Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 60 - Emergency Medical Transportation Services › Subchapter B - Ambulance Service/Provider Responsibilities › Section I-6057 - Ambulances

Current through Register Vol. 50, No. 6, June 20, 2024
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.