Subchapter 3 System Component Standards
A. Manpower categories for personnel shall include:
1. Lay citizens trained in CPR techniques or first aid, or both;
2. First responders;
3. Telecommunicators (including public safety dispatchers);
4. Basic life support personnel (EMTs);
5. Advanced life support personnel (MICTs);
6. Prehospital registered nurses;
7. Emergency room or department registered nurses
8. Specialized care registered nurses;
9. Emergency physicians;
10. Specialty physicians;
11. District EMS medical directors;
12. Medicom physicians; and
13. EMS training personnel.
B. There shall be an adequate number of personnel in the following categories:
1. A sufficient number of trained “911” and public safety dispatchers to provide staffing twenty-four hours daily at each
designated EMS communications facility;
2. At least two EMTs on each basic life support ambulance;
3. At least one EMT and one MICT on each advanced life support ambulance and;
4. At least one district EMS medical director in the system in each county.
C. Because the state has no direct control in the following areas, there shall be reasonable efforts to have an adequate number of
personnel in the following categories:
1. At least twenty per cent of the resident population of each county currently trained in CPR by June 30, 1985;
2. At least fifty per cent of all field police, fire, and lifeguard personnel currently trained as first responders by June 30, 1985;
3. Emergency service nursing personnel that meet the 1984 Joint Commission on Accreditation of Hospitals staffing standards
for hospital emergency services;
4. Emergency physicians that meet the 1984 Joint Commission on Accreditation of Hospitals staffing standards for hospital
D. State-funded courses used for training and retraining of the EMS personnel shall include:
1. State-approved CPR training, using at least the American Heart Association heart-saver course;
2. State-approved public safety first responder training using at least the United States Department of Transportation
“Emergency Training Course” dated Hatch 1979;
3. State approved EMT training;
4. State approved MICT training; and
5. Any other state-approved BLS or ALS training.
E. The department of health shall approve all basic life support and advanced life support courses as required by the board of
F. There shall be annual refresher or continuing education sessions available for public safety first responder, EMT, and MICT
emergency medical services personnel in each county.
[Eff. AUG 12 1985] (Auth: HRS § 321-233) (Imp: HRS §§321-222, 321-224, 321-229).
A. There shall be a communications system that includes a medical radio communications system for emergency medical services,
including disaster response, established consistent with the regulations of the Federal Communications Commission.
B. The personnel, facilities, and equipment of the emergency medical services system in each county shall be linked by a county
central communications system so that requests for emergency medical services shall be handled by a communications
1. Utilizes or will utilize by June 30, 1985, the universal emergency telephone number “911” or another appropriate
single-access number; and
2. Will have direct two-way radio communications with the personnel, facilities, and equipment of the county emergency
medical services system and with the state comprehensive emergency medical services system.
C. Each county communications system shall include a central emergency medical services dispatch center responsible for
receiving and coordinating all requests for emergency medical services and for providing liaison with other public safety and
emergency response systems in order to provide the most effective and efficient management of the immediate problem.
[Eff. AUG 12 1985] (Auth: HRS §321-233) (Imp: HRS §§321-224, 321- 226)
A. There shall be an adequate number of emergency medical ambulances based on the following:
1. Identification of ambulance districts consisting of homogenous geographic areas that are either urban or rural;
2. Establishment, within the prescribed ambulance districts, of ambulance sectors that shall be designated as the geographic
area in which one ambulance unit is capable of responding within the appropriate response standards prescribed herein;
3. Emergency ambulance response in its service area for ninety-five percent of all calls within the average of twenty minutes,
which response time shall be computed from the time the emergency medical services dispatch center notifies the
ambulance to the time the ambulance arrives at the scene-of the emergency; and
4. Provision of backup emergency ambulances as prescribed in Section 11- 72-28(b).
B. All ground and air ambulance vehicles and personnel staffing those vehicles shall conform to the licensing and certification
requirements of this chapter. (c) There shall be appropriate transfer agreements between physicians, the hospitals and the
emergency ambulance services for the transfer of seriously injured, ill, or psychiatrically incapacitated individuals from one
care facility to another.
[Eff. AUG 12 1985] (Auth: HRS §§321-227, 321- 233) (Imp: HRS §§321-224, 321-226, 321-227)
A. Each county shall designate the specific role its public safety personnel shall play in providing emergency medical services as
part of the phased response system established within the county and include:
1. Statements relative to the effective utilization and sharing of personnel, facilities, and equipment;
2. Linkage with the county medical radio communications system;
3. Utilization of appropriately trained personnel; and
4. Cooperative operating procedures and mutual aid plans with other state and county emergency response systems to
include civil defense, private hospitals, military, and the American Red Cross.
[Eff. AUG 12 1985] (Auth: HRS §321- 233) (Imp: HRS §§321-224, 321-226)
A. An emergency medical services system shall provide programs of consumer information and education, taking into account the
needs of visitors as well as residents of the area, to inform the public of the means of obtaining emergency medical services.
1. These programs shall stress the general dissemination of information regarding appropriate methods of medical self-help
and first aid as well as the availability of first-aid training programs in the area; and
2. There shall be a program of consumer information and education relating to CPR programs in order to encourage at least
twenty percent of the residents of each county to be certified in CPR. (b) Any person in each county shall be able to
participate and provide input to the making of policy through membership on or through communications with the state
emergency medical services advisory committee.
[Eff. AUG 12 1985] (Auth: HRS §§321-224, 321-226, 321-233) (Imp: HRS §§321-224, 321-226)
A. All hospitals and specialized care facilities in the state that provide emergency medical services shall be categorized every 1-3
years, in order to identify the readiness and capability of each hospital within each county to provide definitive treatment of
consumers, especially those with serious or critical injuries or illnesses, and its capacity to provide emergency medical care.
B. The categorization of hospitals and specialized care facilities shall be based on the Guidelines for the Categorization of
Hospital Emergency Capabilities, 1971 developed by the American Medical Association Commission on EMS.
[Eff. AUG 12 1985] (Auth: §§321-226, 321-233) (Imp: HRS § 321-226)
A. There shall be appropriate treatment, triage, and transfer protocols for emergency management of seriously ill patients for use
by all acute care facilities and specialty physicians in the areas of trauma, burns, acute cardiac, spinal cord injuries, poison,
high-risk infant, behavioral disorders, high-risk maternal, and pediatric.
B. Information relating to the numbers, types, and capabilities of the specialized care facilities shall be distributed to all acute care
facilities and to the lead emergency physician in each emergency room or department in order to assist the emergency
physician or the patient’s physician in arranging for the most appropriate level of follow up care for an emergency patient.
[Eff. AUG 12 1985] (Auth: HRS §321-233) (Imp: HRS §§321-224, 321-226)
A. During or immediately after the time of patient care, an ambulance patient care report form shall be prepared for each patient,
with at least copies as follows: original copy retained by the ambulance service, one copy to medical facility, if patient is
transported to such, and one copy to be retained by the ambulance service to provide to the director of health, if requested by
the director of health. The ambulance patient care report shall include a copy of the dispatch card, if utilized, and the following
information, on a department-approved standardized form:
1. Patient identification/name;
3. Date of birth, and age;
5. Date and time call was received;
6. Dispatch incident run number;
7. Ambulance unit identification;
8. Crew identification;
9. Time of emergency vehicle departure;
10. Location of incident;
11. Time of arrival at incident location;
12. Patient’s condition observed by arriving crew;
13. Preliminary impression;
14. Anatomical sites of injury or illness;
15. Degree of urgency or severity of patient’s condition;
16. Aid or treatment provided by crew;
17. Time of departure from incident location;
18. Outcome or destination of run; and
19. Time of arrival at destination.
B. Section 11-72-22(a) shall apply with equal force, for the data obtainable, in case any patient dies before being transported
in the ambulance or dies while being transported in an ambulance or dies at any time prior to the acceptance of the patient
into the responsibility of the hospital or medical or other authority if the patient is still under the care or responsibility of the
C. The prehospital data to be recorded on the provided ambulance patient care report form and the available emergency room and
hospital, inpatient data shall be used for the purposes of obtaining follow-up data. Any data recorded, collected, or evaluated for
the prehospital emergency medical data system shall comply with applicable federal and state guidelines and statutes relating
to the privacy of medical data and a patient’s condition
[Eff. AUG 12 1985] (Auth: HRS §321-233) (Imp: HRS §§321-224, 321-226)
A. There shall be a review and evaluation on an ongoing and periodic basis to determine the adequacy of prehospital emergency
medical services and identify areas for improvement of services or correction of deficiencies.
B. Prehospital emergency medical services and systems established in the state shall be evaluated as to the availability and
quality of emergency medical care being provided to assure a reasonable standard of performance by individuals and
organizations providing such services.
C. Periodic reports on the effectiveness of the state comprehensive emergency medical services system shall be made available
to federal and state legislative and executive agencies by the director of health upon request.
[Eff. AUG 12 1985] (Auth: HRS §321-233) (Imp: HRS §§321-224, 321- 225. 321-226)