10a NCAC 13P .0403       RESPONSIBILITIES OF THE MEDICAL DIRECTOR FOR EMS SYSTEMS

(a)  The Medical Director for an EMS System is responsible for the following:

(1)           ensuring that medical control as set forth in Rule .0401(5) of this Section is available 24 hours a day, seven days a week;

(2)           the establishment, approval, and annual updating of adult and pediatric treatment protocols as set forth in Rule .0405 of this Section;

(3)           EMD programs, the establishment, approval, and annual updating of the EMDPRS, including subsequent editions published by the EMDPRS program utilized by the EMS System;

(4)           medical supervision of the selection, system orientation, continuing education and performance of all EMS personnel;

(5)           medical supervision of a scope of practice performance evaluation for all EMS personnel in the system based on the treatment protocols for the system;

(6)           the medical review of the care provided to patients;

(7)           providing guidance regarding decisions about the equipment, medical supplies, and medications that will be carried on all ambulances and EMS nontransporting vehicles operating within the system;

(8)           determining the combination and number of EMS personnel sufficient to manage the anticipated number and severity of injury or illness of the patients transported in Medical Ambulance/Evacuation Bus Vehicles defined in Rule .0219 of this Subchapter; and

(9)           keeping the care provided up-to-date with current medical practice.

(b)  Any tasks related to Paragraph (a) of this Rule may be completed, through the Medical Director's written delegation, by assisting physicians, physician assistants, nurse practitioners, registered nurses, EMDs, or paramedics.

The EMS System Medical Director may delegate physician medical oversight for a licensed EMS provider at the EMT level of service that does not back up the emergency 911 EMS System. Any decision delegating medical oversight for a licensed provider shall comply with the EMS System franchise requirements in Rule .0204 of this Subchapter. Medical oversight delegated for a licensed EMS provider shall meet the following requirements:

(1)           a medical director for adult and pediatric patients. The medical director and assistant medical directors shall meet the criteria defined in "The North Carolina College of Emergency Physicians: Standards for Medical Oversight and Collection;"

(2)           treatment protocols must be adopted in their original form from the standard adult and pediatric treatment protocols as defined in the "North Carolina College of Emergency Physicians: Standards for Medical Oversight and Data Collection;" and

(3)           establish an agency peer review committee that meets quarterly. The agency peer review committee minutes shall be reported to the EMS System peer review committee.

(c)  The Medical Director may suspend temporarily, pending review, any EMS personnel from further participation in the EMS System when he or she determines that the individual's actions are detrimental to the care of the patient, the individual committed unprofessional conduct, or the individual failed to comply with credentialing requirements. During the review process, the Medical Director may:

(1)           restrict the EMS personnel's scope of practice pending completion of remediation on the identified deficiencies;

(2)           continue the suspension pending completion of remediation on the identified deficiencies; or

(3)           permanently revoke the EMS personnel's participation in the EMS System.

History Note:        Authority G.S. 143‑508(b); 143-508(d)(3); 143-508(d)(7);

Temporary Adoption Eff. January 1, 2002;

Eff. April 1, 2003;

Amended Eff. January 1, 2009; January 1, 2004;

Readopted Eff. January 1, 2017;

Amended Eff. April 1, 2024.