Statutes, codes, and regulations
Washington Administrative Code
Title 246 - Health, Department ofTRAUMA/EMERGENCY MEDICAL SERVICESChapter 246-976 - Emergency medical services and trauma care systems
LICENSURE AND VERIFICATION
Section 246-976-300 - Ground ambulance and aid service-Equipment

Wash. Admin. Code § 246-976-300

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Current through Register Vol. 24-23, December 1, 2024
Section 246-976-300 - Ground ambulance and aid service-Equipment
(1) Licensed and verified ground ambulance, aid services, and emergency services supervisory organizations (ESSO) must provide equipment listed in Table A of this section on each licensed vehicle or to their on-site EMS providers for the service levels they are approved by the department to provide when they are available for service.

Table A: Equipment

*Means the use of this equipment at this level of service is determined by the MPD. Department-approved and MPD specialized training protocols must be in place.

BLS

ILS

ALS

Ambulance Vehicle

Aid/ESSO

Ambulance Vehicle

Aid/ESSO

Ambulance Vehicle

Aid/ESSO

Airway Adjuncts

Adjunctive airways, (OPA/ NPA) adult and pediatric assorted

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Water-soluble lubricant

1

1

1

1

2

2

Intubation insertion equipment. Enough for all patient sizes with back up equipment including power sources.

N/A

N/A

Assortment

Assortment

Assortment

Assortment

Stylet for endotracheal tubes (adult and pediatric)

N/A

N/A

N/A

N/A

2 each

2 each

Bougie (gum-elastic) for all patient sizes

N/A

N/A

N/A

N/A

1 each

1 each

ET tube holder (adult and pediatric)

N/A

N/A

N/A

N/A

2 each

2 each

End-tidal CO2 detector

*1

*1

1

1

1

1

Supraglottic airways

*Assortment

*Assortment

Assortment

Assortment

Assortment

Assortment

Cricothyrotomy equipment

N/A

N/A

N/A

N/A

1

1

Chest decompression equipment (to include a nonsafety large bore needle, minimum length of 3.25")

N/A

N/A

N/A

N/A

1

1

McGill forceps (adult and pediatric)

N/A

N/A

1 each

1 each

1 each

N/A

Oxygen saturation monitor

*1

*1

1

1

1

1

Suction

Portable

1

1

1

1

1

1

Vehicle mounted and powered, providing: Minimum of 30 L/min. & vacuum > 300 mm Hg

1

0

1

0

1

0

Spare canister

1

0

1

0

1

0

Tubing, suction

1

1

1

1

1

1

Bulb syringe, pediatric

1

1

1

1

1

1

Rigid suction tips

2

1

2

1

2

1

Catheters

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

Meconium aspirator

N/A

N/A

N/A

N/A

1

1

Oxygen/Delivery Devices

Oxygen delivery system built in or an alternative system approved by the department

1

0

1

0

1

0

3000 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system

1

0

1

0

1

0

300 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system

2

1

2

1

2

1

Cannula, nasal, adult

4

2

4

2

4

2

O2 mask, nonrebreather, adult

4

2

4

2

4

2

O2 mask, nonrebreather, pediatric

2

1

2

1

2

1

BVM, with O2 reservoir to provide tidal volume appropriate for each (adult, pediatric, infant)

1 each

1 each

1 each

1 each

1 each

1 each

Nebulizer

*2

*2

2

2

2

2

Continuous Positive

Airway Pressure (C PAP)

*2

*2

*2

*2

2

2

Patient Assessment and Care

Sphygmomanometer (adult large, regular, and pediatric)

1 each

1 each

1 each

1 each

1 each

1 each

Stethoscope, adult

1

1

1

1

1

1

Thermometer

1

0

1

0

1

0

Flashlight, w/spare or rechargeable batteries & bulb

1

1

1

1

1

1

Automated External Defibrillator (AED)

1

1

1

1

0

0

12 lead ECG monitor with defibrillator

0

0

0

0

1

1

Defibrillator pads -

2 each

2 each

2 each

2 each

2 each

2 each

Tool for estimating pediatric medication and equipment sizes

1

1

1

1

1

1

Glucometer

1

1

1

1

1

1

Glucose measuring supplies

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Wound Care

Dressing, sterile

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Dressing, sterile, trauma

2

2

2

2

2

2

Roller gauze bandage

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Medical tape

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Self-adhesive bandage strips

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Cold packs

4

2

4

2

4

2

Hot packs

2

2

2

2

2

2

Occlusive dressings

2

2

2

2

2

2

Trauma shears

1

1

1

1

1

1

Irrigation solution

2

1

2

1

2

1

Commercial tourniquet

2

2

2

2

2

2

Extrication and Splinting

Collars, rigid. Adult (small, medium, large) or adjustable

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Collars, rigid. Pediatric or functionally equivalent sizes

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Immobilization device, cervical/thoracic, adult

1

0

1

0

1

0

Immobilization device, cervical/thoracic, pediatric

1

1

1

1

1

1

Backboard with straps

1

1

1

1

1

1

Head immobilization equipment

1

1

1

1

1

1

Splint, traction, adult w/ straps

1

0

1

0

1

0

Splint, traction, pediatric, w/straps

1

0

1

0

1

0

Splint, adult (arm and leg)

2 each

1 each

2 each

1 each

2 each

1 each

Splint, pediatric (arm and leg)

1 each

1 each

1 each

1 each

1 each

1 each

IV Access

Intravenous fluid type per protocols

*4

*2

4

2

4

2

Intravenous drip sets per protocols

*4

*2

4

2

4

2

Intravenous start supplies (venous tourniquet, transparent film dressing, antiseptic swab)

*4

*2

4

2

4

2

Catheters, intravenous (14-24 gauge)

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

Intraosseous (Equipment sufficient to perform IO insertion and infusion adult and pediatric)

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

Pediatric volume control

*2

*1

2

1

2

1

Pressure infusion device

*1

0

1

0

1

0

Syringes

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

Needles

Hypodermic

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

*Assortment

Medications

Epinephrine for anaphylaxis adult and pediatric dose

1 each

1 each

1 each

1 each

1 each

1 each

Medications consistent with department-approved MPD protocols

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Storage and handling of pharmaceuticals in ambulances and aid vehicles must be in compliance with the manufacturers'

recommendations

Personal Protection Equipment

Eye protection

2

2

2

2

2

2

Mask

5

5

5

5

5

5

Exam gloves (assortment of sizes)

Assortment

Assortment

Assortment

Assortment

Assortment

Assortment

Gowns (isolation)

3

3

3

3

3

3

Trauma Emergencies

Triage identification tags

12

12

12

12

12

12

General

Gurney, wheeled, collapsible, with a functional restraint system per the manufacturer

1

0

1

0

1

0

Pillows, plastic covered or disposable

1

0

1

0

1

0

Pillowcase, cloth or disposable

2

0

2

0

2

0

Sheets, cloth or disposable

4

2

4

2

4

2

Blankets

2

2

2

2

2

2

Towels, cloth or disposable 12" x 23" minimum

4

2

4

2

4

2

Emesis collection device

5

1

5

1

5

1

Urinal

1

0

1

0

1

0

Bed pan

1

0

1

0

1

0

OB kit

1

1

1

1

1

1

Patient care restraints (commercial)

2 pair

0

2 pair

0

2 pair

0

Garbage bags

2

2

2

2

2

2

Safety vest or equivalent gear

2

1

2

1

2

1

Sharps container mounted

1 each

0

1 each

0

1 each

0

Sharps container portable

1 each

1 each

1 each

1 each

1 each

1 each

(2) A licensed service that provides interfacility transport of patients needing specialty level care (SCT) must make available equipment and medications consistent with the scope of practice and care required for the transport type. Equipment must include all the following:
(a) ALS equipment required in Table A of this section;
(b) Multimodality ventilators capable of invasive ventilation appropriate to all age groups transported;
(c) Invasive hemodynamic monitoring; transvenous pacemakers, central venous pressure, and arterial pressure;
(d) Controlled delivery devices for IV infusions;
(e) Medications consistent with scope of practice and care required for the transport type; and
(f) Neonatal and pediatric equipment sufficient for all aspects of prehospital interfacility specialized care if the ambulance service provides transport to this population.

Wash. Admin. Code § 246-976-300

Amended by WSR 24-15-104, Filed 7/22/2024, effective 9/30/2024

Statutory Authority: Chapters 18.71, 18.73, and 70.168 RCW. 11-07-078, § 246-976-300, filed 3/22/11, effective 5/15/11; 00-08-102, § 246-976-300, filed 4/5/00, effective 5/6/00. Statutory Authority: RCW 43.70.040 and chapters 18.71, 18.73 and 70.168 RCW. 93-01-148 (Order 323), § 246-976-300, filed 12/23/92, effective 1/23/93.