ALS level equipment: To function at the ALS level, the following additional

ALS level equipment: To function at the ALS level, the following additional equipment is required: #21600 1. Advanced Airway and Ventilatory Support Equipment: a. Laryngoscope and tracheal intubation supplies, including laryngoscope blades, bag-valve- mask and oxygen supplies, including PEEP valves; appropriate for ages and potential needs of patients transported. At minimum, one Laryngoscope handle; one each adult, pediatric and infant blades. b. Two of each size of assorted disposable endotracheal tubes according to the scope of the licensee's service and patient mixture with assorted stylets, syringes. c. End-tidal CO2 detectors (may be made onto bag valve mask assemblies or separate); End-tidal CO2 continuous waveform monitoring capabilities available. d. Alternate airway management equipment. Equipment for alternative airways on-board transport vehicles at all times and protocol for management of missed airway attempts. 2. IV Equipment and Supplies: a. IV supplies and fluids are readily available. b. Sterile crystalloid solutions in plastic containers, IV catheters, and administration tubing sets. c. Hanger for IV solutions or a mechanism to provide high flow fluids if needed; All IV hooks are padded, flush mounted, or so located to prevent head trauma to the medical transport personnel in the event of a hard landing in the aircraft. d. Tourniquets, tape, dressings. e. Suitable equipment and supplies to allow for collection and temporary storage of two blood samples. f. A container appropriate to contain used sharp devices - needles, scalpels - which meets OSHA requirements. 3. Medications: Security of medications, fluids and controlled substances shall be maintained by each air ambulance licensee. Controlled substances are in a locked system and kept in a manner consistent with Drug Enforcement Agency (DEA) regulations and approved by the service’s medical director. Medication inventory techniques and schedules shall be maintained in compliance with all applicable local, state, and federal drug laws. 4. Medications shall be easily accessible. 5. There is a method to check expiration dates of medications and supplies on a regular basis. 6. The Bureau of EMS and the Committee on Medical Direction, Training, and Quality Assurance (MDTQA) will approve pharmaceuticals available for use by EMS providers. A list of ‘Required’, ‘Optional’, and ‘Transport only’ drugs for EMS providers in the State is compiled and maintained by the BEMS and the MDTQA. 7. A current list of fluids and medications approved for initiation and transport by Mississippi EMS providers is available from the BEMS office or the BEMS website (www.ems.ms.gov). NOTE: Offline Medical Director may make requests for changes to the list. These requests should be submitted in writing to the BEMS. All requests must detail the rationale for the additions, modifications, or deletions. a. The medical director can modify the medication inventory as required to meet the care needs of their patient mix and in compliance with section (111.06-3C) below. b. The licensee shall have a sufficient quantity of needles, syringes, and accessories necessary to administer the medications in the inventory supply. c. The medical director of the licensee may authorize the licensee with justification to substitute medication(s) listed provided that he first obtains approval from BEMS and provided further that he signs such authorization. 8. Cardiac Monitor-Defibrillator – a. D.C. battery powered portable monitor/defibrillator with paper printout and spare batteries, accessories, and supplies. b. 12-lead cardiac monitor, defibrillator and external pacemaker are secured and positioned so that displays are visible. c. Extra batteries or power source are available for cardiac monitor/defibrillator or external pacemaker. d. Defibrillator is secured and positioned for easy access. e. Pediatric paddles/pads are available if applicable to the scope of care of the medical transport service. f. A defibrillator with appropriate size pads and settings must be available for neonatal transports (if neonatal transports are conducted). 9. External pacemaker on board or immediately available as a carry-on item. 10. Non-Invasive Automatic Blood Pressure Monitor 11. IV Infusion Pump capable of strict mechanical control of an IV infusion drip rate. Passive devices such as dial-a-flows are not acceptable. A minimum of three IV infusion pumps (may be in the same device if individually metered lines with back up available) are on the aircraft or immediately available for critical care transports and as appropriate to the scope of care. 12. Electronic Monitoring Devices - Any electronic or electrically powered medical equipment to be used on board an aircraft should be tested prior to actual patient use to insure that it does not produce Radio Frequency Interference (RFI) or Electro Magnetic Interference (EMI) which would interfere with aircraft radio communications or radio navigation systems. This may be accomplished by reference to test data from organizations such as the military or by actual tests performed by the licensee while airborne.