Current through Register Vol. 43, No. 39, September 26, 2024
(a) The operator shall ensure that the
patient compartment is configured in such a way that air medical personnel have
adequate access to the patient in order to begin and maintain care commensurate
with the patient's needs. The operator shall ensure that the air ambulance has
adequate access and necessary space to maintain the patient's airway and to
provide adequate ventilatory support by an attendant from the secured,
seat-belted position within the air ambulance.
(b) Each air ambulance operator shall have a
policy that addresses climate control of the aircraft for the comfort and
safety of both the patient and air medical personnel. The air medical crew
shall take precautions to prevent temperature extremes that could adversely
affect patient care.
(c) The
operator shall equip each type V air ambulance with the following:
(1) Either two portable functioning
flashlights or a flashlight and one spotlight;
(2) a cot with an elevating head and at least
three safety straps with locking mechanisms or an isolette;
(3) one emesis basin or convenience
bag;
(4) one complete change of
linen;
(5) one blanket;
(6) one waterproof cot cover; and
(7) a "no smoking" sign posted in the
aircraft.
(d) Each
fixed-wing air ambulance shall have a two-way communications system that is
readily accessible to both the medical personnel and the pilot and that meets
the following requirements:
(1) Allows
communication between the aircraft and air traffic control systems;
and
(2) allows air medical
personnel to communicate at all times with medical control, exclusive of the
air traffic control system.
(e) The pilot or pilots shall be sufficiently
isolated from the patient care area to minimize in-flight distractions and
interference.
(f) The operator
shall equip each type V air ambulance with an internal medical system that
includes the following:
(1) An internal oxygen
system with at least one outlet per patient located inside the patient
compartment and with at least 2,500 liters of storage capacity with a minimum
of 200 psi. The pressure gauge, regulator control valve, and humidifying
accessories shall be readily accessible to attendants and medical personnel
from inside the patient compartment during in-flight operations;
(2) an electrically powered suction aspirator
system with an airflow of at least 30 liters per minute and a vacuum of at
least 300 millimeters of mercury. The unit shall be equipped with large-bore,
nonkinking suction tubing and a semirigid, nonmetallic oropharyngeal suction
tip; and
(3) oxygen flowmeters and
outlets that are padded, flush-mounted, or located to prevent injury to air
medical personnel, unless helmets are worn by all crew members during all
phases of flight operations.
(g) The operator shall equip each type V air
ambulance with the following:
(1) A portable
oxygen unit of at least 300-liter storage capacity complete with pressure gauge
and flowmeter with a minimum of 200 psi. The unit shall be readily accessible
from inside the patient compartment;
(2) a portable, self-contained battery or
manual suction aspirator with an airflow of at least 28 liters per minute and a
vacuum of at least 300 millimeters of mercury. The unit shall be fitted with
large-bore, nonkinking suction tubing and a semirigid, nonmetallic,
oropharyngeal suction tip;
(3)
medical supplies and equipment that include the following:
(A) Airway management equipment, including
tracheal intubation equipment, adult, pediatric, and infant bag-valve masks,
and ventilatory support equipment;
(B) a cardiac monitor capable of
defibrillating and an extra battery or power source;
(C) cardiac advanced life support drugs and
therapeutic modalities, as indicated by the ambulance service's medical
protocols;
(D) neonate specialty
equipment and supplies for neonatal missions and as indicated by the ambulance
service's medical protocols;
(E)
trauma advanced life support supplies and treatment modalities, as indicated in
the ambulance service's medical protocols; and
(F) a pulse oximeter and an intravenous
infusion pump; and
(4)
blood-borne and body fluid pathogen protection equipment as described in K.A.R.
109-2-8.
(h) If an
operator's medical protocols are amended, the operator shall submit these
changes to the board with a letter of approval pursuant to
K.S.A.
65-6112(r), and amendments
thereto, within 15 days of implementation of the change.
(i) Equipment and supplies obtained on a
trial basis or for temporary use by the operator shall not be required to be
reported to the board by the operator. If the operator's medical equipment list
is amended, the operator shall submit these changes to the board within 15 days
with a letter of approval from the ambulance service's medical
director.
(j) Each air ambulance
operator shall ensure that each air ambulance has on board, at all times,
appropriate survival equipment for the mission and terrain of the ambulance
service's geographic area of operations.
(k) Each air ambulance operator shall ensure
that the aircraft has an adequate interior lighting system so that patient care
can be provided and the patient's status can be monitored without interfering
with the pilot's vision. The air ambulance operator shall ensure that the
aircraft cockpit is capable of being shielded from light in the patient care
area during night operations or that red lighting or a reduced lighting level
is also provided for the pilot and air ambulance personnel.
(l) Each aircraft shall have at least one
stretcher that meets the following requirements:
(1) Accommodates a patient who is up to six
feet tall and weighs 212 pounds;
(2) is capable of elevating the patient's
head at least 30 degrees for patient care and comfort;
(3) has three securing straps for adult
patients; and
(4) has a
specifically designed mechanism for securing pediatric patients.
(m) Each air ambulance operator
shall ensure that all equipment, stretchers, and seating are so arranged as not
to block rapid egress by air medical personnel or patients from the aircraft.
The operator shall ensure that all equipment on board the aircraft is affixed
or secured in either approved racks or compartments or by strap restraint while
the aircraft is in operation.
(n)
The aircraft shall have an electric inverter or appropriate power source that
is sufficient to power patient-specific medical equipment without compromising
the operation of any electrical aircraft equipment.
(o) When an isolette is used during patient
transport, the operator shall ensure that the isolette is able to be opened
from its secured in-flight position in order to provide full access to the
infant.
(p) Each air ambulance
operator shall ensure that all medical equipment is maintained according to the
manufacturer's recommendations and does not interfere with the aircraft's
navigation or onboard systems.
(q)
(1) Each operator of a type V ambulance
service shall staff each type V air ambulance with a pilot and one of the
following groups of individuals, who shall remain in the patient compartment
during patient transport:
(A) At least two of
the following: physician, physician assistant, advanced practice registered
nurse, or professional nurse; or
(B) one of the individuals listed in
paragraph (q)(1)(A) and one of the following:
(i) An MICT or paramedic; or
(ii) an optional staff member commensurate
with the patient's care needs, as determined by the ambulance service's medical
director or as described in the ambulance service's medical protocols, who
shall be health care personnel as defined in K.A.R. 109-1-1. The medical
personnel shall remain in the patient compartment during patient
transport.
(2)
(A) When
providing critical care transports as defined in K.A.R. 109-1-1, at least one
of the medical personnel specified in paragraphs (q)(1)(A) and (B) shall be
currently certified in advanced cardiac life support by a certifying entity
approved by the board.
(B) When
performing neonatal or pediatric missions, at least one of the medical
personnel specified in paragraphs (q)(1)(A) and (B) shall be currently
certified in advanced life support for neonatal and pediatric patients by a
certifying entity approved by the board.
(C) When responding to the scene of an
accident or medical emergency, not including transports between medical
facilities, at least one of the medical personnel specified in paragraphs
(q)(1)(A) and (B) shall be certified in one of the following areas by a
certifying entity approved by the board:
(i)
International trauma life support-advanced (ITLSA);
(ii) transport professional advanced trauma
course (TPATC);
(iii) trauma nurse
core course (TNCC);
(iv) certified
flight registered nurse (CFRN);
(v)
certified transport registered nurse (CTRN);
(vi) pre-hospital trauma life support
(PHTLS);
(vii) advanced care and
trauma transport (ACTT);
(viii)
critical care emergency medical technician paramedic (CCEMTP); or
(ix) flight paramedic-certification
(FP-C).
