216-RICR-20-10-2
216-RICR-20-10-2. Emergency Medical Services
2.1 Authority
These Regulations are
promulgated pursuant to the authority conferred under R.I. Gen. Laws
§ 23-4.1-10(b) ,
for the purpose of establishing minimum standards for emergency
medical services.
2.2 Incorporated Materials
A. These Regulations hereby
adopt and incorporate HIPAA
Privacy Rule and Public Health: Guidance from CDC and the U.S.
Department of Health and Human Services May 2, 2003/52 (S-1); 1-12 ,
by reference, not including any further editions or amendments
thereof, and only to the extent that the provisions therein are not
inconsistent with these Regulations.
B. These Regulations hereby
adopt and incorporate National Emergency Medical Services Education
Standards published by the National Highway and Traffic Safety
Administration of the U.S. Department of Transportation, 2009
edition, by reference, not including any further editions or
amendments thereof and only to the extent that the provisions therein
are not inconsistent with these Regulations.
C. These Regulations hereby
adopt and incorporate National Fire Protection Agency (NFPA) 1917
Standard for Automotive Ambulances, 2019 edition, by reference, not
including any further editions or amendments thereof and only to the
extent that the provisions therein are not inconsistent with these
Regulations.
D. These Regulations hereby
adopt and incorporate ASTM International E810 Test Method for
Coefficient of Retroreflection of Retroreflective Sheeting Utilizing
the Coplanar Geometry, 2013 edition, by reference, not including any
further editions or amendments thereof and only to the extent that
the provisions therein are not inconsistent with these Regulations.
E. These Regulations hereby
adopt and incorporate American National Standard Z535.1, Safety Color
Code, 2017 edition, by reference, not including any further editions
or amendments thereof and only to the extent that the provisions
therein are not inconsistent with these Regulations.
F. These Regulations hereby
adopt and incorporate SAE International J 1849, 2020 edition, by
reference, not including any further editions or amendments thereof
and only to the extent that the provisions therein are not
inconsistent with these Regulations.
G. These Regulations hereby
adopt and incorporate the Federal specification for Star of Life
Ambulances (KKK-A-1822(F)) (2018) by reference, not including any
further editions or amendments thereof and only to the extent that
the provisions therein are not inconsistent with these Regulations.
2.3 Definitions
A. Wherever used in these
Regulations the following terms shall be construed to mean:
1. "Ambulance" means
any publicly or privately-owned vehicle, designed, constructed,
equipped, and operated for emergency medical treatment and/or
transportation of persons who are sick or injured.
2. "Change of ownership
of ambulance service or EMS training institution" means:
a. In the case of a
partnership, the removal, addition, or substitution of a partner
which results in a new partner acquiring a controlling interest in
such partnership;
b. In the case of an
unincorporated sole proprietorship, the transfer of the title and
property to another person;
c. In the case of a
corporation:
(1) A sale, lease, exchange,
or other disposition of all, or substantially all, of the property
and assets of the corporation; or
(2) A merger of the
corporation into another corporation; or
(3) The consolidation of two
(2) or more corporations, resulting in the creation of a new
corporation; or
(4) In the case of a business
corporation, any transfer of corporate stock which results in a new
person acquiring a controlling interest in such corporation; or
(5) In the case of a
non-business corporation, any change in membership which results in a
new person acquiring a controlling vote in such corporation.
3. "COVID-19" means
the new disease caused by novel coronavirus SARS-CoV-2.
4. "Emergency medical
services" or "EMS" means the practitioners, ambulance
vehicles, and ambulance service entities licensed to provide
emergency medical care, transportation, and preventive care to
mitigate loss of life or exacerbation of illness or injury.
5. "Emergency medical
services instructor-coordinator" or "EMS IC" means an
individual who is licensed both as an EMS practitioner and as an EMS
Instructor-Coordinator.
6. "Emergency medical
services (EMS) practitioner" means an individual who is licensed
to perform emergency medical care and preventive care to mitigate
loss of life or exacerbation of illness or injury.
7. "Healthcare provider"
means a physician, physician assistant, or certified nurse
practitioner licensed to practice in Rhode Island.
8. "Mutual aid"
means an agreement among ambulance services to assist one another
across jurisdictional boundaries.
9. "National Registry of
Emergency Medical Technicians" or "NREMT" means the
not-for-profit, independent, non-governmental registration agency
which conducts examinations for the certification of EMS
practitioners.
10. "RIDOH" means
the Rhode Island Department of Health.
11. "Rhode Island
Continued Competency Program" or "RI-CCP" means the
program that defines how EMS practitioners must accumulate continuing
education hours in certain topic areas to meet licensure renewal
requirements.
12. "Rhode Island
Emergency Medical Services Information System" or "RI-EMSIS"
means the central data repository of EMS data for the State of Rhode
Island.
13. "Unprofessional
conduct" means behavior that does not conform with established
standards of clinical care, or behavior that is a violation of
statutory and/or regulatory requirements.
14. "Volunteer ambulance
service" means a licensed ambulance service that provides
services utilizing staff who are volunteer EMS practitioners.
15. "Volunteer EMS
practitioner" means a licensed EMS practitioner who provides
services without remuneration, other than nominal payment or
reimbursements for expenses.
2.4 Confidentiality Provisions
A. All information concerning
cases or suspected cases shall be held in confidence in accordance
with the provisions of R.I. Gen Laws Chapter 5-37.3 "Confidentiality
of Health Care Communications and Information Act" and all other
applicable State and Federal Statutes and Regulations.
B. The HIPAA Privacy Rule and
Public Health: Guidance from the CDC and the U.S. Department of
Health and Human Services incorporated above expressly permits
disclosures without individual authorization to public health
authorities authorized by law to collect or receive the information
to prevent or control disease, injury, or disability, including, but
not limited to, public health surveillance, investigation, and
intervention.
2.5 Emergency Medical Services
(EMS) Practitioners
A. EMS Practitioners shall be
licensed at the following levels:
1. Emergency Medical Responder
(EMR) means an individual who holds a license to function as an EMR
in Rhode Island.
2. Emergency Medical
Technician (EMT) means an individual who holds a license to function
as an EMT in Rhode Island.
3. Advanced Emergency Medical
Technician (AEMT) means an individual who holds a license to function
as an AEMT in Rhode Island.
4. Advanced Emergency Medical
Technician-Cardiac (AEMT-C) means an individual who holds a license
to function as an AEMT-C in Rhode Island.
5. Paramedic means an
individual who holds a license to function as a paramedic in Rhode
Island.
B. Requirements for initial
licensure at all levels of EMS practice:
1. Applicants for licensure to
function in Rhode Island in any one (1) of the levels of EMS
practitioner must meet the following requirements and provide
supporting documentation at the time of application:
a. Be eighteen (18) years of
age or older.
b. Be a high school graduate
or equivalent.
(1) An EMR applicant is exempt
from this Rule.
c. Possess current National
Registry of Emergency Medical Technicians (NREMT) certification
pertinent to the level of licensure being sought.
d. Provide a biometric
background check conducted within the last month.
e. Pay the application fee
stated in the Fee Structure for Licensing, Laboratory and
Administrative Services Provided by the Department of Health (Part
10-05-2
of this Title), if applicable.
f. Such other information as
RIDOH may require.
2. Additional requirements for
initial licensure of AEMT:
a. Current licensure as an
EMT.
b. Current certification as an
Advanced EMT by the NREMT.
3. Additional requirements for
initial licensure of AEMT-C:
a. Current licensure as an
EMT.
b. Successful completion of a
RIDOH approved AEMT-C education course.
c. Current certification as an
AEMT by the NREMT.
d. Current Advanced Cardiac
Life Support (ACLS) certification.
4. Additional requirements for
initial licensure of Paramedic:
a. Current licensure as an
EMT, AEMT or AEMT-C.
b. Current certification as a
paramedic by the NREMT.
C. Requirements for renewal of
license at all levels of EMS practice:
1. Applicants for licensure
renewal in any one (1) of the levels of EMS practitioner must renew
prior to the date of its expiration by submitting a completed
application form and application fee stated in the Fee Structure for
Licensing, Laboratory and Administrative Services Provided by the
Department of Health (Part 10-05-2
of this Title), if applicable.
2. Requirements for EMR
Practitioner License Renewal
An EMR must maintain NREMT
certification as an Emergency Medical Responder.
3. Requirements for EMT
Practitioner License Renewal
a. An EMT licensed after
January 1, 2012 must maintain NREMT certification as an EMT.
b. An EMT licensed prior to
January 1, 2012 must complete the requirements of the Rhode Island
Continued Competency Program (RI-CCP) or maintain NREMT certification
as an EMT.
4. Requirements for AEMT
Practitioner License Renewal
An AEMT must maintain NREMT
certification as an AEMT.
5. Requirements for AEMT-C
Practitioner License Renewal
An AEMT-C must complete the
requirements of the RI-CCP, or maintain NREMT certification as an
AEMT.
6. Requirements for Paramedic
Practitioner License Renewal
A paramedic must maintain
NREMT certification as a paramedic.
D. Requirements for renewal of
lapsed EMS practitioner licenses
1. An EMS practitioner whose
license has lapsed for a period of less than one (1) year may be
relicensed upon submission of a license application and documentation
of licensure renewal requirements.
2. An EMS practitioner whose
license has lapsed for a period of one (1) to two (2) years may be
relicensed upon:
a. Submission of a license
application and documentation of licensure renewal requirements; and
b. Successful completion of
the appropriate NREMT exam or presentation of a current NREMT
certification.
3. An EMS practitioner whose
license has lapsed for a period of greater than two (2) years will be
subject to the requirements for initial license.
E. Functions and
Responsibilities of EMS Practitioners
1. Each EMS practitioner is
authorized to perform functions based upon his or her level of
education and licensure solely in affiliation with an ambulance
service currently licensed by RIDOH unless providing care as a Good
Samaritan. In performing his or her functions and responsibilities,
the practitioner must follow standing orders from the medical
director for the Center for Emergency Medical Services (CEMS).
a. Notwithstanding any
Regulation or statewide protocol to the contrary, specimens to be
used to test for active COVID-19 or COVID-19 antibodies, including
nasopharyngeal or oropharyngeal specimens, may be collected by EMS
practitioners for the duration of the State of Emergency declaration
arising out of the 2019 novel coronavirus.
2. Ensure that deficiencies in
ambulance equipment are reported to the proper authority.
3. Ensure the ambulance and
the equipment are clean, safe, and in proper working condition.
4. Maintain current knowledge
of RIDOH Regulations, EMS care protocols, and standing orders.
5. Complete a RIDOH-approved
electronic patient care report for all emergency calls.
6. Maintain a current and
valid e-mail address on file with the RIDOH licensing system and the
Rhode Island EMS Information System.
7. Any additional duties
necessary to discharge his or her function as an EMS practitioner
8. All EMS practitioners must
report in writing to CEMS within ten (10) days, any of the following:
a. Any felony charge or felony
conviction in Rhode Island or any other jurisdiction.
b. Any charge or conviction
for driving while intoxicated or under the influence in Rhode Island
or any other jurisdiction.
c. Any charge or conviction
for driving to endanger in Rhode Island or any other jurisdiction.
F. All EMS practitioners must
comply with the pre-employment requirements of the Rules and
Regulations pertaining to Immunization, Testing, and Health Screening
for Health Care Workers (Subchapter 15, Part
7 of this Chapter).
G. Disciplinary Actions
1. In accordance with R.I.
Gen. Laws § 23-4.1-9, RIDOH may deny, revoke, or suspend a
license or invoke other disciplinary action such as probation or
reprimand against any licensee for cause. Cause shall include, but
not be limited to, the following:
a. Fraud or deceit in
procuring or attempting to procure a license
b. Gross negligence in
providing medical care
c. Impairment due to the use
of alcohol or drugs
d. Severe mental incompetence
due to any cause
e. Unprofessional conduct
related to current standards of EMS practice
f. Violation of any Federal or
State law
g. Conduct that has aided,
abetted, or permitted any illegal act that is detrimental to health
and safety
h. Performance of emergency
medical tasks beyond his or her scope of practice, as defined by
education, licensure, and/or standing orders
i. Failure to comply with any
EMS Statutes and Regulations
2. Appeal from disciplinary
actions may be taken pursuant to R.I. Gen. Laws § 23-4.1-9, R.I.
Gen. Laws Chapter 42-35, and Practices and Procedures Before the
Rhode Island Department of Health (Part 10-05-4
of this Title).
2.6 Emergency Medical Services
Instructor-Coordinators (EMS IC)
A. Requirements for initial
licensure of EMS IC:
1. Certificate of completion
from an EMS IC educational program approved by RIDOH. To qualify for
admission to an EMS IC Training Program, an applicant must hold a
Rhode Island EMS practitioner license for at least five (5) years or
have been licensed as an EMS practitioner in another State for at
least five (5) years.
2. Successful completion of
twenty-four (24) hours of student teaching, which must include five
(5) different cognitive sessions and three (3) different psychomotor
training sessions, under the direction of at least three (3)
different RIDOH-licensed EMS Instructor-Coordinators.
3. Successful completion of a
RIDOH EMS IC administrative orientation session.
B. Applicants for EMS IC
licensure with a bachelor’s degree or higher in educational
studies, or NFPA 1041 fire instructor certification, may submit a
request for a waiver to RIDOH from the requirements of the EMS IC
educational program.
C. Requirements for renewal of
EMS IC licensure:
An EMS IC must maintain a
current EMS practitioner license and accrue ten (10) hours of EMS IC
teaching activity per year.
D. Requirements for renewal of
lapsed EMS IC licenses:
1. An EMS IC whose license has
lapsed for a period of less than one (1) year may be relicensed upon
submission of a license application and documentation of licensure
renewal requirements.
2. An EMS IC whose license has
lapsed for a period of one (1) to two (2) years may be relicensed
upon:
a. Successful completion of
twenty-four (24) hours of student teaching, which must include five
(5) different cognitive sessions and three (3) different psychomotor
training sessions under the direction of at least three (3) different
RIDOH-licensed EMS Instructor-Coordinators.
b. Successful completion of a
RIDOH EMS IC administrative orientation session.
c. Submission of a license
application.
3. An EMS IC whose license has
lapsed for a period of greater than two (2) years or longer will be
subject to the requirements for initial license.
E. Functions and
Responsibilities
Administer and conduct
education programs in accordance with the National Emergency Medical
Services Education Standards, 2009 edition, published by the National
Highway and Traffic Safety Administration of the U.S. Department of
Transportation, incorporated at § 2.2(B) of this Part.
2.7 Ambulance Services
A. Ambulance services shall be
licensed at the following levels:
1. Class A: Advanced life
support (ALS)
2. Class B: Basic life support
only (BLS)
3. Class C: EMR
B. Requirements for initial
and renewal licensure of ambulance services:
1. The applicant for an
ambulance service license must be the entity responsible for its
governance, and the license is not transferable among entities.
2. A license will immediately
become null and void and must be returned to RIDOH when service is
discontinued or when any changes in ownership occur pursuant to R.I.
Gen. Laws § 23-4.1-6(f).
3. The license must be posted
in a conspicuous place in the ambulance service central office.
4. Identify the individual or
individuals, which may include existing staff, who fulfill the
following functions:
a. Emergency Medical Services
Chief of Service: the individual who is the lead administrator of the
ambulance service
b. Emergency Medical Services
Communications Coordinator: the individual who ensures that all
communications equipment is functional and meets RIDOH standards
c. Emergency Medical Services
Continuous Quality Improvement Coordinator: the individual who
oversees the quality improvement program in conjunction with the
Medical Director of the service
d. Emergency Medical Services
Coordinator: the individual who directs and coordinates all EMS
activities within an ambulance service. This function must be staffed
by an emergency medical services practitioner or practitioners in
accordance with the level of Emergency Medical Services (pursuant to
§ 2.8(A) of this Part) provided.
e. Emergency Medical Services
Data Manager: the individual who reviews the EMS data for
completeness and accuracy, and submits data to RI EMS Information
System within the required timeframe
f. Emergency Medical Services
Inspection Contact: the individual who ensures compliance with
inspection requirements
g. Emergency Medical Service
Pediatric Emergency Care Coordinator (PECC): the individual who
ensures that the ambulance service and its providers are prepared to
care for ill and injured children
h. Emergency Medical Services
Training Coordinator: the individual who ensures that all RIDOH,
NREMT, and ambulance service training requirements are met
i. Emergency Medical Service
Medical Director: the individual who is a physician board-certified
or board-eligible in emergency medicine and/or EMS
5. Each ambulance service must
have written policies and procedures that are consistent with
accepted standards of EMS care and standing orders, guidelines for
the operation of the service, and the maintenance of the ambulances.
These policies must be comprehensive in nature, must reflect
day-to-day operations, and must address subjects to include, but not
be limited to:
a. The service’s
responsibility to ensure all personnel maintain licensure
b. An orientation and training
plan for all new ambulance service personnel
c. Assurance of compliance
with pre-employment immunization and testing requirements
d. Agreements for mutual aid,
including policies for when mutual aid is to be used
e. Procedures for dispatching
ambulances and related communications including pre-arrival
instructions when applicable
f. Procedures for stocking
medications, supplies, and equipment
g. Policies for use of lights
and sirens
h. Adherence to minimum
staffing requirements and duties
i. Addressing mechanical
failure of vehicles or equipment
j. Cooperation with inspection
authorities
k. Policies for infection
control
l. Maintenance of mechanical
and biomedical equipment and devices in accordance with
manufacturers’ recommendations
m. Acquisition, security and
disposal of controlled substances and other drugs in accordance with
applicable Federal and State Regulations
n. Resolution of complaints
o. Media relations
p. Utilization of the National
Incident Management System (NIMS)
6. Private ground ambulance
services must have the following minimum insurance coverage types and
limit requirements at all times.
a. General liability insurance
with limits of not less than one million dollars ($1,000,000.00) per
each occurrence and two million dollars ($2,000,000.00) in the
aggregate.
b. Automobile liability
insurance with limits of not less than one million dollars
($1,000,000.00) per each accident, and must include all vehicles used
by the applicant.
c. Professional liability
insurance covering errors and omissions with limits of not less than
one million dollars ($1,000,000.00) per each claim and two million
dollars ($2,000,000.00) in the aggregate.
d. Workers compensation
insurance with statutory limits of coverage with employer liability
limits of five hundred thousand dollars ($500,000.00) per each
accident, disease limits of five hundred thousand dollars
($500,000.00) per each employee, and disease policy limit of five
hundred thousand dollars ($500,000.00).
7. Ground ambulance services
must have a secure, temperature-controlled garage to house all
ambulance vehicles when not in use.
8. Each licensed ambulance
service must implement a continuous quality improvement program to
assess, monitor, and evaluate the quality of patient care.
9. Pay the application fee
stated in the Fee Structure for Licensing, Laboratory and
Administrative Services Provided by the Department of Health (Part
10-05-2
of this Title), if applicable.
10. Any other information
required by RIDOH
C. Availability of Ambulance
Services
1. An ambulance service
licensed in Rhode Island must be available to provide ambulance
services on a twenty-four hour (24) basis, seven (7) days a week.
2. Services must be provided
either directly or under a written agreement with other licensed
ambulance services. If agreements are made, a copy of the agreement
must be submitted to RIDOH.
D. Ambulance Service Reporting
Requirements
1. An ambulance service must
maintain appropriate personnel and administrative records, and
electronic patient care reports. All data must be reported to RIDOH
in an electronic format. Records include the following:
a. Evidence of training and
continued competency education
b. Maintenance records for
each licensed ambulance
c. Record for each licensed
ambulance including a list of equipment, and other essential data
d. Maintenance and scheduled
service records for medical devices as required by the manufacturer,
including cardiac monitors/defibrillators, stretchers, and stair
chairs
2. An ambulance service must
report changes in administrative staff to RIDOH within five (5)
business days.
3. Electronic patient care
reports (ePCR)
a. RIDOH-approved electronic
patient care reports for all ambulance calls must be completed.
b. All electronic patient care
reports must meet the standards of the National Emergency Medical
Services Information System (NEMSIS) and the Rhode Island Emergency
Medical Services Information System (RIEMSIS). RIDOH will determine
the NEMSIS version that is applicable and any State-mandated data
fields.
c. Electronic patient care
reports must be posted to RIEMSIS within two (2) hours of completion
of the incident, i.e. transportation to the destination, by the
responding EMS personnel.
d. A digital and paper copy of
the completed patient care report for each patient transported to a
hospital emergency facility must be left with and promptly available
to a designated representative of the receiving facility, who will
sign the report upon receipt of the patient, indicating a transfer of
care. A copy of the patient care report must be retained by the
receiving hospital, the ambulance service, and RIDOH.
4. Reportable Events
a. An ambulance service must
file a written report with RIDOH within seventy-two hours (72) of the
following reportable events involving its service, personnel, or
property:
(1) Fire affecting an
ambulance or service place of business
(2) Theft of an ambulance
(3) Loss, theft or tampering
with any controlled substances, drug delivery devices, or other
regulated medical devices and equipment from an agency facility or
ambulance
(4) An accident involving
personal injury or property damage more than one thousand dollars
($1,000.00) and in which a report is required under the provisions of
R.I. Gen. Laws §
31-26-6
(5) Kidnapping or elopement of
a patient
(6) More than a thirty minute
(30) delay between the time of arrival at a healthcare facility and
transfer of care to a healthcare provider at the receiving facility
(7) Pending or actual labor
disputes or actions which would impact delivery of EMS services
including, but not limited to, strikes, walk-outs and strike notices.
Services must provide a plan, acceptable to the RIDOH, for continued
operation of the service, suspension of operations, or closure in the
event of such actual or potential labor dispute or action.
5. Reportable Incidents
a. An ambulance service must
file a written report with RIDOH within five (5) days of the
following reportable incidents involving its service, personnel, or
property that result in serious injury, illness or death to a patient
not ordinarily expected as a result of the patient’s condition.
These incidents include, but are not limited to, the following:
(1) Medication errors
(2) Deviation from medical
standing orders
(3) Major medical device
failures
(4) Major communications
device failures
6. Ambulance Service Closure
a. An ambulance service must
inform RIDOH in writing of its intent to close at least ninety (90)
days prior to its closure.
b. The ambulance service must
develop a written closure plan to include:
(1) The date the agency will
cease operations
(2) Steps to ensure adequate
staffing throughout the closure process
(3) A process for the
disposition of properties, vehicles, equipment, supplies, and assets
(4) Steps to dispose of any
pharmaceutical, biological, and chemical products and waste
(5) A process to assure
transfer of any contracts to another ambulance service after closure
E. Controlled substances
1. An ambulance service
licensed as Class A-1C, A-1P, A-2C or A-2P Advanced Life Support must
maintain current registration with:
a. RIDOH, in accordance with
the Rhode Island Uniform Controlled Substances Act, R.I. Gen Laws
Chapter 21-28, and
b. U.S. Department of Justice
Drug Enforcement Administration.
2.8 Ambulance Vehicles
A. Ambulance vehicles shall be
licensed at the following classifications:
1. Class A-1C: Advanced Life
Support transporting ambulance
2. Class A-1P: Advanced Life
Support transporting ambulance, paramedic level
3. Class A-2C: Advanced Life
Support non-transporting ambulance
4. Class A-2P: Advanced Life
Support non-transporting ambulance, paramedic level
5. Class A-2A: Advanced Life
Support non-transporting ambulance, advanced EMT level
6. Class B-1: Basic Life
Support transporting ambulance
7. Class B-2: Basic Life
Support non-transporting ambulance
8. Class C: Advanced Life
Support: Air Medical Services
B. Requirements for initial
and renewal licensure for all classifications of ambulance vehicles:
1. The applicant for an
ambulance vehicle license must be the entity responsible for its
governance, and the license is not transferable among entities or
vehicles.
2. A license will immediately
become null and void and must be returned to RIDOH when service is
discontinued or when any changes in ownership occur pursuant to R.I.
Gen. Laws § 23-4.1-6(f).
3. A license must be posted in
a conspicuous place in the ambulance.
4. The ambulance must comply
with the equipment and supply requirements in § 2.12 of this
Part.
5. Any deficiencies cited in
the initial or any other inspection must be corrected before a
license will be issued or renewed.
6. Pay the application fee
stated in the Fee Structure for Licensing, Laboratory and
Administrative Services Provided by the Department of Health (Part
10-05-2
of this Title), if applicable.
7. Any other information
required by RIDOH
C. Requirements for initial
and renewal licensure for all classifications of transporting
ambulance vehicles in class A-1C, A-1P, and B-1:
1. A newly manufactured
ambulance vehicle must conform to the Federal Specification for Star
of Life Ambulances (KKK-A-1822(F)), incorporated at § 2.2(G) of
this Part, and/or the National Fire Protection Agency (NFPA) 1917
Standard for Automotive Ambulances, 2019 edition, incorporated at §
2.2(C) of this Part, as of the date of the original purchase order.
Remounted ambulances shall be considered a newly manufactured
ambulance vehicle.
2. An ambulance vehicle must
be identified with the name of the service prominently lettered on
both sides and the rear of the vehicle.
3. The material for the
emblems and markings must be applied using reflective material that
has a coefficient of retro-reflection measured in accordance with
ASTM International E810 Test Method for Coefficient of
Retroreflection of Retroreflective Sheeting Utilizing the Coplanar
Geometry.
4. The reflective color used
shall be blue, color a, and white, color i, in accordance with the
American National Standard Z535.1, Safety Color Code. They must
comply with the tolerances expressed in terms of Munsell hue, value,
and chroma.
5. For a newly manufactured
ambulance vehicle, the emblems and markings shall be of the type,
size, color, and location as follows:
a. Only ambulance vehicles
licensed as Advanced Life Support Class A-1C, A-1P, A-2C, A-2P, A-2A
or C may be identified by lettering or any other means as "Advanced
Life Support" or any similar designation.
b. Front markings: the word
“AMBULANCE” or “RESCUE” in mirror image, in
block, blue, die cut style letters, not less than four inches (4")
high, centered above the grille. The placement of the word
“AMBULANCE” or “RESCUE” on the curved surface
of the hood or on a flat plastic type bug screen is permitted. A Star
of Life in three inch (3") blue, die cut style, with a white
border must be located both to the right and left of the word
“AMBULANCE” or “RESCUE.”
c. Side markings: each side of
the ambulance must be marked with one (1) Star of Life emblem not
less than sixteen inches (16") in blue, die cut style with a
white border.
d. Rear markings: the rear of
the ambulance must be marked with two (2) Star of Life emblems not
less than ten inches (10"), in blue, die cut style with a white
border.
e. Roof marking: a Star of
Life of not less than thirty-two inches (32") in blue, die cut
style, which may be without the white Staff of Asclepius, must be
provided on the ambulance rooftop.
D. Requirements for initial
and renewal licensure for all classifications of non-transporting
ambulance vehicles in Class A-2C, A-2P, A-2A, or B-2:
1. Be equipped with a warning
device, such as a mechanical siren or electric penetrating unit,
which is audible five hundred feet (500’) to the front
2. Be equipped with red,
flashing, warning lights
3. Be designed to safely and
adequately house required medical equipment and supplies
4. Be marked with one (1) Star
of Life emblem not less than eight inches (8"), in blue, die cut
style with a white border located on one (1) side of the vehicle
5. Be equipped with an audible
backup warning device, activated when the vehicle is shifted into
reverse gear. The device must be rated SAE International J 1849 for
97 dB-a at four feet (4’).
E. Requirements for all
Categories of Ambulance Vehicles:
1. An ambulance vehicle can be
designated as a reserve vehicle. Reserve ambulance vehicles must have
a current Rhode Island Department of Transportation (RIDOT)
inspection sticker. A listing of all required equipment not stocked
at the time of inspection must be maintained in the vehicle, and the
equipment must be placed in the vehicle when the ambulance is placed
into service.
2. An ambulance vehicle must
have current Rhode Island Division of Motor Vehicles (RIDMV) and
RIDOT inspection stickers.
3. An ambulance vehicle must
be maintained in good repair and in safe operating condition at all
times.
4. The interior of an
ambulance vehicle, including equipment and supplies, must be
maintained in accordance with environmental infection control
practices to prevent transmission of disease from patient to EMS
practitioner, as well as from patient to patient between runs.
5. A licensed EMS practitioner
who utilizes latex gloves must do so in accordance with the
provisions of the Rules and Regulations pertaining to the Use of
Latex Gloves by Health Care Workers, in Licensed Health Care
Facilities, and by Other Persons, Firms, or Corporations Licensed or
Registered by the Department (Subchapter 15, Part 3
of this Chapter).
F. Staffing Requirements for
Ambulance Vehicles:
1. Each class of ambulance
must be staffed by Emergency Medical Services practitioners in
accordance with the level of Emergency Medical Services provided.
a. Class A-1C or A-1P
ambulances must be staffed at all times when providing patient care,
by at least two (2) practitioners:
(1) One (1) ALS practitioner,
such as an AEMT-C or a paramedic, who must remain with the patient
while providing advanced life support measures during transportation,
and an EMT, AEMT-C, or paramedic
(2) In accordance with R.I.
Gen. Laws § 23-1-1 , volunteer ambulance services must make
every attempt to meet the above standards to provide ALS care;
however, if these standards cannot be met, the ambulance must be
staffed by at least one (1) AEMT-C or one (1) paramedic, who must
remain with the patient during transport, and one (1) Emergency
Medical Responder (EMR). All initially responding personnel must be
functioning in a volunteer capacity.
b. Class B-1 ambulances must
be staffed by at least two (2) EMTs, one (1) of whom may be the
driver, the other to remain with the patient during transport.
(1) In accordance with R.I.
Gen. Laws § 23-1-1 , a volunteer ambulance service must make
every attempt to meet the above standards to provide BLS care;
however, if these standards cannot be met, the ambulance must be
staffed by at least one (1) EMT, who must remain with the patient
during transport. All initially responding personnel must be
functioning in a volunteer capacity.
c. Class A-2 ambulances must
be staffed by at least one (1) AEMT, one (1) AEMT-C, or one (1)
paramedic to provide ALS, or one (1) EMT to provide BLS.
d. Class B-2 ambulances must
be staffed by at least one (1) EMT, AEMT, AEMT-C or paramedic.
2.9 Exceptions to Licensure
Requirements
A. Any ambulance service,
ambulance vehicle, or EMS practitioner licensed or certified in
another U.S. State or Territory that enters Rhode Island in response
to a call for assistance from a Rhode Island-licensed ambulance
service or RIDOH in a mass casualty/major incident situation, shall
be exempt from the provisions of these Regulations requiring
licensure.
B. Any individual enrolled in
an EMS practitioner education course, functioning under the direct
supervision of a licensed health care professional, shall be exempt
from the provisions of these Regulations requiring licensure.
2.10 Licensing Requirements for
EMS Training Institutions
A. EMS training institutions
shall be licensed at the following levels. A licensed EMS training
institution can conduct training courses at the level of licensure or
below.
1. Paramedic
2. Advanced Emergency Medical
Technician-Cardiac (AEMT-C)
3. Advanced Emergency Medical
Technician (AEMT)
4. Emergency Medical
Technician (EMT)
5. Emergency Medical Responder
(EMR)
B. Requirements for initial
and renewal licensure of EMS training institutions:
1. An EMS training institution
applicant must be the entity responsible for its governance, and the
license is not transferable among entities.
2. A license will immediately
become null and void and must be returned to RIDOH when an EMS
training institution is closed or when any changes in ownership
occur.
3. A license must be posted in
a conspicuous place in the EMS training institution’s central
office.
4. An EMS training institution
applicant must provide a list of the following administrative staff:
a. Program Director: the
individual responsible for the administration, organization, and
supervision of the educational program. The Program Director must
have the following qualifications:
(1) Hold a license as a Rhode
Island EMS Instructor-Coordinator and hold a license at or above the
level of instruction
(2) Have an Associate’s
degree from an accredited institution of higher education if
conducting EMT or Advanced EMT-Cardiac courses, or a Bachelor’s
degree from an accredited institution of higher education if
conducting Paramedic programs
b. Medical Director: the
individual who is a physician who is board-certified or
board-eligible in emergency medicine and/or EMS by the American Board
of Emergency Medicine or the American Osteopathic Board of Emergency
Medicine who oversees the program, evaluates and approves all
instructors, and remains available for consultation during the
training course. The Medical Director must be licensed to practice
medicine in Rhode Island.
c. Faculty: the individuals
who are responsible for all aspects of didactic and clinical
instruction
d. Clinical Coordinator: the
individual responsible for coordinating practicum experiences in
hospitals or other healthcare settings
e. Field Internship
Coordinator: the individual responsible for coordinating practicum
experiences in EMS Ambulance Service settings
5. An EMS training institution
applicant must have written curriculum, policies, and procedures that
are consistent with the National EMS Education Standards.
6. An EMS training institution
applicant must maintain current written agreements and/or contracts
for clinical and field internships.
7. An EMS training institution
applicant must have an official affiliation with one (1) of the
following:
a. Four (4) year college or
university;
b. Two (2) year technical or
community college;
c. Hospital or medical center;
d. Federal, State, county, or
local government entity; or
e. A public or private
corporation that meets State and local business requirements.
8. An EMS training institution
applicant must be located in Rhode Island.
9. An EMS training institution
applicant must pay the application fee stated in the Fee Structure
for Licensing, Laboratory and Administrative Services Provided by the
Department of Health (Part 10-05-2
of this Title).
10. An EMS training
institution applicant must provide any other information required by
RIDOH.
C. EMS Training Institution
Operational Requirements:
1. An EMS training institution
must maintain appropriate student, personnel, and administrative
records, including but not limited to, student admission, advisement,
counseling, and evaluation.
2. An EMS training institution
must annually self-evaluate or review the following:
a. Instructor performance
b. Course completion and pass
rates
c. NREMT pass rates
d. Student evaluations of
instructors and program
3. An EMS training institution
must submit a report summarizing the self-evaluation described in §
2.10(C)(2) of this Part annually, by March 1 st of the
following calendar year.
4. EMS training institutions
must maintain sufficient program resources, including but not limited
to the following:
a. Finances
b. Classroom and laboratory
facilities
c. Equipment and supplies
d. Computers
e. Instructional reference
materials
5. An EMS training institution
must have clear syllabi with policies detailing the following:
a. Class attendance
b. Student behavior
c. Sexual and other forms of
harassment
d. Appearance and attire
e. Grade determination
f. Academic honor code
g. Academic calendar
h. Student grievance procedure
i. Criteria for successful
completion of each segment of the curriculum and graduation
j. Policies and processes by
which students may perform clinical work while enrolled in the
program
6. An EMS training institution
must implement a continuous quality improvement program to assess,
monitor, and evaluate the quality of its instructional programs and
continuing education of its faculty.
7. An EMS training institution
must report changes in administrative staff to CEMS within five (5)
business days.
8. Any other information
required by RIDOH to determine compliance with the standards of this
Part.
2.11 Variances
A. An application for variance
from the requirements of this Part must be made in writing to RIDOH.
Licensing requirements are not eligible for consideration of a
variance.
B. The variance application
must demonstrate that a literal enforcement of these Rules will
result in an unnecessary hardship to the applicant and that such a
variance will not be contrary to the health and safety of the public.
2.12 Minimum Equipment
Requirements for Ambulance Vehicles
A. The following list
indicates the minimum equipment required for each class of ambulance
vehicle license.
R
= Required O = Optional X = Not permitted
Section
1: General Requirements
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Communication
with dispatcher
R
R
R
R
R
R
R
R
Two-way
voice communications
Communication
with hospital
R
R
R
R
R
R
O
R
Two-way
voice communications
Complete
tool kit
R
R
R
R
R
R
R
X
Minimum
of: one (1) open-end adjustable wrench at least twelve inches
(12”); one (1) screwdriver regular blade at least eight
inches (8”); one (1) screwdriver, Phillips type at least
eight inches (8”); one (1) hacksaw with three (3) blades;
one (1) pliers, vise-grip type; one (1) three (3) pound hammer;
one (1) crowbar at least twenty-four inches (24”) or
halligan tool; one (1) battery cable cutter; two (2) ropes, at
least one half inch (½”) diameter, fifty feet (50’)
long; two (2) pairs safety goggles; two (2) pairs work gloves; two
(2) reflective vests/garments or equivalent, ANSI 207-2011
compliant; two (2) flashlights with batteries.
Controlled
substance log book
R
R
R
R
X
X
X
R
Log
of all controlled substances carried, including lot numbers, total
dose given per call, incident number, hospital replacement, and
any wastage. Logbook must be hardcover, bound, and have numbered
pages
Controlled
substance security
R
R
R
R
X
X
X
R
Stored
securely with at least two (2) locks, keyed or combination
DOT
inspection sticker
R
R
R
R
R
R
R
X
Rhode
Island
DOT
registration
R
R
R
R
R
R
R
X
Rhode
Island
Emergency
lights
R
R
R
R
R
R
R
X
Per
NFPA 1917
Equipment
properly secured
R
R
R
R
R
R
R
R
All
supplies, equipment, tools, etc. shall be stored in enclosed
compartments or fastened to secure them during vehicle motion.
Equipment weighing three (3) lbs. or more mounted or stored in a
driving or patient area shall be contained in an enclosed
compartment capable of containing the contents when a ten (10) G
force is applied in the longitudinal, lateral, or vertical axis of
the vehicle, if the equipment is secured in a bracket or mount
that can contain the equipment when the equipment is subjected to
those same forces.
Exhaust
system
R
R
R
R
R
R
R
X
Fire
extinguishers
R
R
R
R
R
R
R
R
Vehicle
shall be equipped with at least two (2) mounted and charged fire
extinguishers, dry chemical, each with a capacity of five (5) lbs.
or greater, approved by Underwriter’s Laboratory (UL), with
at least one (1) mounted in the patient compartment of
transporting ambulances.
Free
from rust/dents
R
R
R
R
R
R
R
R
Non-emergency
exterior lighting
R
R
R
R
R
R
R
R
Patient
compartment lighting
R
R
X
X
X
R
X
R
Per
NFPA 1917
Patient
tracking system/ePCR
R
R
O
O
O
R
O
R
PTS
and ePCR capable laptop computer or tablet and all ancillary
equipment and supplies including a docking station, bar code
scanner, tracking bracelets and triage tags and all shall be in
good working condition. The ePCR software must be RI CEMS
approved. The service shall also maintain a viable data
connectivity plan.
RI
Statewide EMS Protocols
R
R
R
R
R
R
R
R
Siren
R
R
R
R
R
R
R
X
Per
NFPA 1917
Triage/tracking
tags
R
R
R
R
R
R
R
R
Minimum
of twenty-five (25) triage tags
Triangle
reflectors
R
R
R
R
R
R
R
R
Minimum
of 3A9A3:J22A2:J2A2:J22
Section
2: Basic Life Support Supplies and Equipment
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Antiseptic
wipes
R
R
R
R
R
R
R
R
Minimum
of six (6)
Adhesive
tape
R
R
R
R
R
R
R
R
Blood
glucose meter
R
R
R
R
R
R
R
R
One
(1) meter with minimum of five (5) test strips
Blood
pressure cuffs
R
R
R
R
R
R
R
R
Adult,
child, infant, large adult sizes
Cold
packs
R
R
R
R
R
R
R
R
Minimum
of three (3)
Conforming
bandages
R
R
R
R
R
R
R
R
Minimum
of six (6)
Chest
seal dressing
R
R
R
R
R
R
R
R
Minimum
of two (2) commercially prepared units
Hypothermia
blanket
R
R
R
R
R
R
R
R
Minimum
of two (2) Mylar blankets
Mucosal
atomization device
R
R
R
R
R
R
R
R
Minimum
of two (2)
Obstetrics
kit
R
R
R
R
R
R
R
R
Minimum
of one (1)
Pediatric
dosing device
R
R
R
R
R
R
R
R
Minimum
of one (1)
Pelvic
binder
R
R
R
R
R
R
R
R
Minimum
of one (1) adult size
Splints
R
R
R
R
R
R
R
R
Minimum
of two (2) to fit adult and pediatric patients
Sterile
burn sheets
R
R
R
R
R
R
R
R
Minimum
of two (2)
Sterile
gauze
R
R
R
R
R
R
R
R
Gauze
pads in assorted sizes
Sterile
water
R
R
R
R
R
R
R
R
Minimum
of one (1) liter
Stethoscopes
R
R
R
R
R
R
R
R
Minimum
of one (1) adult and one (1) pediatric
Syringes/
needles
R
R
R
R
R
R
R
R
Minimum
of two (2) in each size: ten (10) mL, five (5) mL, one (1) mL; one
(1) sixty (60) mL and two (2) one and one half inch (1-1/2”)
needles
Thermometers
R
R
R
R
R
R
R
R
Minimum
of one (1) with a range of at least seventy-eight (78.0º F)
to one hundred and eleven and nine tenths degrees Fahrenheit
(111.9º F)
Tourniquet
R
R
R
R
R
R
R
R
Minimum
of four (4), commercially prepared
Traction
splint
R
R
O
O
O
R
O
R
Minimum
of one (1) adult size
Trauma
dressings
R
R
R
R
R
R
R
R
Minimum
of three (3)
Trauma
shears
R
R
R
R
R
R
R
R
Minimum
of one (1)
Triangular
bandages
R
R
R
R
R
R
R
R
Minimum
of three (3)
Water
soluble lubricant
R
R
R
R
R
R
R
R
Minimum
of three (3) packets
Section
3: Extrication and Transportation
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Cervical
collars
R
R
R
R
R
R
R
R
Minimum
of one (1) in each size to fit infants through tall adults
Child
seat
R
R
O
O
O
R
O
R
Minimum
of one (1) child restraint seat fitting children weighing from
twenty (20) to forty (40) lbs. The seat must be capable of being
secured to the vehicle’s stretcher. Seat must be compliant
with current Federal Motor Vehicle Safety Standards requirements
Long
spine board
R
R
O
O
O
R
O
R
Minimum
of one (1)
Patient
movement device
R
R
R
R
R
R
R
R
Minimum
of one (1)
Stair
chair
R
R
O
O
O
R
O
O
Minimum
of one (1)
Straps
for long spine board
R
R
O
O
O
R
O
R
Minimum
of four (4), seven feet (7’) to nine feet (9’) in
length
Stretcher/straps/mattress
R
R
X
X
X
R
X
R
Stretcher
having a mattress at least three inches (3”) thick with a
waterproof non-porous covering. Stretcher must be equipped with
appropriate patient restraints: three (3) mounted leg/torso
straps, and two (2) shoulder straps tethered together at stretcher
frame. Patient restraints shall be compliant with all Federal
Motor Vehicle Safety Standards and shall incorporate metal to
metal quick release buckles, be not less than two inches (2”)
wide, and fabricated from nylon or other materials easily cleaned
and disinfected. A fold down, rigid, telescoping I.V. pole and
holder shall be provided on the left side of stretcher. Stretcher
must operate according to manufacturer’s standards and be
current on maintenance and servicing as prescribed by the
manufacturer. All stretchers should only be used with the required
fastener assembly and patient restraint as prescribed by the
manufacturer.
Section
4: Airway and Ventilation
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Advanced
airway device kits
R
R
R
R
R
R
R
R
Minimum
of one (1) of the following advanced airway device kits: LMA kit
that includes, at a minimum, LMA sizes 1, 2, 3, 4 and 5; LT/LTS
kit that includes, at a minimum, LTA sizes 2, 2.5, 3, 4 and 5;
I-gel airway kit that includes, at a minimum, I-gel sizes 1, 1.5,
2, 2.5, 3, 4, and 5; AirQ airway kit that includes, at a minimum,
AirQ airway sizes 0.5, 1, 1.5, 2.0, 2.5, 3.5, and 4.5.
Bag-valve-masks
R
R
R
R
R
R
R
R
Minimum
of one (1) in adult, pediatric and infant sizes
Colorimetric
advanced airway verification devices
R
R
R
R
R
R
R
R
Minimum
of one (1) adult and one (1) pediatric sized device
Continuous
positive airway pressure
R
R
R
R
R
R
R
R
Minimum
of one (1) assembly to include a flow generator, tubing and a
minimum of one (1) small, medium and adult sized mask
Main
oxygen supply
R
R
O
O
O
R
O
R
Per
NFPA 1917
Nasopharyngeal
airways
R
R
R
R
R
R
R
R
Minimum
of four (4), sized 16-34 French
On-board
suction
R
R
O
O
O
R
O
R
Per
NFPA 1917
Oropharyngeal
airways
R
R
R
R
R
R
R
R
Minimum
of three (3) in small, medium and large sizes
Oxygen
cannulas
R
R
R
R
R
R
R
R
Minimum
of one (1) in adult and pediatric sizes
Oxygen
masks
R
R
R
R
R
R
R
R
Minimum
of two (2) each in adult and pediatric sizes
Oxygen
nebulizer
R
R
R
R
R
R
R
R
Minimum
of two (2)
Portable
oxygen cylinder
R
R
R
R
R
R
R
R
Minimum
of one (1) size D or larger with flow meter capable of delivering
one to fifteen (1 to 15) liters per minute of oxygen
Portable
suction unit, battery powered
R
R
O
O
O
R
O
R
Minimum
of one (1)
Portable
suction unit, manual
O
O
R
R
R
O
R
O
Minimum
of one (1)
Pulse
oximeter
R
R
R
R
R
R
R
R
Minimum
of one (1)
Suction
catheters and tubing
R
R
R
R
R
R
R
R
Minimum
of two (2) rigid catheters and two flexible catheters, one (1)
between 6-10 French and one (1) between 12-16 French
Tongue
depressors
R
R
R
R
R
R
R
R
Minimum
of one (1)
Section
5: Infection Control
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Biohazard
bag
R
R
R
R
R
R
R
R
Minimum
of one (1)
Body
substance isolation kits
R
R
R
R
R
R
R
R
Minimum
of one (1) per crew member to include a gown, protective goggles,
one (1) pair of disposable gloves, a mask, a head cover and a
biohazard bag
Latex-free
gloves
R
R
R
R
R
R
R
R
Multiple
sizes
N95
respirators
R
R
R
R
R
R
R
R
Minimum
of one (1) per crew member
Sharps
receptacle
R
R
R
R
R
R
R
R
Minimum
of one (1)
Section
6: Cardiac Care
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Automated
external defibrillator
O
O
O
O
R
R
R
O
Approved
by the U.S. Food and Drug Administration. Minimum of one (1) with
a fully charged battery and a minimum of one (1) set of one (1)
adult defibrillation pads. A minimum of one (1) set of pediatric
defibrillation pads or dosing attenuation device.
Cardiac
monitor and defibrillator
R
R
R
R
X
X
X
R
Approved
by the U.S. Food and Drug Administration. Capable of biphasic
manual defibrillation, synchronized cardioversion, rhythm waveform
display, 12 lead electrocardiogram acquisition, telemetry, and
transcutaneous pacing. Minimum of one (1) with a fully charged
battery and a minimum of one (1) set of one (1) adult
defibrillation pads. A minimum one (1) set of pediatric
defibrillation pads or dosing attenuation device. Functional strip
chart recorder. Electrodes to acquire electrocardiograms
Section
7: Advanced Life Support Supplies and Equipment
Item
A-1C
A-1P
A-2C
A-2P
A-2A
B-1
B-2
C
Description
Constricting
bands
R
R
R
R
R
X
X
R
Minimum
of two (2)
Cricothyrotomy
kit
X
R
X
R
X
X
X
X
Minimum
of one (1)
Endotracheal
intubation kit
O
R
O
R
X
X
X
O
Minimum
of one (1)
Intraosseous
infusion device
R
R
R
R
R
X
X
R
Minimum
of one (1)
IV
catheters in assorted sizes 14-24G
R
R
R
R
R
X
X
R
Minimum
of two (2) in each size
IV
drip sets ten to fifteen (10 to 15) drops
R
R
R
R
R
X
X
R
Minimum
of two (2)
IV
fluid warmer
R
R
O
O
O
X
X
R
Minimum
of one (1) with capacity to hold two (2) one (1) liter IV bags
IV
infusion pump
X
R
X
R
X
X
X
O
Minimum
of one (1)
Morgan
lens
X
R
X
R
X
X
X
O
Minimum
of one (1)
Nasogastric
tubes
X
R
X
R
X
X
X
X
Minimum
of three (3) in sizes between 8-18 French
Padded
arm boards
R
R
R
R
R
X
X
R
Minimum
of one (1)
Pleural
decompression kit
X
R
X
R
X
X
X
X
Minimum
of one (1), and four (4) decompression needles
Stopcock,
3- or 4-way
R
R
R
R
R
X
X
R
Minimum
of one (1)
Volumetric
burette, one hundred (100) mL
R
R
R
R
R
X
X
R
Minimum
of one (1)
B. If one (1) or more of the
critical deficiencies listed below are noted upon inspection, the
vehicle must not operate until all deficiencies are corrected, as
applicable.
1. Automated external
defibrillator
2. Bag-valve-masks
3. Biohazard bag
4. Blood pressure cuffs
5. Cardiac monitor and
defibrillator
6. Cervical collars
7. Communication with
dispatcher
8. Communication with hospital
9. DOT registration
10. Emergency lights
11. Equipment properly secured
12. IV catheters in assorted
sizes 14-24G
13. IV drip sets ten to
fifteen (10 to 15) drops
14. Latex-free gloves
15. Main oxygen supply
16. Nasopharyngeal airways
17. On-board suction
18. Oropharyngeal airways
19. Oxygen masks
20. Oxygen nebulizer
21. Patient Tracking System
and ePCR
22. Portable oxygen cylinder
23. Portable suction unit
24. Sharps receptacle
25. Siren
26. Stair chair
27. Stethoscopes
28. Stretcher/straps/mattress
29. Suction catheters and
tubing
30. Medications in minimum
quantities per the state formulary, unless a national shortage exists
for a particular medication.
C. When applicable, equipment
and supplies must be sealed, clean, unopened, and in the original
manufacturer’s packaging.