NOTICES
Required Air Ambulance Equipment and Supplies
[26 Pa.B. 4567] Title 28 of the Pennsylvania Code § 1007.7(b) (relating to minimum equipment and supplies for air ambulance services), provides that the Department of Health will publish on an annual basis a list of minimum equipment and supplies required for each air ambulance service. The Department hereby gives notice that the following shall constitute the revised required equipment and supply lists for all such services effective 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 list 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. Persons with a disability who require an alternate format of this notice (for example, large print, audiotape, braille) should contact Robert H. Gaumer at the above address or phone number or TDD (717) 783-6514, so that he may make the necessary arrangements.
Air Ambulance Service--Rotorcraft
The following equipment and supplies must be carried by an air ambulance service--rotorcraft.
1. Installed suction device in the patient compartment.
2. Rechargeable portable electric suction apparatus with wide-bore tubing (1).
3. Catheters, Pharyngeal Suctioning rigid (2)--Catheters must be individually wrapped and sterile.
4. Nasopharyngeal airways--Set of (5) different sizes (1). The airways must be clean and a water soluble lubricant available.
5. 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.
6. 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.
7. Suction Catheter, Flexible, Sizes 6 and 8 (1 each) and 10 or 12, 14 or 18 (2 of each)--Catheters must be individually wrapped and sterile. Total of 6.
8. Laryngoscope, Handle With Batteries (1) and Spare Batteries (1 set).
9. Laryngoscope, Blades
Straight Curved # 1 (1) # 3 (1) # 2 (1) # 4 (1) # 3 (1) Sizes S, M or L can also be used for straight blades depending on manufacturer.
10. Lubricating jelly, surgical, sterile (2 cc) containers (2).
11. Magill Forceps, Adult and Pediatric (1 of each).
12. Stylette, Malleable--Pediatric (2) and Adult (1).
13. Cricothyrotomy set, one of two types must be present:
Surgical Needle 1. Sterile Blade 1. 14 Gauge or Larger Catheter 2. Tracheotomy Tube
(90 Degree Angle)2. Transtracheal Jet
Insufflation Equipment3. Securing Mechanism 3. Securing Mechanism 4. Cleansing Materials 4. Cleansing Materials 14. Sphygmomanometer--Child, adult thigh or large adult cuffs (1 each). Note: Sphygmomanometer with interchangeable cuffs is acceptable.
15. Stethoscope (1).
16. Stethoscope, Doppler (1).
17. Penlight (1)--Mini-mags are not acceptable due to possible eye injuries from light.
18. Thermometer-oral (glass or electronic) or tympanic (1)
19. Oxygen, on board, installed, 1,200 liter capacity.
20. Portable Oxygen Unit: (1)--The unit must be equipped:
a. With at least a 300 liter capacity cylinder.
b. Equipped with a yoke.
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.
d. Equipped with gauge/flowmeter that is not gravity dependent and can deliver oxygen at 0-25 liters per minute. Older flowmeters which deliver 0-15 liters are acceptable until replaced.
21. Transparent, disposable oxygen delivery devices with supply tubing:
a. Nasal cannulas--Adult (1) and pediatric (1).
b. 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.
22. Sterile Universal Dressing, (10" x 30"), (4), compactly folded and packaged in a convenient size.
23. 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.
24. Sterile Gauze Pads--(3" x 3"), (25)--Must be individually wrapped or two to a pack and sterile.
25. Soft Self-Adhering Type Bandages, Assorted Sizes (6 rolls total).
26. Adhesive Tape--Assorted Widths--Any type of tape is acceptable so long as at least one roll is of the hypo-allergenic type (4 rolls).
27. 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.
28. Long Spinal Immobilization Device, Rigid or Folding (excluding slat-type or flexible stretcher) (1). May be constructed of wood, aluminum or fiberglass. The intent of this device is to immobilize an entire adult body.
29. Rigid or Semi-Rigid Neck Immobilizers--Small, medium, large and pediatric (1 each)--Traditional soft collars, rolled towels or the like are not acceptable. The immobilizers must be made of a combination of flexible foam and rigid plastic or completely rigid plastic.
30. Hand-operated adult and infant bag-valve devices with supply tubing (1 each), with clear masks. Unit must be capable of 100% oxygen delivery.
31. Hand operated pediatric bag-valve device (450-700 cc) without a pop-off valve, and with supply tubing and clear masks (1). Unit must be capable of 100% oxygen delivery.
32. Nine Foot Straps (3) or straps with ''speed clips'' can be substituted for the 9` straps.
33. Gloves. Non-porous disposable (one pair per crew member responding on aircraft). These need not be sterile. They may be packaged in individual pairs or in a dispensing box.
34. Clear Eye Protection--goggle type or wraparound type with side shields (one per crew member responding on aircraft).
35. Gloves with leather work surface (one per crew member).
36. 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. Can be utilized for splinting lower extremity fractures.
37. Sterile water and/or normal saline solution for irrigation in nonbreakable containers (2 liters total volume). The containers must have a current expiration date and should be kept from exposure to extremes in temperature.
38. Cold Packs, Chemical (4).
39. Heat Packs, Chemical (4).
40. Sponges/Preps/Wipes, Alcohol (10)--These can be as simple as the 1" x 1" ''prep'' packets.
41. Sterile OB Kit (1)--Containing the following:
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.
42. Separate bulb syringe from OB Kit (1).
43. Thermal Blanket (Silver Swaddler) or roll of sterile aluminum foil (1).
43. Bandage Shears (1)--Must be capable of cutting clothing and bandages.
44. Blanket (2)--Must be single bed sizes and clean. Plastic blankets are not acceptable.
45. Sheets (4)--Must be clean and folded.
46. Emesis Container (1).
47. Handlight--(6 volt) (2)--Any of a variety of lights operating on 6 volts is acceptable, in addition to the penlight or flashlight.
48. Fire Extinguisher (1). Rated at least 2A:10B:C shall be carried on each aircraft. A tag or label with the name and address of the company that inspected the unit and the month and year the inspection occurred must be attached to each extinguisher.
49. Communication, on board, intracrew, for each crew member. A two-way communication system must be in place (at least three head sets) to allow voice communication when the aircraft is in flight when noise levels may prevent normal conversation.
50. 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 catheters.
51. Intravenous Administrative Supplies: Microdrip (50-60 drops/ml) and Macrodrip (10-20 drops/ml) sets (2 of each).
52. Intravenous Fluids:
a. D5 and W (250 ml)
b. Sodium Chloride (1,000 ml)
c. Lactated Ringers (1,000 ml)
Any combination of fluids is acceptable as long as it adds up to the recommended ml for each fluid.
53. Tourniquets--for IV use (2). These can be as simple as a strip of latex.
54. Flutter valve, one way, sterile
55. Emergency Drugs--as established by each Air Ambulance Service Medical Director, secured under lock and key.
56. 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).
57. Syringes--as established by each Air Ambulance Service Medical Director.
58. 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.
59. Defibrillator paddle pads (4) or electrode gel (2 tubes).
60. Electrodes, ECG, adult and pediatric sizes (6 each).
61. Radio equipment to enable two-way communications with at least the dispatch center and hospitals to which the air ambulance service most often transports patients.
62. Sharps receptacle (1).
63. Head Protection--helmets or hard hats (1 per crew member).
64. Survival Bag--container including appropriate survival and signaling equipment for the terrain and season.
65. Meconium Aspirator (1).
66. Pediatric equipment sizing tape or equipment age/weight chart (with normal vital signs).
66. Eye protection, clear, disposable (1 per responding crew member).
67. Face mask, disposable (1 per responding crew member).
68. Gown or coat (1 per responding crew member).
69. Surgical caps/foot coverings, disposable (1 set per responding crew member).
70. Double-barrier gloves (1 set per responding crew member)--can be double latex gloves.
71. Container (1 per vehicle or disposable bags) (3 per vehicle) for storage of contaminated clothing/equipment.
72. Copy of exposure control plan for handling of infectious disease patients.
DANIEL F. HOFFMANN, FACHE,
Acting Secretary
[Pa.B. Doc. No. 96-1588. Filed for public inspection September 20, 1996, 9:00 a.m.]
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