Current through Vol. 42, No. 1, September 16, 2024
(a) The tampering, modification, or removal
of the manufacturer's expiration date is prohibited.
(b) Licensed ambulance services shall ensure
that all recalled, outdated, misbranded, adulterated, deteriorated fluids,
supplies, and medications are removed from ambulances immediately.
(c) The medical control physician will
authorize all equipment and medications placed on the units for patient care.
(1) The authorized equipment and medications
will be detailed on a unit checklist and will match the equipment and supplies
with defined minimums needed to treat patients in the manner detailed in the
agency approved protocols. The checklist will also meet the requirements
described in the ambulance file section of this subchapter.
(2) The medications authorized by the medical
director will be detailed on the unit checklist will include the number,
weight, and volume of the medication containers.
(3) An electronic or paper copy of patient
care protocols will be on each in-service ambulance.
(d) Each ground ambulance service vehicle
shall carry:
(1) airway and breathing
equipment and supplies, to include:
(A) a
pulse oximetry device with pediatric and adult capability.
(B) a functioning portable suction apparatus
with wide-bore tubing (1/4"), and rigid and soft suction catheters for adults,
children, and infants, as detailed by agency protocols in addition to the
vehicle mounted suction unit.
(C)
One (1) bulb syringe, with saline drops, sterile, in addition to any bulb
syringes in obstetric kits.
(D) a
minimum of two (2) each, single use adult, pediatric, and infant bag-valve mask
resuscitators with an adult, child, and infant clear masks.
(E) oropharyngeal airways set or a minimum of
two (2) of each size for adult, child, and infant individually wrapped for
sanitation purposes. Nasopharyngeal airways are optional.
(F) a portable ventilator as directed by the
agency medical director and approved protocols.
(G) wall mounted oxygen set with variable
flow regulators and adequate tubing.
(H) portable oxygen cylinder and regulator
with a spare oxygen cylinder appropriately secured.
(I) a minimum of two (2) each adult, child,
and infant sized oxygen masks.
(J)
a minimum of two (2) adult nasal cannulas.
(K) a nebulizer; adult and pediatric, sizes
per local protocols.
(2)
Bandaging materials to include:
(A) two (2)
burn sheets; clean, wrapped, and marked in a plastic bag.
(B) fifty (50) sterile 4"x4"
dressings.
(C) six (6) sterile
6"x8" or 8"x10" dressings.
(D) ten
(10) roller bandages, 2" or larger, such as kerlix, kling, or equivalent.
(E) four (4) rolls of tape
(minimum of one (1) inch width).
(F) four (4) sterile occlusive dressings, 3"
x 8" or larger.
(G) four (4)
triangular bandages.
(H) one (1)
pair of bandage scissors must be on the ambulance or on the on-duty
personnel.
(3) Fracture
immobilization devices, to include:
(A) one
(1) adult and one (1) pediatric traction splint or equivalent device capable of
adult and pediatric application.
(B) two (2) upper and two (2) lower extremity
splints in adult and pediatric sizes.
(C) short spine board or vest type
immobilizer, including straps and accessories as described within agency
protocols.
(D) two (2)adult and one
(1) pediatric size long spine board including straps and head immobilization
devices(s), as described within the agency protocols.
(E) two (2) rigid or adjustable extrication
collars in large, medium, small adult sizes, and pediatric sizes for children
ages 2 years or older, and one (1) infant collar, as described within the
agency protocols. Collars shall not be foam or fiber filled.
(4) Miscellaneous medical
equipment, to include:
(A) one (1) infant,
one (1) child, two (2) adult, and one (1) extra-large blood pressure
cuffs.
(B) stethoscope, one (1)
adult and one (1) pediatric size.
(C) obstetrical kit, with towels, 4"x4"
dressing, umbilical tape, bulb syringe, cord cutting device, clamps, sterile
gloves, aluminum foil, and blanket.
(D) universal communicable disease precaution
equipment including gloves, mask, goggles, gown, and other universal
precautions.
(E) blood-glucose
measurement equipment per medical direction.
(F) CPAP per medical direction.
(G) Semi-automatic advisory defibrillator
(SAAD) with adult and pediatric capability.
(5) Other mandatory equipment, to include:
(A) Two (2) appropriately labeled or
designated waste receptacles for:
(i) waste
that is contaminated by bodily fluids or potentially hazardous or infectious
waste, and,
(ii) waste that does
not present a biological hazard, such as plastic and paper products that are
not contaminated.
(B) one
(1) flexible, portable, soft stretcher for confined space and extrication as
approved by medical direction.
(C)
two way radio communication equipment as detailed in this Chapter and through
the Statewide Interoperability Governing Body utilizing VHF frequency
155.3400.
(D) one (1) sturdy,
lightweight, all-level cot for the primary patient and mounting cot fastener
and/or anchorage assembly that is compliant with the vehicle manufacturing
standards in place at the time of purchase.
(E) at least three (3) strap type restraining
devices (chest, hip, and knee), and compliant shoulder harness shall be
provided per stretcher, cot, and litter (not less than two (2") inches wide,
nylon, easily removable for cleaning, two (2) piece assembly with quick release
buckles).
(F) electronic or paper
patient care reports.
(G) two (2)
fire extinguishers one (1) in the cab of the unit, and one (1) in the patient
compartment of the vehicle. Each mounted in a manner that allows for quick
release and is compliant with the ambulance manufactures standards. Each
extinguisher is to be dry powder, ABC, and a minimum of five (5#)
pounds.
(H) two (2) operable
flashlights.
(I) all ambulance
equipment and supplies shall be maintained in accordance with the sanitation
requirements in this subchapter. Additionally, sterility shall be maintained on
all sterile packaged items.
(J)
digital or strip type thermometer and single use probes.
(K) six (6) instant cold packs.
(L) one (1) length/weight based drug dose
chart or tape.
(M) a minimum of two
(2) DOT approved reflective vests.
(N) one (1) pair of binoculars.
(O) a current copy of the emergency response
guide, electronic or paper format.
(P) As approved by local medical direction, a
child restraint system or equipment for transporting pediatric
patients.
(e)
Intermediate equipment, in addition to the basic equipment, intermediate
licensed service ambulance vehicles shall carry:
(1) intravenous administration equipment in a
sufficient quantity to treat multiple patients requiring this level of care,
including intravenous catheters 14 to 24 gauge, six (6) each.
(2) interosseous needles, two (2) each for
adult and pediatric patients, and associated administration equipment if
approved by local medical control.
(3) appropriate quantities of sterile fluid
as approved by local medical control.
(4) adequate advanced airway equipment per
medical control;
(A) endotracheal tubes, two
(2) sets of cuffed 2.5 to 8.0, as permitted and approved by local medical
control. Uncuffed endotracheal tubes are optional, based on medical director
approval.
(B) supraglottic airway
devices to be used as a primary or secondary airway intervention, as approved
by medical control.
(C)
Laryngoscope handle with extra batteries and bulbs with blade sizes and styles
as approved by local medical control.
(5) blood sampling equipment if approved by
medical control.
(6) one (1)
Occupational Safety and Health Administration (OSHA) approved sharps container.
(7) magill forceps one (1)
pediatric and one (1) adult size, individually wrapped.
(8) continuous waveform capnography required
for use in endotracheal intubation and specific supraglottic airway
devices.
(f) Advanced
Emergency Medical Technician equipment, in addition to the required equipment
for the EMT and the Intermediate, will carry:
(1) medication that is permitted within the
AEMT scope of practice and as approved by the medical control
physician;
(2) equipment and
supplies that are permitted within the AEMT scope of practice and approved by
the medical control physician.
(g) Paramedic equipment, in addition to the
required EMT, Intermediate, and AEMT equipment, the Paramedic level ambulance
will carry:
(1) cardiac monitor/defibrillator
with printout, and appropriate pads, paddles, leads and/or electrodes (adult
and pediatric). Telemetry capability is optional.
(2) medication with quantities to be carried
on each ambulance as detailed in the formulary of agency approved
protocols.
(3) nasogastric tubes;
two (2) each 8 french to 16 french, in accordance with medical control
authorization.
(h) All
ambulance vehicles, regardless of licensure level or level of care provided,
shall carry:
(1) three (3) reflectors
(triangular) or battery powered warning lights;
(2) two (2) OSHA approved hard hats, with
goggles or face shield;
(3) two (2)
pair of heavy work gloves; and
(4)
one (1) spring-loaded window punch or other tool that may be used to access a
patient through a window.
(i) All ambulance services shall have
sufficient and appropriate rescue equipment to gain access to patients either
on board the ambulance or provided through an extrication agreement with a
rescue department or team.
(j) All
assessment and medical equipment utilized for patient care will be maintained
in accordance with the manufacturer's guidelines. Documentation will be
maintained at the agency showing that periodic tests, maintenance, and
calibration are being conducted in accordance with the manufactures
requirements. These types of equipment include, but are not limited to, gurneys
or stretchers, suction devices, pulse oximetry, glucometers, capnography
monitors, end-tidal co2 monitors, CPAP/BiPAP devices, ventilators, and blood
pressure monitors.
Added at 8 Ok Reg
3143, eff 7-18-91 (emergency); Added at 9 Ok Reg 1495, eff 5-1-92; Amended at
17 Ok Reg 392, eff 11-1-99 (emergency); Amended at 17 Ok Reg 2948, eff 7-13-00;
Amended at 19 Ok Reg 386, eff 11-19-01 (emergency); Amended at 19 Ok Reg 1053,
eff 5-13-02; Amended at 19 Ok Reg 2087, eff 6-27-02; Amended at 20 Ok Reg 2368,
eff 7-11-03; Amended at 21 Ok Reg 2755, eff 7-12-04; Amended at 22 Ok Reg 2418,
eff 7-11-05; Amended at 23 Ok Reg 2386, eff 6-25-06; Amended at 25 Ok Reg 2443,
eff 7-11-08
