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B.C. Reg. 210/2010
M191/2010
Deposited June 29, 2010
effective July 1, 2010
This consolidation is current to July 16, 2024.
See the Cumulative B.C. Regulations Bulletin 2024
for amendments effective after July 16, 2024.
Link to consolidated regulation (PDF)
Link to Point in Time

Emergency Health Services Act

Emergency Medical Assistants Regulation

[Last amended September 28, 2022 by B.C. Reg. 194/2022]

Contents
Part 1 — Definitions
1Definitions
Part 2 — Licensing
2Application for licence
3Applicants authorized to practise outside British Columbia
4Short term licence for non-students
5Short term licence for students
6Temporary licence in extraordinary circumstances
7State of Washington emergency medical assistants
8Categories of licence
9Term of licence
9.1Requirements for renewal of EMA FR licence
9.2Reinstatement of expired licence
10Endorsement of other skills
11Condition of licence
12Return of suspended or revoked licence
Part 3 — Registration
13Register
14Inspection of register
Part 4 — Continuing Competence
15Definitions for Part
16Application of Part
17Continuing competence required to maintain licence
18Repealed
19Exceptions
20Reporting requirements
21Information to be included in report
22How information is to be submitted
23EMA must maintain and produce records
24Notice to EMA who fails to meet reporting requirements
25Adjudication
26Evaluating examinations
27Repealed
Part 5 — Release Protocol
28Requirement for protocol
Part 6 — Emergency Provisions
29 Definitions
30 Application
31 When emergency order may be made
32 Emergency orders
33 Additional powers for purposes of emergency order
34 Conferring discretion under emergency order
35 Making emergency orders
36 Minister retains discretion over EMA services
37 Limits on acting as authorized persons
Schedule 1
Schedule 2
Schedule 3

Part 1 — Definitions

Definitions

1   In this regulation:

"ACP" means the category specified in section 8 (1) as Advanced Care Paramedic;

"Act" means the Emergency Health Services Act;

"category" means a category specified in section 8 (1);

"CCP" means the category specified in section 8 (1) as Critical Care Paramedic;

"EMA" means emergency medical assistant;

"EMA FR" means the category specified in section 8 (1) as Emergency Medical Assistant First Responder;

"EMR" means the category specified in section 8 (1) as Emergency Medical Responder;

"ITT" means the category specified in section 8 (1) as Infant Transport Team;

"licence" means a licence issued or renewed in accordance with the Act, this regulation and the rules;

"PCP" means the category specified in section 8 (1) as Primary Care Paramedic;

"register" means the register of EMAs established and maintained under section 6 of the Act;

"rules" means the rules made under section 6 (7) of the Act.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (a).]

Part 2 — Licensing

Application for licence

2   (1) The licensing board may issue a licence in a category to a person who

(a) is not licensed as an EMA in the category,

(b) applies, in the form and manner approved by the licensing board, for a licence in the category, and

(c) provides evidence, satisfactory to the licensing board, that the person

(i) has successfully completed the training program or programs recognized by the licensing board for the category,

(ii) subject to subsection (2), has, no later than 12 months after the date the person completed the training program or programs referred to in subparagraph (i), passed the examinations approved by the licensing board for the category, and

(iii) is of good character and fit to work as an EMA.

(2) If the licensing board is of the opinion that extraordinary circumstances prevented the applicant from completing the licensing examination within 12 months of completing the training program or programs, the licensing board may extend that period for up to a further 6 months.

[am. B.C. Regs. 62/2011, s. 1; 144/2013, Sch. 2, s. 1 (b); 194/2022, s. 1.]

Applicants authorized to practise outside British Columbia

3   (1) In this section:

"another jurisdiction" or "other jurisdiction" means a jurisdiction other than British Columbia;

"in good standing in that other jurisdiction" means that the applicant

(a) is authorized to practise in that other jurisdiction without any conditions, sanctions or restrictions imposed on that practice as a result of determinations made from a review of any patient-care complaint,

(b) is not the subject of an investigation, a pending hearing, a hearing underway or a pending determination or decision relating to any patient-care complaint, and

(c) has not, for reasons of incompetence, incapacity or misconduct,

(i) resigned or otherwise voluntarily given up the applicant's authorization to practise,

(ii) had terms or conditions placed on the applicant's authorization to practise, or

(iii) had the applicant's authorization to practise suspended or cancelled.

(2) The licensing board may issue a licence in a category to a person who

(a) is not licensed as an EMA,

(b) applies to the registrar, in the form and manner approved by the licensing board, for a licence in the category, and

(c) provides evidence, satisfactory to the licensing board, that the person

(i) has in another jurisdiction an authorization to practise that is, in the opinion of the licensing board, equivalent to an authorization to practise as an EMA in the category,

(ii) is in good standing in that other jurisdiction, and

(iii) is of good character and fit to work as an EMA.

(3) If subsection (2) would apply except for the fact that the licensing board does not consider that the qualifications, examinations or training required for the applicant's authorization to practise in the other jurisdiction are equivalent to those required in British Columbia for the category of licence sought, the licensing board

(a) may require the applicant, before the application is approved and a licence is issued, to successfully complete the examinations or training programs that the licensing board considers necessary or appropriate, and

(b) in choosing examinations or training programs for the purpose of paragraph (a), must cover only matters for which the examinations or training of the other jurisdiction are not considered by the licensing board to be equivalent to those required in British Columbia for the category.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Short term licence for non-students

4   (1) In this section, "applicant" means an applicant for a licence in a category

(a) under section 2 who has successfully completed the training programs recognized by the licensing board for the category, or

(b) under section 3.

(2) If the licensing board is of the opinion that an applicant, although not currently qualified, is likely to qualify to be licensed in the category applied for within the near future, the licensing board may

(a) issue to the applicant a licence in that category for a period of up to 30 days, and

(b) extend the term of the licence issued under paragraph (a) for a period of up to 30 days on one or more occasions,

but the total period of the licence must not exceed one year.

(3) If the licensing board issues a licence under this section, it may defer the decision to act or not act under section 2 or 3 during the term of the licence.

(4) If the applicant is an applicant under section 3, section 3 (3) (b) applies to any examinations or training programs that the licensing board requires the applicant to take as a term or condition of a licence issued under this section.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Short term licence for students

5   (1) In this section, "applicant" means an applicant, under section 2, for a licence in a category who has not completed the training programs recognized by the licensing board for the category.

(2) If the licensing board is of the opinion that an applicant, although not currently qualified, is likely to qualify to be licensed under section 2 in the category applied for within the period, the licensing board may issue to the applicant a licence in that category for a period of up to a year.

(3) If the licensing board is of the opinion that an applicant is likely to qualify to be licensed under section 2 in the category within the period of the extension, the licensing board may extend the term of a licence issued under this section for a period of up to 180 days on one or more occasions, but the total period of the licence including the period under subsection (2) must not exceed 2 years.

(4) If the licensing board issues a licence under this section, it may defer the decision to act or not act under section 2 during the term of the licence.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Temporary licence in extraordinary circumstances

6   (1) In this section:

"another jurisdiction" or "other jurisdiction" have the same meaning as in section 3;

"in good standing in that other jurisdiction" has the same meaning as in section 3, but a reference to "the applicant" or "the applicant's" in that provision must be read as a reference to "the person" or "the person's".

(2) If the corporation determines that it is necessary or appropriate in the circumstances for the protection of public health or safety, the corporation may request that the licensing board issue a licence to a person.

(3) If the corporation makes a request under subsection (2), despite sections 2 and 8 (1), the licensing board must issue a licence in a category to the person if the licensing board is of the opinion that the person is able to practise as an EMA in the category without unacceptable risk to public health or safety.

(4) The licensing board may, under this section, issue a licence in a category only to a person who

(a) is an operational manager with the British Columbia Ambulance Service and has previously

(i) been licensed as an EMA, or

(ii) had an authorization in another jurisdiction to practise that is, in the opinion of the licensing board, equivalent to an authorization to practise as an EMA,

(b) has an authorization in another jurisdiction to practise that is, in the opinion of the licensing board, equivalent to an authorization to practise as an EMA, and is in good standing in that other jurisdiction,

(c) is a student licensed under section 5 in the category of PCP, ACP or CCP, or

(d) is a person who provides evidence, satisfactory to the licensing board, that the person has successfully completed training programs that are, in the opinion of the licensing board, substantially equivalent to those recognized by the licensing board for the category.

(5) To be licensed under this section, a person must provide evidence satisfactory to the licensing board that the person is of good character and fit to work as an EMA.

(6) If the requirements under subsections (2) and (3) continue to be met, the licensing board may

(a) issue a licence under this section for a period of up to 30 days, and

(b) extend the term for a further period of up to 30 days on one or more occasions,

but the total period of the licence must not exceed 60 days.

(7) If the licensing board issues a temporary licence to a student under this section,

(a) the licence held by the student under section 5 is suspended for the term of the temporary licence, and

(b) the time during which the licence under section 5 is suspended does not count in the reckoning of

(i) the term of the licence as described in section 5 (2),

(ii) any period of extension of the term, as described in section 5 (3), or

(iii) the total period of the licence, as referred to in section 5 (3),

as applicable.

[am. B.C. Regs. 144/2013, Sch. 2, s. 1 (b); 194/2013, s. 1.]

State of Washington emergency medical assistants

7   (1) The licensing board may issue a licence collectively recognizing as emergency medical assistants all persons certified under chapters 18.71 and 18.73 of the Revised Code of Washington of Washington State, one of the United States of America, to provide the emergency health services described in subsection (2).

(2) The emergency health services to be authorized by a licence under subsection (1) are restricted to emergency health services that the persons referred to in subsection (1)

(a) are authorized to provide in the State of Washington,

(b) provide under the supervision and control required by the terms of their certification in the State of Washington, and

(c) provide in British Columbia while transporting patients from the United States of America to medical facilities in British Columbia or the United States of America.

(3) The provisions of this regulation, other than this section, do not apply to persons covered by a licence under this section.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Categories of licence

8   (1) An EMA may be licensed in only one of the following categories at a time:

(a) Emergency Medical Assistant First Responder;

(b) Emergency Medical Responder;

(c) Primary Care Paramedic;

(d) Advanced Care Paramedic;

(e) Critical Care Paramedic;

(f) Infant Transport Team.

(2) An EMA in the course of practising the profession may provide only

(a) the services specified in Schedule 1 for the category in which the EMA is licensed, and

(b) a service in respect of which the EMA's licence is endorsed under section 10.

Term of licence

9   (1) Subject to sections 4 to 6,

(a) a licence in the category of EMR, PCP, ACP, CCP or ITT expires 5 years after the date it was issued or renewed, or on the date it is voluntarily relinquished, whichever is earlier, and

(b) a licence in the category of EMA FR expires 3 years after the date it was issued or renewed, or on the date it is voluntarily relinquished, whichever is earlier.

(2) The licensing board may, prior to the date that an EMA's licence expires, extend the EMA's licence for a period not longer than 60 days, if satisfied that special circumstances exist such that the EMA will be unable, before the licence expires, to complete any requirement necessary for the renewal of the EMA's licence.

[am. B.C. Regs. 62/2011, s. 2; 144/2013, Sch. 2, s. 1 (b).]

Requirements for renewal of EMA FR licence

9.1   An EMA licensed in the EMA FR category must, before the EMA's licence is renewed by the licensing board, pass any examination required by the licensing board.

[en. B.C. Reg. 62/2011, s. 3; am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Reinstatement of expired licence

9.2   The licensing board may reinstate the licence of a former EMA whose licence has expired if

(a) the licensing board is of the opinion that reinstatement would not constitute an undue risk to public health or safety, and

(b) the former EMA successfully completes any training or written, oral or practical examinations required by the licensing board for the purpose of this section.

[en. B.C. Reg. 62/2011, s. 3; am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Endorsement of other skills

10   (1) If an EMA provides evidence, satisfactory to the licensing board, that the EMA has

(a) passed the examinations approved by the licensing board for the purposes of this subsection,

(b) successfully completed the training recognized by the licensing board for the purposes of this subsection, or

(c) met the requirements in both paragraphs (a) and (b),

as determined necessary by the licensing board, the licensing board may endorse a licence to permit the EMA to provide a service specified in Schedule 2 for the category of licence in which the EMA is licensed.

(2) If the corporation has approved a research project related to the provision of emergency health services, the licensing board may, on request of the corporation, endorse a licence to permit an EMA to provide a service described in the research project.

(3) An endorsement under subsection (2)

(a) is subject to the terms and conditions described in the research project, and

(b) is suspended or terminated on the suspension or termination of the research project.

(4) to (7) Repealed. [B.C. Reg. 239/2016, s. (a).]

[am. B.C. Regs. 144/2013, Sch. 2, s. 1 (b); 194/2013, s. 2; 76/2014, s. 1; 2/2016, s. 1; 239/2016, s. (a).]

Condition of licence

11   It is a condition of every licence that the EMA must comply with the Act and the regulations, including without limitation the Code of Ethics set out in Schedule 3.

[en. B.C. Reg. 62/2011, s. 4.]

Return of suspended or revoked licence

12   If a licence expires or is suspended or revoked, the EMA must, within 48 hours after expiration or after being notified of the suspension or revocation, return the licence to the licensing board.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Part 3 — Registration

Register

13   (1) In the register must be set out, for each EMA, the following:

(a) the EMA's name, address, licence number and place of employment;

(b) the category in which the EMA is licensed, and any endorsements on the licence under section 10;

(c) any terms, limits or conditions set or imposed by the licensing board for the licence;

(d) a notation of each renewal, suspension or revocation of the licence;

(e) any other information the licensing board considers necessary or appropriate.

(2) An EMA must notify the licensing board, in writing, of any change of name, address or place of employment within 30 days after the change, and the change must be entered in the register.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Inspection of register

14   (1) The register and rules must be open to inspection at the office of the licensing board by any person, free of charge, during regular business hours.

(2) Despite subsection (1), the licensing board may refuse access by a person to the register if it is reasonable to believe that

(a) the access could threaten the safety of an EMA, or

(b) the person seeking access is doing so for commercial purposes.

(3) If access is refused under subsection (2), information appropriate in the circumstances concerning matters recorded in the registry may be disclosed, in lieu of access, to the person refused access.

[am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Part 4 — Continuing Competence

Definitions for Part

15   In this Part:

"continuing education activity" means a training or educational program, course, seminar or similar activity;

"continuing education credit" means a credit given by the director, in respect of a continuing education activity;

"director" means a person employed by the government and designated in writing by the minister as director for the purposes of this Part;

"patient contact" means a contact that an EMA has with a patient in the course of practising the profession;

"reporting period" means the period from April 1 of each year to March 31 of the following year.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 288/2012, s. 1.]

Application of Part

16   This Part does not apply to an EMA holding a licence

(a) in the EMA FR category, or

(b) issued under sections 4 to 7 of this regulation.

[en. B.C. Reg. 62/2011, s. 5.]

Continuing competence required to maintain licence

17   (1) In each reporting period, an EMA must meet the following requirements to the director's satisfaction:

(a) accumulate at least 20 continuing education credits;

(b) have one of the following:

(i) at least 20 patient contacts;

(ii) the number of patient contacts that is 20 minus the number of additional continuing education credits allowed under subsection (3).

(2) A continuing education credit or a patient contact will be considered to have met the requirements under subsection (1) only if,

(a) in the case of a continuing education credit, the director is satisfied that the continuing education activity in respect of which the credit is claimed is relevant to the knowledge, skills or abilities required of an EMA in the course of practising the profession, and

(b) in the case of a patient contact, the director is satisfied that the EMA provided full patient assessment or direct patient care to the patient during the contact.

(3) If, in a reporting period, an EMA accumulates fewer than 20 patient contacts and more than 20 continuing education credits, the EMA may substitute the excess continuing education credits, on a one-to-one basis, for the patient contacts otherwise required for the reporting period.

(4) The director must not give a continuing education credit in respect of an examination required under section 26.

[en. B.C. Reg. 62/2011, s. 5.]

Repealed

18   Repealed. [B.C. Reg. 288/2012, s. 2.]

Exceptions

19   (1) If an EMA's licence was issued not more than one year before the last day of a reporting period, sections 17 and 20 do not apply to the EMA in respect of that reporting period.

(2) If an EMA successfully completes a written examination required under section 26 (1), sections 17 and 20 do not apply to the EMA in respect of the reporting period for which the examination is written.

(3) If an EMA successfully completes a practical examination required under section 26 (3), sections 17 and 20 do not apply to the EMA in respect of

(a) the reporting period for which the examination is taken, and

(b) the current reporting period.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 288/2012, s. 3.]

Reporting requirements

20   No later than April 30 in each year, an EMA must submit to the director the information described in section 21 (1) and (2) respecting the continuing education credits and patient contacts claimed by the EMA for the reporting period that has just ended.

[en. B.C. Reg. 288/2012, s. 4.]

Information to be included in report

21   (1) For each continuing education activity in respect of which a continuing education credit is claimed, the EMA must submit information, satisfactory to the director, respecting the following:

(a) the date, duration, location and description of the activity;

(b) the knowledge, skills or abilities of the EMA that were attained, enhanced or supported by the activity.

(2) For each patient contact claimed, the EMA must submit information, satisfactory to the director, respecting the following:

(a) the date and location of the contact;

(b) the type of contact;

(c) the knowledge, skills or abilities applied by the EMA during the contact.

(3) Repealed. [B.C. Reg. 288/2012, s. 5.]

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 288/2012, s. 5.]

How information is to be submitted

22   Information required

(a) under section 21 (1) or (2) must be submitted electronically using the website established and maintained by the ministry for the purposes of this section.

(b) Repealed. [B.C. Reg. 288/2012, s. 5.]

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 288/2012, s. 5.]

EMA must maintain and produce records

23   (1) An EMA must retain, during each reporting period and for at least 3 years after the last day of each reporting period and to the satisfaction of the director, adequate supporting documentation respecting all continuing education credits and patient contacts submitted by the EMA under section 20 for the reporting period.

(2) An EMA must provide the supporting documentation described in subsection (1) to the director at the director's request.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 288/2012, s. 6.]

Notice to EMA who fails to meet reporting requirements

24   (1) The director may deliver a notice under this section to an EMA who the director believes has failed to meet the requirements of section 17 for the applicable reporting period, setting out the following:

(a) the reasons the director believes the EMA has failed to meet the requirements of section 17 for the reporting period;

(b) information describing the adjudication process available under section 25.

(2) A notice under subsection (1) may be delivered only after April 30 in each year.

(3) A notice under subsection (1) must be delivered to an EMA by email to the last known email address of the EMA and is deemed to have been received by the EMA 7 days after the date on which it was sent.

(4) For the purpose of proving deemed receipt of a notice referred to in subsection (1), proof of receipt may be made by affidavit of the director as to the date on which the notice was sent by email.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Regs. 288/2012, s. 7; 194/2022, s. 2.]

Adjudication

25   (1) An EMA to whom a notice under section 24 is delivered may deliver to the director a request for adjudication, setting out the EMA's reasons for believing the requirements under section 17 were met for the applicable reporting period.

(2) A request under subsection (1)

(a) must be delivered no later than 30 days after the date the notice is deemed to have been received under section 24 (4),

(b) may be delivered only by email, facsimile, registered mail or ordinary mail, and

(c) must, if it includes a request that the director accept or give additional credit for continuing education activities or patient contacts not already submitted by the EMA or accepted or given by the director, be accompanied by adequate supporting documentation satisfactory to the director.

(3) The director may extend the time for delivering a request under subsection (1), before or after the time has expired, if the director is satisfied that special circumstances exist.

(4) If the director considers it appropriate in the circumstances, the director may provide the EMA with an opportunity to make additional written submissions.

(5) On reviewing the request of an EMA made under subsection (1) and any submissions made under subsection (4), the director may,

(a) if the director believes the EMA has met the requirements of section 17 for the applicable reporting period, deliver a notice to the EMA confirming that belief on the basis of the information available to the director at the time, and

(b) if the director continues to believe the EMA has failed to meet the requirements of section 17 for the applicable reporting period, deliver a notice to the EMA, setting out the director's reasons for continuing to believe the EMA has failed to meet those requirements for that reporting period.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Regs. 288/2012, s. 8; 27/2022.]

Evaluating examinations

26   (1) The director may require an EMA to whom a notice is delivered under section 25 (5) (b) to successfully complete, no later than the date specified by the director, a written examination approved by the director for the purposes of this section.

(2) An EMA may attempt a written examination required under subsection (1) on one occasion only.

(3) If an EMA fails a written examination required under subsection (1), the director may require the EMA to successfully complete, no later than the date specified by the director, a practical examination approved by the director for the purposes of this section.

(4) An EMA may attempt a practical examination required under subsection (3) on no more than 3 separate occasions.

(5) If an EMA fails any practical examination required under subsection (3) and

(a) the director is not a delegate of the licensing board, the director must recommend to the licensing board and the licensing board must consider, or

(b) the director is a delegate of the licensing board, the director must consider

whether to set terms and conditions for the EMA's licence under section 6 (5) (b) of the Act with respect to the practice of the profession by or the continuing competence of the EMA.

(6) An EMA will be considered to have failed an examination required under this section if the EMA attempts but fails to successfully complete the examination, unless the director is satisfied that special circumstances exist.

[en. B.C. Reg. 62/2011, s. 5; am. B.C. Reg. 144/2013, Sch. 2, s. 1 (b).]

Repealed

27   Repealed. [B.C. Reg. 210/2010, s. 27 (16).]

Part 5 — Release Protocol

Requirement for protocol

28   (1) The corporation must establish a protocol to be used by an EMA who arrives at a location in response to a request for ambulance services to determine when a person who is assessed by the EMA

(a) is to be transported to a place other than a facility, or

(b) is not to be transported.

(2) The protocol must be restricted for use by an EMA who is

(a) an employee of the corporation, or

(b) an employee of an organization, body, person or government that has the written consent of the corporation under section 5.1 (3) (c) of the Act to provide some or all of the services set out in Schedules 1 and 2 of this regulation to a person who, after being assessed as a result of a request for ambulance services, is not transported to a facility.

(3) The protocol may apply to one or more classes of EMA.

[en. B.C. Reg. 123/2017, s. 1.]

Part 6 — Emergency Provisions

Definitions

29   In this Part:

"authorized person" means an EMA who is authorized under an emergency order to perform an activity or to provide a service;

"emergency order" means an order made under section 32;

"medical health officer" means a medical health officer designated under the Public Health Act;

"provincial health officer" means the provincial health officer appointed under the Public Health Act;

"public health emergency" means an emergency that is the subject of a notice provided by the provincial health officer under section 52 (2) of the Public Health Act.

[en. B.C. Reg. 100/2020, Sch. 1.]

Application

30   (1) This Part applies despite any provision to the contrary in the Act or this regulation.

(2) Except with respect to a requirement referred to in section 33 (e), an emergency order applies only during the period that

(a) begins on the date the order comes into effect, and

(b) ends on the earliest of the following dates:

(i) the date stated in the order;

(ii) the date on which the order is rescinded;

(iii) the date on which the provincial health officer provides notice under section 59 (b) of the Public Health Act that the public health emergency that is the subject of the order has passed.

[en. B.C. Reg. 100/2020, Sch. 1.]

When emergency order may be made

31   (1) The provincial health officer may make an emergency order only if the provincial health officer is of the opinion that

(a) the order is necessary for the purpose of responding to a public health emergency

(i) because the operation of any provision of Parts 2 to 5 or a Schedule is adversely affecting, in one or more areas of British Columbia,

(A) the timely delivery of treatment or services in relation to health care,

(B) the scope of treatment or services in relation to health care that can be delivered, or

(C) the efficient and effective use of health human resources,

(ii) because health human resources in one or more areas of British Columbia are insufficient to meet the needs of persons affected by a public health emergency, or

(iii) for any other reason in the public interest, and

(b) authorized persons may perform the activities and provide the services referred to in the order without undue risk to the health or safety of any person.

(2) The provincial health officer must not make an emergency order without first doing all of the following:

(a) giving notice to the minister of the proposed order;

(b) making reasonable efforts to consult with the corporation for the purpose of forming the opinion referred to in subsection (1);

(c) advising the minister of any objections made by the corporation and

(i) how the order addresses those objections, or

(ii) why those objections cannot be accommodated.

[en. B.C. Reg. 100/2020, Sch. 1.]

Emergency orders

32   If the conditions of section 31 are met, the provincial health officer may make an order to do one or more of the following:

(a) authorize, but not require, an EMA to perform a specified activity or provide a specified service that the EMA would not otherwise be permitted to perform or provide under this regulation;

(b) modify or waive a requirement set, or a standard, protocol or treatment guideline established by the corporation, under the Act or this regulation and authorize, but not require, an EMA to perform a specified activity or provide a specified service in accordance with the modification or waiver.

[en. B.C. Reg. 100/2020, Sch. 1.]

Additional powers for purposes of emergency order

33   The provincial health officer may, for the purposes of an emergency order, do one or more of the following:

(a) make the order in respect of a specified person or a class of persons;

(b) set limits or conditions on an authorization made under the order, including limits or conditions with respect to

(i) the training, experience and qualifications of authorized persons,

(ii) the circumstances in which authorized persons may perform an activity or provide a service, and

(iii) the supervision of authorized persons;

(c) set different limits and conditions for different classes of authorized persons or circumstances, including with reference to

(i) the employer or types of employers of authorized persons, and

(ii) the types of places in which an activity may be performed or a service may be provided;

(d) restrict the application of the order to

(i) one or more geographic areas, or

(ii) a period of time, including until the happening of a specified event;

(e) require authorized persons to keep records or make reports in respect of matters relevant to the order and, for this purpose,

(i) authorize, but not require, another person or a person within a class of persons to keep the record or make the report on behalf of the authorized person, and

(ii) provide records or make reports to the provincial health officer, a medical health officer, the minister, the corporation or the licensing board.

[en. B.C. Reg. 100/2020, Sch. 1.]

Conferring discretion under emergency order

34   (1) The provincial health officer may, in an emergency order, confer a discretion on a medical health officer, the corporation, the licensing board or an employer to determine whether an authorized person is competent to perform an activity or provide a service only if the provincial health officer sets limits or conditions under

(a) section 33 (b) (i) to ensure, to the extent practicable, that activities are performed or services provided only by persons who are reasonably competent to do so, or

(b) section 33 (b) (iii) to require direct supervision of the authorized person by a registrant within the meaning of the Health Professions Act who is authorized, under that Act, to perform the activity or provide the service.

(2) The provincial health officer may, in an emergency order, authorize an authorized person to self-assess whether the authorized person is competent to perform an activity or provide a service only if the provincial health officer sets limits or conditions as described in subsection (1).

[en. B.C. Reg. 100/2020, Sch. 1.]

Making emergency orders

35   The provincial health officer must, as soon as practicable after making an emergency order,

(a) publish the order on a website maintained by or on behalf of the provincial health officer, and

(b) give a copy of the order to the minister, the corporation and the licensing board.

[en. B.C. Reg. 100/2020, Sch. 1.]

Minister retains discretion over EMA services

36   The provincial health officer must comply with any direction of the minister with respect to the following:

(a) not making a proposed emergency order;

(b) making changes to a proposed emergency order;

(c) rescinding or modifying an emergency order.

[en. B.C. Reg. 100/2020, Sch. 1.]

Limits on acting as authorized persons

37   (1) Nothing in an emergency order authorizes an EMA to act contrary to a limit or condition imposed by the licensing board on the EMA's licence.

(2) A person must not perform an activity or provide a service under an emergency order if either of the following circumstances apply:

(a) the person is an EMA whose licence is suspended under section 7 (3) or 8 (1) of the Act;

(b) the person is authorized to provide services similar to those of an EMA in another province or a foreign jurisdiction but that authorization is suspended for a reason similar to a reason for which an EMA's licence could be suspended under section 7 (3) or 8 (1) of the Act.

[en. B.C. Reg. 100/2020, Sch. 1.]

Schedule 1

[am. B.C. Regs. 3/2011, s. (a); 76/2014, s. 2; 123/2017, s. 2; 194/2022, ss. 3 to 8.]

Services — Licence Category

(section 8)

EMA FR

1   An EMA holding a licence in the category EMA FR may provide the following services:

(a) scene assessment;

(b) assessment of level of consciousness, skin colour and temperature, pulse, and respiration;

(c) rapid body survey to identify and attend to any life threatening injuries followed by a secondary assessment consisting of a physical examination, medical and incident history, and vital signs;

(d) cardiopulmonary resuscitation;

(e)-(f) Repealed. [B.C. Reg. 194/2022, s. 3 (a).]

(g) maintenance of airways and ventilation, including by

(i) insertion and maintenance of oropharyngeal airway devices and nasopharyngeal airway devices, and

(ii) use of suction devices and bag-valve-mask devices;

(h) oxygen administration and use of oxygen administration equipment;

(i) use of automatic and semi-automatic defibrillators;

(j) wound management not requiring tissue puncture or indentation;

(k) fracture management and immobilization;

(l) lifting/loading and extrication/evacuation.

EMR

2   An EMA holding a licence in the category EMR may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of EMA FR;

(b) occupational first aid;

(c) transportation;

(d) to (i) Repealed. [B.C. Reg. 194/2022, s. 4 (b).]

(j) soft tissue injury treatment.

PCP

3   An EMA holding a licence in the category PCP may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of EMR;

(b) administration of the following inhaled, intramuscular, intranasal, intraosseous, intravenous, nebulized, oral, subcutaneous or sublingual medications:

(i) opioid antagonist;

(ii) Repealed. [B.C. Reg. 194/2022, s. 5 (a) (iii).]

(iii) anti-histaminic;

(iv) sympathomimetic agent;

(v) procoagulant;

(vi) anti-hypoglycemic agent;

(vii) anti-pyretic;

(c) insertion and maintenance of airway devices not requiring visualization of the larynx;

(d) maintenance of intravenous lines, including use of infusion devices and saline locks;

(e) initiation of peripheral intravenous lines;

(f) point-of-care testing to inform emergency treatment or transportation decisions or to provide information for subsequent treatment;

(g) end-tidal carbon dioxide monitoring.

ACP

4   An EMA holding a licence in the category ACP may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of PCP;

(b) cardioversion and external pacing;

(c) Repealed. [B.C. Reg. 194/2022, s. 6 (b).]

(d)-(e) Repealed. [B.C. Reg. 76/2014, s. 2 (b) (ii).]

(f) initiation of external jugular vein cannulation;

(g) cricothyrotomy;

(h) gastric intubation and suction;

(i) maintenance of intravenous lines with medications;

(j) insertion and maintenance of advanced airway devices which do not require laryngoscopy;

(k) Repealed. [B.C. Reg. 194/2022, s. 6 (b).]

(l) administration of colloid and non-crystalloid volume expanders;

(m) administration of the following intravenous, oral, nebulized, endotracheal, intraosseous, intramuscular and rectal medications:

(i) anti-arrhythmic;

(ii) electrolyte — calcium therapy;

(iii) diuretic;

(iv) anti-coagulant;

(v)-(vii) Repealed. [B.C. Reg. 194/2022, s. 6 (b).]

(viii) sedative;

(ix) anti-emetic — anti-nauseant;

(x) histamine antagonist;

(xi) anti-convulsant;

(xii) alkalizer;

(n) reduction of joint dislocations involving neurological or vascular compromise;

(o) administration of drug therapy after consultation with a medical practitioner who is designated by an employer as a medical oversight advisor and who has advised the EMA to administer the drug therapy.

CCP

5   An EMA holding a licence in the category of CCP may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of ACP;

(b) initiation of arterial lines;

(c) use of incubators for thermoregulation;

(d) chest tube insertion;

(e) initiation of central venous line;

(f) escharotomy;

(g) esophageal manometry;

(h) pericardiocentesis;

(i) mechanical ventilation management and strategy development.

ITT

6   An EMA holding a licence in the category ITT may provide the following services:

(a) all services specified in this Schedule and Schedule 2 for the category of PCP;

(b)-(c) Repealed. [B.C. Reg. 194/2022, s. 8 (a).]

(d) administration of the following intravenous, oral, nebulized, endotracheal, intraosseous, intramuscular and rectal medications:

(i) anti-arrhythmic;

(ii) bronchodilator;

(iii) anti-pyretic;

(iv) Repealed. [B.C. Reg. 194/2022, s. 8 (a).]

(v) anti-hypoglycemic agent;

(vi) sedative — anti-epileptic;

(vii) anti-emetic — anti-nauseant;

(viii) histamine antagonist;

(ix) anti-convulsant;

(x) alkalizer;

(e) Repealed. [B.C. Reg. 76/2014, s. 2 (d).]

(f) mechanical ventilation;

(g) maintenance and monitoring of arterial and central venous catheters;

(h) gastric intubation and suction;

(i) management of chest tubes and chest drainage systems;

(j) intravenous blood product administration;

(k) use of incubators for thermoregulation;

(l) administration of drug therapy after consultation with a medical practitioner who is designated by an employer as a medical oversight advisor and who has advised the EMA to administer the drug therapy.

Schedule 2

[am. B.C. Regs. 3/2011, s. (b); 144/2013, Sch. 2, s. 1 (c); 76/2014, s. 3; 194/2022, ss. 9 to 12.]

Services — Licence Endorsement

(section 10)

EMA FR

1   If an EMA holds a licence in the category EMA FR, the licensing board may endorse the licence to permit the EMA to provide one or more of the following services:

(a)-(b) Repealed. [B.C. Reg. 194/2022, s. 9 (a).]

(c) spinal motion restriction;

(d) Repealed. [B.C. Reg. 194/2022, s. 9 (a).]

(e) administration of oral glucose;

(f) emergency childbirth;

(g) Repealed. [B.C. Reg. 194/2022, s. 9 (a).]

(h) assistance to a patient with the administration of a medication to the patient, provided that

(i) if, under the Pharmacy Operations and Drug Scheduling Act, a particular medication is available only on the prescription of a health professional, the medication has already been prescribed to the patient by a health professional,

(ii) the patient has requested the EMA to assist the patient with the administration of the medication,

(iii) the administration of the medication is related to emergency services the EMA is providing to the patient,

(iv) the medication is administered as prescribed, and

(v) the patient is not being transported between health facilities;

(i) use and interpretation of pulse oximeters and CO-oximeters;

(j) use and interpretation of glucometers;

(k) administration of epinephrine by intramuscular auto-injector or intranasal or sublingual preparations;

(l) topical administration of pro-coagulants and anti-fibrinolytics;

(m) intramuscular and intranasal administration of opioid antagonists;

(n) non-invasive blood pressure measurement;

(o) intramuscular and intranasal administration of anti-hypoglycemic agents;

(p) administration of oral analgesics;

(q) administration of acetylsalicylic acid.

EMR

2   If an EMA holds a licence in the category EMR, the licensing board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) maintenance of intravenous lines without medications or blood products;

(b) Repealed. [B.C. Reg. 194/2022, s. 10 (b).]

(c) administration of the following oral, sublingual or inhaled medications:

(i) anti-anginal;

(ii) Repealed. [B.C. Reg. 194/2022, s. 10 (b).]

(iii) analgesics;

(iv) platelet inhibitors;

(d) Repealed. [B.C. Reg. 194/2022, s. 10 (b).]

(e) chest auscultation;

(f) Repealed. [B.C. Reg. 194/2022, s. 10 (b).]

(g) intramuscular administration of epinephrine;

(h) administration of bronchodilators by inhalation and nebulization.

PCP

3   If an EMA holds a licence in the category PCP, the licensing board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) Repealed. [B.C. Reg. 194/2022, s. 11 (a).]

(b) administration of isotonic crystalloid solutions;

(c) endotracheal intubation;

(d) electrocardiogram acquisition;

(e) initiation and maintenance of non-invasive positive pressure airway devices;

(f) administration of the following inhaled, intramuscular, intranasal, intraosseous, intravenous, nebulized, oral, subcutaneous or sublingual medications:

(i) anti-emetic — anti-nauseant;

(ii) vitamins;

(iii) corticosteroids;

(iv) opioid analgesics;

(v) anti-cholinergic;

(g) collection of capillary and venous blood samples;

(h) initiation and maintenance of intraosseous needle cannulation with local anesthetic instillation;

(i) taking microbiology swabs of dermal and mucosal sites;

(j) manual defibrillation with cardiac rhythm interpretation;

(k) electrocardiogram interpretation;

(l) needle thoracentesis;

(m) administration of chemical and biological agent countermeasures.

ACP

4   If an EMA holds a licence in the category ACP, the licensing board may endorse the licence to permit the EMA to provide one or more of the following services:

(a) automated mechanical ventilation;

(b) Repealed. [B.C. Reg. 194/2022, s. 12 (b).]

(c) urinary catheterization;

(d) arterial line management and central venous pressure monitoring;

(e) infusion of blood products;

(f) Repealed. [B.C. Reg. 194/2022, s. 12 (b).]

(g) collection of arterial blood samples;

(h) interpreting laboratory and radiologic data;

(i) Repealed. [B.C. Reg. 76/2014, s. 3 (b).]

(j) chest tube management;

(k) central line management;

(l) management of parenteral feeding lines and equipment;

(m) provision of trans-venous pacing;

(n) invasive wound management;

(o) subcutaneous application of a local anaesthetic;

(p) finger thoracostomy.

Schedule 3

Code of Ethics

The purpose of this code of ethics is to provide general principles of ethical conduct to guide emergency medical assistants in meeting their duties to the public and to the profession.

EMERGENCY MEDICAL ASSISTANTS MUST

(a) consider, above all, the well-being of the patient in the exercise of their duties and responsibilities;

(b) develop and maintain working relationships with other health professions and associations to ensure that patients receive the best possible emergency health care;

(c) protect and maintain the patient's safety and dignity, regardless of the patient's race, colour, ancestry, place of origin, religion, marital status, family status, physical or mental disability, sex or sexual orientation;

(d) preserve the confidence of patient information consistent with the duty to act at all times for the patient's well-being;

(e) not engage in any illegal or unethical conduct nor act in a manner that conflicts with the best interests of the profession;

(f) report to the appropriate authorities any incompetent, illegal or unethical conduct by colleagues or other health care personnel;

(g) carry out professional responsibilities with integrity and in accordance with the highest standards of professional competence;

(h) strive to improve the professional competence of colleagues serving under their direction;

(i) assume responsibility for personal and professional development, and maintain professional standards through training and peer mentoring;

(j) strive to encourage and merit the respect and trust of the public for members of the profession;

(k) refrain from impugning the professional reputation of a colleague or any other health care provider;

(l) promote and encourage compliance with the spirit of these standards within the profession.

[Provisions relevant to the enactment of this regulation: Emergency Health Services Act, R.S.B.C. 1996, c. 182, s. 15.]