Q: Is there a maximum number of non-certified EMTs (e.g., observers/First Responders) that can be on an ambulance at any given time? 

A: The number is limited to service policy but may not exceed the number of seatbelts to which these individuals can be safely restrained without interfering with patient care.

  Under 105 CMR 170.310, such "additional personnel" must "be currently trained in Basic Life Support cardiopulmonary resuscitation through completion of a course not less than the standards established by the Committee on Cardiopulmonary Resuscitation and Emergency Cardiac Care of the American Heart Association". In addition, such personnel can only function in accordance with the policies of the ambulance service.

 Q: What level of staff is required for transport of a patient with a trach that has no known complications and is being treated for a BLS condition unrelated to a respiratory or trach issue?

A: BLS may transport.  The BLS crew should follow the “Tracheostomy Tube Obstruction Management Adult & Pediatric” instructions in Protocol 5.3 if a problem does arise during transport.

Q: Is there a regulation or Administrative Requirement (AR) that requires an inexperienced EMT staff an ambulance with an experienced EMT?

A: There is no specific regulation or AR that requires an inexperienced EMT staff an ambulance with an experienced EMT unless it’s specified in the Affiliation Agreement with the hospital that provides medical oversight or through ambulance service policy.

Q: When staffing an ALS licensed ambulance at the PB level are there any special requirements for the paramedic or EMT?

A: Yes; staffing regulations and associated Administrative Requirements, including AR 2-260 need to be followed. This includes mandatory ALS/BLS Interface intitial training for BOTH the paramedic and the basic before they are allowed to staff in the PB configuration.

Q:  When a service provides an ALS intercept (mutual aid) and the paramedic transports with the patient, does the mutual aid ambulance need to follow the primary ambulance to the hospital or can it return and remain in-service?

For example, Mayberry EMS responds double-medic mutual-aid to Willoughby for the ALS intercept. Willoughby transports with one Mayberry medic onboard. Does the Mayberry Ambulance need to accompany (follow) WIlloughby to the Hospital? Or can one paramedic return to town and remain in-service?

A:  There is no need for the truck to follow as long as the crew has all proper equipment and staff aboard