| (D) awareness that the EMS provider has provided safety
education for ground emergency services personnel.
(f) There shall be two Texas licensed/certified personnel
on board the helicopter when in service. A waiver to the Texas license/certification
may be granted for personnel employed by providers in New Mexico,
Oklahoma, Arkansas, Kansas, Colorado and Louisiana who respond in
Texas and are licensed in their respective state. Staffing of vehicles
shall be as follows:
(1) when responding to an emergency scene, at least
one of the personnel shall be a paramedic;
(2) when responding for an inter-facility transfer,
at least one of the personnel performing patient care duties shall
be a certified or licensed paramedic, registered nurse or physician.
The qualifications and numbers of air medical personnel shall be appropriate
to patient care needs;
(3) when responding as in paragraphs (1) and (2) of
this subsection, the second person may be a certified or licensed
paramedic, registered nurse, or a physician; and
(4) air medical personnel shall not be assigned or
assume the cockpit duties of the flight crew members concurrent with
patient care duties and responsibilities.
(g) Documentation of successful completion of education
specific to the helicopter transport environment in general and the
licensee's operation specifically shall be required. The curriculum
shall be consistent with the Department of Transportation (DOT) Air
Medical Crew - National EMS Education Standards or equivalent program
and each attendant's qualifications shall be documented.
(h) Medical supplies and equipment shall be consistent
with the service's scope of care as defined in the protocols/standing
orders for adult, pediatric, and neonatal patients. Medical equipment
shall be functional without interfering with the avionics nor should
avionics interfere with the function of the medical equipment. Additionally,
the following equipment, clean and in working order, must be on the
aircraft or immediately available for all providers:
(1) one or more stretchers capable of being secured
in the aircraft which meet the following criteria:
(A) can accommodate an adult, 6 feet tall, weighing
212 pounds. There shall be restraining devices or additional appliances
available to provide adequate restraint of all patients including
those under 60 pounds or 36 inches in height;
(B) shall have the head of the primary stretcher, with
recommended manufacturer's or FAA approved restraint system in place,
capable of being elevated up to 30 degrees. The elevating section
shall not interfere with or require that the patient or stretcher
securing straps and hardware be removed or loosened;
(C) shall be sturdy and rigid enough that it can support
cardiopulmonary resuscitation. If a backboard or equivalent device
is required to achieve this, such device will be readily available;
(D) shall have a pad or mattress impervious to moisture
and easily cleaned and disinfected according to Occupational Safety
and Health Administration (OSHA) bloodborne pathogen requirements;
and
(E) shall have a supply of linen for each patient;
(2) adequate amounts of oxygen and masks (for anticipated
liter flow and length of flight with an emergency reserve) available
for every mission;
(3) one portable oxygen tank;
(4) a back-up source of oxygen (of sufficient quantity
to get safely to a facility for replacements). A back-up source may
be the required portable tank if the tank is accessible in the patient
care area during flight;
(5) airway adjuncts as follows:
(A) oropharyngeal airways in at least five assorted
sizes, including for adult, pediatric, and neonatal patients; and
(B) nasopharyngeal airways in at least three sizes
with water soluble lubricant;
(6) at least one suction unit which is portable (bulb
syringes or foot pump is not acceptable);
(7) the following items in amounts and sizes as specified
on a list signed by the medical director:
(A) IV solutions;
(B) IV catheters;
(C) endotracheal tubes;
(D) medications;
(E) any specialized equipment required in medical treatment
protocols/standing orders;
(F) pressure bag;
(G) tourniquets, tape, dressings; and
(H) container appropriate to contain used sharp devices
(needles, scalpels) which meets OSHA requirements;
(8) assessment equipment as follows:
(A) equipment suitable to determine blood pressure
of an adult, pediatric, and neonatal patients during flight;
(B) stethoscope;
(C) penlight/flashlight;
(D) heavy duty bandage scissors;
(E) pulse oximeter;
(F) external cardiac pacing device; and
(G) IV infusion pump capable of strict mechanical control
of an IV infusion drip rate. Passive devices such as dial-a-flow are
not acceptable;
(9) bandages and dressings as follows:
(A) sterile dressings such as 4x4s, abdominal pads;
(B) bandages such as Kerlix, Kling; and
(C) tape in various sizes;
(10) container(s) and methods to collect, contain,
and dispose of body fluids such as emesis, oral secretions, and blood
consistent with OSHA bloodborne pathogen requirements;
(11) infection control equipment. The licensee shall
have a sufficient quantity of the following supplies for all air medical
personnel, and each flight crew member, and all ground personnel with
incidental exposure risks according to OSHA requirements which includes
but is not limited to:
(A) protective gloves;
(B) protective gowns;
(C) protective eyewear;
(D) protective face masks, National Institute for Occupational
Safety and Health (NIOSH) approved N95 or greater;
(E) an approved bio-hazardous waste plastic bag or
impervious container to receive and dispose of used supplies; and
(F) handwashing capabilities or antiviral towelettes;
(12) an adequate trash disposal system exclusive of
bio-hazardous waste control provisions;
(13) security of medications, fluids, and controlled
substances shall be maintained by each air ambulance licensee in compliance
with local, state, and federal drug laws;
(14) 12-lead cardiac monitor defibrillator - DC battery
powered portable monitor/defibrillator with paper printout, accessories
and supplies, with sufficient power supply to meet demands of the
mission;
(15) quantity and type of drugs and specialized equipment
as specified on the medical director's list;
(16) permanently installed climate control equipment
to provide an environment appropriate for the medical needs of patients;
and
(17) survival kit which shall include, but not be limited
to, the following items which are appropriate to the terrain and environments
the provider operates over:
(A) instruction manual;
(B) water;
(C) shelter-space blanket;
(D) knife;
(E) signaling devices;
(F) compass; and
(G) fire starting items.
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