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To amend sections 4742.03, 4765.10, 4765.16, and | 1 |
4765.40 and to enact sections 3701.908, 3701.909, | 2 |
3701.9010, 3727.11, and 4765.44 of the Revised | 3 |
Code to provide for designation of hospital | 4 |
primary stroke centers and establishment of | 5 |
protocols for emergency triage, treatment, and | 6 |
transport of stroke patients. | 7 |
Section 1. That sections 4742.03, 4765.10, 4765.16, and | 8 |
4765.40 be amended and sections 3701.908, 3701.909, 3701.9010, | 9 |
3727.11, and 4765.44 of the Revised Code be enacted to read as | 10 |
follows: | 11 |
Sec. 3701.908. (A) As used in this section, "emergency | 12 |
medical service organization" has the same meaning as in section | 13 |
4765.01 of the Revised Code. | 14 |
(B) The department of health shall maintain a stroke care | 15 |
database and compile, evaluate, and disseminate statistics on | 16 |
stroke treatment and treatment results in this state. The | 17 |
performance metrics used for the database shall be consistent with | 18 |
those developed and approved by the American heart association, | 19 |
centers for disease control and prevention, and the joint | 20 |
commission. The department shall use the "get with the guidelines" | 21 |
stroke program capacity assessment tool for the evaluation of any | 22 |
data collected in the database or a similar assessment tool if | 23 |
that assessment tool ceases to be available. | 24 |
(C) To the extent possible, the department shall do all of | 25 |
the following in completing its duties under division (B) of this | 26 |
section: | 27 |
(1) Coordinate with the council of stroke prevention and | 28 |
education established under section 3701.90 of the Revised Code | 29 |
and national voluntary health organizations involved in stroke | 30 |
treatment quality improvement to avoid duplication and redundancy | 31 |
of data collection and evaluation; | 32 |
(2) Encourage hospitals and emergency medical service | 33 |
organizations to share data and methods on ways to improve the | 34 |
quality of care provided to stroke patients; | 35 |
(3) Facilitate the analysis of stroke care treatment and | 36 |
communication of treatment results among hospitals and emergency | 37 |
medical service organizations. | 38 |
(D) Each hospital and each emergency medical service | 39 |
organization shall provide to the department of health data | 40 |
requested by the department on the treatment of stroke patients | 41 |
served by the hospital or emergency medical service organization. | 42 |
This data is not a public record under section 149.43 of the | 43 |
Revised Code but may be released in analytical or statistical | 44 |
form. | 45 |
(E) Not later than June 1, 2012, and each first day of June | 46 |
thereafter, the department of health shall release a report | 47 |
summarizing the data in the database established under division | 48 |
(B) of this section. The report shall be submitted to the speaker | 49 |
of the house of representatives, president of the senate, and | 50 |
governor. The report shall also be posted on the department's web | 51 |
site. | 52 |
Sec. 3701.909. The department of health shall approve a | 53 |
stroke assessment and protocol tool submitted for the purposes | 54 |
described in division (C) of section 4765.44 of the Revised Code | 55 |
if the assessment and protocol tool meets the requirements of | 56 |
division (B) of that section. | 57 |
Sec. 3701.9010. (A) There is hereby established the stroke | 58 |
system of care task force. The task force shall make | 59 |
recommendations in accordance with division (D) of this section | 60 |
regarding the establishment of an effective system of stroke care, | 61 |
paying particular attention to the establishment of an effective | 62 |
system in the rural areas of the state. | 63 |
(B) The task force shall be composed of the following | 64 |
individuals, who shall be appointed to the task force not later | 65 |
than the effective date of this section: | 66 |
(1) The director of health; | 67 |
(2) The director of the department of public safety, or the | 68 |
director's designee; | 69 |
(3) A representative of the American stroke association | 70 |
appointed by the American stroke association; | 71 |
(4) Two representatives of hospitals that, on the effective | 72 |
date of this section, hold certificates of distinction for primary | 73 |
stroke centers issued by the joint commission, appointed by the | 74 |
director of health; | 75 |
(5) Two representatives of hospitals, one of which shall be a | 76 |
hospital located in a rural county, appointed by the Ohio hospital | 77 |
association; | 78 |
(6) Three physicians, two appointed by the Ohio state medical | 79 |
association and one by the national association of EMS physicians; | 80 |
(7) Two representatives of emergency medical service | 81 |
providers, appointed by the Ohio association of emergency medical | 82 |
services. | 83 |
(C) Vacancies shall be filled in the manner provided for | 84 |
original appointments. Members of the task force shall serve | 85 |
without compensation, except to the extent that serving on the | 86 |
task force is part of their regular duties of employment, but | 87 |
shall be reimbursed for their actual and necessary expenses. | 88 |
The department of health shall provide administrative support | 89 |
to the task force. | 90 |
(D) Not later than six months after the effective date of | 91 |
this section, the task force shall submit recommendations to the | 92 |
department of health on the establishment of an effective stroke | 93 |
system of care in this state. The task force may consult with the | 94 |
council on stroke prevention and education, established under | 95 |
section 3701.90 of the Revised Code. The recommendations shall | 96 |
include all of the following: | 97 |
(1) Protocols for triage, stabilization, and appropriate | 98 |
routing of stroke patients by emergency medical service providers, | 99 |
including protocols for rural areas of the state; | 100 |
(2) Procedures for coordination and communication between | 101 |
hospitals designated primary stroke centers under section 3727.11 | 102 |
of the Revised Code and hospitals not so designated; | 103 |
(3) Support services necessary to ensure that all residents | 104 |
of this state have access to effective and efficient stroke care. | 105 |
On submission of its recommendations, the task force is | 106 |
abolished. | 107 |
(E) Not later than six months after the task force submits | 108 |
its recommendations under division (D) of this section, the | 109 |
department of health shall adopt, in accordance with Chapter 119. | 110 |
of the Revised Code, rules that implement the recommendations. | 111 |
Sec. 3727.11. (A) The department of health shall designate | 112 |
as a primary stroke center any hospital that meets all of the | 113 |
following criteria: | 114 |
(1) Holds a certificate of distinction for primary stroke | 115 |
centers issued by the joint commission; | 116 |
(2) Maintains the requirements for certification; | 117 |
(3) Cooperates with the state board of emergency medical | 118 |
services in the establishment of protocols for assessment, | 119 |
treatment, and transport of stroke patients in accordance with the | 120 |
stroke assessment and protocol tool established under section | 121 |
4765.44 of the Revised Code. | 122 |
(B) A hospital shall not use the term "primary stroke center" | 123 |
or otherwise hold itself out as a primary stroke center unless it | 124 |
has been designated as such under division (A) of this section. | 125 |
(C) In accordance with the notice and hearing requirements of | 126 |
Chapter 119. of the Revised Code, the department may suspend or | 127 |
revoke a hospital's designation as a primary stroke center if the | 128 |
department determines that the hospital no longer meets all the | 129 |
criteria of division (A) of this section. | 130 |
(D) Not later than June 1, 2011, and every June 1 thereafter, | 131 |
the department shall compile and send to each hospital and the | 132 |
medical director and cooperating physician advisory board of each | 133 |
emergency medical service organization, as defined in section | 134 |
4765.01 of the Revised Code, a list of hospitals designated | 135 |
primary stroke centers under this section. The department shall | 136 |
post the list on its web site. | 137 |
(E) Nothing in this section shall limit or prohibit the | 138 |
services provided by a hospital if that hospital is authorized to | 139 |
provide such services. | 140 |
(F) The department may adopt rules for administration of this | 141 |
section. Any such rules shall be adopted under Chapter 119. of the | 142 |
Revised Code. | 143 |
Sec. 4742.03. (A) A person may obtain certification as an | 144 |
emergency service telecommunicator by successfully completing a | 145 |
basic course of emergency service telecommunicator training that | 146 |
is conducted by the state board of education under section 4742.02 | 147 |
of the Revised Code. The basic course of emergency service | 148 |
telecommunicator training shall include, but not be limited to, | 149 |
both of the following: | 150 |
(1) At least forty hours of instruction or training; | 151 |
(2) Instructional or training units in all of the following | 152 |
subjects: | 153 |
(a) The role of the emergency service telecommunicator; | 154 |
(b) Effective communication skills; | 155 |
(c) Emergency service telecommunicator liability; | 156 |
(d) Telephone techniques; | 157 |
(e) Requirements of the "Americans With Disabilities Act of | 158 |
1990," 104 Stat. 327, 42 U.S.C. 12101, as amended, that pertain to | 159 |
emergency service telecommunicators; | 160 |
(f) Handling hysterical and suicidal callers; | 161 |
(g) Law enforcement terminology; | 162 |
(h) Fire service terminology; | 163 |
(i) Emergency medical service terminology; | 164 |
(j) Emergency call processing guides for law enforcement; | 165 |
(k) Emergency call processing guides for fire service; | 166 |
(l) Emergency call processing guides for emergency medical | 167 |
service; | 168 |
(m) Radio broadcast techniques; | 169 |
(n) Disaster planning; | 170 |
(o) Police officer survival, fire or emergency medical | 171 |
service scene safety, or both police officer survival and fire or | 172 |
emergency medical service scene safety; | 173 |
(p) Assessment and treatment of stroke patients. | 174 |
(B) A person may maintain certification as an emergency | 175 |
service telecommunicator by successfully completing at least eight | 176 |
hours of continuing education coursework in emergency service | 177 |
telecommunicator training during each two-year period after a | 178 |
person first obtains the certification referred to in division (A) | 179 |
of this section. The continuing education coursework shall consist | 180 |
of review and advanced training and instruction in the subjects | 181 |
listed in division (A)(2) of this section. | 182 |
(C) If a person successfully completes the basic course of | 183 |
emergency service telecommunicator training described in division | 184 |
(A) of this section, the state board of education or a designee of | 185 |
the board shall certify the person's successful completion. The | 186 |
board shall send a copy of the certification to the person and to | 187 |
the emergency service provider by whom the person is employed. | 188 |
If a person successfully completes the continuing education | 189 |
coursework described in division (B) of this section, the state | 190 |
board of education or a designee of the board shall certify the | 191 |
person's successful completion. The board shall send a copy of the | 192 |
certification to the person and to the emergency service provider | 193 |
by whom the person is employed. | 194 |
Sec. 4765.10. (A) The state board of emergency medical | 195 |
services shall do all of the following: | 196 |
(1) Administer and enforce the provisions of this chapter and | 197 |
the rules adopted under it; | 198 |
(2) Approve, in accordance with procedures established in | 199 |
rules adopted under section 4765.11 of the Revised Code, | 200 |
examinations that demonstrate competence to have a certificate to | 201 |
practice renewed without completing a continuing education | 202 |
program; | 203 |
(3) Advise applicants for state or federal emergency medical | 204 |
services funds, review and comment on applications for these | 205 |
funds, and approve the use of all state and federal funds | 206 |
designated solely for emergency medical service programs unless | 207 |
federal law requires another state agency to approve the use of | 208 |
all such federal funds; | 209 |
(4) Serve as a statewide clearinghouse for discussion, | 210 |
inquiry, and complaints concerning emergency medical services; | 211 |
(5) Make recommendations to the general assembly on | 212 |
legislation to improve the delivery of emergency medical services; | 213 |
(6) Maintain a toll-free long distance telephone number | 214 |
through which it shall respond to questions about emergency | 215 |
medical services; | 216 |
(7) Work with appropriate state offices in coordinating the | 217 |
training of firefighters and emergency medical service personnel. | 218 |
Other state offices that are involved in the training of | 219 |
firefighters or emergency medical service personnel shall | 220 |
cooperate with the board and its committees and subcommittees to | 221 |
achieve this goal. | 222 |
(8) Provide a liaison to the state emergency operation center | 223 |
during those periods when a disaster, as defined in section | 224 |
5502.21 of the Revised Code, has occurred in this state and the | 225 |
governor has declared an emergency as defined in that section. | 226 |
(9) Post all of the following on the board's web site: | 227 |
(a) A list of the hospitals designated as primary stroke | 228 |
centers by the department of health under section 3727.11 of the | 229 |
Revised Code; | 230 |
(b) The standardized stroke assessment and protocol tool | 231 |
adopted under section 4765.44 of the Revised Code. | 232 |
(B) The board may do any of the following: | 233 |
(1) Investigate complaints concerning emergency medical | 234 |
services and emergency medical service organizations as it | 235 |
determines necessary; | 236 |
(2) Enter into reciprocal agreements with other states that | 237 |
have standards for accreditation of emergency medical services | 238 |
training programs and for certification of first responders, | 239 |
EMTs-basic, EMTs-I, paramedics, firefighters, or fire safety | 240 |
inspectors that are substantially similar to those established | 241 |
under this chapter and the rules adopted under it; | 242 |
(3) Establish a statewide public information system and | 243 |
public education programs regarding emergency medical services; | 244 |
(4) Establish an injury prevention program. | 245 |
Sec. 4765.16. (A) All courses offered through an emergency | 246 |
medical services training program or an emergency medical services | 247 |
continuing education program, other than ambulance driving, shall | 248 |
be developed under the direction of a physician who specializes in | 249 |
emergency medicine. Each course that deals with trauma care shall | 250 |
be developed in consultation with a physician who specializes in | 251 |
trauma surgery. Except as specified by the state board of | 252 |
emergency medical services pursuant to rules adopted under section | 253 |
4765.11 of the Revised Code, each course offered through a | 254 |
training program or continuing education program shall be taught | 255 |
by a person who holds the appropriate certificate to teach issued | 256 |
under section 4765.23 of the Revised Code. | 257 |
(B) A training program for first responders shall meet the | 258 |
standards established in rules adopted by the board under section | 259 |
4765.11 of the Revised Code. The program shall include courses in | 260 |
261 | |
established by the board's rules: | 262 |
(1) Emergency victim care; | 263 |
(2) Reading and interpreting a trauma victim's vital signs; | 264 |
(3) Assessment and treatment of stroke patients. | 265 |
(C) A training program for emergency medical | 266 |
technicians-basic shall meet the standards established in rules | 267 |
adopted by the board under section 4765.11 of the Revised Code. | 268 |
The program shall include courses in each of the following areas | 269 |
for at least the number of hours established by the board's rules: | 270 |
(1) Emergency victim care; | 271 |
(2) Reading and interpreting a trauma victim's vital signs; | 272 |
(3) Triage protocols for adult and pediatric trauma victims; | 273 |
(4) In-hospital training; | 274 |
(5) Clinical training; | 275 |
(6) Training as an ambulance driver; | 276 |
(7) Assessment and treatment of stroke patients. | 277 |
Each operator of a training program for emergency medical | 278 |
technicians-basic shall allow any pupil in the twelfth grade in a | 279 |
secondary school who is at least seventeen years old and who | 280 |
otherwise meets the requirements for admission into such a | 281 |
training program to be admitted to and complete the program and, | 282 |
as part of the training, to ride in an ambulance with emergency | 283 |
medical technicians-basic, emergency medical | 284 |
technicians-intermediate, and emergency medical | 285 |
technicians-paramedic. Each emergency medical service organization | 286 |
shall allow pupils participating in training programs to ride in | 287 |
an ambulance with emergency medical technicians-basic, advanced | 288 |
emergency medical technicians-intermediate, and emergency medical | 289 |
technicians-paramedic. | 290 |
(D) A training program for emergency medical | 291 |
technicians-intermediate shall meet the standards established in | 292 |
rules adopted by the board under section 4765.11 of the Revised | 293 |
Code. The program shall include, or require as a prerequisite, the | 294 |
training specified in division (C) of this section and courses in | 295 |
each of the following areas for at least the number of hours | 296 |
established by the board's rules: | 297 |
(1) Recognizing symptoms of life-threatening allergic | 298 |
reactions and in calculating proper dosage levels and | 299 |
administering injections of epinephrine to persons who suffer | 300 |
life-threatening allergic reactions, conducted in accordance with | 301 |
rules adopted by the board under section 4765.11 of the Revised | 302 |
Code; | 303 |
(2) Venous access procedures; | 304 |
(3) Cardiac monitoring and electrical interventions to | 305 |
support or correct the cardiac function. | 306 |
(E) A training program for emergency medical | 307 |
technicians-paramedic shall meet the standards established in | 308 |
rules adopted by the board under section 4765.11 of the Revised | 309 |
Code. The program shall include, or require as a prerequisite, the | 310 |
training specified in divisions (C) and (D) of this section and | 311 |
courses in each of the following areas for at least the number of | 312 |
hours established by the board's rules: | 313 |
(1) Medical terminology; | 314 |
(2) Venous access procedures; | 315 |
(3) Airway procedures; | 316 |
(4) Patient assessment and triage; | 317 |
(5) Acute cardiac care, including administration of | 318 |
parenteral injections, electrical interventions, and other | 319 |
emergency medical services; | 320 |
(6) Emergency and trauma victim care beyond that required | 321 |
under division (C) of this section; | 322 |
(7) Clinical training beyond that required under division (C) | 323 |
of this section. | 324 |
(F) A continuing education program for first responders, | 325 |
EMTs-basic, EMTs-I, or paramedics shall meet the standards | 326 |
established in rules adopted by the board under section 4765.11 of | 327 |
the Revised Code. A continuing education program shall include | 328 |
instruction and training in subjects established by the board's | 329 |
rules for at least the number of hours established by the board's | 330 |
rules. | 331 |
Sec. 4765.40. (A)(1) Not later than two years after | 332 |
333 | |
of emergency medical services shall adopt rules under section | 334 |
4765.11 of the Revised Code establishing written protocols for the | 335 |
triage of adult and pediatric trauma victims. The rules shall | 336 |
define adult and pediatric trauma in a manner that is consistent | 337 |
with section 4765.01 of the Revised Code, minimizes overtriage and | 338 |
undertriage, and emphasizes the special needs of pediatric and | 339 |
geriatric trauma patients. | 340 |
(2) The state triage protocols adopted under division (A) of | 341 |
this section shall require a trauma victim to be transported | 342 |
directly to an adult or pediatric trauma center that is qualified | 343 |
to provide appropriate adult or pediatric trauma care, unless one | 344 |
or more of the following exceptions applies: | 345 |
(a) It is medically necessary to transport the victim to | 346 |
another hospital for initial assessment and stabilization before | 347 |
transfer to an adult or pediatric trauma center; | 348 |
(b) It is unsafe or medically inappropriate to transport the | 349 |
victim directly to an adult or pediatric trauma center due to | 350 |
adverse weather or ground conditions or excessive transport time; | 351 |
(c) Transporting the victim to an adult or pediatric trauma | 352 |
center would cause a shortage of local emergency medical service | 353 |
resources; | 354 |
(d) No appropriate adult or pediatric trauma center is able | 355 |
to receive and provide adult or pediatric trauma care to the | 356 |
trauma victim without undue delay; | 357 |
(e) Before transport of a patient begins, the patient | 358 |
requests to be taken to a particular hospital that is not a trauma | 359 |
center or, if the patient is less than eighteen years of age or is | 360 |
not able to communicate, such a request is made by an adult member | 361 |
of the patient's family or a legal representative of the patient; | 362 |
(f) The victim is subject to the transportation requirements | 363 |
of the stroke assessment and protocol tool adopted under section | 364 |
4765.44 of the Revised Code. | 365 |
(3)(a) The state triage protocols adopted under division (A) | 366 |
of this section shall require trauma patients to be transported to | 367 |
an adult or pediatric trauma center that is able to provide | 368 |
appropriate adult or pediatric trauma care, but shall not require | 369 |
a trauma patient to be transported to a particular trauma center. | 370 |
The state triage protocols shall establish one or more procedures | 371 |
for evaluating whether an injury victim requires or would benefit | 372 |
from adult or pediatric trauma care, which procedures shall be | 373 |
applied by emergency medical service personnel based on the | 374 |
patient's medical needs. In developing state trauma triage | 375 |
protocols, the board shall consider relevant model triage rules | 376 |
and shall consult with the commission on minority health, regional | 377 |
directors, regional physician advisory boards, and appropriate | 378 |
medical, hospital, and emergency medical service organizations. | 379 |
(b) Before the joint committee on agency rule review | 380 |
considers state triage protocols for trauma victims proposed by | 381 |
the state board of emergency medical services, or amendments | 382 |
thereto, the board shall send a copy of the proposal to the Ohio | 383 |
chapter of the American college of emergency physicians, the Ohio | 384 |
chapter of the American college of surgeons, the Ohio chapter of | 385 |
the American academy of pediatrics, OHA: the association for | 386 |
hospitals and health systems, the Ohio osteopathic association, | 387 |
and the association of Ohio children's hospitals and shall hold a | 388 |
public hearing at which it must consider the appropriateness of | 389 |
the protocols to minimize overtriage and undertriage of trauma | 390 |
victims. | 391 |
(c) The board shall provide copies of the state triage | 392 |
protocols, and amendments to the protocols, to each emergency | 393 |
medical service organization, regional director, regional | 394 |
physician advisory board, certified emergency medical service | 395 |
instructor, and person who regularly provides medical direction to | 396 |
emergency medical service personnel in the state; to each medical | 397 |
service organization in other jurisdictions that regularly provide | 398 |
emergency medical services in this state; and to others upon | 399 |
request. | 400 |
(B)(1) The state board of emergency medical services shall | 401 |
approve regional protocols for the triage of adult and pediatric | 402 |
trauma victims, and amendments to such protocols, that are | 403 |
submitted to the board as provided in division (B)(2) of this | 404 |
section and provide a level of adult and pediatric trauma care | 405 |
comparable to the state triage protocols adopted under division | 406 |
(A) of this section. The board shall not otherwise approve | 407 |
regional triage protocols for trauma victims. The board shall not | 408 |
approve regional triage protocols for regions that overlap and | 409 |
shall resolve any such disputes by apportioning the overlapping | 410 |
territory among appropriate regions in a manner that best serves | 411 |
the medical needs of the residents of that territory. The trauma | 412 |
committee of the board shall have reasonable opportunity to review | 413 |
and comment on regional triage protocols and amendments to such | 414 |
protocols before the board approves or disapproves them. | 415 |
(2) Regional protocols for the triage of adult and pediatric | 416 |
trauma victims, and amendments to such protocols, shall be | 417 |
submitted in writing to the state board of emergency medical | 418 |
services by the regional physician advisory board or regional | 419 |
director, as appropriate, that serves a majority of the population | 420 |
in the region in which the protocols apply. Prior to submitting | 421 |
regional triage protocols, or an amendment to such protocols, to | 422 |
the state board of emergency medical services, a regional | 423 |
physician advisory board or regional director shall consult with | 424 |
each of the following that regularly serves the region in which | 425 |
the protocols apply: | 426 |
(a) Other regional physician advisory boards and regional | 427 |
directors; | 428 |
(b) Hospitals that operate an emergency facility; | 429 |
(c) Adult and pediatric trauma centers; | 430 |
(d) Professional societies of physicians who specialize in | 431 |
adult or pediatric emergency medicine or adult or pediatric trauma | 432 |
surgery; | 433 |
(e) Professional societies of nurses who specialize in adult | 434 |
or pediatric emergency nursing or adult or pediatric trauma | 435 |
surgery; | 436 |
(f) Professional associations or labor organizations of | 437 |
emergency medical service personnel; | 438 |
(g) Emergency medical service organizations and medical | 439 |
directors of such organizations; | 440 |
(h) Certified emergency medical service instructors. | 441 |
(3) Regional protocols for the triage of adult and pediatric | 442 |
trauma victims approved under division (B)(2) of this section | 443 |
shall require patients to be transported to a trauma center that | 444 |
is able to provide an appropriate level of adult or pediatric | 445 |
trauma care; shall not discriminate among trauma centers for | 446 |
reasons not related to a patient's medical needs; shall seek to | 447 |
minimize undertriage and overtriage; may include any of the | 448 |
exceptions in division (A)(2) of this section; and supersede the | 449 |
state triage protocols adopted under division (A) of this section | 450 |
in the region in which the regional protocols apply. | 451 |
(4) Upon approval of regional protocols for the triage of | 452 |
adult and pediatric trauma victims under division (B)(2) of this | 453 |
section, or an amendment to such protocols, the state board of | 454 |
emergency medical services shall provide written notice of the | 455 |
approval and a copy of the protocols or amendment to each entity | 456 |
in the region in which the protocols apply to which the board is | 457 |
required to send a copy of the state triage protocols adopted | 458 |
under division (A) of this section. | 459 |
(C)(1) The state board of emergency medical services shall | 460 |
review the state triage protocols adopted under division (A) of | 461 |
this section at least every three years to determine if they are | 462 |
causing overtriage or undertriage of trauma patients, and shall | 463 |
modify them as necessary to minimize overtriage and undertriage. | 464 |
(2) Each regional physician advisory board or regional | 465 |
director that has had regional triage protocols approved under | 466 |
division (B)(2) of this section shall review the protocols at | 467 |
least every three years to determine if they are causing | 468 |
overtriage or undertriage of trauma patients and shall submit an | 469 |
appropriate amendment to the state board, as provided in division | 470 |
(B) of this section, as necessary to minimize overtriage and | 471 |
undertriage. The state board shall approve the amendment if it | 472 |
will reduce overtriage or undertriage while complying with | 473 |
division (B) of this section, and shall not otherwise approve the | 474 |
amendment. | 475 |
(D) No provider of emergency medical services or person who | 476 |
provides medical direction to emergency medical service personnel | 477 |
in this state shall fail to comply with the state triage protocols | 478 |
adopted under division (A) of this section or applicable regional | 479 |
triage protocols approved under division (B)(2) of this section. | 480 |
(E) The state board of emergency medical services shall adopt | 481 |
rules under section 4765.11 of the Revised Code that provide for | 482 |
enforcement of the state triage protocols adopted under division | 483 |
(A) of this section and regional triage protocols approved under | 484 |
division (B)(2) of this section, and for education regarding those | 485 |
protocols for emergency medical service organizations and | 486 |
personnel, regional directors and regional physician advisory | 487 |
boards, emergency medical service instructors, and persons who | 488 |
regularly provide medical direction to emergency medical service | 489 |
personnel in this state. | 490 |
Sec. 4765.44. (A) As used in this section, "primary stroke | 491 |
center" means a hospital designated by the department of health as | 492 |
a primary stroke center under section 3727.11 of the Revised Code, | 493 |
or, if no hospitals have been designated under that section, a | 494 |
hospital that holds a certificate of distinction for primary | 495 |
stroke centers issued by the joint commission. | 496 |
(B) Not later than six months after the effective date of | 497 |
this section, the state board of emergency medical services, in | 498 |
cooperation with the department of health and primary stroke | 499 |
centers, shall establish a stroke assessment and protocol tool. | 500 |
The tool shall: | 501 |
(1) Comply with nationally recognized standards for the | 502 |
assessment of stroke patients; | 503 |
(2) Detail the best practices for the assessment, treatment, | 504 |
and transport of stroke patients by an emergency medical | 505 |
technician-basic, emergency medical technician-intermediate, or | 506 |
paramedic; | 507 |
(3) Establish regional plans for triage and transport of | 508 |
stroke patients to the closest primary stroke centers, that can be | 509 |
reached in not more than sixty minutes. | 510 |
(C) The board shall provide a copy of the stroke assessment | 511 |
and protocol tool established under division (B) of this section | 512 |
to the medical director and cooperating physician advisory board | 513 |
of each emergency medical service organization, and to each | 514 |
EMT-basic, EMT-I, and paramedic. An EMT-basic, EMT-I, or paramedic | 515 |
shall perform emergency medical services the EMT-basic, EMT-I, or | 516 |
paramedic is authorized to provide in accordance with the stroke | 517 |
assessment and protocol tool or with a stroke assessment and | 518 |
protocol tool approved by the department of health under section | 519 |
3701.909 of the Revised Code that meets the requirements of | 520 |
division (B) of this section. | 521 |
(D) The board and the department of health shall post the | 522 |
assessment and protocol tool on their web sites. | 523 |
(E) The board may adopt rules necessary for administration of | 524 |
this section. The rules shall be adopted under Chapter 119. of the | 525 |
Revised Code. | 526 |
Section 2. That existing sections 4742.03, 4765.10, 4765.16, | 527 |
and 4765.40 of the Revised Code are hereby repealed. | 528 |