Staffing

1. The minimum staffing requirement for an advanced life support licensed ground ambulance must consist of a paramedic or equivalent and an emergency medical technician or equivalent. If the crew consists of three or more personnel, the paramedic and emergency medical technician crew may have an emergency medical service vehicle operator as defined in section 33-11-01.2-01 as a third crew member. 2. The primary care provider, whose duties include an assessment of each patient, must hold current cardiopulmonary resuscitation certification and be a licensed paramedic or its equivalent with the following exceptions: a. If, based on the paramedic's, or its equivalent's, assessment findings, a patient's condition requires only basic life support, an emergency medical technician or its equivalent may assume primary care of the patient. b. For scheduled basic life support transfers with a crew of two personnel, the driver and the primary care provider must be at least licensed emergency medical technicians or its equivalent. 3. Responding ambulance crew members may arrive at the scene separately, but the ambulance shall be fully staffed at or above the minimum staffing level before transporting a patient. 4. Providing emergency medical services when dispatched with a lower-level emergency medical service vehicle crew. If an advanced life support ambulance and a lower-level emergency medical service vehicle crew are dispatched to provide emergency medical services for a patient, the following shall apply: a. Upon arrival of an emergency medical service provider from the advanced life support ambulance crew who is a higher-level emergency medical service provider than the highest-level emergency medical service provider of the lower-level emergency medical service vehicle crew who is present, that emergency medical service provider shall assume primary responsibility for the patient. b. If the patient is assessed by the advanced life support ambulance crew to require emergency medical services above the skill level at which the lower-level emergency medical service vehicle crew is operating, and requires transport to a receiving facility, the emergency medical service provider who is responsible for the overall management of the emergency medical services provided to the patient shall decide, consistent with local emergency medical service protocols, who will transport the patient. An appropriately licensed member of the advanced life support ambulance crew shall attend to the patient during the transport. If the lower-level emergency medical service vehicle is used to transport the patient, that emergency medical service provider shall use the equipment and supplies on the lower-level emergency medical service vehicle, supplemented with the additional equipment and supplies, including medications, from the advanced life support ambulance. c. If at the scene or during patient transport by the lower-level emergency medical service vehicle crew, the emergency medical service provider of the advanced life support ambulance crew who has assumed primary responsibility for the patient determines that the lower-level emergency medical service vehicle crew is operating at the skill level needed to attend to the patient's emergency medical services needs, consistent with local emergency medical service protocols, that emergency medical service provider may relinquish responsibility for the patient to the lower-level emergency medical service vehicle crew.