Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 157 - EMERGENCY MEDICAL CARE › Subchapter B - EMERGENCY MEDICAL SERVICES PROVIDER LICENSES › Section 157.12 - Rotor-Wing Air Ambulance Operations

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Rotary wing aircraft (helicopters) operated by a licensed emergency medical
				  services (EMS) provider shall be at the mobile intensive care level. Persons or
				  entities operating rotary wing air ambulances must direct and control the
				  integrated activities of both the medical and aviation components. Although the
				  aircraft operator is directly responsible to the Federal Aviation
				  Administration (FAA) for the operation of the aircraft, typically the
				  organization in charge of the medical functions directs the combined efforts of
				  the aviation and medical components during patient transport operations.
				  Licensed rotary wing aircraft must also meet the requirements of §
										157.11
				  of this title (relating to Requirements for an EMS Provider License) as long as
				  the Airline Deregulation Act of 1978,
				  49 U.S.C.
				  §
											41713(b)(1) et seq.
				  is not violated.
(b) When being
				  used as an ambulance, the helicopter shall:
(1) be configured so that the medical
				  personnel have adequate access to the patient in order to begin and maintain
				  basic and advanced life support treatment;
(2) have an entry that allows loading and
				  unloading of a patient without excessive maneuvering (no more than 45 degrees
				  about the lateral axis and 30 degrees about the longitudinal axis); and does
				  not compromise functioning of monitoring systems, intravenous (IV) lines, or
				  manual or mechanical ventilation;
(3) have a supplemental lighting system in
				  the event standard lighting is insufficient for patient care that includes:
(A) a self-contained lighting system powered
				  by a battery pack or a portable light with a battery source; and
(B) a means to protect the pilot's night
				  adaptation vision. (Use of red lighting or low intensity lighting in the
				  patient care area is acceptable if not able to isolate the patient care
				  area);
(4) have an
				  electric power outlet with an inverter or appropriate power source of
				  sufficient output to meet the requirements of the complete specialized
				  equipment package without compromising the operation of any electrical aircraft
				  equipment;
(5) have protection of
				  the pilot's flight controls, throttles and radios from any intended or
				  accidental interference by the patient, air medical personnel or equipment and
				  supplies; and
(6) have an internal
				  medical configuration located so that air medical personnel can provide patient
				  care consistent with the scope of care of the air medical service, to include:
(A) the space necessary to ensure the
				  patient's airway is maintained and to provide adequate ventilatory support from
				  the secured, seat-belted position of the air medical personnel;
(B) those aircraft with gaseous oxygen
				  systems have equipment installed so that medical personnel can determine if
				  oxygen is on by in-line pressure gauges mounted in the patient care area.
				  Aircraft using liquid or gaseous oxygen should have equipment installed:
(i) with each gas outlet clearly marked for
				  identification;
(ii) with oxygen
				  flow capable of being stopped at the oxygen source from inside the aircraft;
				  and
(iii) so that the measurement
				  of the liter flow and quantity of oxygen remaining is accessible to air medical
				  personnel while in flight. All flow meters and outlets must be padded, flush
				  mounted, or so located as to prevent injury to air medical personnel; or there
				  shall be an operational policy stating that attendants wear helmets;
(C) hangers/hooks available to
				  secure (IV) solutions in place or a mechanism to provide high flow fluids if
				  needed:
(i) all IV hooks shall be padded,
				  flush mounted, or so located as to prevent head trauma to the air medical
				  personnel in the event of a hard landing or emergency with the aircraft; or an
				  operational policy stating that attendants wear helmets; and
(ii) glass containers shall not be used
				  unless required by medication specifications and properly vented;
(D) provision for medication which
				  allows for protection from extreme temperatures if it becomes environmentally
				  necessary;
(E) secure positioning
				  of cardiac monitors, defibrillators, and external pacers so that displays are
				  visible to medical personnel; and
(F) shall assure that all specialized medical
				  equipment is secured throughout transport with adequately engineered designated
				  mounts as approved by FAA.