Conn. Agencies Regs. § 19a-179-18

Current through October 16, 2024

Section 19a-179-18 - Minimum vehicle standards

(a) Basic ambulance vehicles shall be inspected at least annually by OEMS and shall conform to the following design and equipment standards:

(1) Design.

(A) Minimum 60? head room in patient compartment measured from floor aisle space to head liner.

(B) Minimum 114? interior length in patient compartment from inside back door to rear of driver's compartment.

(C) Minimum 12? unobstructed aisle space bet primary patient stretcher and any obstruction for full length of primary patient stretcher on one side.

(D) Ability to achieve and maintain an average patient compartment temperature of 65°-70° regardless of weather conditions.

(E) Electrical intercom or signal lights or an open partition to permit exchange of patient condition information between patient compartment and driver.

(F) Sufficient secure storage to permit secure loading and confinement of all items which could move freely about patient area in the event of a collision or roll over.

(G) Rotating or flashing warning lights visible 360° about vehicle.

(H) Mechanical and/or electrical siren.

(I) Two-way radio communications that are compatible with the state approved communications system and will allow communicating with communications coordinating centers (e.g. regional communications centers, central emergency medical dispatch), dispatch and/or directly to the hospital.

(J) Exterior identification visible on two opposite sides of vehicle showing the name of the service the vehicle is operated by.

(K) Any basic ambulance vehicle shall meet or exceed the design criteria of General Services Administration Specifications KKK-A-1822, as amended, with the following exceptions and/or substitutions [Federal specification number shown in parenthesis () ]:

(i) Spare tire (3.6.10)

(ii) Tire changing tools (3.6.3)

(iii) Engine high idle speed control, automatic (3.7.6.1)

(iv) Internal 12 volt d.c. power (3.7.7.3)

(v) 115 volt a.c. utility power (3.7.8)

(vi) Utility power connector (3.7.8.1) - optional

(vii) Electrical 115 volt a.c. receptacles (3.7.8.2)

(viii) Solid state inverter (3.7.8.3)

(ix) Override front bumpers (3.9.6.1)

(x) Interior storage accommodations (3.11.3)

(xi) Exterior storage accommodations (3.11.1)

(xii) Extrication equipment and storage (3.11.2.1)

(xiii) Storage compartments and cabinet design transparent doors (3.11.3)

(xiv) Color, paint and finish (3.16.2)

(xv) Color standards and tolerances (3.16.2.1)

(xvi) Emblems and markings (3.16.4)-substitute the following:

a. Front of vehicle-the word "AMBULANCE" in block, reflectorized letters, not less than four inches high shall be mirror image, centered above the grill.

b. Sides and rear of vehicle-the word "AMBULANCE" shall be in block, reflectorized letters, not less than six inches high, centered on each side and rear of vehicle body.

(xvii) Rustproofing (3.18)

(xviii) "Star of Life" (4.3)

(xix) Intended Use (6.1)

(2) Equipment

(A) Oxygen administration apparatus with 2 hours supply at 7 lpm flow rate, regulator controlled flow rate permitting adjustment from a minimum of 2 lpm-10 lpm with visual indication of flow rate. Adaptors so that a minimum of 2 patients may be provided 0² at the same time. A minimum of 2 each, nasal cannulas and mouth/nose masks.

(B) Portable oxygen administration apparatus with 30 minutes supply at 7 lpm flow rate, which is operable totally detached from parent vehicle. Such unit shall be capable of accepting attachment to a nasal cannula, mouth/nose mask or as enrichment feed to a forced ventilation unit.

(C) Suction apparatus capable of drawing a vacuum of 300mm of mercury. Such unit shall be operable completely independent of parent vehicle for a minimum period of 15 minutes. Such suction apparatus shall be compatible with both rigid and flexible catheters and a minimum of 1 catheter and 1 spare shall be carried.

(D) Mechanical forced resuscitation unit which is either hand operated (bag mask) or cycled only by operator manual control. Pressure cycles units are not acceptable. Such unit shall be compatible with 0² apparatus carried in the subject vehicle for purposes of oxygen enrichment. Such unit shall be compatible with infant, child and adult masks which shall be made of transparent material and shall be carried.

(E) Nonrigid, mouth-to-mouth, oropharyngeal airway maintenance devices in infant, child and adult sizes. A minimum of 1 and 1 spare for each size.

(F) Bite stick for maintaining an open-jawed position on an unconscious patient.

(G) A minimum of six large dressings of the ABD or multi-trauma type.

(H) Assorted dressings and bandages to facilitate hemorrhage control by direct pressure bandage on any area of the human body regardless of severity of hemorrhage.

(I) Aluminum foil, sterile vaseline gauze or other air excluding dressing material to permit air tight seal of wounds to the chest cavity.

(J) Two sterile sheets for isolating burn patients from external sources of contamination.

(K) A splinting device suitable for providing prolonged traction to a lower limb on a child or adult.

(L) Splinting material to permit immobilization and protection to any portion of a child or adult limb in any position. A minimum of 1 spare shall be carried for each size of splint.

(M) Short extrication device (e.g. short backboard with 2 straps minimum of 9' by 2?, forehead and chin restraints) to permit the immobilization of suspected cervical fracture of a child or adult patient during removal from a confined space while in a seated position and during transport.

(N) A long extrication device (long backboard with 2 straps minimum 9' by 2?) to permit the immobilization and transport of a spinal column fracture without vertical or horizontal expansion, contraction or twisting. A scoop stretcher is not a suitable device for this requirement.

(O) 3 cervical immobilization collars of assorted sizes (extrication type collars are recommended).

(P) Commercial stair chair to permit the movement of a patient either up or down within a confined stairway.

(Q) Adult and pediatric blood pressure manometer and cuff, and stethoscope for determining patient blood pressure both outside and inside of vehicle.

(R) Restraint devices of sufficient strength to restrain a violent adult and sufficiently padded to prevent chafing or injury to patient.

(S) A poison treatment kit in addition to one half gallon potable water.

(T) An obstetrical kit containing a minimum of 1 pair sterile gloves, scissors, umbilical cord clamps or tapes, sterile vaginal dressings, 2 towels, large plastic bag, and swaddling material.

(U) One emesis basis, 1 bed pan and 1 urinal.

(V) Not less than 2 pillows and 2 sets of linen to include 2 sheets 2 pillow cases, and 1 blanket per set.

(W) A minimum of 2 10 lb. ABC UL fire extinguishers, 1 carried in driver compartment and 1 in patient compartment.

(X) At least two battery operated, hand carried portable lights.

(Y) One wrecking bar minimum 24? in length.

(Z) At least one cot with 2 patient securing straps. Such cot shall be removable from the ambulance, and provision shall be made for positive locking when the cot is positioned in the vehicle.

(AA) Glucose in a form easily ingested orally.

(BB) A rebreathing device for use in treating hyperventilation syndrome.

(CC) Highway distress signalling devices, either a minimum of 3 hours duration red burning flares, or four reflectorized road marking triangles.

(DD) Two sets of sandbags.

(EE) Disposable procedure gloves, gowns, masks, and goggles.

(3) Each basic ambulance vehicle shall display decals supplied by OEMS on the rear exterior and in the patient compartment of the vehicle indicating it is certified by OEMS. Such decal shall be easily visible in the patient compartment and on the rear exterior of the vehicle.

(4) All required equipment shall be in working order, and each crew member shall be knowledgeable in the operation of such equipment. Substitution for equipment may be made only with the prior written approval of OEMS, upon its determination that the substituted equipment will function at least as well as that which is specified in subsection (2) above.

(5) Each basic ambulance certified vehicle shall be registered by the Connecticut department of motor vehicles as an ambulance.

(b)MIC Units shall conform to the following design and equipment standards.

(1) Design.

(A) Compliance with all safety and design requirements of the Connecticut department of motor vehicles.

(B) Compliance with all federal requirements for vehicle safety design.

(2) Equipment.

(A) Must comply with applicable requirements for basic certification either first responder or basic ambulance.

(B) Airway maintenance equipment as defined by the RMAC and approved by OEMS.

(C) Pneumatic antishock garment.

(D) Intravenous administration sets as defined by the RMAC and approved by OEMS.

(E) Intravenous solutions in nonbreakable containers ad defined by RMAC and approved by OEMS.

(F) For EMT-Paramedic units only.

(i) Laryngoscope, batteries and blades in adult and pediatric sizes.

(ii) Adult and pediatric endotracheal tubes.

(iii) Electrocardiograph monitor with the capability of making a permanent record.

(iv) Cardiac defibrillator.

(v) Blood sampling tubes.

(vi) Medications in amounts and administration methods as defined by the RMAC and approved by OEMS.

(3) All equipment including that used for invasive therapies shall be cleaned and maintained between uses to assure protection from infection in subsequent use.

(c)Invalid Coach

(1) Vehicle Type-The vehicle is to be a van type unit of standard manufacture which meets all specifications for operations on Connecticut highways, as evidenced by registration with the Connecticut department of motor vehicles and satisfaction of the following requirements.

(2) Doors:

(A) All van type vehicles used shall be equipped with operating doors on each side of the driver's compartment.

(B) A side entrance door or doors shall be provided. These doors may be of the hinged swing double door type or sliding type single door, with a minimum opening of 40? in width and 54? in height. The door shall be equipped with a device which will activate an audible or flashing signal when the panels are not securely closed. The signal shall be clearly identifiable by the seated driver.

(C) The vehicles shall be equipped with a rear opening door or doors of the hinged type, with a minimum opening of 45? in width and 50? in height. Should the vehicle be equipped with a rear bench seat blocking the rear door, the vehicle shall be equipped with a rear bench seat quick release mechanism.

(D) Both side and rear doors shall be equipped with windows.

(3) Interior Design:

(A) The interior side walls shall be insulated with a fire resistant material and covered with suitable material at least equal to that installed by the manufacturer.

(B) The left side of the vehicle behind the driver shall be equipped with windows to be equal to the side door glazing.

(C) The floors shall be designed with 3/4 plywood base and covered with a linoleum, rubberized surface, or commercial grade carpet.

(D) The vehicle shall be equipped with an operating heater and air conditioning system capable of maintaining an interior temperature of 65°-70° F for the comfort of patients.

(E) The vehicle shall be equipped with a two-way radio with the capability of communicating with a dispatcher at all times when a patient is being transported.

(F) The minimum vehicle interior height shall be 60?.

(G) Each van shall be equipped with at least two (2) overhead or dome type interior lights of standard manufacture.

(H) An additional light shall be provided which illuminates the lift device or ramp area. This light shall operate automatically when the side doors are opened.

(4) Roof Design-The vehicle shall be equipped with an extended roof reinforced by rolled bars and/or cages which have been certified to withstand one and one-half times the curb weight of the unloaded vehicle.

(5) Wheelchair Lifting Device-The vehicle shall be equipped with a commercially manufactured manual ramp or an electric or hydraulic lift, which is permanently affixed to the interior of the vehicle. The ramp or lift shall be capable of supporting a minimum total load strength of 600 pounds. The lift or ramp shall be equipped with a protective flange on each longitudinal side, sufficient in height to prevent a wheelchair from accidentally falling off the side of the lift or ramp. The lift or ramp surface shall be composed of or covered with a non-skid material. If an electric or hydraulic lift is utilized, the lift shall also be capable of manual operation in the event of engine failure.

(6) Wheelchair Restraining Devices-The vehicle shall be equipped with wheelchair locking devices securely affixed to the vehicle for each wheelchair position for which the vehicle is designed. The locking device shall be capable of immobilizing the wheelchair so that it is secured in at least two places during transport with longitudinal movement not to exceed two inches forward and backward, and without any lateral movement.

(7) Minimum Equipment:

(A) One first aid kit.

(B) One charged fire extinguisher-at least rated 10 BC. by the Underwriter's Laboratory.

(C) Four 30 minute road flares or warning reflectors.

(D) Separate seat restraints for securing patients in wheelchairs prior to loading, in the same quantity as the maximum number of patients the vehicle is designed to accommodate.

(E) Either motion sickness bags or plastic containers with covers in sufficient number equal to the maximum number of patients the vehicle is designed to accommodate.

(F) Blankets made of nonflammable material in sufficient number equal to the maximum number of patients the vehicle is designed to accommodate.

(8) Exterior Vehicle Identification:

(A) Utilize the state approved handicapped sticker minimum of 4? height and located on each side of the vehicle.

(B) Exterior identification visible on each side of the vehicle identifying the service which operates the vehicle with a minimum 4? lettering.

(C) Seating capacity shall be displayed in 2? lettering at curb side of the vehicle.

(9) All replacement invalid coach vehicles shall be in compliance with these regulations.

(10) All invalid coach vehicles currently in use shall be in compliance with these regulations by January 1, 1990.

(d) Emergency medical service vehicles shall be inspected every two years by OEMS at formally designated biennial inspections in addition to unannounced inspections or at hospital spot checks of ambulance vehicles. At such inspections, the OEMS inspector shall examine the vehicle for compliance with the above requirements and may also inspect for the following:

(1) Tires - for minimum tread depth as required by the Department of Motor Vehicles or for structural damage to the body of the tire.

(2) Holes in the body of the vehicle into the driver or patient compartment.

(3) Broken or missing windows.

(4) Malfunctioning doors or door latches.

(5) Missing door seals.

(6) Missing or broken safety equipment including lights, mirrors, horns, or other devices required by law or regulation necessary to insure the safe operation of the vehicle.

(e) By virtue of the inspection as called for in Sec. 19a-179-18(d) of these regulations, should an OEMS inspector determine that an ambulance vehicle is unsafe for any reason cited in the aforementioned section, the OEMS inspector shall affix a sticker to the outside of the window in the rear door which reads: "THIS VEHICLE IS UNSUITABLE FOR PATIENT TRANSPORTATION." The sticker shall be removed only by an OEMS inspector upon the reinspection of the vehicle and determination that the missing or damaged equipment has been repaired or replaced. During the period of time when the sticker is affixed to the vehicle, said vehicle shall not be used for patient transportation. The owner may request a hearing before the commissioner of health services or his designee to petition for reconsideration, stating upon what grounds such petition is based. Said hearing shall be conducted within forty-five (45) days of the request unless otherwise agreed by the requester and the commissioner.

Conn. Agencies Regs. § 19a-179-18

Effective June 14, 1988; Amended September 30, 2003