Alternate Response Vehicle

Section 515 Section 515.825  Alternate Response Vehicle a)         Ambulance Assistance Vehicles Ambulance assistance vehicles are dispatched simultaneously with an ambulance and assist with patient care prior to the arrival of the ambulance.  Ambulance assistance vehicles include fire engines, trucks, squad cars or chief's cars that contain the staff and equipment required by this Section.  Ambulance assistance vehicles shall not function as assist vehicles if staff and equipment required by this Section are not available.  The agency shall identify ambulance assistance vehicles as a program plan amendment outlining the type and level of response that is planned.  The ambulance assistance vehicle shall not transport or be a primary response vehicle but a supplementary vehicle to support EMS services.  The ambulance assistance vehicle shall be dispatched only if needed.  Ambulance assistance vehicles shall be classified as either: 1)         Advanced ambulance assistance vehicles shall be staffed with a minimum of one Paramedic, PHRN, PHPA, PHAPRN, or physician and shall have all of the required equipment; 2)         Intermediate ambulance assistance vehicles shall be staffed with a minimum of one EMT, EMT-I, A-EMT, Paramedic, PHRN, PHPA, PHAPRN, or physician and shall have all of the required equipment; 3)         Basic ambulance assistance vehicles shall be staffed with a minimum of one EMT, EMT-I, A-EMT, Paramedic, PHRN, PHPA, PHAPRN, or physician and shall have all of the required equipment; or 4)         EMR assistance vehicles shall be staffed with a minimum of one EMR, EMT, EMT-I, A-EMT, Paramedic, PHRN, PHPA, PHAPRN, or physician and shall have all of the required equipment. b)         Non-Transport Vehicles Non-Transport Vehicles are dispatched prior to dispatch of a transporting ambulance and include ambulances and fire engines that contain the staff and equipment required by this Section.  The vehicle service provider shall identify non-transport vehicles as a program plan amendment outlining the type and level of response that is planned.  Non-transport vehicles shall be staffed 24 hours per day, every day of the year. 1)         ALS Non-Transport Vehicles shall have a minimum of either one System authorized Paramedic or one PHRN, PHPA, PHAPRN, and one additional System authorized Paramedic, A-EMT, EMT-I, EMT, PHRN, PHPA, PHAPRN, or physician, and shall have all of the required equipment. 2)         ILS Non-Transport Vehicles shall have a minimum of either one System authorized A-EMT, EMT-I, Paramedic or one PHRN, PHPA, PHAPRN, and one additional System authorized EMT, A-EMT, EMT-I, Paramedic, PHRN, PHPA, PHAPRN, or physician and shall have the required equipment. 3)         BLS Non-Transport vehicles shall be staffed by two System authorized personnel, unless the provider is functioning within the requirements of Section 515.830(i). The vehicle shall be staffed by an EMT or higher on all responses and shall have all of the required equipment. c)         Equipment Requirements Each vehicle used as an alternate response vehicle shall meet the following equipment requirements, as determined by the Department by an inspection. 1)         Functional portable oxygen cylinder, with a capacity of not less than 350 liters 2)         Dial flowmeter/regulator for 15 liters per minute 3)         Delivery tubes 4)         Adult, child and infant masks 5)         Adult squeeze bag and valve, with adult and child masks 6)         Child squeeze bag and valve, with child, infant and newborn size masks 7)         Airways, oropharyngeal − adult, child and infant (sizes 0-5) 8)         Airways, nasopharyngeal with lubrication (sizes 12-30F) 9)         Manually operated suction device 10)         Triangular bandages or slings 11)         Roller bandages, self-adhering (4" by 5 yds) 12)         Trauma dressings 13)         Sterile gauze pads (4" by 4") 14)         Vaseline gauze (3" by 8") or vented chest seal 15)         Bandage shears 16)         Adhesive tape rolls 17)         Blanket 18)         Long backboard (if required by the EMS System protocols) 19)         Cervical collars − adult, child and infant 20)         Extremity splints − adult/child, long/short 21)         Adult/child/infant blood pressure cuffs and gauge 22)         Stethoscope 23)         Burn sheet, individually wrapped 24)         Sterile saline or water solution (1,000ml), plastic bottles or bags 25)         Obstetrical kit, sterile − minimum one, pre-packaged with the following minimal supplies:  sterile towels, scissors or retractable blade/scalpel, two umbilical cord clamps, maternal pads, placenta bag, pair of gloves, mask with eye protection, drape sheet, gauze sponges, underpad, disposable gown/apron, and bulb syringe. In addition, for newborns, clear plastic wrap or plastic bag, and newborn cap. 26)         Thermal absorbent blanket and head cover, aluminum foil roll or appropriate heat reflective material – minimum one 27)         Cold packs 28)         EMS patient care reports 29)         Nonporous disposable gloves 30)         Personal protective equipment (PPE), including gowns, eye/nose/mouth protection or face shields 31)         Flashlight 32)         Equipment to allow reliable communications with hospital 33)         ILS/ALS System-approved equipment A)        Medication box B)        Airway equipment, including laryngoscope and assorted blades C)        Monitor/defibrillator, equipped with pediatric size defibrillation pads or paddles or an advanced AED unit with 3 lead capability, defibrillation override, and a cardiac rhythm display 34)        Opioid antagonist, including, but not limited to, Naloxone, with administration equipment appropriate for the licensed level of care 35)        Automated external defibrillator (AED) that includes pediatric capabilities e)         Registration of Non-transport Provider Agencies Each non-transport provider shall complete and submit to the Department either the EMS non-transport provider application or EMS non-transport application for an existing transport provider, available on the Department's Division of EMS website. f)         Inspection of Non-transport EMS Providers The Department will schedule initial inspections.  Thereafter, non-transport ambulance assist providers shall perform annual self-inspections, using forms provided by the Department, and shall submit the form to the EMS System for submission to the Department upon completion of the inspection.  The Department will perform inspections randomly or as the result of a complaint. g)         Issuance and Renewal of License Upon payment of the appropriate fee, qualifying non-transport providers shall be issued a provider license that lists a number for each level of care approved.  Licenses will not be issued for individual Non-Transport Vehicles. Providers shall inform the EMS System and the Department of any modifications to the application, using the System Modification forms (sys-mod).  Licenses will be issued for one year and will be renewed upon completion of the self-inspection.