):

(i) All EMT and AEMT Skills and

Medications;

(ii) Laryngoscope;

(iii) Endotracheal (ET) Intubations

(Orally);

(iv) Valsalva’s Maneuvers;

(v) Intravenous Infusion;

(vi) Obtain Venous Blood;

(vii) Glucose Measuring and

Administration;

(viii) Needle Thoracostomy and

Cricothyroidotomy;

(ix) Trans-Cutaneous Pacing and

Synchronized Cardioversion;

(x) Medications: (Approved by Medical

Director).

(4) Notable Optional Skills:

(A) Emergency Medical Responder (EMR):

(i) Epi-Pens;

(ii) Naloxone.

(B) Emergency Medical Technician

(EMT/Basic Life Support):

(i) Perilaryngeal Airways;

(ii) Epi-Pens;

(iii) Duodote Kits;

(iv) Intravenous Access;

(v) Naloxone.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) Additional Medications and Skills

approved by the Medical Director.

(D) Paramedic (Advanced Life Support):

(i) Local EMS Agencies may add

additional Medications and Skills if approved

by Medical Director.

(5) Written Skills and Exams:

(A) Emergency Medical Responder (EMR):

(i) Administered by the National

Registry of EMTs; or

(ii) Administered by the State EMS

Office.

(B) Emergency Medical Technician (EMT/

Basic Life Support):

(i) Administered by the National

Registry of EMTs; or

(ii) Administered by the State EMS

Office.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) Administered by the National

Registry of EMTs; or

(ii) Administered by the State EMS

Office.

(D) Paramedic (Advanced Life Support):

(i) Administered by the National

Registry of EMTs; or

(ii) Administered by the State EMS

Office.

(6) Length of Certification or Licensure:

(A) Emergency Medical Responder (EMR):

(i) Two (2)-Year Certification and

Licensure.

(B) Emergency Medical Technician (EMT/

Basic Life Support):

(i) Two (2)-Year Certification and

Licensure.

(C) Advanced Emergency Medical

Technician (AEMT);

(i) Two (2)-Year Certification and

Licensure.

(D) Paramedic (Advanced Life Support):

(i) Two (2)-Year Certification and

Licensure.

(7) Refresher Course/Continuing Education:

(A) Emergency Medical Responder (EMR):

(i) Eight (8)-hour Refresher Course;

(ii) Eight (8)-hours of Continuing

Education every two (2) years.

(B) Emergency Medical Technician (EMT/

Basic Life Support):

(i) Twenty (20)-hour Refresher

Course;

(ii) Twenty (20)-hours of Continuing

Education every two (2) years.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) Twenty-five (25)-hour Refresher

Course;

(ii) Twenty-five (25)-hours of

Continuing Education every two (2) years.

(D) Paramedic (Advanced Life Support):

(i) Thirty (30)-hour Refresher Course;

(ii) Thirty (30)-hours of Continuing

Education every two (2) years.

(8) Certification and Licensed Provisions:

(A) Emergency Medical Responder (EMR):

(i) Certified and Licensed Locally; or

(ii) Reciprocity application.

(B) Emergency Medical Technician

(EMT/Basic Life Support):

(i) Certified and Licensed Locally; or

(ii) Reciprocity application.

(C) Advanced Emergency Medical

Technician (AEMT):

(i) Certified and Licensed Locally; or

(ii) Reciprocity application.

(D) Paramedic (Advanced Life Support):

(i) Certified and Licensed Locally; or

(ii) Reciprocity application.