South Dakota Code § 36-4B-15

Medical supervision--Direct and indirect control--Hardship exemption
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Except as otherwise provided in this section, advanced life support personnel must, through the use of direct and indirect control, be supervised by a physician licensed in accordance with chapter
36-4
.
If advanced life support personnel are affiliated with an ambulance service that has been granted a hardship exemption in accordance with chapter
34-11
, the personnel must, through the use of direct and indirect control, be supervised by a:
(1) Physician licensed in accordance with chapter
36-4
;
(2) Physician assistant licensed in accordance with chapter
36-4A
; or
(3) Nurse practitioner licensed in accordance with chapter
36-9A
.
A physician, or a physician assistant or nurse practitioner if the ambulance service has been granted a hardship exemption, must oversee the practice and review the patient care reports of the advanced life support personnel.

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