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PA Bulletin, Doc. No. 96-1589

NOTICES

Required Ambulance Equipment and Supplies

[26 Pa.B. 4569]

   Title 28 of the Pennsylvania Code § 1005.10(c)(2) (relating to minimum equipment and supplies for BLS and ALS ambulances), provides that the Department of Health will publish on an annual basis a list of minimum equipment and supplies required for each respective service. The Department hereby gives notice that the following shall constitute the revised required equipment and supply lists for all such services effective as of October 1, 1996, and shall remain in effect until modified by the Department by subsequent published notice. Questions or inquiries concerning the equipment and supply lists must be directed to Robert H. Gaumer, Division of Emergency Medical Services Systems, Room 1033, Health and Welfare Building, Harrisburg, PA 17120, (717) 787-8740.

Basic Life Support Ambulance Service

   The following equipment and supplies must be carried by a Basic Life Support Ambulance Service:

   1.  Rechargeable portable electric suction apparatus with wide-bore tubing (1)--The unit must have a water supply to lubricate and clear the tubing.

   2.  Catheters, pharyngeal suctioning rigid (2)--Catheters must be individually wrapped and sterile.

   3.  Nasopharyngeal airways--One set of (5) different sizes. The airways must be clean and a water soluble lubricant available.

   4.  Oropharyngeal airways--One set of (6) different sizes (1). Any of the catheter guide or channel type airways are acceptable. The airways must be clean. Esophageal Obturator or Gastric Tube Airways are not acceptable substitutes.

   5.  Sphygmomanometer--Child, adult, thigh (or large adult) cuffs (1 each). Note:  (1) manometer with interchangeable cuffs is acceptable.

   6.  Stethoscope (1).

   7.  Penlight (1)--Mini-mags are not acceptable.

   8.  Portable oxygen unit (1)--The unit must be equipped:

   a.  With at least a 300 liter capacity cylinder.

   b.  Equipped with a yoke. This is a device which commonly has a three pin connector which fits into the top of the cylinder.

   The cylinder must have a minimum total pressure of 500 pounds per square inch (psi).

   c.  Equipped with a nonsparking wrench to open and close valve on top of cylinder or a tank opening device as part of the cylinder.

   d.  Equipped with gauge/flowmeter that is not gravity dependent and can deliver oxygen at 0-25 liters per minute. Older models with a range of 15 are acceptable until replaced.

   e.  A full space cylinder (300 liter capacity) must be available.

   9.  Transparent, disposable oxygen delivery devices with supply tubing:

   --Nasal cannulas--Adult (1) and pediatric (1)

   --High concentration mask, capable of providing 80% or greater concentration of oxygen--Adult (1), infant (1) and pediatric (1)

   --Each device must be individually wrapped. Oxygen masks which can easily convert to two or more different types are acceptable as long as the minimum numbers are maintained.

   10.  Sterile universal dressings (10" x 30") (4)--Compactly folded and packaged in a convenient size.

   11.  Occlusive dressings (3" x 4") (4)--Used to seal a sucking chest wound. Any dressing which can form an airtight seal, such as petroleum jelly impregnated gauze, plastic wrap or aluminum foil.

   12.  Sterile gauze pads (minimum of 3" x 3") (25)--Must be individually wrapped or two to a pack and sterile.

   13.  Soft self-adhering type bandages, assorted sizes (6 rolls total). These are sometimes referred to as roller gauze or roller bandages. They need not be sterile but must be clean and wrapped.

   14.  Adhesive tape, assorted widths (4 rolls)--Any type of tape is acceptable so long as at least one roll is of the hypo-allergenic type.

   15.  Long spine board, rigid or folding (excluding slat type of flexible stretcher) (1)--May be constructed of wood, aluminum or fiberglass.

   16.  Lateral cervical spine immobilization device (1) for example, manufactured CID, tightly rolled towels, blankets or foam bags. Sandbags are not acceptable. The device must have a means of attachment to the long spine board. This may be as simple as adhesive tape. If rolled towels are to be used, they must be pre-rolled and ready for use at all times.

   17.  Short spine immobilization device (1)--This device must be constructed of wood, vinyl, fiberglass, metal, plastic, leather, cloth or any combination of these materials. Fully rigid or corset type immobilizers are acceptable. The device must be capable of easy application to a patient in a sitting or semi-sitting position and in conjunction with a rigid or semi-rigid neck immobilizer which fully immobilizes the cervical spine.

   18.  Rigid or semi-rigid neck immobilizers, small, medium, large and pediatric (1 each)--Traditional soft collars, rolled towels or the like are not acceptable. Each collar must be constructed of a solid, rigid material (plastic) or a combination of such plastic and a flexible form fitting material (foam).

   19.  Hand operated adult and infant bag-valve-mask devices with supply tubing and clear masks (1 each). Unit must be capable of 100% oxygen delivery. The unit must be equipped with a bag or tube reservoir or some other port of oxygen to enter and fill the bag.

   20.  Hand operated pediatric bag-valve-mask device (450-700 cc) with supply tubing and clear masks (1), and without a pop-off valve. Unit must be capable of 100% oxygen delivery. The unit must be equipped with a bag or tube reservoir or some other port of oxygen to enter and fill the bag.

   21.  Pocket mask with one-way valve (1), with an oxygen port.

   22.  9 ft. straps (5)--Used with long and short boards as well as patient restraints in addition to those on the litter. Straps with ''speed clips'' or spider straps can substitute for three (3) of the 9 ft. straps, if the service carries backboards with pins for speed clips.

   23.  Folding litter and/or collapsible device for patient transport (for example, stairchair which can accommodate a prone, recumbent or supine patient) (1)--A wide variety of devices are acceptable ranging from army cots to slat-type flexible stretchers. This device is in addition to the litter and long spine board.

   24.  Lower extremity mechanical traction splint, adult and child (1 each) or adult and child capable (1) will fulfill this requirement. The unit must contain:

   a.  a frame of some type

   b.  limb support slings

   c.  padded ankle hitch

   d.  padded pelvic support

   e.  traction strap

   If appropriate padded and hitches are available, a half ring splint will be acceptable, assuming adult and child capabilities exist.

   25.  3" wide padded board splints, 4.5 ft., 3 ft., 15 inches (2 each)--Splints of cardboard, plastic (including pneumatic), wire ladder, metal or canvas slotted lace-on may be carried in place of the 3 ft. and 15 inch boards.

   26.  Pneumatic counter pressure anti-shock device--compartmentalized by leg and abdomen, adult and child (1 each) or adult and child combination (1) will fulfill this requirement. The device must be accompanied with an appropriate air pump, hoses and valves supplied by the manufacturer. Can be utilized to splint lower extremity fractures.

   27.  Sterile water and/or normal saline solution for irrigation in nonbreakable containers (2 liters total volume). The containers must be marked with expiration dates which have not expired. An assortment of containers is acceptable so long as there is a total of 2 liters (2,000 milliliters or cc's).

   28.  Sterile burn sheet (4 ft. x 4 ft.)--Most are commercially prepared but any sheet which is nonpilling and sterile is acceptable.

   29.  Cold packs, chemical (4).

   30.  Triangular bandages (8)--These must be triangular pieces of cloth approximately 40 inches across the base. Safety pins must be on hand for use with triangular bandages.

   31.  Sterile OB kits (2)--Each kit must contain the following contents:

   a.  1 pair of sterile gloves.

   b.  2 umbilical cord clamps.

   c.  tape or tie-offs.

   d.  2 towels.

   e.  2 plastic bags.

   f.  1 bulb aspirator.

   g.  2 sanitary pads.

   h.  1 scalpel.

   32.  Bulb syringe separate form OB kits (1). Must be sterile.

   33.  Thermal blanket (Silver Swaddler) (1), or roll of sterile aluminum foil.

   34.  Pediatric equipment sizing tape or equipment age/weight chart (with normal vital signs).

   35.  Bandage shears (1)--Must be capable of cutting clothing and bandages.

   36.  Pillow (1).

   37.  Blankets (2)--Must be single bed sizes and clean. Plastic blankets are not acceptable.

   38.  Sheets (4)--Must be clean and folded.

   39.  Pillowcases (2)

   40.  Towels (4)--Any size.

   41.  Disposable tissues (1 box).

   42.  Emesis container (1)--In addition to bed pan.

   43.  Urinal (1).

   44.  Bed pan (1).

   45.  Disposable drinking cups (3 oz. or larger) (4)--Used for protecting eye injuries from further aggravation. They must be constructed of a material which is easily collapsed (paper).

   46.  State approved triage tags (25).

   47.  Handlight (6 or more volts) (2)--Any of a variety of lights operating on 6 or more volts is acceptable.

   48.  Hazard warning devices (3)--for example, reflectors, flares and fuses. Used for traffic detouring and safety perimeters. Must be capable of 30 minutes operation time.

   49.  Radio equipment which operates on public service frequencies assigned by the FCC and enables medical two-way communications with dispatch and hospitals to which the ambulance service most often transports patients during medical emergencies. A cellular telephone may only be used as a backup means of communications when the radio system fails.

   50.  Emergency jump kit. Virtually any container made of plastic, cloth, metal, fiberglass or wood is acceptable as long as it is large enough to hold basic patient care equipment and supplies.

   51.  U. S. Department of Transportation Guidebook for Initial Response to Hazardous Materials Incidents. (Current Copy)

   52.  Thermometers--oral (glass or electronic) or tympanic (1).

   53.  Hot packs, chemical (4).

   54.  Sharps receptacle (1).

   55.  Suction catheters, flexible 6 and 8 (1 each), and 10 or 12, 14 or 18 (2 each). Total of 6.

   56.  Instant glucose (40% dextrose-d-glucose gel)--minimum of either 3 single dose tube of 15 grams each, or 1 three-dose tube of 45 grams.

   57.  Activated charcoal--minimum of 50 grams, either in powdered form or premixed suspension.

   58.  Large screwdrivers, phillips and slotted (1 each). Each must be at least 8" in length.

   59.  Pliers (slipjoint, lineman's, needlenose, arc joint (water pump) and locking) (1 of each). The needlenose pliers must be at least 6" in length, the lineman's at least 7" and the remaining three, at least 8".

   60.  Hand-held sledge hammer (3 lbs.) (1)--Must have a 10" handle. If the handle is made of wood it should be unpainted.

   61.  Impact metal-cutting tool (1)--May be a commercial product or any device designed to cut automotive grade sheet metal.

   62.  Short pry bar (1)--Must be 12" in length.

   63.  Cold chisel (7" x 3/4") (1).

   64.  Hacksaw with 2 extra blades (1)--Must have a 12 inch blade and some type of lubricant such as a petroleum based oil or liquid soap.

   65.  Adjustable wrench (10") (1).

   66.  Center punch (1).

   67.  Hard hat (1 per responding crew member)--minimum of 2.

   68.  Clear eye protection. Goggle type or wraparound type with side shields (1 pair per crew member responding on vehicle, minimum of 2 pair).

   69.  Gloves (1 pair per crew member responding on vehicle, minimum of two pair). The anterior surface (palm and fingers) of the gloves must be covered with work grade leather.

   70.  Eye protection, clear, disposable (1 per responding crew member)--face shield type.

   71.  Face mask, disposable (1 per responding crew member).

   72.  Gown or coat (1 per responding crew member).

   73.  Surgical caps/foot coverings, disposable (1 set per responding crew member).

   74.  Double-barrier gloves (1 set per responding crew member)--can be double latex gloves and should be designed specifically as a barrier against infection.

   75.  Container (1 per vehicle or disposable bags) (3 per vehicle) for storage of contaminated clothing/equipment. If a bag, must be color-coded (red) and constructed of heavy-duty plastic.

   76.  Copy of exposure control plan for handling of infectious disease patients.

Advanced Life Support Ambulance Services

A.  Mobile Intensive Care Unit (MICU)

   The following equipment and supplies must be carried by a Mobile Intensive Care Unit (MICU):

   1.  All of the equipment and supplies required by a Basic Life Support Service as previously identified.

   2.  Sponges/preps/wipes, alcohol (10)--These can be as simple as the 1" x 1" packets.

   3.  Airways:  Endotracheal tubes--Cuffed sterile or uncuffed sterile--sizes and quantities.

   a.  2.5 mm or 3.0 mm (2 each)

   b.  3.5 mm or 4.0 mm (2 each)

   c.  4.5 mm or 5.0 mm (2 each)

   d.  5.5 mm or 6.0 mm (2 each)

   e.  6.5 mm or 7.0 mm (2 each)

   f.  7.5 mm or 8.0 mm (2 each)

   g.  8.5 mm or 9.0 mm (2 each)

   The cuff must be present on sizes 5.0 mm and larger. Tubes must be individually wrapped and sterile.

   4.  Laryngoscope, handle with batteries (1) and spare batteries (1) set.

   5.  Laryngoscope, blades:

StraightCurved
# 1 (1)# 3 (1)
# 2 (1)# 4 (1)
# 3 (1)

Sizes S, M and L can also be used depending on manufacturer of straight blades.

   6.  Lubricating jelly, surgical, sterile (2 cc) containers (2).

   7.  Magill forceps, adult and pediatric (1 of each).

   8.  Phlebotomy equipment. Blood collection vacuum tubes (per regional policies). Blood collection vacuum tube barrel (1) and vacuum phlebotomy needles (2). Tubes should have a current expiration date.

   9.  Catheters, over the needle (intravenous).

   a.  14 gauge (4)

   b.  16 gauge (4)

   c.  18 gauge (4)

   d.  20 gauge (4)

   e.  22 gauge (4)

   f.  24 gauge (2)

   Each must be individually wrapped and sterile. Total of 22.

   10.  Intravenous administration supplies. Microdrip (50-60 drops/ml) and Macrodrip (10-20 drops/ml) sets (2 of each).

   11.  Intravenous fluids.

   a.  D5 and W (250 ml)

   b.  Sodium Chloride (1,000 ml)

   c.  Lactated Ringers (1,000 ml)

   The number of bags for each fluid must add up to the total ml required for each fluid in any combination. If regional protocols do not require all three fluids, then total mls for the required fluids must add up to 2,250 mls.

   12.  Tourniquets for IV use (2). These can be as simple as a strip of latex.

   13.  Emergency drugs per regional protocols and within State guidelines, and secured under double lock and key.

   14.  Needles, hypodermic.

   a.  IV (16-20 gauge)) (4)

   b.  Subcutaneous (23-25 gauge) (4)

   c.  Intramuscular (20-22 gauge) (4)

   d.  Intraosseous (14-18 gauge) (2)

   These must be available in various sizes as indicated above. Each must be individually wrapped and sterile. Total of 14.

   15.  Syringes, per regional or local protocols.

   16.  Defibrillator/monitor with synchronized cardioversion capabilities, DC electric power, portable, battery-operated with paper readout, with spare battery or alternate power source, with ECG cables with three lead capability and pediatric paddles.

   17.  Defibrillator paddle pads (4) or electrode gel (2 tubes).

   18.  Electrodes, ECG, adult and pediatric sizes (6 each).

   19.  Stylette, malleable--pediatric (2) and adult (1).

   20.  ALS medications per guidelines published by the Department.

   21.  Meconium aspirator (1).

B.  ALS Squad Unit

   The following equipment and supplies must be carried by an Advanced Life Support Squad Unit:

   1.  Airways:  endotracheal tubes--cuffed sterile or uncuffed sterile--sizes and quantities:

   a.  2.5 mm or 3.0 mm (2 each)

   b.  3.5 mm or 4.0 mm (2 each)

   c.  4.5 mm or 5.0 mm (2 each)

   d.  5.5 mm or 6.0 mm (2 each)

   e.  6.5 mm or 7.0 mm (2 each)

   f.  7.5 mm or 8.0 mm (2 each)

   g.  8.5 mm or 9.0 mm (2 each)

   2.  Catheters, pharyngeal suctioning, rigid (2)--Catheters must be individually wrapped and sterile.

   3.  Suction catheter, flexible, sizes 6 and 8 (1 each), 10 or 12, 14 or 18 (2 of each)--Catheters must be individually wrapped and sterile. Total of 6.

   4.  Laryngoscope, handle with batteries (1) and spare batteries.

   5.  Laryngoscope, blades.

StraightCurved
# 1 (1)# 3 (1)
# 2 (1)# 4 (1)
# 3 (1)

Can use sizes S, M and L for straight blades depending on manufacturer.

   6.  Lubricating jelly, surgical, sterile (2 cc) containers (2).

   7.  Magill forceps, adult and pediatric (1 of each).

   8.  Nasopharyngeal airways, set of (5) different sizes (1)--The airways must be clean and a water soluble lubricant available.

   9.  Stylette, malleable, pediatric (2) and adult (1).

   10.  Rechargeable portable electric suction apparatus with wide-bore tubing (1)--The unit must have a water supply to lubricate and clear the tubing.

   11.  Oropharyngeal airways, set of (6) different sizes (1)--Any of the catheter guide or channel type airways are acceptable. The airways must be clean. Esophageal obturator or gastric tube airways are not acceptable substitutes.

   12.  Sphygmomanometer--Child, adult, thigh (or large adult) cuffs (1 each). Note:  (1) manometer with interchangeable cuffs is acceptable.

   13.  Stethoscope (1).

   14.  Penlight (1)--Mini-mags are not acceptable.

   15.  Portable oxygen unit (1)--The unit must be:

   a.  With at least a 300 liter capacity cylinder.

   b.  Equipped with a yoke. This is a device which commonly has a three pin connector which fits into the top of the cylinder.

   Each cylinder must have a minimum total pressure of 500 pounds per square inch (psi).

   c.  Equipped with a nonsparking wrench to open and close valve on top of cylinder or a tank opening device as part of the cylinder.

   d.  Equipped with gauge/flowmeter that is not gravity dependent and can deliver oxygen of 0-25 liters per minute. Older models with a range of 15 are acceptable until replaced.

   e.  A spare cylinder (300 liter capacity) must be available.

   16.  Transparent, disposable oxygen delivery devices with supply tubing:

   --Nasal cannulas--Adult (1) and pediatric (1)

   --High concentration mask, (partial or non-rebreather), capable of providing 80% or greater concentration of oxygen--Adult (1), infant (1) and pediatric (1)

   --Each device must be individually wrapped.

   17.  Sterile universal dressings (10" x 30") (4)--Compactly folded and packaged in a convenient size (4).

   18.  Occlusive dressings (3" x 4") (4)--Used to seal a sucking chest wound. Any dressing which can form an airtight seal, such as petroleum jelly impregnated gauze, plastic wrap or aluminum foil.

   19.  Sterile gauze pads (minimum of 3" x 3") (25)--Must be individually wrapped or two to a pack and sterile.

   20.  Soft self-adhering type bandages, assorted sizes (6 rolls total). They need not be sterile but must be clean and wrapped.

   21.  Adhesive tape, assorted widths (4 rolls)--Any type of tape is acceptable so long as at least one roll is of the hypo-allergenic type.

   22.  Short spine immobilization device (1)--This device must be constructed of wood, vinyl, fiberglass, metal, plastic, leather, cloth or any combination of these materials. Fully rigid or corset type immobilizers are acceptable.

   23.  Rigid or semi-rigid neck immobilizers, small, medium, large and pediatric (1 each)--Traditional soft collars, rolled towels or the like are not acceptable. Each collar must be constructed of a solid, rigid material (plastic) or a combination of such plastic and a flexible form fitting material (foam).

   24.  Lateral cervical spine immobilization device (1) for example, manufactured CID, tightly rolled towels, blankets or foam bags. Sandbags are not acceptable. The device must have a means of attachment to the long spine board. This may be as simple as adhesive tape. If rolled towels are to be used, they must be pre-rolled and ready for use at all times.

   25.  Hand operated adult and infant bag-valve devices (1 each) with supply tubing and clear masks. Unit must be capable of 100% oxygen delivery (1)--The unit must be equipped with a bag or tube reservoir or some other port of oxygen to enter and fill the bag.

   26.  Hand operated pediatric bag-valve device (450-700 cc) (1) with supply tubing and clear masks, and without pop-off valve. The unit must be equipped with a bag or tube reservoir or some other port of oxygen to enter and fill the bag.

   27.  Pocket mask with one-way valve (1), and with an oxygen port.

   28.  Long spine board, rigid or folding (excluding slat type of flexible stretcher) (1)--May be constructed of wood, aluminum or fiberglass.

   29.  Pneumatic counter pressure anti-shock device compartmentalized by leg and abdomen, adult and child (1 each) or adult and child combination (1) will fulfill this requirement. The device must be accompanied with an appropriate air pump, hoses and valves supplied by the manufacturer. Can be utilized for lower extremity fractures.

   30.  Cold packs, chemical (4).

   31.  Heat packs, chemical (4)--One side of the pack must be insulated to protect a patient from a burn.

   32.  Sponges/preps/wipes--alcohol (10)--These can be as simple as the 1" x 1" ''prep'' packets.

   33.  Sterile water and/or normal saline solution for irrigation in nonbreakable containers (2 liters total volume). The containers must be marked with expiration dates which have not expired. Any assortment of containers is acceptable so long as there is a total of 2 liters (2,000 milliliters or cc's), in addition to IV solutions required.

   34.  Sterile burn sheets (4 ft. x 4 ft.) (2)--Most are commercially prepared, but any sheet which is non-pilling and sterile is acceptable.

   35.  Triangular bandages (8)--These must be triangular pieces of cloth approximately 40 inches across the base. Safety pins must be on hand for use with triangular bandages.

   36.  Sterile OB kits (2)--The contents must be listed on the outside of the container, and should contain the following:

   a.  1 pair of sterile gloves.

   b.  2 umbilical cord clamps.

   c.  tape on tie-offs.

   d.  2 towels.

   e.  2 plastic bags.

   f.  1 bulb aspirator.

   g.  2 sanitary pads.

   h.  1 scalpel.

   37.  Separate bulb syringe (1). Must be sterile.

   38.  Thermal blanket (Silver Swaddler) (1), or roll of sterile aluminum foil.

   39.  Bandage shears (1)--Must be capable of cutting clothing and bandages.

   40.  Blankets (2)--Must be single bed size and clean. Plastic blankets are not acceptable.

   41.  State approved triage tags (25).

   42.  Handlight (6 or more volts) (2)--Any of a variety of lights operating on 6 or more volts is acceptable.

   43.  Hazard warning devices (3)--for example, reflectors, flares and fuses. Use for traffic detouring and safety perimeters. Must be capable of 30 minutes operation time.

   44.  Phlebotomy equipment:  blood collection vacuum tubes (per regional policies), blood collection vacuum tube barrels (1), and vacuum phlebotomy needles (2). Tubes should have a current expiration date.

   45.  Catheters, over the needle (intravenous).

   a.  14 gauge (4)

   b.  16 gauge (4)

   c.  18 gauge (4)

   d.  20 gauge (4)

   e.  22 gauge (4)

   f.  24 gauge (2)

   Each must be individually wrapped and sterile. Total of 22.

   46.  Intravenous administration supplies. Microdrip (50-60 drops/ml) and Macrodrip (10-20 drops/ml) sets (2 of each).

   47.  Intravenous fluids.

   a.  D5 and W (250 ml)

   b.  Sodium Chloride (1,000 ml)

   c.  Lactated Ringers (1,000 ml)

   The number of bags for each fluid must add up to the total ml required for each fluid in any combination. If regional protocols do not require all three fluids, then total mls for the required fluids must add up to 2,250 mls. Fluids must be kept from extremes in temperatures.

   48.  Tourniquets for IV use (2). These can be as simple as a strip of latex.

   49.  Emergency drugs per regional protocols and within State guidelines--They must be secured under double lock and key.

   50.  Needles, hypodermic.

   a.  IV (16-20 gauge) (4)

   b.  Subcutaneous (23-25 gauge) (4)

   c.  Intramuscular (20-22 gauge) (4)

   d.  Intraosseous (14-18 gauge) (2)

   These must be available in various sizes as indicated above. Each must be individually wrapped and sterile. Total 14.

   51.  Syringes, per regional or local protocols.

   52.  Defibrillator/monitor with synchronized cardioversion capabilities, DC electric power, portable, battery-operated with paper readout, with spare battery or alternate power source, with ECG cables with three lead capability and pediatric paddles.

   53.  Defibrillator paddle pads (4) or electrode gel (2 tubes).

   54.  Electrodes, ECG, adult and pediatric sizes (6 each).

   55.  Radio equipment which operates on public service frequencies assigned by the FCC and enables medical two-way communications with dispatch and hospitals to which the ambulance service most often transports patients during medical emergencies. Cellular phones can only be used as a back-up means of communications when radio system fails.

   56.  Sharps receptacle (1).

   57.  U. S. Department of Transportation Guidebook for Initial Response to Hazardous Materials Incidents. (Current copy)

   58.  Thermometer--oral (glass or electronic) or tympanic (1).

   59.  Instant glucose (40% dextrose-d-gel). Minimum of either 3 single dose tubes of 15 grams each, or 1 three-dose tube of 45 grams.

   60.  Activated charcoal-minimum of 50 grams, either in powdered form or premixed suspension.

   61.  Meconium aspirator (1).

   62.  Pediatric equipment sizing tape or equipment age/weight chart (with normal vital signs).

   63.  Large screwdrivers, phillips and slotted (1 each). Each must be at least 8" in length.

   64.  Pliers (slipjoint, lineman's, needlenose, arc joint (water pump and locking) (1 of each). The needlenose pliers must be at least 6" in length, the lineman's at least 7" and the remaining three, at least 8".

   65.  Hand-held sledge hammer (3 lbs.) (1)--Must have a 10" handle. If the handle is made of wood it must be unpainted.

   66.  Impact metal-cutting tool (1)--Must be a commercial product or any device designed to cut automotive grade sheet metal.

   67.  Short pry bar (1)--Must be 12" in length.

   68.  Cold chisel (7" x 3/4") (1).

   69.  Hacksaw with 2 extra blades (1)--Must have a 12 inch blade and some type of lubricant such as a petroleum based oil or liquid soap.

   70.  Adjustable wrench (10") (1).

   71.  Center punch (1).

   72.  Clear eye protection. Goggle type or wraparound type with side shields (1 per crew member responding on vehicle).

   73.  Gloves (1 pair per crew member responding on vehicle). The anterior surface (palm and fingers) of the gloves must be covered with work grade leather.

   74.  Hard hat (1 per crew member responding on vehicle).

   75.  Eye protection, clear, disposable (1 per responding crew member). (face shield)

   76.  Face mask, disposable (1 per responding crew member).

   77.  Gown or coat (1 per responding crew member).

   78.  Surgical caps/foot coverings, disposable (1 set per responding crew member).

   79.  Double-barrier gloves (1 set per responding crew member)--can be double latex gloves, specifically designed as a barrier against infection.

   80.  Container (1 per vehicle or disposable bags) (3 per vehicle) for storage of contaminated clothing/equipment. If bags, must be color-coded (red), and constructed of heavy-duty plastic.

   81.  Copy of exposure control plan for handling of infectious disease patients.

   Persons with a disability who require an alternate format of this notice (for example, large print, audiotape, braille) should contact Robert H. Gaumer, Division of Emergency Medical Services Systems at (717) 787-8740 or TDD (717) 783-6514, so that he may make the necessary arrangements.

DANIEL F. HOFFMANN, FACHE,   
Acting Secretary

[Pa.B. Doc. No. 96-1589. Filed for public inspection September 20, 1996, 9:00 a.m.]



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