La. Admin. Code tit. 48 § I-6057

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-6057 - Ambulances

A. Any vehicle used as an ambulance must be designed and constructed by the manufacturer as such.

B. The following medical and safety equipment are requirements for certification of all ground ambulances operating within the state of Louisiana.

1. All ambulances must have a national standard public safety two-way radio communication (day-to-day communications). The ambulance dispatch center(s) and/or point(s) of dispatch must be capable of interactive two-way communications within all of the service's defined area.

2. Two-way radio with disaster communications must be VHF-National EMS Mutual Aid Frequency, V-MED 28, also known as the Hospital Emergency Activation Radio (HEAR) system 155.34 0 Mhz with carrier squelch, ENCODER optional.

3. Direct communication with a physician and hospital must be conducted through:

a. HEAR; or

b. wireless telephone;

c. Radio Telephone Switch Station (RTSS); or

d. Med. 10 System, etc.

4. All ambulances must carry the following basic medical supplies and equipment:

a. one suction unit capable of providing a suction of at least 300 mm Hg;

b. two wide bore tubing;

c. two rigid pharygeal tonsilar wide bore tip;

d. a second suction unit that is portable;

e. two each suction liners or refills, if required;

f. two suction catheters, 5 fr, or 6 fr, or 5/6 fr;

g. two suction catheters, 14 fr or larger;

h. one portable oxygen cylinder, at least 500 psi, 2000 psi full, appropriate color;

i. one portable oxygen regulator/ flowmeter, variable flow;

j. one fixed oxygen cylinder, "M" or "O" cylinder, at least 500 psi, 2000 psi full, appropriate color or equivalent;

k. one fixed oxygen regulator, variable flow;

l. one oxygen wrench;

m. one fixed oxygen flowmeter;

n. one humidifier;

o. four adult non-rebreather masks;

p. four pediatric non-rebreather masks;

q. four adult nasal prongs with supply tubing;

r. two adult BVM with reservoir and supply tubing;

s. two pediatric BVM with reservoir and supply tubing;

t. two oral airways, adult;

u. two oral airways, child;

v. two oral airways, pediatric;

w. one traction splint with ratchet, straps, and ankle hitch, adult;

x. two extremity splints, upper;

y. two extremity splints, lower;

z. three extrication-type cervical collars, adult;

aa. three extrication-type cervical collarspediatric;

bb. three cervical immobilization devices;

cc. three long spine immobilization device with at least 3 points of confinement (one must be a clamshell device);

dd. one short spine immobilization device with appropriate straps and pillows;

ee. two burn sheets, sterile;

ff. fifty small sterile dressings, 4" x 4" (at least 25 packs of 2);

gg. ten large combine dressings, sterile, 5" x 9" or larger;

hh. two multi-trauma dressings, 10" x 30" or larger or 18" x 24" military abdominal dressings;

ii. eight triangle bandages, commercial;

jj. ten soft roller bandages, 2" wide, unused rolls;

kk. six rolls of hypoallergenic adhesive tape, 1" and 2" or wider (no paper tape);

ll. two occlusive dressings, 3" x 8" petroleum gauze or commercial chest seal;

mm. four chemical cold packs;

nn. two liters normal saline for irrigation in plastic containers;

oo. sterile water, 500 cc or larger in plastic container;

pp. oral glucose, 12.5 mg (cake icing may be substituted);

qq. one aspirin, 325 mg (5 grain) or four aspirin, 81 grain pediatric;

rr. one albuterol inhalation solution, 2.5 mg with appropriate delivery device;

ss. three per crew member Mark I kits (.7 mg atropine and 2 PAM-V0;

tt. radio communication, two-way disaster;

uu. radio communication, two way EMT to physician;

vv. radio communication, two way EMT to dispatch;

ww. one OB kit;

xx. one roll of aluminum or a silver swaddler;

yy. one blood pressure cuff, adult;

zz. one blood pressure cuff, pediatric;

aaa. one stethoscope;

bbb. one pair trauma shears;

ccc. one set of three triangle reflectors (or cyalume light sticks, or traffic; cones), set;

ddd. two flashlights, minimum of 2 "C" cell size with spare batteries and bulbs;

eee. twenty-five triage tags; and

fff. one supra glottis airway approved by the Louisiana EMS Certification Commission.

5. All ambulances must carry the following infection control supplies and equipment:

a. one box of non-sterile exam gloves;

b. one box of gloves, non latex;

c. two pair of full peripheral glasses with face masks, or fluid shields;

d. one per crew member jumpsuit/gown, impervious to liquid, disposable;

e. two readily identifiable trash bags, labeled for contaminated wastes;

f. one pair per crew member shoe covers;

g. one sharps container, 1 quart;

h. one bottle or 12 towelettes of commercial antimicrobial hand cleaner;

i. two biohazard trash bags;

j. four N-95 masks;

k. one set per crew member, chemical resistant, full body coverage coverall with hood;

l. one pair per crew member, chemical resistant footwear;

m. one roll per crew member, chemical sealant tape (not duct tape); and

n. one pair per crew member, chemical resistant goggle with a minimum of a N-95 mask.

6. All ambulances must be equipped with the following:

a. two fire extinguishers, 2:-10:B:C;

b. two blankets;

c. one current US DOT Hazardous Materials Guidebook;

d. one set per crew member, hard hat and safety goggles (ANZ! 37.1 or NFPA approved fire fighter turn out gear);

e. one pair per crew member, leather or nomex gauntlet gloves;

f. one per crew member, incident command vest with florescent trim and appropriate logos;

g. one stretcher, wheeled, multi-level;

h. one set of stretcher straps with at least three points of confinement, including shoulder harness; and

i. all ambulances that are not staffed and equipped to the EMT Paramedic level must carry:

i. one automated external defibrillator with electrodes and leads;

ii. one epinephrine auto injector adult, .30 mg; and

iii. one epinephrine auto injector, pediatric, .15 mg.

7. The following must be carried by all ambulances that are not staffed and equipped to the EMT Paramedic level:

a. an automated external defibrillator (either automatic or semi-automatic) with the appropriate lead cables and at least two sets of the appropriate disposable electrodes. If the automated defibrillator is also capable of manual defibrillation, then an appropriate lock-out mechanism (such as an access code, computer chip, or lock and key) to prevent unauthorized use of the device by those persons not authorized to manually defibrillate must be an integral part of the device;

b. two bags of IV fluids for KVO lines, D5W or isotonic 0.9 percent NaCl, 250 cc bag minimum:

i. all IV fluids must be in plastic bags or bottles, not glass bottles, unless medically indicated otherwise;

c. 4,000 cc IV fluids for volume expansion, Ringers' Lactate or 0.9% isotonic NaCl (these bags of saline do not include the bags or bottles of saline above for irrigation purposes):

i. all IV fluids must be in plastic bags or bottles, not glass bottles, unless medically indicated otherwise;

d. four sets of minidrip tubing;

e. four sets of macrodrip tubing;

f. one set of Y-type blood tubing;

g. two extension tubings;

h. one three-way stop cock;

i. four over-the-needle IV catheters, 14 gauge;

j. four over-the-needle IV catheters, 16 gauge;

k. four over-the-needle IV catheters, 18 gauge;

l. four over-the-needle IV catheters, 20 gauge;

m. four over-the-needle IV catheters, 22 gauge;

n. two venous tourniquets;

o. two syringes, 1 cc w/ .1cc graduations;

p. two syringes, 3cc to 6 cc;

q. two syringes, 10 cc to 12 cc;

r. two syringes, 30 cc w/leur lock

s. two hypodermic needles, 21 to 23 gauge;

t. two hypodermic needles, 25 to 27 gauge;

u. one EPA or OSHA approved sharps container for use at the patient's side;

v. ten antiseptic solution wipes;

w. one IV pole or roof hook;

x. three arm boards of various sizes; and

y. one supra glotic airway device as approved by the Louisiana EMS Certification Commission.

8. The following must be carried by all paramedic level ambulances:

a. two intra osseus needles of preference;

b. one McGill forceps, adult;

c. one McGill forceps, pediatric;

d. one tube or five packets of water soluble lubricant not containing cellulose;

e. two endotracheal tubes, uncuffed, 3.0 to 3.5;

f. two endotracheal tubes, uncuffed, 4.0 to 4.5;

g. two endotracheal tubes, uncuffed, 5.0 to 5.5;

h. two endotracheal tubes, cuffed, 6.0 to 6.5;

i. two endotracheal tubes, cuffed, 7.0 to 7.5;

j. two endotracheal tubes, cuffed, 8.0 to 8.5;

k. two stylettes, adult;

l. two stylettes, pediatric;

m one laryngoscope handle w/ 1 set of spare batteries and bulbs, or two disposable handle units;

n. one laryngoscope blade, Size 0, straight, or two disposable blades, Size 0, straight;

o. one laryngoscope blade, Size 1, straight, or two disposable blades, Size 1, straight;

p. one laryngoscope blade, Size 2, straight, or two disposable blades, Size 2, straight;

q. one laryngoscope blade, Size 3, straight or curved, or two disposable blades, Size 3, straight or curved;

r. one laryngoscope blade, Size 4, straight or curved, or two disposable, Size 4, straight or curved;

s. one cardiac monitor defibrillator with paper strip recorder;

t. two sets defib pads or gel;

u. one set of lead cables;

v. two sets of disposable monitoring electrodes;

w. one glucometer, CLIA approved;

x. two end tidal CO2 detection or monitoring devices;

y. analgesic:

i. one aspirin 5 grain or four 81 mg;

ii. morphine *, 10 mg/ml;

z. anti-arrhythmic:

i. five Adenosine, 6 mg;

ii. four Atropine, pf, 1 mg;

iii. one Calcium Chloride, 10 percent, 1 gram;

iv. three Amiodorone (pre-filled), 150 mg or four Lidocaine,100 mg pf bolus;

v. one Lidocaine, pm, 1 gram;

aa. anti-convulsive:

i. one Valium *, 10 mg/2 ml;

ii. two Mag Sulfate, 2 grams;

bb. anti-histamine:

i. one Benadryl, 50 mg;

cc. bronco-dilators:

i. one Albuterol, 2.5 mg*;

dd. cardio-vascular:

i. two Dopamine, pm, 200 mg;

ii. three NTG, .4mg Tablet or spray;

ee. diabetic control:

i. two D50W, 50 cc; and

ii. two Glucagon, 1 mg;

ff. loop diuretic:

i. two Bumex, 2 mg or two Lasix, 80 mg;

gg. narcotic antagonist:

i. Naloxone, 2mg;

hh. vasopressors, 12 mg total;

i. at least two Epinephrine, 1 mg 1:1000;

ii. at least two Epinephrine, 1 mg 1:10000; and

iii. Vasopressin, 1 mg (optional).

NOTE: *or alternative medication approved by the appropriate parish or component medical society.

C. All ambulances must have a functional air conditioner and heater in the patient compartment. They must function within the vehicle manufacturer's recommended guidelines or specifications.

La. Admin. Code tit. 48, § I-6057

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:480 (March 2009), amended LR 41:2154 (October 2015).

AUTHORITY NOTE: Promulgated in accordance with R.S. 40:1235.2.