Section 309.24. Medical and surgical equipment.

 

(1)  All ambulances shall be equipped with the following:

(a) An automatic, semiautomatic or manual defibrillator as specified in the standard operating procedures approved by the medical director of the service, 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) Two transparent nonrebreathing reservoir oxygen masks of each size, adult and child, and 2 infant size masks with adequate length tubing, and 2 adult nasal cannula. 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 FiO 2 of 90%, 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 advanced airways.

(br) All in-service ambulances shall carry epinephrine as specified in the standard operating procedures approved by the medical director of the service. The service shall carry 2 ampules with approved delivery devices or 2 preloaded syringes, or 2 adult and 2 child automatic injection devices.

(c) One set of oral airways from size 0 to 6.

(d) Six or more nasopharyngeal airways sized from 12 fr to 34 fr.

(dm) Water soluble lubricant.

(e) Not less than 6, 10 x 30 inch universal or trauma dressings.

(f) Fifty or more sterile gauze pads, 4 x 4 inches or larger.

(g) Twelve soft-rolled, self-adhering bandages, 3 inches wide or larger.

(h) Four sterile occlusive dressings at least 3 inches by 9 inches.

(i) Two rolls of medical tape, 2 inches or larger.

(j) Two clean burn sheets.

(k) Eight triangular bandages.

(L) Bandage shears, 7 inches or larger.

(m) One large adult, one regular adult and one child size blood pressure cuff calibrated to measure within + or -4 mm. Hg.

(n) One stethoscope.

(o) Traction splints. This requirement may be met by one of the following:

1. One adult commercial traction splint and documented methodology for the stabilization of a pediatric femur fracture signed by the ambulance provider's medical director with appropriate equipment.

2. One adult and pediatric commercial traction splint capable of immobilizing femur fractures in patients over the age of 4.

3. One adult and one pediatric traction splint.

(p) One short spine board or comparable adult extrication device with appropriate straps.

(q) Two long spine boards or comparable spinal immobilization device with appropriate straps.

(r) A child size spine board or comparable spinal immobilization device with appropriate straps.

(s) Splinting devices capable of rigid support and immobilization of a joint above and a joint below an injury made from an appropriate material, such as cardboard, metal, pneumatic, vacuum, wood or plastic, 2 at least 3 feet long, and 2 at least 15 inches long.

(t) Two liters of sterile saline irrigation solution in plastic containers.

(v) Obstetrical kit including all of the following:

1. Sterile gloves.

2. Scissors or disposable scalpels.

3. Two umbilical cord clamps.

4. Sterile dressings.

5. Towels.

6. Plastic bags.

7. Blanket or other appropriate heat-reflective material, enough to cover a newborn.

8. Bulb syringe.

(w) A laryngoscope and set of blades in adult and pediatric sizes, or disposable one-piece laryngoscopes in adult and pediatric sizes.

(wm) One adult and one pediatric size Magill forceps.

(wr) An orthopedic break apart stretcher.

(x) Rigid cervical collars; 2 adult, 2 child and 2 infant.

(xm) Infection control personal protective equipment and materials, including all of the following:

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. Hand wash of a commercial antimicrobial type, such as a towelette, spray or liquid.

7. At least one commercial sharps container.

8. Bio-hazard bags of identifiable color or markings, or both.

(xr) All services shall have latex-free equipment and supplies as directed by a protocol, approved by the services medical director for the treatment, care and used by latex-sensitive patients and attendants.

(y) Medications and drugs specified in the standard operating procedures approved by the medical director of the service. This shall include oral glucose in single patient use containers, and epinephrine as specified in the standard operating procedures approved by the medical director of the service, and included in the plan approved by the department of health services.

(z) Two cervical-head immobilizer devices capable of being attached to spine boards.

(2)  The following are one patient-use items and shall remain sealed until the time of use. Unsealed containers of the following may not be kept:

(a) Sterile saline solution.

(b) Liquid oral glucose.

(c) Epinephrine.

(3)  In addition to the medical and surgical equipment specified in sub. (1) , ambulances staffed with EMT-intermediates shall be equipped with the following:

(a) Sterile intravenous infusion agents, in plastic containers, with necessary IV starting equipment, including an assortment of appropriately sized adult and pediatric IV catheters, including small sized catheters to at least 24 gauge.

(b) Subcutaneous injection equipment.

(c) Two advanced airways.

(d) Prepackaged medications, drugs and solutions specified in the standard operating procedures approved by the medical director of the service and the department of health services.

(4)  In addition to the medical and surgical equipment specified in subs. (1) , (2) and (3) , ambulances staffed by EMT-paramedics shall carry the following:

(a) Electrocardiogram monitor with tape printout.

(b) Two or more intraosseous needles.

(c) Endotracheal intubation equipment as specified by the medical director of the service adequate to cover infants through adults.

(d) Medications and drugs specified in the standard operating procedures approved by the medical director of the service and the department of health services.

(e) One pediatric stethoscope.

(f) Pediatric paddles or 2 sets of pads.

(g) Pediatric and adult size endotracheal tube stylets.

(h) Length/weight-based drug dose chart or tape.

(5)  No medications, drugs, fluids, solutions or containers shall be kept beyond their expiration date.

Cr. Register, October, 1986, No. 370 , eff. 11-1-86; am. (1) (a), (m), (p) and (q) and (1) (w) 3. renum. (1) (b) to be (1) (c), (1) (c) to (e) to be (1) (d) to (f), (1) (f) and (g) to be (1) (g) and (i) and am. (1) (g) and (i), (1) (h) to be (1) (j) and am. (1) (j), (1) (i) to be (1) (k) and am. (1) (k), (1) (j) to be (1) (L), (1) (r) to be (1) (s) and am. (1) (s), (2) and (3) to be (3) and (4) and am. (3) and (4), cr. (1) (b), (h) (r), (z), (za), (zb), (zc) and (zd) r. (1) (s), (z) and (za), (2) and (5) r. and recr. (1) (t), Register, April, 1994, No. 460 , eff. 5-1-94; r. and recr. (1) (a), (b), (o), (s) and (4) (b), cr. (1) (am), (bm), (br), (dm), (v) 8., (xm), (xr), (y) and (4) (e) to (h), am. (1) (c), (d), (f), (h) to (k), (m), (q), (v) 7., (2) (intro.), (3) (a) and (d), (4) (c) and (d), r. (1) (u), (w), (zb), (zc), (2) (b) and (c), renum. (1) (x), (y), (z), (za), (zd), (2) (d) and (e) to be (1) (w), (wm), (wr), (x), (z), (2) (b) and (c) and am. (1) (wr), (2) (b) and (c), Register, February, 1999, No. 518 , eff. 4-1-99; corrections in (1) (a), (y), (3) (d) and (4) (d) made under s. 13.92 (4) (b) 6. , Stats., Register December 2010 No. 660 .