USA Statutes : nevada
Title : Title 40 - PUBLIC HEALTH AND SAFETY
Chapter : CHAPTER 450B - EMERGENCY MEDICAL SERVICES
The Legislature hereby
declares that prompt and efficient emergency medical care and
transportation is necessary for the health and safety of the people of
Nevada, and that minimum standards for such care and all persons
providing it must be established.
(Added to NRS by 1981, 1599; A 1993, 2828)
As used in this chapter, unless the
context otherwise requires, the words and terms defined in NRS 450B.025
to 450B.110 , inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1973, 1141; A 1985, 1693; 1987, 1043, 2207; 1993,
2118, 2828; 1995, 725; 1999, 1172 )
“Advanced emergency medical technician” means a person:
1. Trained in advanced emergency medical care in a training
program approved by the board; and
2. Certified by the health officer as having satisfactorily
completed the training program.
(Added to NRS by 1987, 2206; A 1993, 2828)
“Air ambulance” means an
aircraft especially designed, constructed, modified or equipped to be
used for the transportation of injured or sick persons. “Air ambulance”
does not include any commercial aircraft carrying passengers on regularly
scheduled flights.
(Added to NRS by 1973, 1141)
“Ambulance” means a motor
vehicle which is specially designed, constructed, equipped and staffed to
provide basic, intermediate or advanced care for one or more:
1. Sick or injured persons; or
2. Persons whose medical condition may require special observation
during transportation or transfer,
Ê including, without limitation, such a vehicle of a fire-fighting agency.
(Added to NRS by 1973, 1141; A 1985, 1726, 2117; 2001, 998 )
“Attendant” means a person
responsible for the care of a sick or injured person in an ambulance or
air ambulance, and includes the driver of an ambulance but not the pilot
of an air ambulance.
(Added to NRS by 1973, 1141)
“Board” means:
1. In a county whose population is less than 400,000, the State
Board of Health.
2. In a county whose population is 400,000 or more, the district
board of health.
(Added to NRS by 1973, 1141; A 1993, 2828; 1995, 2547; 2005, 2471
)
“Committee” means the Committee
on Emergency Medical Services.
(Added to NRS by 1999, 1170 )
“Emergency
medical dispatcher” means a person who:
1. Has completed a training program in emergency medical
dispatching which has been approved by the board; and
2. Has been certified as having satisfactorily completed such a
training program by an entity approved by the board to provide such
training.
(Added to NRS by 1993, 2117)
“Emergency
medical technician” means a person:
1. Trained in basic emergency medical care in a training program
approved by the board; and
2. Certified by the health officer as having satisfactorily
completed the training program.
(Added to NRS by 1987, 2206; A 1993, 2828)
Emergency medical technician certificate” means the certificate issued
by the health authority acknowledging successful completion of an
approved course for an emergency medical technician at the level
identified on the certificate.
(Added to NRS by 1973, 1141; A 1987, 2207; 1993, 2828)
“Firefighter” means a person
who holds a license and is employed by or serving as a volunteer with a
fire-fighting agency.
(Added to NRS by 1985, 1692; A 2005, 330 )—(Substituted in revision for NRS 450B.073)
“Fire-fighting
agency” means a fire department or fire protection district of the State
or a political subdivision which holds a permit issued pursuant to this
chapter. The term does not include a person or governmental entity, other
than a governmental entity to whom a permit is issued in accordance with
the provisions of NRS 450B.1985 ,
which provides transportation of sick or injured persons to a medical
facility.
(Added to NRS by 1985, 1692; A 1987, 718; 2001, 998 )
[Replaced in revision by NRS
450B.071 .]
“Health authority” means:
1. In a county whose population is less than 400,000, the Health
Division.
2. In a county whose population is 400,000 or more, the district
board of health.
(Added to NRS by 1993, 2827; A 1995, 2547; 2005, 2471 )
“Health Division” means
the Health Division of the Department of Health and Human Services.
(Added to NRS by 1973, 1141; A 1973, 1406)
“Health officer” means:
1. In a county whose population is less than 400,000, the State
Health Officer.
2. In a county whose population is 400,000 or more, the district
health officer.
(Added to NRS by 1993, 2827; A 1995, 2547; 2005, 2471 )
“Intermediate emergency medical technician” means a person:
1. Trained in intermediate emergency medical care in a training
program approved by the board; and
2. Individually certified by the health officer as having
satisfactorily completed the training program.
(Added to NRS by 1981, 277; A 1993, 2828)
“License” means the license
issued by the health authority under the provisions of this chapter to an
attendant of an ambulance or an air ambulance or to a firefighter
employed by or serving as a volunteer with a fire-fighting agency.
(Added to NRS by 1973, 1141; A 1985, 1693; 1993, 2828; 2005, 330
)
“Permit” means the permit issued
by the health authority under the provisions of this chapter to:
1. A person, agency of the State or political subdivision to own
or operate an ambulance or air ambulance in the State of Nevada; or
2. A fire-fighting agency to provide intermediate or advanced
medical care to sick or injured persons:
(a) At the scene of an emergency; or
(b) At the scene of an emergency and while transporting those
persons to a medical facility.
(Added to NRS by 1973, 1141; A 1985, 1693; 1993, 2829; 2001, 998
)
“Trauma” means any acute injury
which, according to standardized criteria for triage in the field,
involves a significant risk of death or the precipitation of
complications or disabilities.
(Added to NRS by 1987, 1042)
“Volunteer attendant”
means a person who does not receive the majority of his annual employment
income from employment as an attendant, and who is not employed by a
commercial ambulance firm or corporation.
(Added to NRS by 1973, 1141)
The
board shall establish and promulgate such rules, regulations, standards
and procedures as it determines are necessary to administer the
provisions of this chapter.
(Added to NRS by 1973, 1141)
1. The board shall adopt regulations establishing reasonable
minimum standards for:
(a) Sanitation in ambulances and air ambulances;
(b) Medical and nonmedical equipment and supplies to be carried in
ambulances and air ambulances and medical equipment and supplies to be
carried in vehicles of a fire-fighting agency;
(c) Interior configuration, design and dimensions of ambulances
placed in service after July 1, 1979;
(d) Permits for operation of ambulances, air ambulances and
vehicles of a fire-fighting agency;
(e) Records to be maintained by an operator of an ambulance or air
ambulance or by a fire-fighting agency; and
(f) Treatment of patients who are critically ill or in urgent need
of treatment.
2. The health officers of this state shall jointly adopt
regulations to establish the minimum standards for the certification of
emergency medical technicians. Upon adoption of the regulations, each
health authority shall adopt the regulations for its jurisdiction. After
each health authority adopts the regulations, the standards established
constitute the minimum standards for certification of emergency medical
technicians in this state. Any changes to the minimum standards must be
adopted jointly by the health officers and by each health authority in
the manner set forth in this subsection. Any changes in the minimum
standards which are not adopted in the manner set forth in this
subsection are void.
3. A health officer may adopt regulations that impose additional
requirements for the certification of emergency medical technicians in
his jurisdiction, but he must accept the certification of an emergency
medical technician from the jurisdiction of another health officer as
proof that the emergency medical technician has met the minimum
requirements for certification.
(Added to NRS by 1973, 1142; A 1979, 69; 1981, 1553; 1985, 1693;
1993, 2829)
1. In adopting regulations under NRS 450B.120 and 450B.130 , the board may use standards and regulations
proposed by:
(a) The Committee on Trauma of the American College of Surgeons;
(b) The United States Department of Transportation;
(c) The United States Public Health Service;
(d) The Bureau of Health Insurance of the Social Security
Administration;
(e) The American Academy of Orthopaedic Surgeons;
(f) The National Academy of Sciences—National Research Council;
(g) The American Heart Association; and
(h) Regional, state and local emergency medical services committees
and councils.
2. The board may establish different standards for commercial,
volunteer, industrial and other categories of ambulances and
fire-fighting agencies to reflect different circumstances and in the
public interest.
(Added to NRS by 1973, 1142; A 1985, 1693; 1993, 2829)
1. The health authority shall administer and enforce the
provisions of this chapter.
2. The health authority and its authorized agents shall enter upon
and inspect, in a reasonable manner and during reasonable business hours,
the premises and vehicles of persons and governmental entities providing
services regulated pursuant to the provisions of this chapter.
(Added to NRS by 1973, 1142; A 1985, 1694; 1987, 2207; 1989, 1505,
1928; 1993, 2830)
COMMITTEE ON EMERGENCY MEDICAL SERVICES
1. The Committee on Emergency Medical Services, consisting of nine
members appointed by the Governor, is hereby created.
2. Upon request of the Governor, employee associations that
represent persons that provide emergency medical services, including,
without limitation, physicians and nurses that provide emergency medical
services, emergency medical technicians, ambulance attendants,
firefighters, fire chiefs and employees of rural hospitals, shall submit
to the Governor written nominations for appointments to the Committee.
3. After considering the nominations submitted pursuant to
subsection 2, the Governor shall appoint to the Committee:
(a) One member who is a physician licensed pursuant to chapter 630
or 633 of NRS and
who has experience providing emergency medical services;
(b) One member who is a registered nurse and who has experience
providing emergency medical services;
(c) One member who is a volunteer firefighter;
(d) One member who is employed by a fire-fighting agency at which
some of the firefighters are employed and some serve as volunteers;
(e) One member who is employed by an urban fire-fighting agency;
(f) One member who is employed by or serves as a volunteer with a
medical facility that is located in a rural area and that provides
emergency medical services;
(g) One member who is employed by an organization that provides
emergency medical services in an air ambulance and whose duties are
closely related to such emergency medical services;
(h) One member who is employed by a privately owned entity that
provides emergency medical services; and
(i) One member who is employed by an operator of a service which is:
(1) Provided for the benefit of the employees of an industry
who become sick or are injured at the industrial site; and
(2) Staffed by employees who are licensed attendants and
perform emergency medical services primarily for the industry.
4. In addition to the members set forth in subsection 3, the
following persons are ex officio members of the Committee:
(a) An employee of the Health Division, appointed by the
Administrator of the Health Division, whose duties relate to
administration and enforcement of the provisions of this chapter;
(b) The county health officer appointed pursuant to NRS 439.290
in each county whose population is
100,000 or more, or his designee; and
(c) A physician who is a member of a committee which consists of
directors of trauma centers in this State and who is nominated by that
committee.
5. The term of each member appointed by the Governor is 2 years,
and such a member may not serve more than two consecutive terms.
6. The Governor shall not appoint to the Committee two persons who
are employed by or volunteer with the same organization, except the
Governor may appoint a person who is employed by or volunteers with the
same organization of which a member who serves ex officio is an employee.
7. Each member of the Committee shall appoint an alternate to
serve in his place if he is temporarily unable to perform the duties
required of him pursuant to NRS 450B.151 to 450B.154 , inclusive.
8. A position on the Committee that becomes vacant before the end
of the term of the member must be filled in the manner prescribed by this
section for the remainder of the term.
(Added to NRS by 1999, 1170 ; A 2005, 330 )
1. The Committee shall elect a chairman from among its members.
The term of the Chairman is 1 year.
2. The Committee shall meet at the call of the Chairman at least
four times each year.
3. The Committee shall adopt rules for its own management.
4. A member of the Committee serves without compensation, except
that, for each day or portion of a day during which he attends a meeting
of the Committee or is otherwise engaged in the business of the
Committee, a member of the Committee is entitled to receive the per diem
allowance and travel expenses provided for state officers and employees
generally. The per diem allowance and travel expenses must be paid by the
Health Division from money not allocated by specific statute for another
use.
(Added to NRS by 1999, 1171 )
The Committee shall:
1. Review and advise the Health Division regarding the management
and performance of emergency medical services in this State and regarding
statewide emergency medical protocols;
2. Advise the Health Division on matters of policy relating to
emergency care, including, without limitation, the qualifications of
persons who provide emergency medical services;
3. Advise the board and Health Division with respect to the
preparation and adoption of regulations regarding emergency care;
4. Review periodically the budget of the Health Division that
relates to emergency medical services;
5. Encourage the training and education of emergency medical
service personnel to improve the system of public safety in this State;
and
6. Perform such other duties as may be required by law or
regulation.
(Added to NRS by 1999, 1171 )
The Health Division shall
provide administrative support and assistance to the Committee.
(Added to NRS by 1999, 1172 )
EMERGENCY MEDICAL DISPATCHERS
1. An educational institution, public or private agency or other
entity may provide a training program for emergency medical dispatchers
and issue certificates of completion if the program meets the
requirements set forth in the regulations of the board and is approved by
the board.
2. The board shall adopt regulations:
(a) Prescribing the requirements for a program for training and
certifying an emergency medical dispatcher;
(b) Prescribing the procedures for an educational institution,
public or private agency or other entity to obtain the approval of the
board to provide such a program; and
(c) Establishing such fees as are necessary to cover the cost of
administering the provisions of this section.
(Added to NRS by 1993, 2117)
AMBULANCE ATTENDANTS, EMERGENCY MEDICAL TECHNICIANS AND FIREFIGHTERS
1. The health authority may issue licenses to attendants and to
firefighters employed by or serving as volunteers with a fire-fighting
agency.
2. Each license must be evidenced by a card issued to the holder
of the license, is valid for a period not to exceed 2 years and is
renewable.
3. An applicant for a license must file with the health authority:
(a) A current, valid certificate evidencing his successful
completion of a program or course for training in emergency medical
technology, if he is applying for a license as an attendant, or, if a
volunteer attendant, at a level of skill determined by the board.
(b) A current valid certificate evidencing his successful
completion of a program for training as an intermediate emergency medical
technician or advanced emergency medical technician if he is applying for
a license as a firefighter with a fire-fighting agency.
(c) A signed statement showing:
(1) His name and address;
(2) His employer’s name and address; and
(3) A description of his duties.
(d) Such other certificates for training and such other items as
the board may specify.
4. The board shall adopt such regulations as it determines are
necessary for the issuance, suspension, revocation and renewal of
licenses.
5. Each operator of an ambulance or air ambulance and each
fire-fighting agency shall annually file with the health authority a
complete list of the licensed persons in its service.
6. Licensed physicians, registered nurses and licensed physician
assistants may serve as attendants without being licensed under the
provisions of this section. A registered nurse who performs advanced
emergency care in an ambulance or air ambulance shall perform the care in
accordance with the regulations of the State Board of Nursing. A licensed
physician assistant who performs advanced emergency care in an ambulance
or air ambulance shall perform the care in accordance with the
regulations of the Board of Medical Examiners.
7. Each licensed physician, registered nurse and licensed
physician assistant who serves as an attendant must have current
certification of completion of training in:
(a) Advanced life-support procedures for patients who require
cardiac care;
(b) Life-support procedures for pediatric patients who require
cardiac care; or
(c) Life-support procedures for patients with trauma that are
administered before the arrival of those patients at a hospital.
Ê The certification must be issued by the Board of Medical Examiners for
a physician or licensed physician assistant or by the State Board of
Nursing for a registered nurse.
8. The Board of Medical Examiners and the State Board of Nursing
shall issue a certificate pursuant to subsection 7 if the licensed
physician, licensed physician assistant or registered nurse attends:
(a) A course offered by a national organization which is nationally
recognized for issuing such certification;
(b) Training conducted by the operator of an ambulance or air
ambulance; or
(c) Any other course or training,
Ê approved by the Board of Medical Examiners or the State Board of
Nursing, whichever is issuing the certification. The Board of Medical
Examiners and the State Board of Nursing may require certification of
training in all three areas set forth in subsection 7 for a licensed
physician, licensed physician assistant or registered nurse who primarily
serves as an attendant in a county whose population is 400,000 or more.
(Added to NRS by 1973, 1142; A 1977, 962; 1979, 70; 1981, 278,
1554; 1985, 1694, 2118; 1987, 2207; 1993, 317, 2830; 1995, 725; 1997,
690; 2001, 782 ; 2005, 331 )
Except as otherwise provided in this chapter, unlicensed
relatives of a sick or injured patient and other persons may ride in an
ambulance if there are two attendants in the ambulance, each of whom is
licensed pursuant to this chapter or exempt from licensing pursuant to
subsection 6 of NRS 450B.160 .
(Added to NRS by 1989, 286; A 1993, 318)
[Effective until the date of the repeal of the federal law
requiring each state to establish procedures for withholding, suspending
and restricting the professional, occupational and recreational licenses
for child support arrearages and for noncompliance with certain processes
relating to paternity or child support proceedings.]
1. Any person desiring certification as an emergency medical
technician must apply to the health authority using forms prescribed by
the health authority.
2. The health authority, pursuant to regulations and procedures
adopted by the board, shall make a determination of the applicant’s
qualifications to be certified as an emergency medical technician, and
shall issue a certificate as an emergency medical technician to each
qualified applicant.
3. A certificate as an emergency medical technician is valid for a
period not exceeding 2 years and may be renewed if the holder of the
certificate complies with the provisions of this chapter and meets the
qualifications set forth in the regulations and standards established by
the board pursuant to this chapter. The regulations and standards
established by the board must provide for the completion of a course of
instruction, within 2 years after initial licensure, relating to the
medical consequences of an act of terrorism that involves the use of a
weapon of mass destruction. The course must provide at least 4 hours of
instruction that includes instruction in the following subjects:
(a) An overview of acts of terrorism and weapons of mass
destruction;
(b) Personal protective equipment required for acts of terrorism;
(c) Common symptoms and methods of treatment associated with
exposure to, or injuries caused by, chemical, biological, radioactive and
nuclear agents;
(d) Syndromic surveillance and reporting procedures for acts of
terrorism that involve biological agents; and
(e) An overview of the information available on, and the use of,
the Health Alert Network.
Ê The board may thereafter determine whether to establish regulations and
standards requiring additional courses of instruction relating to the
medical consequences of an act of terrorism that involves the use of a
weapon of mass destruction.
4. The health authority may suspend or revoke the certificate of
an emergency medical technician if it finds that the holder of the
certificate no longer meets the prescribed qualifications. Unless the
certificate is suspended by the district court pursuant to NRS 425.540
, the holder of the certificate may
appeal the suspension or revocation of his certificate pursuant to
regulations adopted by the board.
5. The board shall determine the procedures and techniques which
may be performed by an emergency medical technician.
6. A certificate issued pursuant to this section is valid
throughout the State, whether issued by the Health Division or a district
board of health.
7. The Health Division shall maintain a central registry of all
certificates issued pursuant to this section, whether issued by the
Health Division or a district board of health.
8. The board shall adopt such regulations as are necessary to
carry out the provisions of this section.
9. As used in this section:
(a) “Act of terrorism” has the meaning ascribed to it in NRS
202.4415 .
(b) “Biological agent” has the meaning ascribed to it in NRS
202.442 .
(c) “Chemical agent” has the meaning ascribed to it in NRS 202.4425
.
(d) “Radioactive agent” has the meaning ascribed to it in NRS
202.4437 .
(e) “Weapon of mass destruction” has the meaning ascribed to it in
NRS 202.4445 .
(Added to NRS by 1973, 1143; A 1977, 70; 1981, 279, 1555; 1991,
1916; 1993, 2831; 1995, 2548; 1997, 2056; 2003, 2953 ; 2005, 2471 )
[Effective on the date of the repeal of the federal law
requiring each state to establish procedures for withholding, suspending
and restricting the professional, occupational and recreational licenses
for child support arrearages and for noncompliance with certain processes
relating to paternity or child support proceedings.]
1. Any person desiring certification as an emergency medical
technician must apply to the health authority using forms prescribed by
the health authority.
2. The health authority, pursuant to regulations and procedures
adopted by the board, shall make a determination of the applicant’s
qualifications to be certified as an emergency medical technician, and
shall issue a certificate as an emergency medical technician to each
qualified applicant.
3. A certificate as an emergency medical technician is valid for a
period not exceeding 2 years and may be renewed if the holder of the
certificate meets the qualifications set forth in the regulations and
standards established by the board pursuant to this chapter. The
regulations and standards established by the board must provide for the
completion of a course of instruction, within 2 years after initial
licensure, relating to the medical consequences of an act of terrorism
that involves the use of a weapon of mass destruction. The course must
provide at least 4 hours of instruction that includes instruction in the
following subjects:
(a) An overview of acts of terrorism and weapons of mass
destruction;
(b) Personal protective equipment required for acts of terrorism;
(c) Common symptoms and methods of treatment associated with
exposure to, or injuries caused by, chemical, biological, radioactive and
nuclear agents;
(d) Syndromic surveillance and reporting procedures for acts of
terrorism that involve biological agents; and
(e) An overview of the information available on, and the use of,
the Health Alert Network.
Ê The board may thereafter determine whether to establish regulations and
standards requiring additional courses of instruction relating to the
medical consequences of an act of terrorism that involves the use of a
weapon of mass destruction.
4. The health authority may suspend or revoke the certificate of
an emergency medical technician if it finds that the holder of the
certificate no longer meets the prescribed qualifications. The holder of
the certificate may appeal the suspension or revocation of his
certificate pursuant to regulations adopted by the board.
5. The board shall determine the procedures and techniques which
may be performed by an emergency medical technician.
6. A certificate issued pursuant to this section is valid
throughout the State, whether issued by the Health Division or a district
board of health.
7. The Health Division shall maintain a central registry of all
certificates issued pursuant to this section, whether issued by the
Health Division or a district board of health.
8. The board shall adopt such regulations as are necessary to
carry out the provisions of this section.
9. As used in this section:
(a) “Act of terrorism” has the meaning ascribed to it in NRS
202.4415 .
(b) “Biological agent” has the meaning ascribed to it in NRS
202.442 .
(c) “Chemical agent” has the meaning ascribed to it NRS 202.4425
.
(d) “Radioactive agent” has the meaning ascribed to it in NRS
202.4437 .
(e) “Weapon of mass destruction” has the meaning ascribed to it in
NRS 202.4445 .
(Added to NRS by 1973, 1143; A 1977, 70; 1981, 279, 1555; 1991,
1916; 1993, 2831; 1995, 2548; 1997, 2056; 2003, 2953 ; 2005, 2471 , 2472 , effective on the date of the repeal of
the federal law requiring each state to establish procedures for
withholding, suspending and restricting the professional, occupational
and recreational licenses for child support arrearages and for
noncompliance with certain processes relating to paternity or child
support proceedings)
[Expires by limitation on the date of the
repeal of the federal law requiring each state to establish procedures
for withholding, suspending and restricting the professional,
occupational and recreational licenses for child support arrearages and
for noncompliance with certain processes relating to paternity or child
support proceedings.]
1. An applicant for the issuance or renewal of a license as an
attendant or firefighter employed by a fire-fighting agency or an
emergency medical technician certificate shall submit to the health
authority the statement prescribed by the Division of Welfare and
Supportive Services of the Department of Health and Human Services
pursuant to NRS 425.520 . The statement
must be completed and signed by the applicant.
2. The health authority shall include the statement required
pursuant to subsection 1 in:
(a) The application or any other forms that must be submitted for
the issuance or renewal of the license or certificate; or
(b) A separate form prescribed by the health authority.
3. A license or certificate described in subsection 1 may not be
issued or renewed by the health authority if the applicant:
(a) Fails to submit the statement required pursuant to subsection
1; or
(b) Indicates on the statement submitted pursuant to subsection 1
that he is subject to a court order for the support of a child and is not
in compliance with the order or a plan approved by the district attorney
or other public agency enforcing the order for the repayment of the
amount owed pursuant to the order.
4. If an applicant indicates on the statement submitted pursuant
to subsection 1 that he is subject to a court order for the support of a
child and is not in compliance with the order or a plan approved by the
district attorney or other public agency enforcing the order for the
repayment of the amount owed pursuant to the order, the health authority
shall advise the applicant to contact the district attorney or other
public agency enforcing the order to determine the actions that the
applicant may take to satisfy the arrearage.
(Added to NRS by 1997, 2055; A 2005, 332 )
[Expires by limitation on the
date of the repeal of the federal law requiring each state to establish
procedures for withholding, suspending and restricting the professional,
occupational and recreational licenses for child support arrearages and
for noncompliance with certain processes relating to paternity or child
support proceedings.]
1. If the health authority receives a copy of a court order issued
pursuant to NRS 425.540 that provides
for the suspension of all professional, occupational and recreational
licenses, certificates and permits issued to a person who is the holder
of a license as an attendant or firefighter employed by a fire-fighting
agency or an emergency medical technician certificate, the health
authority shall deem the license or certificate issued to that person to
be suspended at the end of the 30th day after the date on which the court
order was issued unless the health authority receives a letter issued to
the holder of the license or certificate by the district attorney or
other public agency pursuant to NRS 425.550 stating that the holder of the license or
certificate has complied with the subpoena or warrant or has satisfied
the arrearage pursuant to NRS 425.560 .
2. The health authority shall reinstate a license as an attendant
or firefighter employed by a fire-fighting agency or an emergency medical
technician certificate that has been suspended by a district court
pursuant to NRS 425.540 if:
(a) The health authority receives a letter issued by the district
attorney or other public agency pursuant to NRS 425.550 to the person whose license or certificate was
suspended stating that the person whose license or certificate was
suspended has complied with the subpoena or warrant or has satisfied the
arrearage pursuant to NRS 425.560 ; and
(b) The person whose license or certificate was suspended pays any
fees imposed by the health authority for the reinstatement of a suspended
license or certificate.
(Added to NRS by 1997, 2056; A 2005, 333 )
[Expires by limitation on the date of the repeal
of the federal law requiring each state to establish procedures for
withholding, suspending and restricting the professional, occupational
and recreational licenses for child support arrearages and for
noncompliance with certain processes relating to paternity or child
support proceedings.] An application for the issuance or renewal of a
license as an attendant or firefighter employed by a fire-fighting agency
or an emergency medical technician certificate must include the social
security number of the applicant.
(Added to NRS by 1997, 2056; A 2005, 333 )
1. The health authority may, at its discretion, issue a
provisional license as an attendant to a person who does not meet the
qualifications established pursuant to this chapter, if the health
authority determines that such issuance will be in the public interest.
2. A provisional license as an attendant must not be made valid
for more than 1 year from the date of issuance and is not renewable.
(Added to NRS by 1973, 1144; A 1987, 2208; 1993, 2832)
BASIC EMERGENCY CARE
1. A program for training in the basic care of a patient in urgent
need of medical care or observation must be:
(a) Supervised by a physician and approved by the health authority;
or
(b) Presented by a national organization which is nationally
recognized for providing such training and approved by the board.
2. Except as otherwise provided in subsections 3 and 4, training
in basic care must include:
(a) Procedures to establish and maintain an open airway in a
patient;
(b) Administration of oxygen, both manually and by a device which
uses intermittent positive pressure;
(c) Cardiopulmonary resuscitation;
(d) Treatment of shock;
(e) Control of bleeding;
(f) Treatment of wounds;
(g) Application of splints;
(h) Treatment for poisoning;
(i) Childbirth; and
(j) Rescue.
3. A program for training in the basic care of a patient may
follow the curriculum prepared by the United States Department of
Transportation as a national standard for emergency medical technicians.
4. The board may adopt regulations which prescribe other
requirements for training in the basic care of a patient in urgent need
of medical care or observation.
5. An owner of an ambulance shall not offer basic care of a
patient in urgent need of medical care or observation unless the
attendant has successfully completed a program of training in such care
or is exempt, pursuant to subsection 6 of NRS 450B.160 , from the requirement to obtain that
training.
6. The board may by regulation prescribe additional requirements
for receiving and maintaining certification in basic emergency care. The
curriculum for training must be:
(a) At the level of advanced first aid; or
(b) At least equivalent to any curriculum prepared by the
Department of Transportation as a national standard for emergency medical
technicians.
(Added to NRS by 1985, 2117; A 1987, 2208; 1993, 318, 2832)
INTERMEDIATE EMERGENCY CARE
1. A program of training in intermediate emergency care of a
patient in urgent need of medical care or observation must be conducted
by a licensed physician and approved by the health authority.
2. A program of training for an intermediate emergency medical
technician must include an approved curriculum in intravenous therapy and
the management of a passage for air to the lungs. Only a certified
emergency medical technician with experience as established by the board
is eligible for this training.
3. In order to maintain his certification, each intermediate
emergency medical technician must annually:
(a) Comply with the requirements established by the board for
continuing medical education; and
(b) Demonstrate his skills as required by regulation of the board.
4. The board may by regulation prescribe the curriculum and other
requirements for training and maintaining certification in intermediate
emergency care. The curriculum must be at least equivalent to any
curriculum prepared by the United States Department of Transportation as
a national standard for intermediate emergency medical technicians.
5. A person shall not represent himself to be an intermediate
emergency medical technician unless he has on file with the health
authority a currently valid certificate demonstrating successful
completion of the program of training required by this section.
6. Except as authorized by subsection 6 of NRS 450B.160 , an attendant or firefighter shall not
perform, and the owner, operator, director or chief officer of an
ambulance or a fire-fighting agency must not offer, intermediate
emergency care without fulfilling the requirements established by the
board.
(Added to NRS by 1981, 277; A 1981, 1557; 1985, 1695; 1987, 2209;
1993, 319, 2833; 1995, 725; 2005, 333 )
An intermediate emergency
medical technician may perform any procedure and administer any drug
approved by regulation of the board.
(Added to NRS by 1981, 278; A 1987, 2210)
ADVANCED EMERGENCY CARE
1. Only a certified emergency medical technician who is a licensed
attendant or a firefighter with experience as established by the board is
eligible for training as an advanced emergency medical technician.
2. A program of training in advanced emergency care for advanced
emergency medical technicians must be conducted by a licensed physician
and approved by the health authority.
3. In order to maintain his certification, each advanced emergency
medical technician must annually:
(a) Comply with the requirements established by the board for
continuing medical education; and
(b) Demonstrate his skills as required by regulation of the board.
4. The board may by regulation prescribe the curriculum and other
requirements for training and maintaining certification in advanced
emergency care. The curriculum must be at least equivalent to any
curriculum prepared by the United States Department of Transportation as
a national standard for advanced emergency medical technicians.
5. A person shall not represent himself to be an advanced
emergency medical technician unless he has on file with the health
authority a currently valid certificate evidencing his successful
completion of the program of training required by this section.
6. Except as authorized by subsection 6 of NRS 450B.160 , an attendant or firefighter shall not
perform, and the owner, operator, director or chief officer of an
ambulance or a fire-fighting agency must not offer, advanced emergency
care without fulfilling the requirements established by the board.
(Added to NRS by 1973, 610; A 1975, 38; 1979, 71; 1981, 1555; 1985,
1696; 1987, 2210; 1993, 319, 2833; 1995, 725; 2005, 334 )
An attendant or a firefighter
who is an advanced emergency medical technician may perform any procedure
and administer any drug approved by regulation of the board.
(Added to NRS by 1973, 610; A 1975, 38; 1981, 1556; 1985, 1696;
1987, 2211; 2005, 334 )
PERMIT AUTHORIZING FIRE-FIGHTING AGENCY TO PROVIDE INTERMEDIATE OR
ADVANCED MEDICAL CARE
1. Except as otherwise provided in subsection 2, no permit may be
issued pursuant to this chapter authorizing a fire-fighting agency to
provide intermediate or advanced medical care to sick or injured persons
while transporting those persons to a medical facility.
2. Except as otherwise provided in subsection 9 of NRS 450B.200
, the district board of health in a
county whose population is 400,000 or more may issue a permit pursuant to
NRS 450B.200 or 450B.210 authorizing a fire-fighting agency to
provide intermediate or advanced medical care to sick or injured persons
at the scene of an emergency and while transporting those persons to a
medical facility.
(Added to NRS by 2001, 998 ; A 2005, 2473 )
AMBULANCES AND VEHICLES OF FIRE-FIGHTING AGENCIES
1. The health authority may issue a permit for the operation of an
ambulance, an air ambulance or a vehicle of a fire-fighting agency at the
scene of an emergency.
2. Each permit must be evidenced by a card issued to the holder of
the permit.
3. No permit may be issued unless the applicant is qualified
pursuant to the regulations of the board.
4. An application for a permit must be made upon forms prescribed
by the board and in accordance with procedures established by the board,
and must contain the following:
(a) The name and address of the owner of the ambulance or air
ambulance or of the fire-fighting agency;
(b) The name under which the applicant is doing business or
proposes to do business, if applicable;
(c) A description of each ambulance, air ambulance or vehicle of a
fire-fighting agency, including the make, year of manufacture and chassis
number, and the color scheme, insigne, name, monogram or other
distinguishing characteristics to be used to designate the applicant’s
ambulance, air ambulance or vehicle;
(d) The location and description of the places from which the
ambulance, air ambulance or fire-fighting agency intends to operate; and
(e) Such other information as the board deems reasonable and
necessary to a fair determination of compliance with the provisions of
this chapter.
5. The board shall establish a reasonable fee for annual permits.
6. All permits expire on July 1 following the date of issue, and
are renewable annually thereafter upon payment of the fee required by
subsection 5 at least 30 days before the expiration date.
7. The health authority shall:
(a) Revoke, suspend or refuse to renew any permit issued pursuant
to this section for violation of any provision of this chapter or of any
regulation adopted by the board; or
(b) Bring an action in any court for violation of this chapter or
the regulations adopted pursuant to this chapter,
Ê only after the holder of a permit is afforded an opportunity for a
public hearing pursuant to regulations adopted by the board.
8. The health authority may suspend a permit if the holder is
using an ambulance, air ambulance or vehicle of a fire-fighting agency
which does not meet the minimum requirements for equipment as established
by the board pursuant to this chapter.
9. The issuance of a permit pursuant to this section or NRS
450B.210 does not authorize any
person or governmental entity to provide those services or to operate any
ambulance, air ambulance or vehicle of a fire-fighting agency not in
conformity with any ordinance or regulation enacted by any county,
municipality or special purpose district.
10. A permit issued pursuant to this section is valid throughout
the State, whether issued by the Health Division or a district board of
health. An ambulance, air ambulance or vehicle of a fire-fighting agency
which has received a permit from the district board of health in a county
whose population is 400,000 or more is not required to obtain a permit
from the Health Division, even if the ambulance, air ambulance or vehicle
of a fire-fighting agency has routine operations outside the county.
11. The Health Division shall maintain a central registry of all
permits issued pursuant to this section, whether issued by the Health
Division or a district board of health.
12. The board shall adopt such regulations as are necessary to
carry out the provisions of this section.
(Added to NRS by 1973, 1144; A 1977, 71; 1981, 279; 1985, 1697;
1987, 2212; 1991, 1916; 1993, 2834; 1995, 2548; 2005, 2473 )
1. The board may issue provisional permits limited as to time,
place and purpose, based on the need therefor. No provisional permit may
be issued for a period of longer than 6 months. The board may establish a
reasonable fee for such provisional permits.
2. Unless otherwise limited in the permit, a provisional permit
issued pursuant to this section is valid for providing emergency services
throughout the State, whether issued by the Health Division or a district
board of health.
(Added to NRS by 1973, 1145; A 1991, 1917; 2005, 2474 )
Subsequent to issuance of any
permit under NRS 450B.200 and
450B.210 , the health authority shall
cause to be inspected the ambulances, aircraft, vehicles, medical
supplies, equipment, personnel, records, premises and operational
procedures of a holder of a permit whenever that inspection is deemed
necessary, but no less frequently than once each year. The periodic
inspection required by this section is in addition to any other state or
local inspections required for ambulances, aircraft or motor vehicles
under statute or ordinances.
(Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2835)
The public or private owner of an ambulance or air ambulance
or the fire-fighting agency who owns a vehicle used in providing
emergency medical care shall not permit its operation and use without the
equipment required by regulations and standards of the board.
(Added to NRS by 1973, 1145; A 1985, 1699)
1. Each public and private owner of an ambulance or air ambulance
shall file his schedule of rates with the health authority. Any change in
a schedule must be filed before the change becomes effective.
2. The health authority shall keep each schedule of rates or
changes filed with it for at least 3 years after the schedule has been
superseded or otherwise become ineffective.
(Added to NRS by 1979, 726; A 1993, 2835)
TREATMENT OF TRAUMA
A person shall not operate a center for the
treatment of trauma without first applying for and obtaining the written
approval of the Administrator of the Health Division.
(Added to NRS by 1987, 1042)
1. The board shall establish a program for treating persons who
require treatment for trauma and for transporting and admitting such
persons to centers for the treatment of trauma. The program must provide
for the development, operation and maintenance of a system of
communication to be used in transporting such persons to the appropriate
centers.
2. The State Board of Health shall adopt regulations which
establish the standards for the designation of hospitals as centers for
the treatment of trauma. The State Board of Health shall consider the
standards adopted by the American College of Surgeons for a center for
the treatment of trauma as a guide for such regulations. The
Administrator of the Health Division shall not approve a proposal to
designate a hospital as a center for the treatment of trauma unless the
hospital meets the standards established pursuant to this subsection.
3. Each district board of health in a county whose population is
400,000 or more shall adopt regulations which establish the standards for
the designation of hospitals in the county as centers for the treatment
of trauma which are consistent with the regulations adopted by the State
Board of Health pursuant to subsection 2. A district board of health
shall not approve a proposal to designate a hospital as a center for the
treatment of trauma unless the hospital meets the standards established
pursuant to this subsection.
4. A proposal to designate a hospital located in a county whose
population is 400,000 or more as a center for the treatment of trauma:
(a) Must be approved by the Administrator of the Health Division
and by the district board of health of the county in which the hospital
is located; and
(b) May not be approved unless the district board of health of the
county in which the hospital is located has established and adopted a
comprehensive trauma system plan concerning the treatment of trauma in
the county, which includes, without limitation, consideration of the
future trauma needs of the county, consideration of and plans for the
development and designation of new centers for the treatment of trauma in
the county based on the demographics of the county and the manner in
which the county may most effectively provide trauma services to persons
in the county.
5. Upon approval by the Administrator of the Health Division and,
if the hospital is located in a county whose population is 400,000 or
more, the district board of health of the county in which the hospital is
located, of a proposal to designate a hospital as a center for the
treatment of trauma, the Administrator of the Health Division shall issue
written approval which designates the hospital as such a center. As a
condition of continuing designation the hospital must comply with the
following requirements:
(a) The hospital must admit any injured person who requires medical
care.
(b) Any physician who provides treatment for trauma must be
qualified to provide that treatment.
(c) The hospital must maintain the standards specified in the
regulations adopted pursuant to subsections 2 and 3.
(Added to NRS by 1987, 1042; A 1993, 2835; 2005, 1349 )
The State Board of Health shall adopt regulations which
require each hospital to record and maintain information concerning the
treatment of trauma in the hospital. The Board shall consider the
guidelines adopted by the American College of Surgeons which concern the
information which must be recorded.
(Added to NRS by 1987, 1043; A 1993, 2836)
In addition to the education and training required by this
chapter, the Health Division shall cooperate with the American College of
Surgeons to provide training in the treatment of trauma.
(Added to NRS by 1987, 1043)
PROHIBITED ACTS
1. A person or governmental entity shall not engage in the
operation of any ambulance or air ambulance service in this state without
a currently valid permit for that service issued by the health authority.
2. A fire-fighting agency shall not provide intermediate or
advanced medical care to sick or injured persons at the scene of an
emergency or while transporting those persons to a medical facility
without a currently valid permit for that care issued by the health
authority.
(Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2836; 2001, 999
)
Except
as otherwise provided in this chapter, a person shall not serve as an
attendant on any ambulance or air ambulance and a firefighter shall not
provide intermediate or advanced medical care to sick or injured persons
at the scene of an emergency or while transporting those persons to a
medical facility unless he holds a currently valid license issued by the
health authority under the provisions of this chapter.
(Added to NRS by 1973, 1145; A 1985, 1699; 1993, 2836; 2001, 999
; 2005, 334 )
A person shall not represent himself to be an
emergency medical technician unless he has been issued a currently valid
certificate as an emergency medical technician by the health authority.
(Added to NRS by 1979, 71; A 1993, 2836)
1. Except as otherwise provided in this section, the public or
private owner of an ambulance or air ambulance or a fire-fighting agency
which owns a vehicle used in providing medical care to sick or injured
persons at the scene of an emergency or while transporting those persons
to a medical facility shall not permit its operation and use by any
person not licensed under this chapter.
2. An ambulance carrying a sick or injured patient must be
occupied by a driver and an attendant, each of whom is licensed as an
attendant pursuant to this chapter or exempt from licensing pursuant to
subsection 6 of NRS 450B.160 , except
as otherwise provided in subsection 5 or in geographic areas which may be
designated by the board and for which the board may prescribe lesser
qualifications.
3. An air ambulance carrying a sick or injured patient must be
occupied by a licensed attendant, or a person exempt from licensing
pursuant to subsection 6 of NRS 450B.160 , in addition to the pilot of the aircraft.
4. The pilot of an air ambulance is not required to have a license
under this chapter.
5. A person who operates or uses a vehicle owned by a
fire-fighting agency is not required to be licensed under this chapter,
except that such a vehicle may not be used to provide intermediate or
advanced medical care to sick or injured persons:
(a) At the scene of an emergency unless at least one person in the
vehicle is licensed to provide the care; or
(b) While transporting those persons to a medical facility unless
at least two persons in the vehicle are licensed to provide the care.
(Added to NRS by 1973, 1145; A 1985, 1699; 1993, 320; 2001, 999
)
1. Except as otherwise provided in subsection 2, a fire-fighting
agency or an owner, operator, director or chief officer of an ambulance
shall not represent, advertise or imply that it:
(a) Is authorized to provide advanced emergency care; or
(b) Uses the services of an advanced emergency medical technician,
Ê unless the service has a currently valid permit to provide advanced
emergency care issued by the health authority.
2. Any service in a county whose population is less than 400,000,
that holds a valid permit for the operation of an ambulance but is not
authorized by the health authority to provide advanced emergency care may
represent, for billing purposes, that its ambulance provided advanced
emergency care if:
(a) A registered nurse employed by a hospital rendered advanced
emergency care to a patient being transferred from the hospital by the
ambulance; and
(b) The equipment deemed necessary by the health authority for the
provision of advanced emergency care was on board the ambulance at the
time the registered nurse rendered advanced emergency care.
3. A hospital that employs a registered nurse who renders the care
described in subsection 2 is entitled to reasonable reimbursement for the
services rendered by the nurse.
(Added to NRS by 1979, 71; A 1985, 1700; 1987, 2213; 1989, 286,
1936; 1993, 2836)
WITHHOLDING LIFE-SUSTAINING TREATMENT
As used in NRS 450B.400 to 450B.590 , inclusive, unless the context otherwise
requires, the words and terms defined in NRS 450B.405 to 450B.475 , inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1997, 287; A 2001, 815 )
“Attending physician”
has the meaning ascribed to it in NRS 449.550 .
(Added to NRS by 2001, 814 )
“Do-not-resuscitate identification” means:
1. A form of identification approved by the health authority,
which signifies that:
(a) A person is a qualified patient who wishes not to be
resuscitated in the event of cardiac or respiratory arrest; or
(b) The patient’s attending physician has:
(1) Issued a do-not-resuscitate order for the patient;
(2) Obtained the written approval of the patient concerning
the order; and
(3) Documented the grounds for the order in the patient’s
medical record.
2. The term also includes a valid do-not-resuscitate
identification issued under the laws of another state.
(Added to NRS by 1997, 287)
“Do-not-resuscitate order” means a written directive issued by a
physician licensed in this state that emergency life-resuscitating
treatment must not be administered to a qualified patient. The term also
includes a valid do-not-resuscitate order issued under the laws of
another state.
(Added to NRS by 1997, 288)
“Do-not-resuscitate protocol” means the standardized procedure and
guidelines established by the board for the withholding of emergency
life-resuscitating treatment in compliance with a do-not-resuscitate
order or a do-not-resuscitate identification.
(Added to NRS by 1997, 288; A 1999, 45 )
“Health care
facility” has the meaning ascribed to it in NRS 449.800 .
(Added to NRS by 1997, 288)
“Life-resuscitating treatment” means cardiopulmonary resuscitation or a
component of cardiopulmonary resuscitation, including chest compressions,
defibrillation, cardioversion, assisted ventilation, airway intubation or
administration of cardiotonic drugs.
(Added to NRS by 1997, 288)
“Person who administers emergency medical services” means a
paid or volunteer firefighter, law enforcement officer, emergency medical
technician, ambulance attendant or other person trained to provide
emergency medical services.
(Added to NRS by 1997, 288)
NRS 450B.470 “Qualified patient” defined. “Qualified patient” means:
1. A patient 18 years of age or older who has been determined by
his attending physician to be in a terminal condition and who:
(a) Has executed a declaration in accordance with the requirements
of NRS 449.600 ; or
(b) Has been issued a do-not-resuscitate order pursuant to NRS
450B.510 .
2. A patient who is less than 18 years of age and who:
(a) Has been determined by his attending physician to be in a
terminal condition; and
(b) Has been issued a do-not-resuscitate order pursuant to NRS
450B.510 .
(Added to NRS by 1997, 288; A 2001, 815 )
“Terminal condition”
has the meaning ascribed to it in NRS 449.590 .
(Added to NRS by 2001, 814 )
The provisions of NRS 450B.400 to 450B.590 , inclusive, apply only to emergency medical
services administered to a qualified patient:
1. Before he is admitted to a medical facility; or
2. While the qualified patient is being prepared to be
transferred, or is being transferred, from one health care facility to
another health care facility.
(Added to NRS by 1997, 288; A 2001, 816 )
1. The board shall adopt regulations to carry out the provisions
of NRS 450B.400 to 450B.590 , inclusive. The regulations must establish:
(a) A do-not-resuscitate protocol; and
(b) The procedure to apply for a do-not-resuscitate identification.
2. The board may establish a fee for:
(a) A do-not-resuscitate identification to be collected by the
health authority. The fee may not exceed the actual cost to the health
authority of:
(1) Manufacturing or obtaining the identification from a
manufacturer, including the cost of shipping and handling; and
(2) Engraving the identification.
(b) The issuance of a bracelet or medallion which indicates that a
do-not-resuscitate identification has been issued to a qualified patient.
3. In the case of a district board of health, such regulations
take effect immediately upon approval by the State Board of Health.
(Added to NRS by 1997, 288; A 1999, 45 ; 2001, 816 ; 2005, 2475 )
Each
do-not-resuscitate identification issued by the health authority must
include, without limitation:
1. An identification number that is unique to the qualified
patient to whom the identification is issued;
2. The name and date of birth of the patient; and
3. The name of the attending physician of the patient.
(Added to NRS by 1997, 288)
The board may enter into an agreement
for the manufacture of a bracelet or medallion to be worn by a qualified
patient which indicates that the qualified patient has been issued a
do-not-resuscitate identification. Such a bracelet or medallion may be
issued to a qualified patient in addition to, and not in lieu of, the
do-not-resuscitate identification.
(Added to NRS by 2001, 814 )
1. A physician licensed in this state may issue a written
do-not-resuscitate order only to a patient who has been determined to be
in a terminal condition.
2. Except as otherwise provided in subsection 3, the order is
effective only if the patient has agreed to its terms, in writing, while
he is capable of making an informed decision.
3. If the patient is a minor, the order is effective only if:
(a) The parent or legal guardian of the minor has agreed to its
terms, in writing; and
(b) The minor has agreed to its terms, in writing, while he is
capable of making an informed decision if, in the opinion of the
attending physician, the minor is of sufficient maturity to understand
the nature and effect of withholding life-resuscitating treatment.
4. A physician who issues a do-not-resuscitate order may apply, on
behalf of the patient, to the health authority for a do-not-resuscitate
identification for that patient.
(Added to NRS by 1997, 289; A 2001, 816 )
Except as otherwise provided in NRS 450B.525 :
1. A qualified patient may apply to the health authority for a
do-not-resuscitate identification by submitting an application on a form
provided by the health authority. To obtain a do-not-resuscitate
identification, the patient must comply with the requirements prescribed
by the board and sign a form which states that he has informed each
member of his family within the first degree of consanguinity or
affinity, whose whereabouts are known to him, or if no such members are
living, his legal guardian, if any, or if he has no such members living
and has no legal guardian, his caretaker, if any, of his decision to
apply for an identification.
2. An application must include, without limitation:
(a) Certification by the patient’s attending physician that the
patient suffers from a terminal condition;
(b) Certification by the patient’s attending physician that the
patient is capable of making an informed decision or, when he was capable
of making an informed decision:
(1) He executed:
(I) A written directive that life-resuscitating
treatment be withheld under certain circumstances; or
(II) A durable power of attorney for health care
decisions pursuant to NRS 449.800 to
449.860 , inclusive; or
(2) He was issued a do-not-resuscitate order pursuant to NRS
450B.510 ;
(c) A statement that the patient does not wish that
life-resuscitating treatment be undertaken in the event of a cardiac or
respiratory arrest;
(d) The name, signature and telephone number of the patient’s
attending physician; and
(e) The name and signature of the patient or the attorney-in-fact
or agent who is authorized to make health care decisions on the patient’s
behalf pursuant to a durable power of attorney for health care decisions.
(Added to NRS by 1997, 289; A 1999, 45 ; 2001, 817 )
1. A parent or legal guardian of a minor may apply to the health
authority for a do-not-resuscitate identification on behalf of the minor
if the minor has been:
(a) Determined by his attending physician to be in a terminal
condition; and
(b) Issued a do-not-resuscitate order pursuant to NRS 450B.510
.
2. To obtain such a do-not-resuscitate identification, the parent
or legal guardian must:
(a) Submit an application on a form provided by the health
authority; and
(b) Comply with the requirements prescribed by the board.
3. An application submitted pursuant to subsection 2 must include,
without limitation:
(a) Certification by the minor’s attending physician that the minor:
(1) Suffers from a terminal condition; and
(2) Has been issued a do-not-resuscitate order pursuant to
NRS 450B.510 ;
(b) A statement that the parent or legal guardian of the minor does
not wish that life-resuscitating treatment be undertaken in the event of
a cardiac or respiratory arrest;
(c) The name of the minor;
(d) The name, signature and telephone number of the minor’s
attending physician; and
(e) The name, signature and telephone number of the minor’s parent
or legal guardian.
4. The parent or legal guardian of the minor may revoke the
authorization to withhold life-resuscitating treatment by removing or
destroying or requesting the removal or destruction of the identification
or otherwise indicating to a person that he wishes to have the
identification removed or destroyed.
5. If, in the opinion of the attending physician, the minor is of
sufficient maturity to understand the nature and effect of withholding
life-resuscitating treatment:
(a) The do-not-resuscitate identification obtained pursuant to this
section is not effective without the assent of the minor.
(b) The minor may revoke the authorization to withhold
life-resuscitating treatment by removing or destroying or requesting the
removal or destruction of the identification or otherwise indicating to a
person that he wishes to have the identification removed or destroyed.
(Added to NRS by 2001, 815 )
Except as otherwise provided in NRS
450B.525 , a qualified patient who
possesses a do-not-resuscitate identification may revoke his
authorization to withhold life-resuscitating treatment by removing or
destroying or requesting the removal or destruction of his identification
or otherwise indicating to a person that he wishes to have his
identification removed or destroyed.
(Added to NRS by 1997, 289; A 2001, 817 )
1. A person is not guilty of unprofessional conduct or subject to
civil or criminal liability if he:
(a) Is a physician who:
(1) Causes the withholding of life-resuscitating treatment
from a qualified patient who possesses a do-not-resuscitate
identification in accordance with the do-not-resuscitate protocol; or
(2) While the patient is being prepared to be transferred,
or is being transferred, from one health care facility to another health
care facility, carries out a do-not-resuscitate order that is documented
in the medical record of a qualified patient, in accordance with the
do-not-resuscitate protocol;
(b) Pursuant to the direction of or with the authorization of a
physician, participates in:
(1) The withholding of life-resuscitating treatment from a
qualified patient who possesses a do-not-resuscitate identification in
accordance with the do-not-resuscitate protocol; or
(2) While the patient is being prepared to be transferred,
or is being transferred, from one health care facility to another health
care facility, carrying out a do-not-resuscitate order that is documented
in the medical record of a qualified patient, in accordance with the
do-not-resuscitate protocol; or
(c) Administers emergency medical services and:
(1) Causes or participates in the withholding of
life-resuscitating treatment from a qualified patient who possesses a
do-not-resuscitate identification;
(2) Before a qualified patient is admitted to a medical
facility, carries out a do-not-resuscitate order that has been issued in
accordance with the do-not-resuscitate protocol; or
(3) While the patient is being prepared to be transferred,
or is being transferred, from one health care facility to another health
care facility, carries out a do-not-resuscitate order that is documented
in the medical record of a qualified patient, in accordance with the
do-not-resuscitate protocol.
2. A health care facility, ambulance service or fire-fighting
agency that employs a person described in subsection 1 is not guilty of
unprofessional conduct or subject to civil or criminal liability for the
acts or omissions of the employee carried out in accordance with the
provisions of subsection 1.
3. A physician, a person pursuant to the direction or
authorization of a physician, a health care facility or a person
administering emergency medical services who provides life-resuscitating
treatment pursuant to:
(a) An oral or written request made by a qualified patient, or the
parent or legal guardian of a qualified patient, who may revoke the
authorization to withhold life-resuscitating treatment pursuant to NRS
450B.525 or 450B.530 ; or
(b) An observation that a qualified patient, or the parent or legal
guardian of a qualified patient, has revoked or otherwise indicated that
he wishes to revoke the authorization to withhold life-resuscitating
treatment pursuant to NRS 450B.525 or
450B.530 ,
Ê is not guilty of unprofessional conduct or subject to civil or criminal
liability.
(Added to NRS by 1997, 289; A 2001, 817 )
1. Except as otherwise provided in subsection 2, a person who
administers emergency medical services shall comply with
do-not-resuscitate protocol when he observes a do-not-resuscitate
identification or carries out a do-not-resuscitate order.
2. A person who administers emergency medical services and who is
unwilling or unable to comply with the do-not-resuscitate protocol shall
take all reasonable measures to transfer a qualified patient who
possesses a do-not-resuscitate identification or has been issued a
do-not-resuscitate order to a physician or health care facility in which
the do-not-resuscitate protocol may be followed.
(Added to NRS by 1997, 290; A 2001, 818 )
1. Unless he has knowledge to the contrary, a physician, any other
provider of health care or any person who administers emergency medical
services may assume that a do-not-resuscitate identification complies
with the provisions of NRS 450B.400
to 450B.590 , inclusive, and is valid.
2. The provisions of NRS 450B.400 to 450B.590 , inclusive, do not create a presumption
concerning the intention of a:
(a) Qualified patient or a parent or legal guardian of a qualified
patient who has revoked authorization to withhold life-resuscitating
treatment pursuant to NRS 450B.525 or
450B.530 ; or
(b) Person who has not obtained a do-not-resuscitate identification,
Ê concerning the use or withholding of life-resuscitating treatment in a
life-threatening emergency.
(Added to NRS by 1997, 290; A 2001, 819 )
1. Death that results when life-resuscitating treatment has been
withheld pursuant to the do-not-resuscitate protocol and in accordance
with the provisions of NRS 450B.400
to 450B.590 , inclusive, does not
constitute a suicide or homicide.
2. The possession of a do-not-resuscitate identification or the
issuance of a do-not-resuscitate order does not affect the sale,
procurement or issuance of a policy of life insurance or an annuity or
impair or modify the terms of a policy of life insurance or an annuity. A
policy of life insurance or an annuity is not legally impaired or
invalidated if life-resuscitating treatment has been withheld from an
insured who possesses a do-not-resuscitate identification or has been
issued a do-not-resuscitate order, notwithstanding any term in the policy
or annuity to the contrary.
3. A person may not prohibit or require the possession of a
do-not-resuscitate identification or the issuance of a do-not-resuscitate
order as a condition of being insured for, or receiving, health care.
(Added to NRS by 1997, 290; A 2001, 819 )
1. It is unlawful for:
(a) A person who administers emergency medical services to fail
willfully to transfer a qualified patient in accordance with the
provisions of NRS 450B.550 .
(b) A person purposely to conceal, cancel, deface or obliterate a
do-not-resuscitate identification of a qualified patient, unless it is
done in compliance with a request of the qualified patient or a parent or
legal guardian of the qualified patient to remove or destroy the
do-not-resuscitate identification pursuant to NRS 450B.525 or 450B.530 .
(c) A person to falsify or forge the do-not-resuscitate
identification of a qualified patient or purposely to conceal or withhold
personal knowledge of the revocation of a do-not-resuscitate
identification with the intent to cause the use, withholding or
withdrawal of life-resuscitating treatment.
2. A person who violates any of the provisions of this section is
guilty of a misdemeanor.
(Added to NRS by 1997, 291; A 2001, 819 )
400 to 450B.590 , inclusive. The provisions of NRS 450B.400
to 450B.590 , inclusive, do not:
1. Require a physician or other provider of health care to take
action contrary to reasonable medical standards;
2. Condone, authorize or approve mercy killing, euthanasia or
assisted suicide;
3. Substitute for any other legally authorized procedure by which
a person may direct that he not be resuscitated in the event of a cardiac
or respiratory arrest;
4. Affect or impair any right created pursuant to the provisions
of NRS 449.535 to 449.690 , inclusive; or
5. Affect the right of a qualified patient to make decisions
concerning the use of life-resuscitating treatment, if he is able to do
so, or impair or supersede a right or responsibility of a person to
affect the withholding of medical care in a lawful manner.
(Added to NRS by 1997, 291)
AUTOMATED EXTERNAL DEFIBRILLATORS
1. Not later than July 1, 2004, and thereafter:
(a) The board of trustees of a school district in a county whose
population is 100,000 or more shall ensure that at least one automated
external defibrillator is placed in a central location at each high
school within the district.
(b) The Reno-Tahoe Airport Authority shall ensure that at least
three automated external defibrillators are placed in central locations
at the largest airport within the county.
(c) The board of county commissioners of each county whose
population is 400,000 or more shall ensure that at least seven automated
external defibrillators are placed in central locations at the largest
airport within the county.
(d) The Board of Regents of the University of Nevada shall ensure
that at least two automated external defibrillators are placed in central
locations at each of:
(1) The largest indoor sporting arena or events center
controlled by the University in a county whose population is 100,000 or
more but less than 400,000; and
(2) The largest indoor sporting arena or events center
controlled by the University in a county whose population is 400,000 or
more.
(e) The Health Division shall ensure that at least one automated
external defibrillator is placed in a central location at each of the
following state buildings:
(1) The Capitol Building in Carson City;
(2) The Kinkead Building in Carson City;
(3) The Legislative Building in Carson City; and
(4) The Grant Sawyer Building in Las Vegas.
(f) The board of county commissioners of each county whose
population is 100,000 or more shall:
(1) Identify five county buildings or offices in each of
their respective counties which are characterized by large amounts of
pedestrian traffic or which house one or more county agencies that
provide services to large numbers of persons; and
(2) Ensure that at least one automated external
defibrillator is placed in a central location at each county building or
office identified pursuant to subparagraph (1).
2. Each governmental entity that is required to ensure the
placement of one or more automated external defibrillators pursuant to
subsection 1:
(a) May accept gifts, grants and donations for use in obtaining,
inspecting and maintaining the defibrillators;
(b) Shall ensure that those defibrillators are inspected and
maintained on a regular basis; and
(c) Shall encourage the entity where the automated external
defibrillator is placed to require any employee who will use the
automated external defibrillator to successfully complete the training
requirements of a course in basic emergency care of a person in cardiac
arrest that includes training in the operation and use of an automated
external defibrillator and is conducted in accordance with the standards
of the American Heart Association, the American National Red Cross or any
other similar organization.
3. As used in this section, “automated external defibrillator”
means a medical device that:
(a) Has been approved by the United States Food and Drug
Administration;
(b) Is capable of recognizing the presence or absence, in a
patient, of ventricular fibrillation and rapid ventricular tachycardia;
(c) Is capable of determining, without intervention by the operator
of the device, whether defibrillation should be performed on the patient;
(d) Upon determining that defibrillation should be performed,
automatically charges and requests delivery of an electrical impulse to
the patient’s heart; and
(e) Upon action by the operator of the device, delivers to the
patient’s heart an appropriate electrical impulse.
(Added to NRS by 2003, 2464 )
MISCELLANEOUS PROVISIONS
1. Each hospital in this State which receives a person in need of
emergency services and care who has been transported to the hospital by
an ambulance, air ambulance or vehicle of a fire-fighting agency that has
a permit to operate pursuant to this chapter shall ensure that the person
is transferred to a bed, chair, gurney or other appropriate place in the
hospital to receive emergency services and care as soon as practicable,
but not later than 30 minutes after the time at which the person arrives
at the hospital.
2. The Health Division shall adopt regulations concerning the
manner in which a hospital and an attendant responsible for the care of a
person in need of emergency services and care during transport to the
hospital shall determine and track the time at which a person arrives at
a hospital and the time at which the person is transferred to an
appropriate place in the hospital to receive emergency services and care
for the purposes of this section. The regulations must provide that:
(a) The time at which a person arrives at a hospital is the time at
which he is presented to the emergency room of the hospital; and
(b) The time at which the person is transferred to an appropriate
place in the hospital to receive emergency services and care is the time
at which the person is physically in that place and the staff of the
emergency room of the hospital have received a report concerning the
person.
3. This section does not create a duty of care and is not a ground
for civil or criminal liability.
4. As used in this section:
(a) “Emergency services and care” has the meaning ascribed to it in
NRS 439B.410 .
(b) “Hospital” has the meaning ascribed to it in NRS 449.012 .
(Added to NRS by 2005, 1474 )
An applicant for any
permit, license or certificate issued pursuant to this chapter shall
furnish to the health authority a complete set of his fingerprints and
written permission authorizing the health authority to forward those
fingerprints to the Central Repository for Nevada Records of Criminal
History for submission to the Federal Bureau of Investigation for its
report. The health authority may exchange with the Federal Bureau of
Investigation any information respecting the fingerprints of an applicant.
(Added to NRS by 1981, 278; A 1993, 2837; 2003, 2850 )
Each holder of a permit shall maintain accurate records
upon such forms as may be provided by the health authority and containing
such information as may be reasonably required by the board concerning
the care or transportation of each patient, or both, within this state
and beyond its limits. These records must be available for inspection by
the health authority at any reasonable time and copies thereof must be
furnished to the health authority upon request. This record does not
constitute a diagnosis, and a legal signature is not required on forms
dealing with the type of injury sustained by a particular patient. The
health authority shall compile and provide a summary of this information.
(Added to NRS by 1973, 1145; A 1985, 1700; 1993, 2837)—(Substituted
in revision for NRS 450B.270)
The issuance of a permit does not authorize any person,
firm, corporation or association to provide ambulance services or to
operate an ambulance without a franchise or permit in any county or
incorporated city which has enacted an ordinance making it unlawful to do
so.
(Added to NRS by 1973, 1146)—(Substituted in revision for NRS
450B.280)
The following are exempted
from the provisions of this chapter:
1. The occasional use of a vehicle or aircraft to transport
injured or sick persons, which vehicle or aircraft is not ordinarily used
in the business of transporting persons who are sick or injured.
2. A vehicle or aircraft rendering services as an ambulance or air
ambulance in case of a major catastrophe or emergency if ambulance or air
ambulance services with permits are insufficient to render the services
required.
3. Persons rendering service as attendants in case of a major
catastrophe or emergency if licensed attendants cannot be secured.
4. Ambulances and air ambulances based outside this State.
5. Attendants based outside this State.
6. Vehicles owned and operated by search and rescue organizations
chartered by the State as corporations not for profit or otherwise
existing as nonprofit associations which are not regularly used to
transport injured or sick persons except as part of rescue operations.
7. Ambulances or air ambulances owned and operated by an agency of
the United States Government.
(Added to NRS by 1973, 1146; A 1987, 2213; 1991, 1918)—(Substituted
in revision for NRS 450B.290)
No county or city may
operate an ambulance or contract to have another operate an ambulance or
provide for the operation of a fire-fighting agency in violation of this
chapter or the regulations adopted under this chapter.
(Added to NRS by 1973, 1146; A 1985, 1700)—(Substituted in revision
for NRS 450B.310)
The health authority may
operate training programs and may contract with others to operate
training programs for ambulance attendants, ambulance service operators,
firefighters, law enforcement officers, physicians, nurses and others in
emergency first aid, emergency care and any other techniques associated
with emergency care, transportation and treatment of the sick and injured
and the proper operation of an ambulance service.
(Added to NRS by 1973, 1146; A 1993, 2837; 2005, 334 )
1. Any person or other entity who is an employer or is vested with
the power to discharge or recommend the discharge of a person who serves
as a volunteer ambulance driver or attendant shall not deprive the person
performing that service of his employment as a consequence of his action
as a volunteer ambulance driver or attendant.
2. A person discharged in violation of subsection 1 may commence a
civil action against his employer and obtain:
(a) Wages and benefits lost as a result of the violation;
(b) An order of reinstatement without loss of position, seniority
or benefits;
(c) Damages equal to the amount of lost wages and benefits; and
(d) Reasonable attorney’s fees fixed by the court.
3. Any applicant for employment who is, and any employee who
becomes, a volunteer ambulance driver or attendant must disclose that
fact to his prospective or present employer.
4. As used in this section, “volunteer ambulance driver or
attendant” means a person who is a driver of or attendant on an ambulance
owned or operated by:
(a) A nonprofit organization that provides volunteer ambulance
service in any county, city or town in this State; or
(b) A political subdivision of this State.
(Added to NRS by 1997, 467)
PENALTIES
Any person who violates any of
the provisions of this chapter is guilty of a misdemeanor.
(Added to NRS by 1973, 1147)—(Substituted in revision for NRS
450B.330)
