Medical and surgical equipment

Medical and surgical equipment. (1) All ambulances shall be equipped with the following: (a) An automatic, semiautomatic or manual defibrillator for use on adults and pediatric patients as specified in the standard operating procedures approved by the medical director that the ambulance service reports to and included in the plan approved by the department of health services, with appropriately sized defibrillation or conduction pads. This paragraph applies to all in-service ambulances. (am) Oxygen administration equipment, including adequate length tubing; transparent masks, adult and child sizes, both non-rebreathing and valveless; nasal cannulas, adult, child, and infant sizes; nebulizers, adult, child, and infant sizes; and a tracheostomy tube. All masks, tubing and cannulas shall be single-patient use. (b) One bag-valve-mask unit for each size, adult, child and infant. The bag shall be hand-operated, self-refilling with an accumulator capable of delivering an FiO2 of 90 percent, and may not have a pop-off valve. The mask portion shall be transparent. The valve portion shall be clear, disposable and operable in cold weather. A child bag shall have a reservoir of approximately 450 ml, and an adult bag shall have a reservoir of at least 1000 ml. (bm) All in-service ambulances shall have 2 approved non-visualized advanced airways. (br) Laryngoscope with adult and pediatric blades. (c) Oropharyngeal airways sizes 0 to 5, adult, child, and infant sizes. (cm) Nasopharyngeal airways sizes 16F to 34F, adult and child sizes. (cr) Adult and pediatric forceps. (d) Water soluble lubricant. (e) Pulse oximeter with pediatric and adult probes. (em) Blood glucose monitoring equipment. (f) Bandages and bandaging accessories to include: 1. Commercially packaged or sterile burn sheets, minimum 2. 2. Triangular bandages, minimum 2. 3. Sterile multi-trauma dressings in various large and small sizes. 4. Abdominal dressings 10 inches by 12 inches or larger. 5. Four-inch by 4-inch or other suitable size gauze sponges. 6. Gauze rolls, various sizes sufficient for expected uses. 7. Occlusive dressing or equivalent, sterile 3 inches by 8 inches or larger. 8. Adhesive hypoallergenic tape of various sizes. (fm) Arterial tourniquet. (fr) Heavy bandage or paramedic scissors for cutting clothing, belts and boots. (g) Sphygmomanometer with pediatric, adult regular, and adult large size cuffs. (h) Adult and pediatric stethoscopes. (i) Cervical collars, rigid for children ages 2 years or older; child and adult sizes small, medium, and large. (im) Head immobilization devices, firm padding or commercial devices for adults and children. (j) Lower extremity, femur traction devices for adults and children. (jm) Upper and lower extremity immobilization devices, joint-above and joint-below fracture, in sizes appropriate for adults and children. The devices shall be rigid support constructed with appropriate material, such as cardboard, metal, pneumatic, vacuum, wood, or plastic. (k) Impervious, radiolucent long backboard and short extrication/ immobilization device. Long back-board shall be head-to-feet length with at least 3 appropriate restraint straps and with capabilities to add padding for children and handholds for moving patients. (km) Orthopedic, scoop-type, break-apart stretcher. (L) Obstetrical kit including all of the following: 1. Sterile gloves. 2. Scissors or other cutting utensil. 3. Umbilical cord clamps. 4. Sterile dressings. 5. Towels. 6. Bulb suction or bulb syringe. 7. Thermal absorbent blanket and head cover, aluminum foil roll, or appropriate heat-reflective material, enough to cover a newborn. (Lm) Length/weight-based tape or appropriate reference material for pediatric equipment sizing and drug dosing based on estimated or known weight. (m) Thermometer with low temperature capability. (n) Commercial cold packs and hot packs. (o) Sterile saline solution for irrigation, bottles or bags. (p) Blanket, a minimum of 4 sheets, linen or paper and pillow. (pm) Towels. (q) Disposable emesis bags or basins. (qm) Disposable bedpan. (qr) Disposable urinal. (r) Infection control equipment to include: 1. Three or more eye protection units (full peripheral glasses or shield). 2. Three or more surgical masks. 3. Three or more pairs of nonsterile gloves. 4. Three or more jumpsuits or gowns that are disposable and impervious to body fluids. 5. Three or more disposable shoe covers. 6. Waterless hand cleanser, commercial antimicrobial, in towelette, spray or liquid form. 7. Standard commercial sharps containers, fixed and portable. 8. Bio-hazard bags of identifiable color, markings, or both. 9. Disinfectant solution for cleaning equipment. 10. N95 or N100 respiratory protection masks.