Header:
KANSAS ADMINISTRATIVE REGULATIONS
AGENCY 109 BOARD OF EMERGENCY MEDICAL SERVICES
ARTICLE 2. AMBULANCE SERVICES; PERMITS AND REGULATIONS
Date:
08/31/2009
Document:
109-2-8. Standards for type I, type II, type IIA, and type V ground ambulances and equipment.
(a) Each ambulance shall meet the vehicle and equipment standards that are applicable to that class of ambulance.
(b) Each ambulance shall have the ambulance license prominently displayed in the patient compartment.
(c) The patient compartment size shall meet or exceed the following specifications:
(1) Headroom: 60 inches; and
(2) length: 116 inches.
(d) Each ambulance shall have a heating and cooling system that is controlled separately for the patient and the driver compartments. The air conditioners for each compartment shall have separate evaporators.
(e) Each ambulance shall have separate ventilation systems for the driver and patient compartments. These systems shall be separately controlled within each compartment. Fresh air intakes shall be located in the most practical, contaminant-free air space on the ambulance. The patient compartment shall be ventilated through the heating and cooling systems.
(f) The patient compartment in each ambulance shall have adequate lighting so that patient care can be given and the patient's status monitored without the need for portable or hand-held lighting. A reduced lighting level shall also be provided. A patient compartment light and step-well light shall be automatically activated by opening the entrance doors. Interior light fixtures shall be recessed and shall not protrude more than 11/2 inches.
(g) Each ambulance shall have an electrical system to meet maximum demand of the electrical specifications of the vehicle. All conversion equipment shall have individual fusing that is separate from the chassis fuse system.
(h) Each ambulance shall have lights and sirens as required by K.S.A. 8-1720 and K.S.A. 8-1738, and amendments thereto.
(i) Each ambulance shall have an exterior patient loading light over the rear door, which shall be activated both manually by an inside switch and automatically when the door is opened.
(j) The operator shall mark each ambulance licensed by the board as follows:
(1) The name of the ambulance service shall be in block letters, not less than four inches in height, and in a color that contrasts with the background color. The service name shall be located on both sides of the ambulance and shall be placed in such a manner that it is readily identifiable to other motor vehicle operators.
(2) Any operator may use a decal or logo that identifies the ambulance service in place of lettering. The decal or logo shall be at least 10 inches in height and shall be in a color that contrasts with the background color. The decal or logo shall be located on both sides of the ambulance and shall be placed in such a manner that the decal or logo is readily identifiable to other motor vehicle operators.
(3) Each ambulance initially licensed by the board before January 1, 1995 that is identified either by letters or a logo on both sides of the ambulance shall be exempt from the minimum size requirements in paragraphs (1) and (2) of this subsection.
(k) Each type I, type II, type IIA, and type V ambulance shall have a communications system that is readily accessible to both the attendant and the driver and is in compliance withK.A.R 109-2-5(a).
(l) An operator shall equip each ambulance as follows:
(1) At least two annually inspected ABC fire extinguishers or comparable fire extinguishers with at least five pounds of dry chemical, which shall be secured. One fire extinguisher shall be easily accessible by the driver, and the other shall be easily accessible by the attendant;
(2) either two portable, functional flashlights or one flashlight and one spotlight;
(3) one four-wheeled or six-wheeled, all-purpose, multilevel cot with an elevating head and at least two safety straps with locking mechanisms;
(4) one urinal;
(5) one bedpan;
(6) one emesis basin or convenience bag;
(7) one complete change of linen;
(8) two blankets;
(9) one waterproof cot cover;
(10) one pillow; and
(11) a ''no-smoking'' sign posted in the patient compartment and the driver compartment.
(m) The operator shall equip each ground ambulance with the following internal medical systems:
(1) An oxygen system with at least two outlets located within the patient compartment and at least 2,000 liters of storage capacity, with a minimum oxygen level of 200 psi. The cylinder shall be in a compartment that is vented to the outside. The pressure gauge and regulator control valve shall be readily accessible to the attendant from inside the patient compartment; and
(2) a functioning, on-board, electrically powered suction aspirator system with a vacuum of at least 300 millimeters of mercury at the catheter tip. The unit shall be easily accessible with large-bore, nonkinking suction tubing and a large-bore, semirigid, nonmetalic oropharyngeal suction tip.
(n) The operator shall equip each ground ambulance with the following medical equipment:
(1) A portable oxygen unit of at least 300-liter storage capacity, complete with pressure gauge and flowmeter and with a minimum oxygen level of 200 psi. The unit shall be readily accessible from inside the patient compartment;
(2) a functioning, portable, self-contained battery or manual suction aspirator with a vacuum of at least 300 millimeters of mercury at the catheter tip and a transparent or translucent collection bottle or bag. The unit shall be fitted with large-bore, nonkinking suction tubing and a large-bore, semirigid, nonmetallic oropharyngeal suction tip, unless the unit is self-contained;
(3) a hand-operated, adult bag-mask ventilation unit, which shall be capable of use with the oxygen supply;
(4) a hand-operated, pediatric bag-mask ventilation unit, which shall be capable of use with oxygen supply;
(5) oxygen masks in adult and pediatric sizes;
(6) nasal cannulas in adult and pediatric sizes;
(7) oropharyngeal airways in adult, pediatric, and infant sizes;
(8) a blood pressure manometer with extra large, adult, and pediatric cuffs and a stethoscope;
(9) an obstetric kit with contents as described in the ambulance service's medical protocol;
(10) sterile burn sheets;
(11) sterile large trauma dressings;
(12) assorted sterile gauze pads;
(13) occlusive gauze pads;
(14) rolled, self-adhering bandages;
(15) adhesive tape at least one inch wide;
(16) bandage shears;
(17) one liter of sterile water, currently dated or one liter of sterile saline, currently dated; and
(18) currently dated medications, as authorized by the scope of practice and protocols.
(o) The operator shall equip each ground ambulance with the following patient-handling and splinting equipment:
(1) A long spinal-immobilization device, complete with accessories to immobilize a patient;
(2) a short spinal immobilization device, complete with accessories to immobilize a patient;
(3) a set of extremity splints including one arm and one leg splint, in adult and pediatric sizes;
(4) a set of rigid cervical collars in assorted adult and pediatric sizes;
(5) foam wedges or other devices that serve to stabilize the head, neck, and back as one unit; and
(6) patient disaster tags.
(p) The operator shall equip each type I, type IIA, type II, and type V ground ambulance with the following blood-borne and body fluid pathogen protection equipment in a quantity sufficient for crew members:
(1) Surgical or medical protective gloves;
(2) protective goggles, glasses or chin-length clear face shields;
(3) filtering masks that cover the mouth and nose;
(4) nonpermeable, full-length, long-sleeve protective gowns;
(5) a leakproof, rigid container clearly marked as ''contaminated products'' for the disposal of sharp objects; and
(6) a leakproof, closeable container for soiled linen and supplies.
(q) The operator shall equip each type I ambulance, type IIA ambulance, and type V ambulance with the following:
(1) A monitor-defibrillator;
(2) a drug supply as listed in the ambulance service's medical protocols;
(3) intravenous administration sets according to medical protocol;
(4) intravenous solutions in plastic bags or plastic bottles as listed in the ambulance service's medical protocols;
(5) assorted syringes and needles necessary to meet the requirements of the medical protocols; and
(6) if authorized by protocols, endotracheal tubes and laryngoscope blades in adult, child, and infant sizes.
(r) If an operator's medical protocols or equipment list is amended, a copy of these changes shall be submitted to the board by the ambulance service operator within 15 days of implementation of the change. Equipment and supplies obtained on a trial basis or for temporary use by the operator shall not be required to be reported to the board by an operator.
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