Frequently Asked Questions

General

  1. What has changed between the 2005 and 2009 NCCEP Standards Documents?
    The 2009 NCCEP Standards Documents have changed significantly since the 2005 Version. Here is a section-by-section breakdown of the changes:

    Section I: Qualifications for EMS Medical Directors

    This section has been changed based on the 2009 NC EMS Rules by removing the Model EMS System Medical Direction requirements. Also, the continuing medical education requirements for all EMS Medical Directors and Advisors has been changed from an hour based requirement to a required attendance at 1 of 3 Medical Director Updates which will be held across the state each year. This change to a face-to-face meeting requirement reflects an interested in more dialogue and networking throughout the state between EMS Medical Directors.

    Section II: EMS Vehicle Equipment Requirements

    This section has been revised based on a new recommended ambulance equipment list developed by the American College of Emergency Physicians, the American Academy of Pediatrics, and the American College of Surgeons. The pediatric equipment sizes have been more formally listed to meet new reporting requirements associated with the federal EMS for Children Program.

    Within the equipment requirements, there is a very strong recommendation for EMS Systems and Agencies to move toward Waveform Capnography and 12 Lead ECG capabilities on all active EMS vehicles that are primarily responding to the scene of a 911 emergency. The ability to perform Pulse Oximetry and Blood Glucose Measurement must be present at the scene of every EMS event for EMT-Basic, Intermediate, and Paramedic level professionals.

    Section III: Standards for EMS Skills and Medications

    With the EMS Skills and Medications Section, the EMS Model System requirements were removed and many of the past EMS Model System medications are now required at the baseline EMS System level. Both the Medication and Skills list now only reflects the skills and medications that are present in the 2009 NCCEP Protocols. There are many more skills and medications approved by the NC Medical Board for EMS use which can be found on the NC Medical Board document provided in the Reference Materials section of these documents.

    This document defines the skills that are required for use by all EMS professional levels. Some noted requirements within this document include a requirement for all levels to have a Blind Insertion Airway Device with a recommendation to maintain a device with pediatric sizes; the use of colorimetric ETCO2 detection for invasive airways is required for all levels of EMS professionals who use these devices; there is a very strong recommendation for EMS Systems and Agencies to move toward Waveform Capnography and 12 Lead ECG capabilities; and there is a requirement to have the ability to perform Pulse Oximetry and Blood Glucose Measurement at the scene of every EMS event.

    Section IV: Standards for Emergency Medical Dispatch

    There were no changes to this section

    Section V: EMS Patient Care Treatment Protocols

    Every Protocol in the 2009 NCCEP Patient Care Treatment Protocols were updated and revised when compared to the 2005 version. These changes reflect revisions based on standard of care and the new 2009 NC EMS Rules. The 2009 NC EMS Rules require all EMS Systems and Agencies to implement the 2009 Patient Care Treatment Protocols unchanged unless there is an objective reason within the EMS Systems or Agencies community to make a change. The NC EMS Medical Director must approve and changes and additions to the 2009 NCCEP Protocols.

    In preparation for this 2009 EMS Rule and to standardize the 2009 NCCEP Protocols, the structure of the protocols has been changed. Within each protocol the order of care (assessment, skills, and medications) have been grouped to indicate that all of the items listed within a box can be accomplished simultaneously. This better reflects actual patient care and, in many cases, removes the requirement to list which skills or medications must be accomplished in which order.

    New Protocols included in the 2009 version include: Pediatric Pain Control, Police Custody, Burns-Thermal, and Burns-Chemical and Electrical.

    Section VI: EMS Patient Care Operations Policies

    All of the 2005 NCCEP Policy documents were reviewed and updated. Three additional Policy documents were created including: EMS Back In Service Time, EMS Dispatch Center Time, and EMS Wheels Rolling (Turn-Out) Time.

    Section VII: EMS Procedure Documents

    All of the 2005 NCCEP Procedure documents were reviewed and updated. Additional 2008 Procedure documents include: Airway-BIAD King, Airway-Endotracheal Tube Introducer, Airway-Foreign Body Obstruction, Wound Care-Hemostatic Agent, Wound Care-Taser Probe Removal, and Wound Care-Tourniquet.

    Section VIII: EMS Data Collection Requirements

    The 2009 NCCEP Dataset has been changed from an actually data dictionary to a list of data elements from the NHTSA Version 2.2.1 Dataset. A copy of the NHTSA Version 2.2.1 Dataset can be found in many formats at www.NEMSIS.org. One clarification was made to the 2009 NCCEP Dataset. In the 2009 version, all of the components of the Glasgow Coma Score are required as opposed to only a total score.

    Section IX: EMS Performance Improvement Guideline

    This is a completely new section of the NCCEP Standards and is reference in the 2009 EMS Rules. The Performance Improvement Guideline is a list of items/issues that are to be reviewed by the EMS System Peer Review Committee during each calendar year. These items reflect EMS service delivery, EMS professionals performance, and patient care areas which should be monitored on an ongoing basis by each EMS System and Agency.

  2. How does the NC Office of EMS, NCCEP, and the NC Medical Board work together to define EMS standards and requirements?
    The North Carolina Office of EMS (NC OEMS), the North Carolina College of Emergency Physicians (NCCEP), and the North Carolina Medical Board (NCMB) work together to provide leadership, direction, and regulatory oversight for EMS.

    North Carolina law empowers that the NCMB to determine the skills and medications which EMS professionals at all certified levels may perform or administer. The NCMB lists the skills and medications that are approve for use in a document known as the NC Medical Board Approved Medications and Skills for Credentialed EMS Personnel. EMS professionals may only use the skills and medications on this list. Changes to this document can be made as needed. Each year the EMS Advisory Council work with the NC EMS Medical Director to discuss and recommend skills and medications which should be presented to the NCMB for consideration. If endorsed by the EMS Advisory Council, the NC EMS Medical Director presents any change requests to the NCMB. If the NCMB approves the changes they are added to the list. This process occurs a maximum of twice per year.

    The NCCEP has been given the authority by NC EMS Rules to develop and maintain several EMS Standards documents titled the NCCEP Standards for Medical Oversight and Data Collection. This document defines many EMS standards for North Carolina. The NCCEP Skills and Medications Requirements document lists the required skills and medications that must be used/carried by EMS Systems, Agencies, and Professionals. This list is taken from the larger list of NCMB approved medications and skills. The NCCEP Skills and Medications list is a subset of the NCMB list.

    The North Carolina Department of Health and Human Services (NC DHHS) is responsible for the regulatory oversight of healthcare in general. The NC OEMS functions within the Division of Health Services Regulation within the NC DHHS. It is the role of the NC OEMS to assure that EMS Systems, Agencies, and Professionals within NC follow the NC EMS Rules that reference both the NCMB and NCCEP documents.

  3. What is the deadline for implementation of all of the 2009 NCCEP Standards Documents?
    It is important for NC EMS to migrate to the 2009 NCCEP Standards as soon as possible. The 2009 NCCEP Standards must be implemented within each EMS System, Agency, and Professional by December 31, 2009. Many EMS Systems will be required to implement sooner if their EMS System Plan is up for renewal in 2009. Any EMS System or Agency that has not implemented the 2009 NCCEP Protocols by December 31, 2009 must use the 2009 NCCEP Protocols unchanged.

  4. As an EMS System, How Do I Use These Documents?
    North Carolina's EMS Systems must implement all components of the 2009 NCCEP Standards documents based on the level of EMS professionals used within the EMS System. The implementation of the EMD Standard is required if the EMS System has implemented Emergency Medical Dispatch.

    Each EMS System must develop and maintain a protocol, policy, and procedure manual that minimally addresses the following:

    • A protocol corresponding to each NCCEP protocol (identically titled) must be incorporated into the EMS System's manual.
      • The NCCEP protocols cross all technician levels: MR, EMT, EMT-I, and EMT-P.
      • Each EMS System must adopt the NCCEP protocols unchanged unless there is an objective community based need to make a change or addition.
      • If a change or addition is desired, the EMS System Medical Director must contact the NC EMS Medical Director to discuss the need. If objective information is provided which will result in a likely benefit to the community based on improved patient care and/our outcomes, a template will be provided to develop the changed or additional protocol.
    • A policy corresponding to each NCCEP policy (identically titled) must be incorporated in the EMS systems manual.
      • Each EMS system may choose to adopt the NCCEP policies unchanged or develop their own individual protocols for each topic.
    • A procedure corresponding to each NCCEP procedure (identically titled) that is used by the EMS system must be incorporated in the EMS systems manual.
      • Each EMS system may choose to adopt the NCCEP procedure unchanged or develop a procedure for each topic.
    • A drug list indicating all the medications used by the EMS system, complete with indications, contraindications, dosage, and administrative routes.
      • The NCCEP Drug List may be adopted unchanged to fulfill this requirement or a customized document may be prepared.
    • Several supporting documents are provided for reference with this NCCEP document. It is recommended that these supporting documents be included in the EMS manual, however, they are not required.
    • A description of the EMD card manufacturer and version must be included in the manual of EMS Systems that provide Emergency Medical Dispatch Services. No other documentation is required for EMD protocols unless changes to the cards have been made. Any changes to the questions (not the determinants) must be approved by the North Carolina EMS Medical Director.
    • The content of this document must be reflected in each EMS systems protocols, policies, and procedures by December 31, 2009. If any EMS System has not developed and obtained approval for EMS System Protocols, Policies, and Procedures by December 31, 2009 the EMS System must use the 2009 NCCEP Protocols, Polices, and Procedures unchanged beginning January 1, 2010.

  5. As an EMS Agency, How Do I Use These Documents?
    EMS Agencies in general function under and EMS System and must adopt the EMS Systems implementation of the 2009 NCCEP Standards. There are a few exceptions.

    If the EMS Agency is a Medical Transport Agency operating in multiple EMS Systems, they in general should adopt the 2009 NCCEP Protocols unchanged so that care can be standardized.

    If the EMS Agency is a Specialty Care Transport Program, the Agency will be required to develop its own protocols based on the 2009 NCCEP documents. Where possible the 2009 NCCEP Protocols should remain unchanged but it is understood that changes will be required in the Specialty Care Transport Program setting.

  6. As an EMS Professional, How Do I Use These Documents?
    EMS Professionals will be responsible for following the EMS System and Agency implementation of the 2009 NCCEP Standards where they work. It is very well known that EMS Professionals often hold many jobs in different EMS Systems and Agencies. For this reason, the 2009 NCCEP Protocols have become more standardized and in the majority of implementations should be used unchanged.

Qualifications for EMS Medical Directors

  1. What has changed between the 2005 and 2009 NCCEP Medical Director Documents?
    This section has been changed based on the 2009 NC EMS Rules by removing the Model EMS System Medical Direction requirements. Also, the continuing medical education requirements for all EMS Medical Directors and Advisors has been changed from an hour based requirement to a required attendance at 1 of 3 Medical Director Updates which will be held across the state each year. This change to a face-to-face meeting requirement reflects an interested in more dialogue and networking throughout the state between EMS Medical Directors.

  2. Why was the CME requirement changed?
    The change from an hours based approach to attending one mandatory 4-hour meeting which will be held 3 times per year was to increase attention to North Carolina specific issues and to promote networking and collaboration across and between EMS Systems and Agencies. Even though only one meeting is required, each meeting will vary in content and EMS Medical Directors are encouraged to participate in as many of the meetings as possible.

  3. When is the next EMS Medical Director's Course?
    The NC EMS Medical Director's Course is migrating to an online version based on the National EMS Medical Director's Curriculum developed by NHTSA. Since there is new content based on the 2009 EMS Rules that must be included in this course, it is currently being updated and is not currently active. Once the course becomes active (in the first 6 months of 2009), all EMS Medical Directors will be notified.

    Only new EMS Medical Directors are required to take the course but it is recommended for everyone. Once the course is available all new EMS Medical Directors will have 6 months to complete the course. It will take approximately 7 hours to complete the course online.

  4. Is the EMS Medical Director's Course restricted to only EMS Medical Directors?
    No, any EMS Director or other EMS Administrator is welcome to take the NC Online EMS Medical Director's Course once it is available.

  5. What are the dates and locations for the three EMS Medical Director Meetings for 2009?
    The EMS Medical Director meetings will be held as follows:

    Meeting 1 will be held on Friday, February 13th, 2009 from 1 PM to 5 PM in Wilmington, NC (Eastern NC) in association with the NC Association of EMS Administrators Winter Conference. This is will be held at the Wilmington Hilton Riverside and information can be found at www.NCAEMSA.org.

    Meeting 2 will be held in Asheville, NC (Western NC) in association with the NC Association of EMS Administrators Summer Conference on July 17th, 2009 from 1 PM to 5 PM.

    Meeting 3 will be held in conjunction with the EM Today Conference in Greensboro, NC (Central NC) on Tuesday, October 6th, 2009 during the AM Session.

  6. Are the EMS Medical Director's Meetings restricted to only EMS Medical Directors?
    No, any EMS Director or other EMS Administrator is welcome to attend the EMS Medical Director's Meetings. Please follow the same registration procedures as EMS Medical Directors.

  7. Will these locations and dates change each year?
    Since the three meeting locations reflect North Carolinas 3 regions (West, Central, and East), the locations of these meetings and their association with the NC Association of EMS Administrators and the EM Today Conference will remain. The dates will vary slightly each year but are held the same months each year.

  8. What happens if I (EMS Medical Director) do not attend one of these meetings?
    Since this is a mandatory requirement in North Carolina, you could not longer serve as the EMS Medical Director for the EMS Agency or System.

Requirements for EMS Equipment

  1. What has changed between the 2005 and 2009 NCCEP EMS Equipment Documents?
    This section has been revised based on a new recommended ambulance equipment list developed by the American College of Emergency Physicians, the American Academy of Pediatrics, and the American College of Surgeons. The pediatric equipment sizes have been more formally listed to meet new reporting requirements associated with the federal EMS for Children Program.

    Within the equipment requirements, there is a very strong recommendation for EMS Systems and Agencies to move toward Waveform Capnography and 12 Lead ECG capabilities on all active EMS vehicles that are primarily responding to the scene of a 911 emergency. The ability to perform Pulse Oximetry and Blood Glucose Measurement must be present at the scene of every EMS event for EMT-Basic, Intermediate, and Paramedic level professionals.

  2. How is this equipment reflected in the NC OEMS Vehicle Inspection Form?
    The equipment listed on the 2009 NCCEP Equipment requirements is the basis for the NC OEMS Inspection form. The NC OEMS Vehicle Inspection Form is used to assure compliance with the 2009 NCCEP Equipment Standards.

  3. When are permitted vehicles required to have this equipment in place?
    It is important for NC EMS to migrate to the 2009 NCCEP Standards as soon as possible. The 2009 NCCEP Standards must be implemented within each EMS System, Agency, and Professional by December 31, 2009. Many EMS Systems will be required to implement sooner if their EMS System Plan is up for renewal in 2009. Any EMS System or Agency that has not implemented the 2009 NCCEP Protocols by December 31, 2009 must use the 2009 NCCEP Protocols unchanged.

  4. What information was used to create this list?
    This section has been revised based on a new recommended ambulance equipment list developed by the American College of Emergency Physicians, the American Academy of Pediatrics, and the American College of Surgeons. The pediatric equipment sizes have been more formally listed to meet new reporting requirements associated with the federal EMS for Children Program.

  5. Is 12 Lead ECG required for all EMS vehicles?
    It is a goal within NC to have the capability to obtain a 12 Lead ECG on any patient receiving a 911 EMS response. Although there is no requirement for 12 Lead ECG to be on every in-service EMS permitted vehicle, it is highly recommended.

  6. Is Capnography required for all EMS vehicles?
    It is a goal within NC to have the capability to measure waveform Capnography on any patient receiving a 911 EMS response. Although there is no requirement for Capnography to be on every in-service EMS permitted vehicle, it is highly recommended.

  7. Is Pulse Oximetry and Glucose Measurement required for all EMS Vehicles?
    Pulse Oximetry and the ability to measure Blood Glucose must be available to monitor any patient cared for within any EMS System. If it is not available on all EMS Vehicles, both of these important patient monitoring skills must be monitored by the EMS System Peer Review Committee to assure they are being used and are available for all patients based on the 2009 NCCEP Patient Care Treatment Protocols.

  8. Why are Colorimetric ETCO2 Detectors required by EMT-Basic, Intermediate, and Paramedic Level Agencies?
    Colorimetric ETCO2 Detectors provide the most reliable and objective confirmation of invasive airway placement and ventilation. With the increased use of Blind Insertion Airway Devices (BIAD) such as as the King LT, Combitube, and LMA Airways, the ability to confirm airway placement and ventilation at the EMT-Basic Level is critical.

  9. Now that Blind Insertion Airway Devices are required at all levels, which devices have pediatric sizes?
    Although not required, pediatric sized Blind Insertion Airway Devices (BIAD) are highly recommended. Currently, there are pediatric sizes available for the King LT and LMA devices. A smaller adult size of the Combitube is not typically considered pediatric.

  10. Are AEDs required to have pediatric sized pad capability?
    Since 2000, Automated External Defibrillators have been released with pediatric sized pads. Older AED devices have not been compatible with pediatric pads so many AEDs on the street are technically for adults only. It is appropriate to use any AED on a child as long as the pads do not touch each other, meaning adult sized pads will work on many children.

    That being said as new AEDs are purchased for new deployments or to retire the old adult only devices, pediatric capable devices with both adult and pediatric pads should be purchased.

Requirements for EMS Skills and Medications

  1. What has changed between the 2005 and 2009 NCCEP Skills and Medication Documents?
    With the EMS Skills and Medications Section, the EMS Model System requirements were removed and many of the past EMS Model System medications are now required at the baseline EMS System level. Both the Medication and Skills list now only reflects the skills and medications that are present in the 2009 NCCEP Protocols. There are many more skills and medications approved by the NC Medical Board for EMS use which can be found on the NC Medical Board document provided in the Reference Materials section of these documents.

    This document defines the skills that are required for use by all EMS professional levels. Some noted requirements within this document include a requirement for all levels to have a Blind Insertion Airway Device with a recommendation to maintain a device with pediatric sizes; the use of colorimetric ETCO2 detection for invasive airways is required for all levels of EMS professionals who use these devices; there is a very strong recommendation for EMS Systems and Agencies to move toward Waveform Capnography and 12 Lead ECG capabilities; and there is a requirement to have the ability to perform Pulse Oximetry and Blood Glucose Measurement at the scene of every EMS event.

  2. How do the NC Medical Board and NCCEP work together to determine the skills and medications that EMS Systems, Agencies, and Professionals are able to use?
    The NCCEP has been given the authority by NC EMS Rules to develop and maintain several EMS Standards documents titled the NCCEP Standards for Medical Oversight and Data Collection. This document defines many EMS standards for North Carolina. The NCCEP Skills and Medications Requirements document lists the required skills and medications that must be used/carried by EMS Systems, Agencies, and Professionals. This list is taken from the larger list of North Carolina Medical Board approved medications and skills. The NCCEP Skills and Medications list is a subset of the NC Medical Board list.

    As a reference document, the NC Medical Board Medications and Skills List is posted on the website with the 2009 NCCEP Standards.

  3. Are EMS Systems, Agencies, and Professionals only permitted to use the Medications and Skills as they are listed on the NCCEP Skills and Medications document?
    No, the NCCEP Skills and Medications document is a subset of the larger NC Medical Board's Medications and Skills List. As a reference document, the NC Medical Board Medications and Skills List is posted on the website with the 2009 NCCEP Standards. The Medical Board document is the formal list of all medications and skills that are permitted to be used by EMS professionals at each certified level.

  4. The 2005 NCCEP documents listed more medications and skills than the 2009 version. Are the EMS Systems, Agencies, and professionals only allowed to use the medications and skills listed on this 2009 document?
    The 2009 NCCEP Skills and Medications document only lists the medications and skills that are included in the 2009 NCCEP Patient Care Treatment Protocols. Please refer to the North Carolina Medical Board Medications and Skills List (included in the 2009 NCCEP Reference Documents) for all other medications and skills which can be used/performed by EMS professionals in North Carolina.

  5. Where can I find a list of all of the medications and skills which EMS professionals are permitted to use/perform?
    As a reference document, the NC Medical Board Medications and Skills List is posted on the website with the 2009 NCCEP Standards.

Requirements for Emergency Medical Dispatch (EMD) Programs

  1. What has changed between the 2005 and 2009 NCCEP EMD Program Documents?
    There were no changes to this section.

Requirements for EMS Patient Care Treatment Protocols

Requirements for 2009 NCCEP Policies

  1. What has changed between the 2005 and 2009 NCCEP Policy Documents?
    All of the 2005 NCCEP Policy documents were reviewed and updated. Three additional Policy documents were created including: EMS Back In Service Time, EMS Dispatch Center Time, and EMS Wheels Rolling (Turn-Out) Time.

  2. Which 2009 NCCEP Policies are required to be implemented by EMS Systems?
    All 20 of the 2009 NCCEP Patient Care Related Operational Policies are required to be implemented within each EMS System.

  3. Can the 2009 NCCEP Policy Documents be changed by local EMS Systems to better reflect the local community and operations?
    Yes, EMS Systems may change any of the 2009 NCCEP Policy documents to better reflect the local community and operations.

  4. Are there templates that can be downloaded by EMS Systems to use if changes to the Policy documents are needed?
    Yes, Microsoft Visio Templates are available and can be downloaded from the 2009 NCCEP Standards Website.

  5. If an EMS System elects to change one or several of the 2009 NCCEP Policy documents, what is the process?
    All changes to the 2009 NCCEP Policy documents must be submitted to OEMS through the EMS System's Regional Specialist. The Regional Specialist will work with the NC EMS Medical Director to obtain approval. The documents will then reside in the EMS System Plan.

  6. Are the 2009 NCCEP EMS Policy documents included in the printed 2009 EMS Patient Care Treatment Protocol Manual?
    No, the NCCEP based EMS Policy documents will be maintained in the EMS System Plan.

  7. Are the 2009 NCCEP Policies required to be on each NC OEMS permitted EMS vehicle?
    No, the NCCEP based EMS Policy documents will be maintained in the EMS System Plan.

Requirements for 2009 NCCEP Procedures

  1. What has changed between the 2005 and 2009 NCCEP Procedure Documents?
    All of the 2005 NCCEP Procedure documents were reviewed and updated. Additional 2008 Procedure documents include: Airway-BIAD King, Airway-Endotracheal Tube Introducer, Airway-Foreign Body Obstruction, Wound Care-Hemostatic Agent, Wound Care-Taser Probe Removal, and Wound Care-Tourniquet.

  2. Which 2009 NCCEP Procedures documents are required to be implemented by EMS Systems?
    EMS Systems and Agencies are required to maintain the skills and medications that are required in the 2009 NCCEP Requirements for Skills and Medications. The Procedure documents that reflect these skills are required. Additional skills and Procedure documents beyond this requirement should be implemented based on need and available resources.

  3. Can the 2009 NCCEP Procedures Documents be changed by local EMS Systems to better reflect the local community and operations?
    Yes, EMS Systems may change any of the 2009 NCCEP Procedure documents, except for Airway-Drug Assisted Intubation, to better reflect the local community and operations. The Airway-Drug Assisted Intubation Procedure may not be changed since is a required component of a formal Drug Assisted Intubation Program.

  4. Are there templates that can be downloaded by EMS Systems to use if changes to the Policy documents are needed?
    Yes, Microsoft Visio Templates are available and can be downloaded from the 2009 NCCEP Standards Website.

  5. If an EMS System elects to change one or several of the 2009 NCCEP Procedures documents, what is the process?
    All changes to the 2009 NCCEP Procedure documents must be submitted to OEMS through the EMS System's Regional Specialist. The Regional Specialist will work with the NC EMS Medical Director to obtain approval. The documents will then reside in the EMS System Plan.

  6. Are the 2009 NCCEP EMS Procedures documents included in the printed 2009 EMS Patient Care Treatment Protocol Manual?
    No, the NCCEP based EMS Policy documents will be maintained in the EMS System Plan.

  7. Are the 2009 NCCEP Procedures documents required to be on each NC OEMS permitted EMS vehicle?
    No, the NCCEP based EMS Policy documents will be maintained in the EMS System Plan.

Requirements for 2009 NCCEP Data Collection Dataset

  1. What has changed between the 2005 and 2009 NCCEP Dataset Documents?
    The 2009 NCCEP Dataset has been changed from an actually data dictionary to a list of data elements from the NHTSA Version 2.2.1 Dataset. A copy of the NHTSA Version 2.2.1 Dataset can be found in many formats at www.NEMSIS.org. One clarification was made to the 2009 NCCEP Dataset. In the 2009 version, all of the components of the Glasgow Coma Score are required as opposed to only a total score.

  2. How was the 2009 NCCEP Dataset Requirement developed?
    The NCCEP Dataset Requirement was created through a state consensus process back in 2002 when the NHTSA Version 2.2.1 Dataset was released. This dataset has remained unchanged since that time with the exception of the 2009 change to the Glasgow Coma Score data elements.

  3. Is the 2009 NCCEP Dataset based on any national standard?
    The 2009 NCCEP Dataset is based completely on the NHTSA Version 2.2.1 Dataset often referred to as the NEMSIS Dataset. The dataset can be found as www.NEMSIS.org.

  4. Are EMS Systems and Agencies permitted to change the 2009 NCCEP EMS required dataset?
    No, each EMS System and Agency must collect and electronically submit data to NC OEMS via the PreMIS System using the 2009 NCCEP dataset. Understanding that all of the 2009 NCCEP required data elements are not pertinent to every EMS event, each EMS System or Agency must collect the appropriate data elements for each patient encounter.

  5. Which EMS software is capable of collecting all of the 2009 NCCEP EMS Data Elements?
    The NC OEMS and the EMS Performance Improvement Center (EMSPIC) strongly recommend that EMS Systems and Agencies only use software that has obtained NEMSIS Gold Compliance. This means the software has been tested and shown to be capable of collecting all of the 2009 NCCEP required data elements and submitting them to NC OEMS via PreMIS. A list of NEMSIS Gold Compliant Software is maintained at www.NEMSIS.org.

  6. How often must data be electronically submitted from EMS Systems and Agencies to NC OEMS via the PreMIS System?
    Per the 2009 EMS Rules, EMS Systems and Agencies must submit data electronically to NC OEMS via PreMIS within 24 hours of the EMS event. May EMS software packages can automate this process. Please contact your software vendor or the EMSPIC for more information and the automated data submission process.

Requirements for 2009 NCCEP EMS Performance Improvement Guideline

  1. What has changed between the 2005 and 2009 NCCEP EMS Performance Improvement Guideline?
    This is a completely new section of the NCCEP Standards and is reference in the 2009 EMS Rules. The Performance Improvement Guideline is a list of items/issues that are to be reviewed by the EMS System Peer Review Committee during each calendar year. These items reflect EMS service delivery, EMS professionals performance, and patient care areas which should be monitored on an ongoing basis by each EMS System and Agency.

  2. What is the purpose of the NCCEP EMS Performance Improvement Guideline?
    The EMS Performance Improvement (PI) Guideline is a tool to assist the EMS System's Peer Review Committee in the ongoing evaluation of the EMS Service Delivery, EMS Professional performance, and Patient Care provided. The EMS PI Guideline in combination with reports from PreMIS can make Peer Review Committee meetings more meaningful and productive.

  3. Are all EMS Systems required to use NCCEP EMS Performance Improvement Guideline?
    Yes, all EMS System and Specialty Care Transport Program Peer Review Committees must use the EMS Performance Improvement Guideline

  4. How does the EMS System Peer Review Committee use and apply the NCCEP EMS Performance Improvement Guideline?
    The EMS PI Guideline contains 60 topics that are important to monitor from a quality and performance perspective. All 6 of the EMS Performance Improvement Toolkits are also included in the EMS PI Guideline. The EMS Peer Review Committee must review all of the mandatory items listed in the Guideline within a calendar year (EMS Toolkits twice each year). Depending on the volume of EMS events, the Peer Review Committee must meet a minimum of quarterly by NC EMS rules. Busier EMS Systems will need to meet more frequently. The review of each of these topics will be supplemented with reports from the NC EMS Data System (PreMIS, SMARTT, and CIS).

  5. How does the EMS System obtain reports via PreMIS and the EMS Toolkits to address the issues outlined in the NCCEP EMS Performance Improvement Guideline?
    By May of 2009, the NC EMS Data System will deploy reports specific to the EMS Performance Improvement Guideline. These reports will be accessible by the EMS Administrators and Medical Directors of each EMS System, Agency (including Specialty Care Transport Programs).

  6. How does the NC OEMS and the EMSPIC assist EMS Systems with the NCCEP EMS Performance Improvement Guideline?
    The EMSPIC and NC OEMS will provide technical assistance to EMS Systems and Agencies in the use of the EMS PI Guideline. NC OEMS Regional Specialist can sit in on Peer Review Committee Functions and the EMSPIC can provide technical assistance with the EMS Toolkits and other PreMIS reports.

  7. What evidence must the EMS System Peer Review Committee provide to NC OEMS as proof that the NCCEP EMS Performance Improvement Guideline is in use?
    Discussion of the topics associated with the EMS Performance Improvement Guideline should be reflected in the minutes of the EMS Peer Review Committee.

2009 NCCEP EMS Standards Appendices

  1. What has the purpose of the 2009 NCCEP Standards Appendix documents?
    The 2009 NCCEP Standards Appendix documents serve to provide sample and reference information to important EMS event and patient situations. Whether these documents are used as is or a local version is created, each EMS System is strongly recommended to address the topics defined by these documents.

  2. Are the 2009 NCCEP Appendix documents required to be implemented by all EMS Systems and Agencies?
    No, the 2009 NCCEP Standards Appendix documents are not required. Each EMS System is strongly recommended to address the topic defined by these documents.

  3. Can EMS Systems and Agencies change or alter the NCCEP Appendix documents?
    Yes, the NCCEP Appendix documents are provided on an "as is" basis. EMS Systems or Agencies may change and use these documents as needed.

  4. Are the NCCEP Appendix documents available in an editable form to allow local changes?
    No, these NCCEP Appendix documents are provided “as is” Editable versions are not available.

  5. Who owns the NCCEP Appendix Documents?
    The NCCEP Appendix documents are a compilation of materials which have been accumulated by the NC EMS Medical Director over the past 20 years and provided as a resource with the NCCEP Standards. Where copyright materials exist, it is noted within the documents. All permissions have been received and are on file for the use of any copyrighted material.

  6. Are the NCCEP Appendix documents included in the formal printed version of the 2009 NCCEP EMS Patient Care Treatment Protocols?
    It is unlikely that any of the Appendix documents will be included in the printed version of the 2009 NCCEP Patient Care Treatment Protocols due to cost limitations.

2009 NCCEP EMS Standards Reference Documents

  1. What has the purpose of the 2009 NCCEP Reference documents?
    The Reference Documents included with the 2009 NCCEP Standards consist of formal documents that are not owned or controlled by NCCEP. These are documents that are important to the implementation of the NCCEP Standards documents and to the regulatory function of the NC OEMS.

  2. Who owns each of the 2009 NCCEP Reference Documents?
    • The PreMIS Preliminary Report is a document created by the EMSPIC for use by EMS Systems, Agencies, and Professionals with the PreMIS System.
    • The NC EMS Airway Evaluation Form was created by the NC OEMS for use in the ongoing evaluation and peer review of invasive airway procedures.
    • The NC Medical Orders for Scope of Treatment (MOST) Form is a legal NC form sanctioned by NC law and maintained by the NC OEMS.
    • The NC Do Not Resuscitate Form is a legal NC form sanctioned by NC law and maintained by the NC OEMS.
    • The NC Medical Board Approved Medications and Skills Formulary for Credentialed EMS Personnel is maintained by the NC Medical Board and reference in NC EMS Rule.

  3. What is the purpose of the PreMIS Preliminary Form?
    The PreMIS Preliminary Form was designed to meet two potential needs. First the form is a resource and training form for those who are learning to use the electronic patient care reporting system known as PreMIS.

    A second important function of the PreMIS Preliminary Form is to provide a form that can be left with the patient at the destination (hospital, nursing home, etc.) when the formal patient care report has not been completed.

  4. Is the PreMIS Preliminary Form required to be used by EMS Systems, Agencies, and Professionals?
    No, the PreMIS Preliminary Form is not required.

    All EMS Systems, Agencies, and Professionals are required to leave some form of written documentation describing the care provided by EMS to the patient when the patient is transferred from EMS to another healthcare provider.

  5. Is the NC EMS Airway Evaluation Form required to be used by EMS Systems, Agencies, and Professionals?
    The NC EMS Airway Evaluation Form is required to be used by all EMS Systems and Agencies who perform Drug Assisted Intubation. Its use is strongly recommended for all EMS Systems and Agencies as a tool to evaluate and monitor all invasive airway procedures.

  6. If my EMS System or Agency has implemented the Airway-Drug Assisted Intubation (often referred to as RSI), is the NC EMS Airway Evaluation Form required to be used?
    Yes, the EMS Airway Evaluation Form must be completed by the EMS Professional, reviewed by EMS administration, and signed by the EMS Medical Director on every Drug Assisted Intubation.

  7. Can the NC EMS Airway Evaluation Form be changed by local EMS Systems or Agencies?
    No, the NC EMS Airway Evaluation Form was created based on the National Association of EMS Physicians Airway Evaluation Dataset. It is a formal OEMS document and cannot be altered.

  8. My EMS System or Agency has implemented Airway-Drug Assisted Intubation (often referred to as RSI). Is a copy of the NC EMS Airway Evaluation Form required to be provided to the NC EMS Medical Director for review on each Drug Assisted Intubation procedure done?
    Yes, as part of a Drug Assisted Intubation Program every EMS System or Agency must forward a copy of the completed EMS Airway Evaluation Forms for each Drug Assisted Intubation to the NC EMS Medical Director. These forms must be submitted at the end of each quarter (March, June, September, and December)

  9. Is there additional information I can obtain on the NC MOST and NC DNR Form use?
    Yes, there is a free online educational program that was developed by the NC OEMS and the EMSPIC available at www.emspic.org. It is good for 1 hour of CME and strongly recommended for all NC EMS Professionals.

2009 NCCEP EMS Drug List

  1. What is the purpose of the 2009 NCCEP EMS Drug List?
    The purpose of the 2009 NCCEP Drug List is to provide a quick access standardized list of medications with their indications, contraindications, and dosages. The Drug List only includes medications that are included in the 2009 NCCEP Patient Care Treatment Protocols.

  2. Are all EMS Medications approved for use by EMS Professionals included in the 2009 NCCEP EMS Drug List?
    No, the 2009 NCCEP Drug List only contains the medications that are included in the 2009 NCCEP Patient Care Treatment Protocols. Please refer to the North Carolina Medical Board Medications and Skills List (included in the 2009 NCCEP Reference Documents) for all other medications and skills that can be used/performed by EMS professionals in North Carolina.

  3. Are all medication contra-indications and potential drug reactions listed in the 2009 NCCEP EMS Drug List?
    This NCCEP Drug List is provided as a reference only. It does not contain all of the contraindications and potential adverse reactions for each listed drug. It is the responsibility of each EMS System, Agency, and Medical Director to assure that each EMS professional is knowledgeable about the use each drug in this formulary.

  4. What is the purpose of the 2009 NCCEP EMS Color-Coded Drug List?
    The purpose of the 2009 NCCEP Color-Coded Drug List is to provide a quick access standardized list of medication and equipment sizes for pediatric patients based on the Broselow Pediatric Length Based Tape. The Color-Coded Drug List only includes medications that are included in the 2009 NCCEP Patient Care Treatment Protocols.

  5. Can the 2009 NCCEP EMS Drug List be changed locally by EMS Systems or Agencies?
    Yes, the NCCEP EMS Drug List can be changed locally by EMS Systems and Agencies as needed.

  6. How can an EMS System or Agency add additional medications to the NCCEP EMS Drug List?
    Medications can be added to the Drug List document through the normal protocol approval process. All changes must be approved by both the local EMS Medical Director and the NC State EMS Medical Director.

  7. Can a template be obtained by local EMS Systems or Agencies that wish to change the 2009 NCCEP EMS Drug List?
    Yes, a template can be downloaded from the 2009 NCCEP Standards Website.

  8. Is the 2009 NCCEP EMS Drug List and Color-Coded Drug List included in the formal printed version of the 2009 NCCEP EMS Patient Care Treatment Protocols?
    Yes, the 2009 NCCEP EMS Drug List and Color-Coded Drug List will be included in the printed version of the 2009 NCCEP EMS Patient Care Treatment Protocols.