(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;

(3)           EMD programs, the establishment, approval, and annual updating of the Emergency Medical Dispatch Priority Reference 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;

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

(10)         developing and implementing an orientation plan for all hospitals within the EMS system that use MICN, EMS-NP, or EMS-PA personnel to provide on-line medical direction to EMS personnel. This plan shall include:

(A)          a discussion of all EMS System treatment protocols and procedures;

(B)          an explanation of the specific scope of practice for credentialed EMS personnel, as authorized by the approved EMS System treatment protocols required by Rule .0405 of this Section;

(C)          a discussion of all practice settings within the EMS System and how scope of practice may vary in each setting;

(D)          a mechanism to assess the ability to use EMS System communications equipment, including hospital and prehospital devices, EMS communication protocols, and communications contingency plans as related to on-line medical direction; and

(E)           the completion of a scope of practice performance evaluation that verifies competency in Parts (A) through (D) of this Subparagraph and that is administered under the direction of the Medical Director.

(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.

(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.