| (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 installed in the aircraft
cabin which meet the following criteria:
(A) can accommodate an adult, 6 feet tall, weighing
212 pounds except for a neonatal stretcher, with recommended manufacturer's
or FAA approved restraint system in place, which has been fitted with
an isolette. 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) the head of each stretcher, with recommended manufacturer's
or FAA approved restraint system in place, shall be capable of being
elevated up to 45 degrees. The elevating section must hinge at or
near the patient's hips and shall not interfere with or require that
the patient or stretcher securing straps and hardware be removed or
loosened;
(C) each stretcher, with recommended manufacturer's
or FAA approved restraint system in place, shall be positioned in
the cabin to allow the air medical personnel clear view of the patient
and shall ensure that medical personnel always have access to the
patient's head and upper body for airway control procedures as well
as sufficient space over the area where the patient's chest is to
adequately perform closed chest compression or abdominal thrusts on
the patient;
(D) a pad or mattress impervious to moisture and easily
cleaned and disinfected according to Occupation Safety and Health
Administration (OSHA) bloodborne pathogen requirements;
(E) a device to make the stretcher surface rigid enough
if the surface of the stretcher under the patient's torso is not firm
enough to support adequate chest compressions; and
(F) shall have a supply of linen for each patient;
(2) an adequate and manually-controlled supply of gaseous
or liquid medical oxygen, attachments for humidification, and a variable
flow regulator for each patient;
(A) a humidifier, if used, shall be a sterile, disposable,
one-time usage item;
(B) the licensee shall have and demonstrate the method
used to calculate the volume of oxygen required to provide sufficient
oxygen for the patient's needs for the duration of the transport;
(C) the licensee shall have a plan to provide the calculated
volume of oxygen plus a reserve equal 1000 liters or the volume required
to reach an appropriate airport, whichever is longer;
(D) all necessary regulators, gauges and accessories
shall be present and in good working order;
(E) the oxygen system shall be securely fastened to
the airframe using FAA approved restraining devices;
(i) a separate emergency backup supply of oxygen of
not less than 57 liters with regulator and flow meter;
(ii) one adult, one child, one pediatric, one neonatal
size non- rebreathing mask, one adult size nasal cannula and necessary
connective tubings and appliances.
(3) an electrically-powered suction apparatus with
wide bore tubing, a large reservoir and various sizes suction catheters.
The suction system may be built into the aircraft or provided with
a portable unit. Backup suction is required and can be a manually
operated device. (Bulb syringe not acceptable);
(4) hand operated bag-valve-mask ventilators of adult,
pediatric and infant sizes with clear masks in adult, pediatric, and
neonatal patients. It shall be capable of use with a supplemental
oxygen supply and have an oxygen reservoir;
(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) assessment equipment as follows:
(A) equipment suitable to determine blood pressure
of the adult, pediatric, and neonatal patients during flight;
(B) stethoscope;
(C) penlight/flashlight;
(D) heavy duty bandage scissors; and
(E) pulse oximeter;
(7) bandages and dressings as follows:
(A) sterile dressings such as 4x4s, ABD pads;
(B) bandages such as Kerlix, Kling; and
(C) tape in various sizes.
(8) 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;
(9) urinal and bedpan with toilet tissue;
(10) infection control equipment. The licensee shall
have a sufficient quantity of the following supplies for all air medical
personnel, 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.
(11) an adequate trash disposal system exclusive of
bio-hazardous waste control provisions;
(12) the following additional equipment in amounts
and sizes specified by the medical director is required for an air
ambulance provider to function at the advanced level:
(A) advanced airway management equipment appropriate
to the patient's needs;
(B) sterile crystalloid solutions in plastic containers,
IV catheters, and administration tubing sets;
(C) hanger for IV solutions;
(D) pressure bag;
(E) tourniquets, tape, dressings;
(F) container appropriate to contain used sharp devices,
needles, scalpels which meets OSHA requirements;
(G) a list signed by medical director defining quantities
and types of drugs to be carried; and
(H) any specialized equipment required in medical treatment
protocols/standing orders.
(13) 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;
and
(14) 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.
(i) A system for security of medications, fluids, and
controlled substances shall be maintained by each air ambulance licensee
in compliance with local, state, and federal drug laws.
(j) The air ambulance provider shall own the following
equipment or shall have a written lease agreement explaining the availability
of the equipment for use when the patient's condition indicates the
need:
(1) external cardiac pacing device;
(2) IV infusion pump capable of strict mechanical control
of an IV infusion drip rate. Passive devices such as dial-a-flow are
not acceptable; and
(3) a mechanical ventilator that can deliver up to
100% oxygen concentration at pressures, rates and volumes appropriate
for the size of the patient.
|
