Pennsylvania: Agency level of Certification

medic493

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I am going to be doing a series of forum posts detailing the most up-to-date levels of EMS agencies in the state of Pennsylvania, as well as the types of EMS providers. This post will be dedicated to Pennsylvania agency types, and thoughts on our system. Pennsylvania requires all EMS agencies operating in the state to be licensed by the state. Except, in the case of MCI's, extenuating circumstances, and US Fed. Gov. EMS; in this case out of state EMS can operate in the state.

We have 5 primary levels of EMS care Air, ALS, iALS, BLS, QRS but 11 special categories of EMS units.

QRS: Quick Response Service. This designation is required for an agency to operate a first responder medical service (non-transporting units). This is the certification that many fire departments obtain to bridge the gap of extra long ambulance response times.
-QRS units operate using our state's BLS protocols, and require at least one provider certified as an EMR, or higher
-QRS units can carry anything allowed in BLS protocols for BLS units, but have less stringent equipment requirements.
-One exception, EMR's cannot perform pulse oximetry according to BLS protocols, so no Pulse oximetry and a few other skills are not permitted for EMR's operating QRS units.
-Also, must have at least one driver certified, or complying with EMSVO requirements. (EMSVO is a state operated approval process of evoc certified drivers).

BLS: A BLS unit must always have at least one EMT-Basic level, or higher staffing the unit.

-BLS Squad Service: A unit typically an SUV, fire engine, etc (non-transporting) that is staffed with at least 1 EMT-Basic of higher. These units are non-transporting, and carry all BLS equipment required by state. You can see this unit usually operating a chief's car, or EMS duty officer car.
-BLS Ambulance: Transporting ambulance staffed by at least one EMT-Basic, 1 EMR, and 1 EMSVO cerified driver. If there are 2 staff members: 1 EMT, and 1 EMR, the driver must be the EMR. The EMSVO can be can be the same person as the EMR.
-BLS Water Ambulance: Same rules as BLS Ambulance.

iALS: unit staffed with at least one Advanced-EMT, or higher.
iALS squad service, ambulance, and water ambulance all follow the same pattern as BLS.
-Squad must have at least 1 AEMT, Ambulance with 1AEMT and 1 EMT-B, and water same as ambulance,etc. Obviously, iALS carrying medications which are not carried by BLS.

ALS: unit staffed with at least 1 paramedic, or higher.
-ALS squad(1 Medic or higher), Ambulance (1 medic + EMT-Basic), and water ambulance all have same pattern as BLS, and iAls. Obviously, more medications for ALS.

Critical Care: same as ALS, but must have at least 2 providers above level of Advanced EMT. If one paramedic or higher is present, the second provider may be a special healthcare provider (must be approved by state), such as a respiratory therapist.

Air: Must have at least one pilot, and 2 EMS providers above the level of AEMT. This includes paramedic, pre-hospital RN, PHPE (pre-hospital physician extender= Physician Assistant), or PHP (pre-hospital physician). All of these types of providers must have received special training in programs to comply with their expanded ALS medication/scope of practice.

Tactical EMS/Special Ops:
This license allows agencies perform special, and austere tasks within any level, and with permission of the state, and proper training may do skills that are possibly beyond what the state allows normally.

Final Note:
-All agencies must have medical directors that are compliant with that level of care, and can perform activities such as QA/QI, etc.
- QRS and Squad Service vehicles can be firetrucks, boats, cars, motorcycles, or even flying saucers.
Next post will be about the providers themselves!
 

EpiEMS

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Never2Old

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PA actually only has four EMS protocols:

- BLS
- AEMT
- ALS
- CCT

We do have multiple licensing categories for the various agencies and vehicles as stated by the OP.
 
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medic493

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PA actually only has four EMS protocols:

- BLS
- AEMT
- ALS
- CCT

We do have multiple licensing categories for the various agencies and vehicles as stated by the OP.
I agree, but there is technically a separate scope of practice for EMR's (no separate book of protocols). Also, I would say that because there are different drug lists for Air, you could argue Air to be separate level.
 
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