The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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OREGON HEALTH AUTHORITY,

PUBLIC HEALTH DIVISION

 

DIVISION 255
AMBULANCE LICENSING

333-255-0000
Definitions
(1) “Advanced
Emergency Medical Technician (AEMT)” means a person who is licensed by the
Authority as an Advanced Emergency Medical Technician.
(2) "Ambulance"
or "Ambulance Vehicle" means any privately or publicly owned motor vehicle, aircraft,
or watercraft that is regularly provided or offered to be provided for the emergency
transportation of persons who are ill or injured or who have disabilities.
(3) “Ambulance
Based Clinician” means a Registered Nurse, Physician, or Physician Assistant
who:
(a) Has an
active license in Oregon and is in good standing with the Oregon Board of Nursing
or the Oregon Medical Board; and
(b) Staffs
an ambulance for a licensed ambulance service.
(4) "Ambulance
Service" means any person, governmental unit, corporation, partnership, sole proprietorship,
or other entity that operates ambulances and that holds itself out as providing
prehospital or medical transportation to persons who are ill or injured or who have
disabilities.
(5) "Ambulance
Service Area (ASA)" means a geographic area served by one ground ambulance service
provider, and may include all or portion of a county, or all or portions of two
or more contiguous counties.
(6) "Authority"
means the Emergency Medical Services and Trauma Systems Program, within the Oregon
Health Authority.
(7) "Business
day" means Monday through Friday when the Authority is open for business, excluding
holidays.
(8) "Emergency
Care" means the performance of acts or procedures under emergency conditions in
the observation, care and counsel of the ill, injured or disabled; in the administration
of care or medications as prescribed by a licensed physician, insofar as any of
these acts is based upon knowledge and application of the principles of biological,
physical and social science as required by a completed course utilizing an approved
curriculum in prehospital emergency care. However, "emergency care" does not include
acts of medical diagnosis or prescription of therapeutic or corrective measures.
(9) "EMS"
means Emergency Medical Services.
(10) "EMS
Medical Director" has the same meaning as "Supervising Physician" in ORS 682.025.
(11) “Emergency
Medical Responder (EMR)” means a person who is licensed by the Authority as
an Emergency Medical Responder.
(12) "Emergency
Medical Services Provider (EMS Provider)" means a person who has received formal
training in prehospital and emergency care and is state-licensed to attend to any
ill, injured or disabled person. Police officers, fire fighters, funeral home employees
and other personnel serving in a dual capacity, one of which meets the definition
of "emergency medical services provider" are "emergency medical services providers"
within the meaning of ORS chapter 682.
(13) "Emergency
Medical Technician (EMT)” means a person who is licensed by the Authority
as an Emergency Medical Technician.
(14) "EMT-Basic"
has the same meaning as Emergency Medical Technician.
(15) "EMT-Intermediate"
means a person who is licensed by the Authority as an EMT-Intermediate.
(16) "EMT-Paramedic"
has the same meaning as Paramedic.
(17) "In
Operation" means the time beginning with the initial response of the ambulance and
ending when the ambulance is available to respond to another request for service.
An ambulance that transports a patient becomes available to respond when the care
of the patient has been transferred.
(18) "License"
means the documents issued by the Authority to the owner of an ambulance service
when the service and its ambulances are found to be in compliance with ORS chapter
682, OAR chapter 333, division 250 and OAR chapter 333, division 255.
(19) "Non-emergency
Care" means the performance of acts or procedures on a patient who is not expected
to die, become permanently disabled or suffer permanent harm within the next 24-hours,
including but not limited to observation, care and counsel of a patient and the
administration of medications prescribed by a physician licensed under ORS chapter
677, insofar as any of those acts are based upon knowledge and application of the
principles of biological, physical and social science and are performed in accordance
with scope of practice rules adopted by the Oregon Medical Board in the course of
providing prehospital care as defined by this rule.
(20) "Owner"
means the person having all the incidents of ownership in an ambulance service or
an ambulance or, where the incidents of ownership are in different persons, the
person, other than a security interest holder or lessor, entitled to the possession
of an ambulance vehicle or operation of an ambulance service under a security agreement
of a lease for a term of 10 or more successive days.
(21) “Paramedic”
means a person who is licensed by the Authority as a Paramedic.
(22) "Patient"
means a person who is ill or injured or who has a disability and who is transported
in an ambulance.
(23) "Person"
means any individual, corporation, association, firm, partnership, joint stock company,
group of individuals acting together for a common purpose, or organization of any
kind and includes any receiver, trustee, assignee, or other similar representatives
thereof.
(24) "Physician"
means a person licensed under ORS chapter 677, actively registered and in good standing
with the Oregon Medical Board as a Medical Doctor (MD) or Doctor of Osteopathic
Medicine (DO).
(25) "Physician
Assistant (PA)" means a person licensed under ORS chapter 677, actively registered
and in good standing with the Oregon Medical Board.
(26) "Prehospital
Care" means that care rendered by EMS providers as an incident of the operation
of an ambulance as defined by ORS chapter 682 and that care rendered by EMS providers
as incidents of other public or private safety duties, and includes, but is not
limited to "emergency care" as defined by ORS chapter 682.
(27) "Prehospital
Care Report Form (PCRF)" means an Authority-approved form or electronic field data
format that is completed for all patients receiving prehospital assessment, care
or transportation to a medical facility.
(28) “Qualified
Driver” means someone who is not licensed by the Authority and who meets Authority
requirements to operate a ground ambulance.
(29) "Registered
Nurse (RN)" means a person licensed under ORS chapter 678, actively registered and
in good standing with the Oregon Board of Nursing.
(30) “Rural
Ambulance Service” means ambulance service located in an area where all geographic
areas are 10 or more miles from the centroid of a population center of 40,000 or
more.
(31) "Sanitary"
means being free from all body fluids, dirt, dust, grease or other extraneous matter.
(32) "Scope
of Practice" means the maximum level of emergency or non-emergency care that an
emergency medical technician may provide.
(33) "Specialty
Care Transport (SCT)" means interfacility transportation of a critically injured
or ill beneficiary by a ground ambulance vehicle, including medically necessary
supplies and service, at a level of service beyond the scope of the Paramedic. SCT
is necessary when a beneficiary's condition requires ongoing care that must be furnished
by one or more health professionals in an appropriate specialty area, for example
nursing, emergency medicine, respiratory care, cardiovascular care, or a Paramedic
with additional training. Any skill or medication in addition to or not found in
the Department of Transportation curriculum for Paramedics would be defined as additional
training and is defined by the EMS medical director.
(34) "Standing
Orders" means the written detailed procedures for medical or trauma emergencies
issued by the EMS medical director to be performed by appropriate certificate holders
or licensees in conformance with the scope of practice and level of licensure.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0600;
HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f.
& ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91; HD 8-1993, f. 6-22-93,
cert. ef. 7-1-93; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0000;
OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH
12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0010
Application
Process to Obtain an Ambulance License
(1) An ambulance
service owner that wishes to obtain an ambulance license must apply for and receive
an ambulance license from the Authority before placing an ambulance into operation.
(2) The Authority
shall issue an ambulance license to the owner of an ambulance service that is not
subject to disqualification from licensure for any reason specified in ORS chapter
682, OAR chapter 333, division 250 or these rules. The ambulance service owner must:
(a) Have
a current ambulance service license;
(b) Have
paid the fees required by ORS chapter 682 and these rules;
(c) Agree
to comply with all applicable federal, state and local laws and regulations governing
the operation of a licensed ambulance; and
(d) Submit
a completed application in a form specified by the Authority in accordance with
ORS 682.045 and these rules.
(3) An application
for an air ambulance license must be made on an Authority-approved form containing
at a minimum:
(a) The name
and address of the person or public entity owning the aircraft;
(b) If other
than the applicant's true name, the name under which the applicant is doing business;
(c) The description
of the ambulance:
(A) Indication
if the aircraft was purchased from an ambulance service in Oregon;
(B) Type
of aircraft:
(i) Fixed-wing;
or
(ii) Rotary-wing.
(C) Number
of engines;
(D) Make
of aircraft;
(E) Model
of aircraft;
(F) Year
of manufacture;
(G) Federal
Aviation Authority (FAA) registration number;
(H) Whether
a major repair or alteration has been made to the aircraft, and if so, a FAA Form
337 must be on file in the licensee's office for each repair or alteration made;
(I) Aircraft
colors:
(i) Fuselage;
(ii) Stripe;
and
(iii) Lettering.
(J) Insigne
name, monogram or other distinguishing characteristics. A photo of the air ambulance
may be submitted to show these characteristics.
(4) An application
for a ground ambulance must be made on an Authority-approved form containing at
a minimum:
(a) The name
and address of the person or public entity owning the ambulance;
(b) If other
than the applicant's true name, the name under which the applicant is doing business;
(c) The description
of the ambulance:
(A) Whether
the ground ambulance was purchased from an ambulance service in Oregon;
(B) Make
of vehicle;
(C) Model
type of vehicle;
(D) Year
of manufacture;
(E) Whether
the vehicle is a remounted chassis;
(F) Conversion
manufacturer;
(G) Vehicle
Identification Number;
(H) Vehicle
license plate number;
(I) Mileage
at the time of licensing;
(J) Ambulance
colors:
(i) Body;
(ii) Stripe;
and
(iii) Lettering.
(K) Insigne
name, monogram or other distinguishing characteristics. A photo of the ground ambulance
may be submitted to show these characteristics.
(d) A copy
of the ground ambulance manufacturers authenticated Star-of-Life certificate or
Final Stage Vehicle Manufacturing Certification of compliance;
(A) A previously
owned ambulance must have, at a minimum, a January 1, 1995, Star-of-Life certificate;
or
(B) A newly
constructed ambulance must have at a minimum a Star-of-Life certificate or a Final
Stage Vehicle Manufacturing Certificate of compliance.
(5) A completed
application for the licensing of a marine ambulance must contain, at a minimum:
(a) The name
and address of the person or public entity owning the ambulance;
(b) If other
than the applicant's true name, the name under which the applicant is doing business;
(c) The description
of the ambulance:
(A) Whether
the marine craft was purchased from an ambulance service in Oregon;
(B) Whether
the patient-care area is covered or uncovered;
(C) Number
of engines;
(D) Type
of engines:
(i) Inboard;
(ii) Outboard;
or
(iii) Both
inboard and outboard.
(E) Make
of marine craft;
(F) Model
of marine craft;
(G) Year
of manufacture;
(H) Marine
craft registration number;
(I) Marine
craft license plate number;
(J) Ambulance
colors:
(i) Hull;
(ii) Stripe;
and
(iii) Lettering.
(K) Insigne
name, monogram or other distinguishing characteristics. A photo of the marine ambulance
may be submitted to show these characteristics.
(d) A signed
and dated statement that the application contains truthful information.
(6) The completed
ambulance license application must be submitted to the Authority with a nonrefundable
ambulance licensing fee of:
(a) $45,
when the service has a maximum of four full-time paid positions; and
(b) $80,
when the service has five or more full-time paid positions.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 5-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH
1-2013, f. & cert. ef. 1-25-13
333-255-0020
Issuance
of License to Operate an Ambulance
(1) When the completed
ambulance license application with a nonrefundable ambulance license fee as specified
in OAR 333-255-0010(6)(a) or (6)(b) has been received by the Authority and if it
is found that the submitted data complies with the requirements of ORS chapter 682
and these rules, the Authority shall issue an ambulance license for the specified
ambulance within 10 business days.
(2) The ambulance
license:
(a) Shall
be valid until June 30 of each year, unless sooner revoked or suspended. The initial
licensing period may not exceed 15 months;
(b) If issued
between April 1 and June 30, shall expire on June 30 of the following year; and
(c) Must
be conspicuously displayed in the operator's or patient compartment of the ambulance,
or otherwise as directed by the Authority.
(3) Except
when specifically exempted by ORS 682.035 and OAR 333-250-0030(3)(a) through (3)(d),
an out-of-state licensed ambulance that operates in Oregon must be licensed by the
Authority:
(a) An ambulance
license shall be granted when the ambulance is currently licensed in another state,
the standards of which meet or exceed those of Oregon; and
(b) The owner
submits to the Authority:
(A) A completed
Oregon ambulance license application;
(B) A non-refundable
ambulance licensing fee as specified in OAR 333-255-0010(6)(a) or (6)(b); and
(C) A copy
of the current home-state ambulance license.
(4) An ambulance
license is not transferable to a replacement ambulance or to a new owner.
(5) An ambulance
license shall be issued to an owner of an ambulance used as a reserve, so long as
the ambulance meets all construction and mechanical requirements at the time of
manufacture. A reserve ambulance shall not be required to have patient care equipment
on-board at all times. However, when the ambulance is placed in operation, it must
meet all ambulance licensing requirements.
(6) If an
ambulance license becomes lost, damaged or destroyed, the licensee must obtain an
application for a replacement license from the Authority. The licensee must submit
the completed application with a nonrefundable fee of $10 to the Authority for each
replacement license and shall receive a replacement license within 10 business days.
(7) When
an ambulance is found to be in non-compliance with ORS chapter 682 or these rules,
the Authority may deny, suspend or revoke the ambulance license as authorized by
ORS 682.220.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0605;
HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f.
& cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from
333-028-0005; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert.
ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0030
Denial, Suspension
or Revocation of an Ambulance License
(1) The Authority
may, in compliance with proper administrative procedures as prescribed in ORS chapter
183, deny, suspend, or revoke an ambulance license issued under these rules, or
an ambulance service license issued under OAR 333-250-0030, if the Authority determines:
(a) A violation
of ORS chapter 682 or of these rules has occurred that poses a significant threat
to the health and safety of the public or an applicant does not meet the requirements
of ORS chapter 682 or these rules;
(b) The ambulance
owner makes a material omission or misrepresentation of facts on an application
for a license or waiver, or in response to an inquiry or investigation. This includes
the intentional misrepresentation or misstatement of a material fact, concealment
of or failure to make known any material fact or any other means by which misinformation
or false impression is knowingly given or deceit in obtaining or attempting to obtain
a license or waiver or in any other transaction with the Authority;
(c) Defacing,
altering, removing or obliterating any portion of any official entry upon a license,
licensing decal, or waiver issued by the Authority;
(d) Failure
to have the appropriate personnel, medical equipment and supplies required for operation
at the highest level of service provided when the ambulance is in operation as prescribed
by these rules;
(e) When
an ambulance, upon inspection by the Authority, manifests evidence of a mechanical
or equipment deficiency that poses a significant threat to the health or safety
of patients or crew, the Authority shall immediately suspend that ambulance from
operation. No ambulance that has been suspended from operation may be operated as
an ambulance until the licensee has certified and the Authority has confirmed that
the deficiency has been corrected; and
(f) Other
reasons determined by the Authority to pose a significant threat to the Authority
and safety and the well being of patients.
(2) The licensee
must return all indications of licensing, including certificates and the remains
of ambulance license decals to the Authority by registered mail, posted within 48
hours of either receipt of notification of suspension or revocation or the effective
date of revocation, whichever is later.
(3) The Authority
must provide appropriate public notification of the suspension or revocation of
an ambulance license.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94,
Renumbered from 333-028-0006; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007,
f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10, cert. ef. 7-1-10; PH 1-2013,
f. & cert. ef. 1-25-13
333-255-0040
Surrender
of License to Operate an Ambulance
(1) The ambulance
license in the owner's possession must be surrendered to the Authority immediately
upon notification by the Authority of the suspension or revocation of an ambulance
service or ambulance license, or upon the sale of an ambulance, or upon the termination
of operations.
(2) An ambulance
license is non-transferable. When the owner sells, trades, or donates an ambulance,
or terminates the business, the licensee must notify the Authority within 10 days
of the transaction by listing the date that the sale was completed and the full
name and address of the purchaser of the ambulance on the back of the ambulance
license and surrendering all ambulance licenses for that ambulance to the Authority.
(3) When
an ambulance is decommissioned and not sold to another licensed ambulance service,
the owner of the ambulance shall be responsible for the removal of the ambulance
license decals. Ambulance license decals shall be returned to the Authority within
10 business days. In addition to the removal of the ambulance license decals, the
owner of the vehicle shall remove any emblems or markings as defined in OAR 333-255-0060(5)
identifying the vehicle as an ambulance.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0610;
HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f.
& cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from
333-028-0010; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert.
ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13; PH 1-2013, f. & cert. ef.
1-25-13
333-255-0050
Right of
Entry and Inspection of an Ambulance
(1) The Authority
may conduct an inspection of an ambulance vehicle for the purpose of evaluating
the eligibility of an ambulance service to receive or retain an ambulance license
and to ensure the health, safety, and welfare of the persons who utilize ambulances.
The ambulance service may be exempted from the inspection process if;
(a) The ambulance
service is accredited by a nationally recognized EMS service program accreditation
entity that meets or exceeds Oregon requirements. A copy of the inspection report
from the nationally recognized EMS service program accreditation entity must be
filed with the Authority for approval; or
(b) The ambulance
service and ambulance has undergone inspections from a governmental agency or state
designee. A copy of the inspection report from the governmental agency or state
designee must be filed with the Authority for approval.
(2) Initial
and routine inspections of an ambulance must be scheduled with the management of
the ambulance service at least 72 hours in advance of the inspection unless otherwise
mutually agreed upon by the Authority and ambulance service representative.
(3) Inspections
for the purpose of investigating a complaint do not require giving advanced notice
to the licensee. Unless the Authority gives written approval, no person may give
advanced notice of an unannounced inspection.
(4) Upon
request of the Authority, an ambulance service owner, manager, employee, volunteer
or agent must, at a reasonable time and without delay, permit entry by the Authority
onto all premises housing an ambulance for the purpose of an ambulance inspection.
No one, including but not limited to, the owner, the manager, employees, volunteers,
and agents, may impede the Authority in conducting a lawful inspection of an ambulance
to evaluate compliance with ORS chapter 682 and these rules.
(5) In conducting
an inspection, the Authority must:
(a) Identify
him or herself by presenting Authority identification to the owner, manager, ranking
employee, or volunteer present at the site of an inspection;
(b) Inform
the ambulance service representative of the purpose for the inspection; and
(c) Inform
the ambulance service representative when the inspection has been completed and
the results of the inspection.
(6) The Authority
may inspect an ambulance at any reasonable time including, but not limited to, whenever
the ambulance is present at the ambulance service office or any satellite-office
location.
(7) The Authority
shall conduct an inspection without impeding patient care or unreasonably delaying
patient transport unless, in the judgment of the Authority, the lack of properly
operating patient care equipment, the safety condition of the ambulance, or the
patient care being rendered is detrimental or is reasonably likely to be detrimental
to the patient's health, safety, or welfare.
(8) When
an ambulance is found to be in violation with ORS chapter 682 or these rules, and
requires a second or subsequent on-site inspection, the Authority may impose a civil
penalty as authorized in ORS 682.224:
(a) A subsequent
on-site inspection must be conducted and passed on the same day as the initial inspection
if the ambulance is to remain available for operation;
(b) If the
subsequent on-site inspection reveals that all violations have not been corrected
and those violations constitute an immediate danger or threat to the public, the
Authority may immediately suspend the ambulance license. The suspension shall remain
in force until all violations have been corrected;
(c) The Authority
shall immediately notify the county health department and the administrator of the
county ASA plan of any ambulance license suspension; and
(d) A copy
of the completed inspection form shall be given to a representative of the ambulance
service and one copy each shall be sent to the county health department and administrator
of the county ASA plan.
(9) An Authority
representative may accompany an ambulance crew on a call for the purpose of evaluating
compliance with the requirements of ORS chapter 682 and these rules.
(10) The
Authority shall have the authority to make photographic or video-graphic documentation
as part of an inspection for or investigation of non-compliance with ORS chapter
682 and these rules.
(11) Failure
of the licensee to produce records for inspection or to permit examination of an
ambulance or patient care equipment by the Authority shall be grounds for the denial,
suspension or revocation of an ambulance license.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 5-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0060
Ground Ambulance
Construction Criteria
(1) The construction
criteria for a new ground ambulance shall comply with June 1, 2008 Federal Specifications
for the Star-of-Life Ambulance Certification. Copies of the specifications are available
through the Authority.
(2) The construction
criteria for a previously owned ambulance must comply with the November 1, 1994
Federal Specifications for the Star-of-Life Ambulance Certification, or standards
as defined by the Final Stage Vehicle Manufacturing Certification of compliance.
Copies of the specifications are available through the Authority.
(3) The construction
criteria for remounting a Type I or Type III ambulance is:
(a) The patient
compartment must have been built after November 1, 1994; and
(b) The remounting
must be done by a recognized ambulance manufacturer, a recognized vehicle modifier,
a remount center, or licensee with an established in-house remount program. The
agency doing the remounting must utilize current nationally recognized vehicle modification
techniques and industry standard parts and components. The agency doing remounting
shall provide a notarized statement that the structural integrity of the specific
patient compartment was not compromised during the remounting, and the remounting
has not invalidated the Star-of-Life Certification or Final Stage Vehicle Manufacturing
Certificate of compliance.
(4) A licensee
may establish an in-house remount program by obtaining the necessary training, appropriate
equipment and facilities to remount a vehicle to the described standard.
(5) The owner
of an ambulance must select an exterior color, emblems, and markings for the ambulance
that will ensure the prompt recognition of that vehicle as an ambulance. All ambulance
vehicles shall be clearly identified by appropriate emblems and markings on the
front, side, roof, and rear of the vehicle.
(a) The size,
number and locations of the "Star-of-Life" emblems are:
(A) Sides
— a 12 to 16-inch emblem must be located on the left and right side panels.
(B) Roof
— a 32-inch emblem must be located on the roof.
(b) The size,
number and locations of the word "AMBULANCE" are:
(A) Front
— centered, in block letters, not less than four inches high, must be in mirror
image and centered above the grille;
(B) Rear
— in block letters of not less than six inches in height and centered on the
rear door panels or an approved alternative; and
(C) Acceptable
alternatives for the word "AMBULANCE" includes generic terms that do not connote
any particular level of service, limited to "MEDIC UNIT", "FIRE MEDIC UNIT", "EMERGENCY
MEDICAL SERVICES", "EMS UNIT" or other phrases as the Authority, in its sole discretion,
may permit.
(c) The locations
of additional markings are:
(A) An ambulance
shall display the service or organization name or logo on the vehicle;
(B) An ambulance
may not display on its exterior any level of service which is not provided at all
times when that ambulance is in operation.
(6) An ambulance
in operation and a reserve ambulance must be reasonably equipped and maintained,
and maintenance records must be kept and made available for inspection by the Authority.
An ambulance must be equipped with the following items in satisfactory working condition:
(a) Audio/visual
devices must be in compliance with the Star-of-Life Certification or the Final Stage
Vehicle Manufacturing Certificate of compliance;
(b) An ambulance
shall comply with Federal Motor Vehicle Safety Standards (FMVSS) and Department
of Transportation (DOT) vehicle equipment standards for the ambulance at the time
of manufacture;
(c) In case
of dual batteries, batteries located in the engine compartment must have heat shields.
If the batteries are located elsewhere, they must be sealed off from the occupants'
compartment in a ventilated area.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0655;
HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994,
f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0055; OHD 5-2001, f. &
cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f. 6-30-10,
cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0070
Ground Ambulance
Operating Requirements
(1) In order to
operate a ground ambulance a licensee shall:
(a) Have
a qualified driver that meets the qualifications in OAR chapter 333, division 250;
(b) Have
EMS providers or other qualified licensed health care professionals staffing the
ambulance, as required by OAR chapter 333, division 250.
(c) Ensure
that the appropriate equipment is available and in satisfactory working condition,
stored in a sanitary and secure manner that protects the viability and safe operation
of medications and equipment, including but not limited to:
(A) Installed
medical oxygen cylinder with a capacity of at least 3,000 liters and having not
less than 500 psi:
(i) The installed
medical oxygen cylinder must be located in a vented compartment; and
(ii) The
compartment shall not be utilized for storage of any non-secured equipment. No combustible
items shall be stored in the oxygen compartment.
(B) Oxygen
pressure regulator:
(i) The oxygen
must be delivered by a single-stage regulator which is set to at least 50 psi;
(ii) The
pressure regulator controls must be accessible from inside the patient compartment;
and
(iii) The
pressure regulator or other display must be visible from inside the patient compartment.
(C) Oxygen
flow meter, mounted — 2:
(i) The flow
meter must be readable from the EMT seat and squad bench; and
(ii) The
flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.
(D) Portable
medical oxygen cylinder with a capacity of at least 300 liters and having not less
that 500 psi:
(i) The oxygen
must be delivered by a yoke regulator with a pressure gauge and non-gravity-dependent
flow meter that is visible and accessible to the medical personnel; and
(ii) The
flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.
(E) Spare
portable oxygen cylinder that is full, tagged, sealed and securely mounted;
(F) Oxygen
non-rebreathing masks with tubing:
(i) Pediatric
— 2; and
(ii) Adult
— 3.
(G) Oxygen
nasal cannula with tubing that is transparent and disposable, adult — 3;
(H) Bag-valve-mask
ventilation device with reservoir. The device must:
(i) Have
a standard universal adapter;
(ii) Be operable
with or without an oxygen supply;
(iii) Be
manually operated and self-refilling; and
(iv) Have
bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid
in assorted sizes to include adult, child, and newborn/infant.
(I) Pharyngeal
esophageal airway devices in assorted sizes with agency supervising physician approval;
(J) Oxygen
Saturation Monitor;
(K) Endtidal
CO2 detection device in assorted sizes;
(L) Oropharyngeal
airways in assorted sizes to include adult, child, and newborn/infant;
(M) Nasopharyngeal
airways in assorted sizes;
(N) Two suction
apparatus. Suction apparatus:
(i) Shall
be electrically powered or battery powered with pressure regulator.
(ii) If battery
powered, shall have enough back-up batteries to maintain suction during routine
transport.
(O) Adequate
supply of wide-bore tubing, commercial rigid pharyngeal curved suction tips and
flexible suction catheters sized from infant to adult;
(P) Collection
canisters, either disposable or sealable liners, with adequate capacity.
(Q) Cardiac
monitoring equipment including, at a minimum, a portable battery operated automatic
external defibrillator (AED) or semi-automatic defibrillator with pediatric capabilities
and sufficient pediatric accessories for proper operation on a pediatric patient.
(R) A wheeled
stretcher:
(i) Capable
of securely fastening to the ambulance body;
(ii) Having
a minimum of three restraining devices and an upper torso (over the shoulder) restraint;
(iii) Containing
a standard size waterproof foam mattress; and
(iv) Capable
of having the head of the stretcher tilted upwards to a 60-degree semi-sitting position.
(S) At least
one folding stretcher, the number required based on the stretcher-carrying capacity
of the ambulance, or an additional long backboard:
(i) Capable
of securely fastening to the squad bench when carrying a patient; and
(ii) Having
a minimum of three restraining devices and an upper torso (over the shoulder) restraint.
(T) Fracture
immobilization equipment, including but not limited to:
(i) Traction
splints in assorted adult sizes or adult child combination;
(ii) Extremity
splints in assorted sizes;
(iii) Extrication
collars in assorted pediatric through adult sizes;
(iv) Scoop
stretcher, folding or non-folding type with necessary restraining devices with sufficient
supplies for head immobilization;
(v) Short
backboard or equivalent with necessary restraining devices with sufficient supplies
for head immobilization;
(vi) Long
backboard with necessary restraining devices with sufficient supplies for head immobilization;
(vii) Pediatric
backboard with necessary restraining straps with sufficient supplies for head immobilization;
(viii) Bandages
and dressings in assorted sizes, sterile and non-sterile; and
(ix) Adhesive
or hypo-allergenic tape in assorted sizes.
(U) Miscellaneous
equipment, including but limited to:
(i) Emesis
containers;
(ii) Stethoscope,
pediatric and adult;
(iii) Aneroid
sphygmomanometer in assorted sizes;
(iv) Bandage
shears;
(v) Hypothermia
thermometer;
(vi) Disposable
obstetrical kit;
(vii) Chemical
heat and cold packs assorted;
(viii) Urinals,
female and male, one each;
(ix) Bedpan;
(x) Set of
extremity restraining devices;
(xi) Blood
glucose level testing kit or blood glucose level test strips;
(xii) Medications
and fluids authorized for Basic Life Support (BLS) use as required by the EMS medical
director; and
(xiii) Linen
supplies and replacements sufficient to cover wheeled stretchers.
(V) Personal
protection equipment sufficient for crew and patient(s), including but not limited
to:
(i) Non-latex
disposable gloves;
(ii) Disposable
face masks;
(iii) Protective
eyewear;
(iv) Disposable
isolation gowns;
(v) Commercial
antimicrobial hand cleanser;
(vi) Surface
cleaning disinfectant;
(vii) Sharps
container for the patient care compartment and a separate container for each kit
that contains needles; and
(viii) Infectious
waste disposal bags.
(W) Security
and rescue equipment, including but not limited to:
(i) Fire
extinguisher, 5lb. (2A-10BC type) — mounted and readily accessible in either
the driver's or patient compartment;
(ii) Road
flares, red colored chemical lights, the number and burning time to equal at least
180 minutes, or a minimum of six reflective triangles;
(iii) Flashlight;
(iv) Leather
gloves sufficient for crew;
(v) Reflective
vests for each crew member;
(vi) HEPA
mask for each crew member; and
(vii) Adequate
extrication equipment for agencies that provide initial response without the response
of other rescue apparatus or equipment.
(X) The 2008
Department of Transportation Emergency Response Guidebook, (Initial Response to
Hazardous Materials Incidents);
(Y) Triage
tags — 25;
(Z) Oregon
Trauma Systems Identification Bracelets — 5;
(AA) Prehospital
Care Report Forms or electronic field data form;
(BB) A copy
of BLS standing orders dated within one year and signed by the EMS medical director;
(CC) A universal
"No Smoking" sign conspicuously displayed in the driver's and patient compartment;
and
(DD) A universal
“Fasten Seatbelt” sign conspicuously displayed in the driver’s
compartment.
(2) An ambulance
shall have two-way radio communication equipment to provide reliable contact between
the ambulance and central dispatch, the receiving hospital, and online medical direction.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist. HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650;
HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986,
f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert.
ef. 10-18-91, Former 333-028-0050(3) Renumbered to 333-028-0051, former 333-028-0050(4)
& (5) Renumbered to 333-028-0052; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD
18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0050; OHD 5-2001,
f. & cert. ef. 2-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010, f.
6-30-10, cert. ef. 7-1-10; PH 16-2010(Temp), f. & cert. ef. 7-16-10 thru 1-1-11;
PH 1-2011, f. & cert. ef. 1-6-11; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0071
Ground Ambulance Operating Requirements When Providing Intermediate Level Care
(1) A ground ambulance
in operation and providing intermediate life support care must have at a minimum
the following staffing:
(a) A qualified
driver, an EMT or above, and an advanced emergency medical technician or EMT-Intermediate;
or
(b) A driver
who is licensed at least at an EMT level and an advanced emergency medical technician.
(2) Notwithstanding
section (1) of this rule a rural ambulance service as that term is defined in OAR
333-255-0000(30) is permitted to operate a ground ambulance providing intermediate
level care with a qualified driver and one AEMT or an EMT-Intermediate if the rural
ambulance service:
(a) Notifies
the county responsible in writing for the applicable ASA of the reduced staffing
and the county notifies the ambulance service in writing that it does not object
to the reduced staffing;
(b) Notifies
the licensee’s supervising physician in writing of the reduced staffing and
the supervising physician notifies the ambulance service in writing that he or she
does not object to the reduced staffing; and
(c) Provides,
to the Authority in writing by certified mail, the following:
(A) A description
of efforts made to comply with the staffing requirements in section (1) of this
rule; and
(B) A copy
of the county’s notice that it does not object.
(3) If a
rural ambulance service is operating with reduced staffing pursuant to section (2)
of this rule and the ambulance service responds to a call with reduced staffing,
a copy of the PCHR must be sent to the Authority within 14 days of responding to
the call.
(4) A rural
ambulance service operating with reduced staffing pursuant to section (2) of this
rule must make a continuous effort to attempt to comply with the staffing requirements
in section (1) of this rule and comply with the requirements of section (2) of this
rule annually.
(5) A ground
ambulance must meet all requirements specified in OAR 333-255-0070.
(6) A ground
ambulance in operation and providing intermediate level care must have the following
items in satisfactory working condition, kept in a sanitary manner, stored in a
secure manner and be readily accessible to the medical personnel:
(a) All items
specified in OAR 333-255-0070;
(b) Cardiac
Monitoring Equipment:
(A) A portable
battery powered manual monitor defibrillator capable of recording ECG reading;
(B) ECG electrodes,
adult and pediatric;
(C) Hands-free
defibrillation patches, adult and pediatric or defibrillation paddles, adult and
pediatric;
(D) Contact
gel if using paddles;
(E) Patient
cables — 2; and
(F) ECG paper.
(c) Any physiologic
isotonic crystalloid solution or combinations thereof — 6000 cc in any size
containers;
(d) Medications
and fluids authorized for use by an AEMT or EMT-Intermediate as required by the
EMS medical director. Storage of controlled substances in an ambulance must adhere
to the signed and dated procedures as specified in OAR 333-250-0047(3)(a) and (b);
(e) Vascular
access devices:
(A) Over-the-needle
catheters in assorted sizes 24-gauge through 14-gauge; and
(B) Specifically-designed
needles or device with needles for intraosseous infusions.
(f) A copy
of standing orders for AEMTs and/or EMT-Intermediates dated within one year and
signed by the EMS medical director.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11; PH 1-2013, f.
& cert. ef. 1-25-13
333-255-0072
Ground Ambulance
Operating Requirements When Providing Advanced Level Care
(1) A ground ambulance
in operation and providing advanced life support care must have at a minimum the
following staffing:
(a) A qualified
driver, an EMT or above, and a Paramedic, RN, PA or physician who is trained in
prehospital emergency medical care; or
(b) A driver
who is licensed at least at an EMT level and a Paramedic.
(2) Notwithstanding
section (1) of this rule a rural ambulance service as that term is defined in OAR
333-255-0000(30) is permitted to operate a ground ambulance providing advanced level
care with a qualified driver and one Paramedic, RN, PA, or physician if the rural
ambulance service:
(a) Notifies
the county responsible in writing for the applicable ASA of the reduced staffing
and the county notifies the ambulance service in writing that it does not object
to the reduced staffing;
(b) Notifies
the licensee’s supervising physician in writing of the reduced staffing and
the supervising physician notifies the ambulance service in writing that he or she
does not object to the reduced staffing; and
(c) Provides,
to the Authority in writing by certified mail, the following:
(A) A description
of efforts made to comply with the staffing requirements in section (1) of this
rule; and
(B) A copy
of the county’s notice that it does not object.
(3) If a
rural ambulance service is operating with reduced staffing pursuant to section (2)
of this rule and the ambulance service responds to a call with reduced staffing,
a copy of the PCHR must be sent to the Authority within 14 days of responding to
the call.
(4) A rural
ambulance service operating with reduced staffing pursuant to section (2) of this
rule must make a continuous effort to attempt to comply with the staffing requirements
in section (1) of this rule and comply with the requirements of section (2) of this
rule annually.
(5) A person
who is at the Paramedic license level, or an RN, PA or physician who is trained
in prehospital emergency medical care must be in the patient compartment when a
patient is receiving advanced life support care.
(6) When
a RN, PA or physician is staffing an ambulance in lieu of a Paramedic and providing
advanced level life support care he or she must have:
(a) A current
American Heart Association "Health Care Provider," American Red Cross "Basic Life
Support for the Professional Rescuer" or other Authority-approved equivalent cardiopulmonary
resuscitation (CPR) course completion document;
(b) A current
Advanced Cardiac Life Support course or other Authority-approved equivalent completion
document;
(c) A pediatric
advanced life support course or other Authority-approved equivalent completion document;
(d) A Prehospital
Trauma Life Support, Basic Trauma Life Support, Trauma Emergency Assessment Management
or Trauma Nurse Core Course completion document. The Trauma Emergency Assessment
Management and Trauma Nurse Core Course must include a supplemental prehospital
rapid extrication training session;
(e) The ability
to properly assist in extricating, lifting and moving a patient;
(f) Not consumed
any alcoholic beverages in the eight hours prior to working on an ambulance; and
(g) Not be
taking any medications that could impair the giving of proper patient care.
(7) A ground
ambulance must meet all requirements specified in OAR 333-255-0070.
(8) Advanced
life support patient care equipment. A ground ambulance in operation and providing
advanced level care must have the following advanced life support equipment in satisfactory
working condition, kept in a sanitary manner and which is readily accessible to
medical personnel:
(a) All items
specified in OAR 333-255-0070;
(b) Nasogastric
tubes in assorted sizes;
(c) Cardiac
monitoring equipment as specified in OAR 333-255-0071(2)(b);
(d) Advanced
airway care equipment:
(A) Laryngoscope
handle and assorted blade sizes, adult and pediatric;
(B) Spare
dated batteries for the laryngoscope handle;
(C) Spare
bulbs for the laryngoscope blades;
(D) Endotracheal
tubes in assorted sizes, adult and pediatric;
(E) Magill
Forceps — adult and child;
(F) Intubation
stylettes — adult and child;
(G) Endtidal
CO2 detection device;
(H) Oxygen
saturation monitor; and
(I) Chest
decompression equipment.
(e) Sterile
intravenous agents and medications authorized by the EMS medical director;
(f) Vascular
access devices:
(A) Over-the-needle
catheters in assorted sizes 24-gauge through 14-gauge; and
(B) Specifically-designed
needles or device designed for intraosseous infusions.
(g) Storage
of controlled substances in an ambulance must adhere to the signed and dated procedures
as specified in OAR 333-250-0047(3)(a) and (b); and
(h) A copy
of standing orders for Paramedics or ambulance based clinicians dated within one
year and signed by the EMS medical director.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11; PH 1-2013, f.
& cert. ef. 1-25-13
333-255-0073
Ground Ambulance
Operating Requirements When Providing Only Specialty Level Care
(1) A ground ambulance
in operation and providing only specialty level care during inter-facility transfers
must have a minimum staff of two qualified persons as defined by the Center for
Medicare Services or additional staff, the number and type, requested by the transferring
physician:
(a) A qualified
driver who complies with the requirements specified in OAR chapter 333, division
250; and
(b) A person
who is at the Paramedic license level, RN, PA, physician or other qualified persons
who have additional specialty care training and who must be in the patient compartment
when a patient is receiving specialty level care.
(2) A ground
ambulance must meet all requirements specified in OAR 333-255-0072.
(3) The Paramedics,
RNs, PAs, physicians or other qualified persons must have the:
(a) Training
to properly operate all patient care equipment carried on an ambulance, including
specialty care equipment necessary to care for the patient during the transfer;
(b) Training
to do titration of intravenous medications necessary to care for the patient during
transfer; and
(c) Ability
to properly assist in lifting and moving a patient.
(4) The personnel
staffing an ambulance must not:
(a) Have
consumed any alcoholic beverages in the eight hours prior to working on an ambulance;
and
(b) Be taking
any medications that could impair the giving of proper patient care.
(5) A ground
ambulance in operation and providing only specialty level care must have the following
patient care equipment in a satisfactory working condition, stored in a sanitary
and secure manner, and be readily accessible to the medical personnel:
(a) All patient
care equipment specified in OAR 333-255-0072; and
(b) Any other
patient care equipment or supplies anticipated or required for patient care.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2011, f. & cert. ef. 1-6-11; PH 1-2013, f.
& cert. ef. 1-25-13
333-255-0079
Exception
to the Two Person Staffing Requirement
(1) The Authority
may, on application from any full volunteer or part volunteer ambulance service,
authorize an exception to the two-person requirement as prescribed by ORS 682.068
and OAR 333-255-0070(1), 333-255-0071(1) or 333-255-0072(1) if provisions acceptable
to the Authority have been made to assure timely arrival of the two-person crew
as required by ORS 682.068 and OAR 333-255-0070(1), 333-255-0071(1) or 333-255-0072(1).
(2) A full
volunteer or part volunteer ambulance service making application for an exception
under this rule must submit an application to the Authority in a format prescribed
by the Authority:
(a) The application
must be approved by the EMS medical director of the ambulance service, the governing
body of each municipality for which the exception is being requested and by the
county ambulance service planning authority. The application must contain written
approval of all such bodies prior to submission to the Authority;
(b) An application
for an exception to this provision must provide for and include a description of:
(A) An alerting
system which shall make known to the intended responders the location of the emergency
and either two-way radio communication between responders such that response can
be coordinated by responding personnel, or a fixed schedule of assigned personnel,
with designation of the parties who are to respond directly to the scene of an emergency
and parties who are to operate the ambulance;
(B) Personnel
who respond directly to the scene of an emergency must be individually equipped
with equipment necessary to provide initial patient care, including uniform or personal
protective clothing, disposable gloves and a pocket ventilation mask or other appropriate
ventilatory adjuncts;
(C) Copies
of approved standard operating procedures or general orders which address the number
of personnel to respond to the scene, organizational policies regarding the operation
of motor vehicles by personnel responding to the scene and prohibiting entry into
dangerous scenes; and
(D) A method
of assuring that neither of the following shall be permitted to occur:
(i) An ambulance
driven by a person not licensed as an EMT arrives at an emergency scene but an EMT
or higher fails to arrive or arrives substantially later than the responding ambulance;
or
(ii) An ambulance
driven by an EMT or higher arrives at the scene but no other qualified driver, as
specified by these rules, arrives at the scene to operate the ambulance.
(c) Whenever
possible, an agency operating under an exception to the general rule granted pursuant
to this rule must endeavor to assure that a qualified driver who is not licensed
at least to the EMT level is trained to the EMR level and meets the requirements
for a qualified driver as specified in OAR 333-250-0031.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 1-2013,
f. & cert. ef. 1-25-13
333-255-0080
Air Ambulance
Configuration and Survival Equipment Requirements
(1) An air ambulance
in operation must be in compliance with all Federal Aviation Administration (FAA)
regulations contained in Part 135, and ORS chapter 682, and must be maintained and
maintenance records must be kept and made available for inspection by the Authority:
(a) The aircraft
must have:
(A) A climate
control system to prevent temperature extreme that would adversely affect patient
care;
(B) Interior
lighting, so that patient care can be given and patient status monitored without
interfering with the pilot's vision. The cockpit must be sufficiently isolated,
by protective barrier, to minimize in-flight distraction or interference;
(C) At least
one outlet per patient and current for 110 volts (50/60 cycle) alternating current
or other current which is capable of operating all electrically-powered medical
equipment;
(D) A back-up
source of electric current or batteries capable of operating all electrically-powered
life support equipment for one-hour;
(E) An adequate
door to allow loading and unloading of a patient without rotating the patient and
stretcher more than 30 degrees about the longitudinal (roll) axis or 45 degrees
about the lateral (pitch) axis;
(F) A configuration
that allows the medical personnel access to the patient in order to begin and maintain
treatment modalities. There must always be complete access to the patient's head
and upper body for effective airway management;
(G) The stretcher
and medical equipment placed in a manner that shall not impede rapid egress by personnel
or patient from the aircraft;
(H) Communications
equipment to ensure both internal crew and air-to-ground exchange of information
between individuals and agencies appropriate to the mission. Scene response aircraft
must be able to communicate with EMS and law enforcement personnel at the scene;
and
(I) An installed
self-activating emergency locator transmitter.
(b) The aircraft
must have survival equipment for crew members and patient consisting of:
(A) Clothes
for the season and area to be served;
(B) Thermal
(space) blanket;
(C) Plastic
tarp, at least 5' x 7';
(D) Signal
mirror;
(E) Compass;
(F) Canned
smoke signal, or flare pistol and flares or pencil-flares;
(G) Large
flashlight;
(H) Orange
signal banner;
(I) Noise
maker (whistle);
(J) Drinkable
water or intravenous fluid;
(K) Tea;
(L) Salt
and sugar;
(M) Beef
jerky or granola bars;
(N) Waterproof
matches; and
(O) Fire
extinguisher (ABC rating).
(2) The aircraft
owner who does not own their medical equipment or employ their medical personnel,
must have on file with the Authority a copy of the signed and dated agreement or
contract with the agency that does provide either the medical personnel or medical
equipment to be used on the air ambulance. The signed and dated agreement or contract
must be filed annually or whenever substantive changes are made, whichever is more
frequent.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650;
HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986,
f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert.
ef. 10-18-91, Renumbered from 333-028-0050(3); HD 18-1994, f. 6-30-94, cert. ef.
7-1-94, Renumbered from 333-028-0051; OHD 5-2001, f. & cert. ef. 4-24-01; PH
2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0081
Air Ambulance
Operating Requirements for Prearranged Inter-Facility Transfers
(1) Fixed-wing aircraft
in operation and providing pre-arranged inter-facility transfers requiring basic
level care must have a minimum staff of two persons:
(a) A pilot
adhering to all regulations set forth in FAA Part 135 for air medical transport;
and
(b) One Paramedic,
RN, PA or physician having:
(A) Documentation
that at least one member of the medical crew has successfully completed the 2004
Association of Air Medical Services (AAMS) Curriculum Guidelines or equivalent.
The curriculum must include emergency care procedures, aircraft safety and altitude
physiology. There must be written documentation of an annual review of the Air Medical
Crew course material. The length and content of the review must be established by
the EMS medical director and be kept on file with the ambulance service;
(B) A current
American Heart Association "Health Care Provider", American Red Cross "Basic Life
Support for the Professional Rescuer" or other Authority-approved equivalent CPR
course completion document;
(C) The ability
to properly assist in lifting and moving a patient; and
(D) The knowledge
to properly operate all patient care equipment that may be used.
(2) Fixed
or rotary-wing aircraft in operation and providing pre-arranged inter-facility transfers
requiring advanced life support care must have a minimum staff of two persons:
(a) A pilot
adhering to all regulations set forth in FAA Part 135 for air medical transport;
and
(b) One Paramedic,
RN, PA or physician meeting the requirements specified in paragraph (1)(b)(A) through
(1)(b)(D) of this rule.
(3) Fixed
or rotary-wing aircraft in operation and providing pre-arranged inter-facility transfers
requiring specialty level care must have a minimum staff of two persons:
(a) A pilot
adhering to all regulations set forth in FAA Part 135; and
(b) One Paramedic,
RN, PA, physician or other qualified person(s), who must:
(A) Meet
the requirements specified in paragraph (1)(b)(A) through (1)(b)(D) of this rule;
(B) Have
documentation of completing additional specialty care training as defined by the
EMS medical director;
(C) Have
training to properly operate specialty care equipment necessary to care for the
patient during the transfer; and
(D) Have
training to do titration of intravenous medications necessary to care for the patient
during the transfer.
(4) An air
ambulance in operation and providing specialty level care must have the following
patient care equipment in a satisfactory working condition, stored in a sanitary
and secure manner, and be readily accessible to the medical personnel:
(a) All patient
care equipment specified in subsection (7)(a) through (7)(k) of this rule;
(b) All patient
care equipment specified in OAR 333-255-0082(2)(d) through (2)(i); and
(c) Any other
patient care equipment required during the transfer.
(5) When
an inter-facility transfer is requested, a representative from the ambulance service
must contact the attending physician at the sending facility, prior to the transfer,
to determine which type of aircraft; fixed-wing, rotary-wing, pressurized or non-pressurized,
is needed based on the patient's medical condition and which additional equipment
and personnel are required.
(6) Patient
Care Equipment. The following patient care equipment, in satisfactory working condition
and kept in a sanitary manner, is required on all air ambulance flights. The equipment
may be kept separate from the aircraft in modular pre-packaged form, so as to be
available for rapid loading, easy securing and easy access aboard the aircraft:
(a) Medical
oxygen cylinders and regulators:
(A) Medical
oxygen cylinder with a capability of at least 600 liters and having not less than
500psi:
(i) The oxygen
cylinder(s) must be securely fastened to the aircraft while in flight;
(ii) The
oxygen must be delivered by a yoke regulator with a pressure gauge and a non-gravity-dependent
flow meter that is visible and accessible to the medical personnel; and
(iii) The
flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.
(B) A spare
portable oxygen cylinder that is full, tagged, sealed, and securely mounted.
(b) Medical
oxygen administration equipment:
(A) Oxygen
non-rebreathing masks with tubing:
(i) Pediatric
— 2; and
(ii) Adult
— 2.
(B) Oxygen
nasal cannula with tubing that is transparent and disposable, adult —2;
(C) Bag-valve-mask
ventilation device with reservoir. The device must:
(i) Have
a standard universal adapter (15 mm tracheal tube/22 mm mask);
(ii) Be operable
with or without an oxygen supply;
(iii) Be
manually operated and self-refilling;
(iv) Have
valves that operate effectively at temperatures down to 0° F;
(v) Have
bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid
in assorted sizes to include adult, child, and newborn/infant.
(c) Airway
maintenance devices:
(A) Pharyngeal
esophageal airway devices in assorted sizes;
(B) Endtidal
CO2 detection device in assorted sizes;
(C) Oropharyngeal
airways in assorted sizes to include adult, child, and newborn/infant; and
(D) Nasal
airways in assorted sizes.
(d) Suction
equipment:
(A) Portable
suction aspirator:
(i) The unit
must be either a self-contained battery or oxygen-powered unit that can operate
continuously for 20 minutes and is rechargeable or be a manually-powered unit;
(ii) The
unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds
after the suction tube is closed;
(iii) The
unit must provide a free air flow of at least 20 liters per minute;
(iv) The
unit must be adjustable for use on children and intubated patients;
(v) The unit
must include at least a 300 ml collection bottle; and
(vi) A secondary
suction apparatus.
(B) Suction
connecting tubing and catheters:
(i) Suction
connecting tubing that is at least one-quarter of an inch in diameter, translucent
and will not kink or collapse under high suction — 2; and
(ii) Suction
catheters in assorted sizes and types for adult, child, and newborn/infant.
(e) Stretcher.
The stretcher must:
(A) Be securely
fastened to the aircraft in accordance with FAA Part 135; and
(B) Have
a minimum of three restraining devices and an upper torso (over the shoulder) restraint.
(f) Miscellaneous
equipment:
(A) Emesis
containers;
(B) Stethoscope,
adult and pediatric;
(C) Aneroid
sphygmomanometer in assorted sizes:
(D) Bandage
shears;
(E) Hypothermia
thermometer;
(F) Chemical
heat and cold packs, assorted;
(G) Blood
glucose level testing kit or blood glucose level test strips;
(H) Urinals,
female and male, one each;
(I) Bed pan
(Exempt from rotary-wing aircraft); and
(J) Set of
extremity restraining devices.
(g) Personal
protection equipment sufficient for crew and patient(s) including:
(A) Disposable
gloves;
(B) Disposable
face masks;
(C) Protective
eyewear;
(D) Disposable
isolation gowns;
(E) Hand
cleaning solution or foam;
(F) Surface
cleaning disinfectant;
(G) Sharps
container for each kit that contains needles; and
(H) Infectious
waste disposal bags.
(h) Linen
supplies and replacements to cover stretcher;
(i) Prehospital
Care Report Form or electronic field data form;
(j) A copy
of standing orders for EMS providers, RNs and PAs dated within one year and signed
by the EMS medical director; and
(k) A universal
"No Smoking" sign must be conspicuously displayed in the cockpit and patient compartment.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0082
Air Ambulance
Operating Requirements for Scene Response
(1) Rotary-wing
aircraft in operation and providing scene response care must have a minimum staff
of two persons:
(a) A pilot
adhering to all regulations set forth in FAA Part 135; and
(b) One Paramedic,
RN, PA, or physician having:
(A) Documentation
that at least one member of the medical crew successfully completed the 2004 Association
of Air Medical Services (AAMS) Curriculum Guidelines or equivalent. The curriculum
must include emergency care procedures, aircraft safety and altitude physiology.
There must be written documentation of an annual review of the Air Medical Crew
course material. The length and content of the review must be established by the
EMS medical director and be kept on file with the ambulance service;
(B) The ability
to properly assist in extricating, lifting and moving a patient; and
(C) The knowledge
to properly operate all patient care equipment that may be used.
(2) The following
prehospital scene patient care equipment is required on all prehospital scene responses:
(a) All patient
care equipment specified in OAR 333-255-0081(7)(a) through (7)(k);
(b) Fracture
immobilization equipment:
(A) Traction
splints in assorted adult or adult-child combination;
(B) Extremity
splints in assorted sizes;
(C) Extrication
collars in assorted pediatric through adult sizes;
(D) Short
backboard or equivalent with necessary restraining devices with sufficient supplies
for head immobilization;
(E) Long
backboard with necessary restraining devices with sufficient supplies for head immobilization;
(F) Scoop
stretcher with necessary restraining devices with sufficient supplies for head immobilization;
and
(G) Pediatric
backboard with necessary restraining devices with sufficient supplies for head immobilization.
(c) Bandages
and dressings in assorted sizes, sterile and non-sterile;
(d) Adhesive
or hypo-allergenic tape in assorted sizes;
(e) Cardiac
monitoring equipment:
(A) Manual
monitor/defibrillator;
(B) Monitoring
electrodes, infant and adult;
(C) Patient
cables — 2; and
(D) ECG paper.
(f) Advanced
airway care equipment:
(A) Laryngoscope
handle and assorted blade sizes, adult and pediatric;
(B) Spare
dated batteries for the laryngoscope handle;
(C) Spare
bulbs for the laryngoscope blades;
(D) Endotracheal
tubes in assorted sizes, adult and pediatric;
(E) Magill
Forceps, child and adult;
(F) Intubation
stylettes, child and adult;
(G) Endtidal
CO2 detection device;
(H) Oxygen
saturation monitor; and
(I) Chest
decompression kit.
(g) Sterile
intravenous agents and medications authorized by the EMS medical director;
(h) Vascular
access devices:
(A) Over-the-needle
catheters in assorted sizes 24-gauge through 14-gauge; and
(B) Specifically-designed
needles for intraosseous infusions.
(i) Nasogastric
tubes in assorted sizes;
(j) Storage
of controlled substances in an ambulance must adhere to the signed and dated procedures
as specified in OAR 333-250-0047(3)(a) and (3)(b);
(k) Oregon
Trauma System's Identification Bracelets — 5;
(l) Miscellaneous
equipment:
(i) The 2008
Department of Transportation Emergency Response Guidebook (Initial Response to Hazardous
Materials Incidents); and
(ii) A copy
of standing orders for Paramedics, RNs and PAs dated within one year and signed
by the EMS medical director.
(3) In a
prehospital resuscitation, when no other practical means of transportation, including
any other properly equipped license-holder, is reasonably available, a license-holder
may deviate from the rules to the extent necessary to meet the rescue situation.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0090
Marine Ambulance
Configuration and Survival/Rescue Equipment Requirements
(1) A marine ambulance
in operation must be in compliance with all the requirements which relate to marine
ambulances, any applicable federal navigation regulations, ORS chapter 682, and
these rules. Maintenance records must be kept and made available for inspection
by the Authority:
(2) Marine
craft size and configuration. The marine craft must be of sufficient size to accommodate,
at a minimum, the operator, two EMS providers, one patient, and the required supplies
and equipment and be configured to allow full access to the patient. The marine
craft must have:
(a) Adequate
lighting, so that patient care can be given and patient status be monitored;
(b) At least
one outlet per patient and current for 110 volts (50/60 cycle) alternating current
or other current which is capable of operating all electrically-powered medical
equipment;
(c) An adequate
door or opening to allow loading and unloading of the patient without rotating the
patient and stretcher more than 30 degrees about the longitudinal (roll) axis or
45 degrees about the lateral (pitch) axis;
(d) A configuration
that allows the medical personnel access to the patient in order to begin and maintain
treatment modalities. There must always be complete access to the patient's head
and upper body for effective airway management; and
(e) The stretcher
or litter and medical equipment placed in a manner that must not impede rapid egress
by personnel or patient from the marine craft.
(3) Marine
craft equipment. A marine craft ambulance must have the following items in good
working condition:
(a) Anchor
with line that is three times the maximum depth of water in areas of usual operation;
(b) Docking
fenders — 2;
(c) Mooring
lines — 2;
(d) Self
or mechanical bailer;
(e) Search
light with a minimum of 200,000 candle power of illumination;
(f) Swim
harness and 75-foot tethering line;
(g) Waterproof
flashlight, six volt minimum;
(h) Navigational
charts for service area and navigational aids, including a compass;
(i) A cold
water protection device for each crew member;
(j) Life
jackets — 2 adult and 2 child; and
(k) Boat
hook with minimum of 10 foot capability.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: HD
63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650;
HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986,
f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert.
ef. 10-18-91, Renumbered from 333-028-0050(4) & (5); HD 18-1994, f. 6-30-94,
cert. ef. 7-1-94, Renumbered from 333-028-0052; OHD 5-2001, f. & cert. ef. 4-24-01;
PH 2-2007, f. & cert. ef. 2-1-07; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0091
Marine Ambulance
Operating Requirements When Providing Basic Level Care
(1) A marine ambulance
in operation and providing basic level care must have a staff of at least two persons:
(a) An operator,
who:
(A) Has a
valid US Coast Guard pilot's license;
(B) Operates
the marine ambulance in compliance with any applicable marine craft statutes;
(C) Has not
consumed any alcoholic beverages in the eight hours prior to operating an ambulance;
and
(D) Is not
taking any medications that could impair the safe operation of the ambulance.
(b) A person
who is at or above the EMT license level who must be with the patient at all times.
The person at or above the EMT level attending the patient must:
(A) Not have
consumed any alcoholic beverages in the eight hours prior to working on an ambulance;
and
(B) Not be
taking any medications that could impair the giving of proper patient care.
(c) If the
operator is not a licensed EMS provider, the operator must meet the requirements
specified in paragraphs (1)(a)(A) through (1)(a)(D) of this rule and meet the requirements
of a qualified driver specified in OAR 333-250-0031.
(2) Basic
life support care equipment. A marine ambulance in operation and providing basic
level care must have the following patient care equipment in a satisfactory working
condition, kept in a sanitary manner, stored in a secure manner and be readily accessible
to the medical personnel:
(a) Medical
oxygen cylinders and regulators:
(A) Medical
oxygen cylinder with a minimum capacity of 600 liters;
(i) The oxygen
must be delivered by a yoke regulator with a pressure gauge and a non-gravity-dependent
flow meter that is visible and accessible to the medical personnel; and
(ii) The
flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.
(B) A spare
portable oxygen cylinder that is full, tagged, sealed and securely mounted.
(b) Medical
oxygen administration equipment:
(A) Oxygen
non-rebreathing masks with tubing:
(i) Pediatric
— 2; and
(ii) Adult
— 2.
(B) Oxygen
nasal cannulas with tubing that are transparent and disposable, adult — 2;
(C) Bag-valve-mask
ventilation device with reservoir. The device must:
(i) Have
a standard universal adapter (15 mm tracheal tube/22 mm mask);
(ii) Be operable
with or without an oxygen supply;
(iii) Be
manually operated and self-refilling;
(iv) Have
valves that operate effectively at temperatures down to 0° F; and
(v) Have
bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid
in assorted sizes to include adult, child, and newborn/infant.
(c) Airway
maintenance devices:
(A) Pharyngeal
esophageal airway devices in assorted sizes if the EMS medical director approved
use;
(B) Endtidal
CO2 detection device in assorted sizes;
(C) Oropharyngeal
airways in assorted sizes to include adult, child and newborn/infant; and
(D) Nasal
airways in assorted sizes.
(d) Suction
equipment:
(A) Portable
suction aspirator:
(i) The unit
must be either a self-contained battery or oxygen-powered unit that can operate
continuously for 20 minutes and is rechargeable or be a manually-powered unit;
(ii) The
unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds
after the suction tube is closed;
(iii) The
unit must provide a free air flow of at least 20 liters per minute;
(iv) The
unit must be adjustable for use on children and intubated patients;
(v) The unit,
including at least a 300 ml collection bottle; and
(vi) A secondary
suction apparatus.
(B) Suction
connecting tubing and catheters:
(i) Suction
connecting tubing that is at least one-quarter of an inch in diameter, translucent
and will not kink or collapse under high suction — 2; and
(ii) Suction
catheters that are in assorted sizes and types for adult, child and newborn/infant.
(e) Cardiac
monitoring equipment: Automatic or semi-automatic defibrillator. The unit must be
capable of operating independently of an electrical outlet, and delivering total
defibrillation energy sufficient to meet the number of shocks and power settings
prescribed in the EMS medical director's standing orders and be inclusive of the
2005 American Heart Association guidelines for emergency cardiac care or equivalent
standards as approved by the Authority.
(f) Stretcher.
The stretcher must:
(A) Be a
plastic or metal basket stretcher with a four-point bridle;
(B) Have
a locking mechanism which can be securely fastened to the craft below the gunwale
level; and
(C) Have
a minimum of four restraining devices, one of which shall be a torso (over the shoulder)
restraint.
(g) Fracture
immobilization equipment:
(A) Traction
splints in assorted adult sizes or adult/child combination;
(B) Extremity
splints in assorted sizes;
(C) Extrication
collars in assorted pediatric through adult sizes;
(D) Short
backboard or equivalent with necessary restraining devices with sufficient supplies
for head immobilization;
(E) Long
backboard with necessary restraining devices with sufficient supplies for head immobilization;
and
(F) Pediatric
backboard with necessary restraining devices with sufficient supplies for head immobilization.
(h) Bandages
and dressings in assorted sizes, sterile and non-sterile;
(i) Adhesive
or hypo-allergenic tape in assorted sizes;
(j) Miscellaneous
equipment:
(A) Emesis
containers;
(B) Stethoscope,
pediatric and adult;
(C) Aneroid
sphygmomanometer in assorted sizes:
(D) Bandage
shears;
(E) Hypothermia
thermometer;
(F) Disposable
obstetrical kit;
(G) Chemical
heat and cold packs assorted;
(H) Urinals,
female and male, one each;
(I) Bed pan;
(J) Set of
extremity restraining devices; and
(K) Blood
glucose level testing kit or blood glucose level testing strips.
(k) Personal
protection equipment sufficient for crew and patient(s) including:
(A) Disposable
gloves;
(B) Disposable
face masks;
(C) Protective
eyewear;
(D) Disposable
isolation gowns;
(E) Hand
cleaning solution or foam;
(F) Surface
cleaning disinfectant;
(G) Sharps
container for the patient compartment and a separate container for each kit that
contains needles;
(H) Infectious
waste disposal bags; and
(I) The 2008
Department of Transportation — Emergency Response Guidebook (Initial Response
to Hazardous Materials Incidents.)
(l) Medications
and fluids authorized for use by an EMT as required by the EMS medical director;
(m) Linen
supplies and replacements sufficient to cover stretchers;
(n) Communication
equipment. Communications equipment must consist of a VHF/FM marine radio with at
least 25 watts of power. In addition, the radio must have the capability to have
reliable contact between the marine ambulance and a ground or air ambulance and
with a hospital having online medical direction;
(o) Prehospital
Care Report Form or electronic field data;
(p) Oregon
Trauma System Identification Bracelets — 5;
(q) A copy
of standing orders for EMTs dated within one year and signed by the EMS medical
director; and
(r) A universal
"No Smoking" sign conspicuously displayed in the pilot's and patient area.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117 & 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0092
Marine Ambulance
Operating Requirements When Providing Intermediate Level Care
(1) A marine ambulance
in operation and providing intermediate life support care must have a minimum staff
of two persons:
(a) An operator
who complies with the requirements specified in OAR 333-255-0091(1)(a)(A) through
(1)(a)(D) or (1)(c)(A) through (1)(c)(D); and
(b) A person
who is at or above the AEMT license level and who must be with the patient at all
times. If the qualified driver is not a licensed EMT, then a second EMT must be
available for patient care both in the marine ambulance or on scene.
(2) Intermediate
life support care equipment. A marine ambulance in operation and providing intermediate
level care must have the following patient care equipment in a satisfactory working
condition, kept in a sanitary manner, stored in a secure manner and be readily accessible
to the medical personnel:
(a) All of
the items specified in OAR 333-255-0091(2)(a) through (2)(r);
(b) Any physiologic
isotonic crystalloid solution or combinations thereof — 6000 cc in any size
containers;
(c) Medications
and fluids authorized for use by an AEMT or EMT-Intermediate as required by the
EMS medical director;
(d) Vascular
access devices:
(A) Over-the-needle
catheters in assorted sizes 24 gauge through 14 gauge; and
(B) Specifically-designed
needles for intraosseous infusions.
(e) A copy
of standing orders for AEMTs and/or EMT-Intermediates dated within one year and
signed by the EMS medical director.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 12-2010,
f. 6-30-10, cert. ef. 7-1-10; PH 1-2013, f. & cert. ef. 1-25-13
333-255-0093
Marine Ambulance
Operating Requirements When Providing Advanced Level Care
(1) A marine ambulance
in operation and providing advanced level care must have a minimum staff of two
persons:
(a) An operator
who complies with the requirements specified in OAR 333-255-0091(1)(a)(A) through
(1)(a)(D) or (1)(c)(A) through (1)(c)(D); and
(b) A person
who is at the Paramedic license level or an RN, PA or physician who is trained in
prehospital emergency medical care must be attending to the patient when a patient
is receiving advanced life support care. If the operator is not a licensed EMT,
then a second EMT must be available for patient care both on the marine ambulance
and on scene. The Paramedic, RN, PA, physician, or other qualified personnel must:
(A) Not have
consumed any alcoholic beverages in the eight hours prior to working on an ambulance;
and
(B) Not be
taking any medications that could impair the giving of proper patient care.
(c) When
a RN, PA or physician is staffing an ambulance in lieu of a Paramedic and is providing
advanced level care he or she must have:
(A) A current
American Heart Association "Health Care Provider", American Red Cross "Basic Life
Support for the Professional Rescuer" or other Authority-approved equivalent CPR
course completion document;
(B) A current
Advanced Cardiac Life Support course or other Authority-approved equivalent completion
document;
(C) A pediatric
advanced life support course or other Authority-approved equivalent completion document;
(D) A Prehospital
Trauma Life Support, Basic Trauma Life Support, Trauma Emergency Assessment Management
or Trauma Nurse Core Course completion document. The Trauma Emergency Assessment
Management and Trauma Nurse Core Course must include a supplemental prehospital
rapid extrication training session;
(E) The ability
to properly assist in extricating, lifting and moving a patient; and
(F) The knowledge
to properly operate all patient care equipment that may be used.
(2) A marine
ambulance in operation and providing advanced level care must have the following
advanced life support patient care equipment in a satisfactory working condition,
kept in a sanitary manner and which is readily accessible to medical personnel:
(a) All items
specified in OAR 333-255-0091(2)(a) through (2)(r);
(b) Cardiac
monitoring equipment:
(A) Manual
monitor/defibrillator;
(B) Monitoring
electrodes, infant and adult;
(C) Patient
cables — 2; and
(D) ECG paper.
(c) Advanced
airway care equipment:
(A) Laryngoscope
handle and assorted blade sizes, adult and pediatric;
(B) Spare
dated batteries for the laryngoscope handle;
(C) Spare
bulbs for the laryngoscope blades;
(D) Endotracheal
tubes in assorted sizes, adult and pediatric;
(E) Magill
Forceps, adult and child;
(F) Intubation
stylettes, adult and pediatric;
(G) Endtidal
CO2 detection device; and
(H) Chest
decompression equipment.
(d) Sterile
intravenous agents and medications authorized by the EMS medical director;
(e) Vascular
access devices:
(A) Over-the-needle
catheters in assorted sizes 14-gauge through 24-gauges; and
(B) Specifically-designed
needles for intraosseous infusions.
(f) Nasogastric
tubes in assorted sizes;
(g) The storage
of controlled substances in a marine ambulance must adhere to the procedure specified
in OAR 333-250-0047(2)(a) and (b); and
(h) A copy
of standing order for Paramedics, RNs and PAs dated within one-year and signed by
the EMS medical director.
(3) The special
equipment required for a marine ambulance may be kept separate from the craft in
modular watertight and buoyant containers for rapid loading and easy access aboard
the marine craft.
Stat. Auth.: ORS
682.017

Stats. Implemented:
ORS 682.017 - 682.117, 682.991

Hist.: OHD
5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07; PH 1-2013,
f. & cert. ef. 1-25-13

The official copy of an Oregon Administrative Rule is
contained in the Administrative Order filed at the Archives Division,
800 Summer St. NE, Salem, Oregon 97310. Any discrepancies with the
published version are satisfied in favor of the Administrative Order.
The Oregon Administrative Rules and the Oregon Bulletin are
copyrighted by the Oregon Secretary of State. Terms
and Conditions of Use