Central New York Regional Emergency Medical Services Program. Policy Statement. Serving: Cayuga, Cortland, Onondaga, Oswego and Tompkins Counties

Transcription

1 No Central New York Regional Emergency Medical Services Program Policy Statement Serving: Cayuga, Cortland, Onondaga, Oswego and Tompkins Counties Date: 11/10/16 Re: Minimum Required Equipment for Advanced Life Support Services Page 1 of 9 Supersedes/Updates: 00-01, 08-03, 09-03, 11-01, 13-01, 14-10, Policy: Minimum required equipment for certified ambulance and advanced life support first response services. Advanced life support services are defined as those that provide prehospital Advanced Emergency Medical Technician, Critical Care, and/or Paramedic care per Title 10 of the New York Codes, Rules and Regulations Part and must meet the requirements of Title 10 of the New York Codes, Rules and Regulations Please refer to New York State Department of Health Bureau of EMS Policy Statement (or updated version) for additional information on defibrillators and epinephrine requirements. Title 10 of the New York Codes, Rules and Regulations Part requires the following: 1. Advanced Emergency Medical Technician services must have the capacity for voice communication to receive medical direction. 2. Critical Care and Paramedic services must have the capacity for voice communication to receive medical direction. VHF Radio Capability: It is recommended that all agencies have VHF Radio capability with 6-8 channels with the following channels installed: Channel Ambulance to Hospital (Primary) Channel 2 - EMS Units' own frequency for dispatch Channel Ambulance to Hospital (Secondary) Channel Ambulance to Public Safety Agencies Channel For additional current frequency and future expansion Approval of Length-Based Resuscitation Tapes: The CNY Region will approve the use of length-based resuscitation tapes for the estimation of ideal body weight in pediatric patients. While the estimation of actual weight may vary based on the child s body habitus, the provider should use the weight that is indicated on the tape because many of the medication dosages in the protocols should be calculated using ideal body weight. 1

2 CNY Minimum Required Equipment Ambulance Equipment/ Supplies Portable Bag Ambulance AEMT EMT-CC EMT-P Cardiac Monitor/Defibrillator 0 1 X X AED 0 1 X 12-Lead Transmission (1) 0 1 X X Continuous Waveform Capnography 0 1 X X X Glucometer (2) 1 0 X X X Length-Based Resuscitation Tape 1 1 X X Protocol Book (3) 0 1 X X X Pulse Oximeter (Requirement is met if device is supplied with cardiac monitor.) 0 1 X X X Endotracheal Tubes X X X X X X X X X X X X X X X X X X X X X X X X X X X Water Soluble Jelly Tube or 1 1 X X X Packets 4 4 X X X 10 cc Syringe for endotracheal tube 2 1 X X X Alternative Airway Device Adult Set 1 1 X X X Pediatric Set 1 1 X Adult Stylet (can be packaged with ETT) 1 1 X X X Pediatric Stylet (can be packaged with ETT) 1 1 X X Laryngoscope Handle 1 1 X X X Laryngoscope Blades Curved X X X Curved X X X Curved X X X Straight X Straight X Straight X X X Straight X X X Straight X X X Adult Magill Forceps 1 0 X X X Pediatric Magill Forceps 1 0 X X 2

3 CNY Minimum Required Equipment Ambulance Equipment/ Supplies Portable Bag Ambulance AEMT EMT-CC EMT-P End Tidal CO 2 Detector Adult 1 0 X X X End Tidal CO 2 Detector Pediatric 1 0 X X X Esophageal Detector Device 1 0 X X X Nebulizers 1 2 X X X Atomizer 1 1 X X X Gum Elastic Boogie 1 1 X X X Pelvic Stabilizer Device (1) 0 1 X X X Arterial Tourniquet 1 1 X X X Surgical Airway Device (4) 1 1 X CPAP 0 1 Adult Set X X X (adult set specified by the manufacturer) Suction Catheters 8 French 1 1 X X X 10 French 1 1 X X X 12 French 1 1 X X X Yankauer 1 1 X X X 14 gauge x 3 IV Catheter 2 2 X X Orogastric Tubes 14 French 1 1 X 16 French 1 1 X 1000 ml Normal Saline 1 3 X X X 100 ml Normal Saline 1 1 X X Macrodrip IV Admin. Set 1 3 X X X Microdrip IV Admin. Set 1 1 X X Large Bore Saline Lock Kit 3 2 X X X Protective IV Catheter 14G X 1¼ 2 3 X X X Protective IV Catheter 16G 2 3 X X X Protective IV Catheter 18G 2 3 X X X Protective IV Catheter 20G 2 3 X X X Protective IV Catheter 22G 2 2 X X Protective IV Catheter 24G 2 2 X X Intraosseous Needle Adult 1 1 X X X (powered device) Intraosseous Needle Peds 1 1 X X X 1cc Syringe with 25G Needle 2 2 X X 3cc Syringe 2 2 X X 5cc Syringe 2 2 X X 10cc Syringe 2 2 X X 18G Hypodermic Needle 2 2 X X (If packaged with a syringe, this will count toward the 22G Hypodermic Needle 2 2 X X (If packaged with a syringe, this will count toward the Disposable Razors 2 1 X X X 3

4 CNY Minimum Required Equipment Ambulance Equipment/ Supplies Portable Bag Ambulance AEMT EMT-CC EMT-P Disposable IV Tourniquets (If packaged 2 2 X X X with a saline lock kit, this will count toward the Alcohol Prep Pads (If packaged with a 6 12 X X X saline lock kit, this will count toward the Transparent Dressings (If packaged with 2 2 X X X a saline lock kit, this will count toward the 2 x 2 Gauze Pads (If packaged with a 6 12 X X X saline lock kit, this will count toward the Iodine Pads or Chlorhexidine Wipes 2 2 X Band-aids 6 12 X X X 9 Padded IV Armboard 1 1 X X X Spare Patient Monitor Cables 0 1 X X EKG Electrode Set Adult 2 4 X X EKG Electrode Set Pediatric (5) 2 2 X X AED Pad Adult 1 1 X AED Pad - Pediatric 1 1 X Pacing/Defibrillation Pad Adult 1 1 X X Pacing/Defibrillation Pad Pediatric 1 1 X X Medications: Adenosine 6 mg/2 ml 3 3 X X Albuterol 2.5 mg/3 ml 4 4 X X X Amiodarone 150 mg/3 ml Ampule 3 3 X X Aspirin 81 mg Chewable Tablets 1 Bottle 0 X X X Atropine Sulfate 1 mg/10 ml Syringe 2 2 X X Calcium Chloride 100 mg/ 1 ml 1 1 X Dexamethasone 10 mg / 1 ml 1 1 X X Dextrose 10% 25 grams/unit in 250 ml 2 1 X X X Diltiazem 5 mg/1 ml 2 2 X X Diphenhydramine 50 mg/1 ml 1 1 X X Epi-Pen Autoinjector Adult 1 0 X Epi-Pen Autoinjector Pediatric 1 0 X Epinephrine 1:10,000 1 mg/10 ml 6 6 X X X Epinephrine 1:1,000 1 mg/1 ml Ampule 3 3 X X Etomidate 20 mg/10 ml Vial 2 1 X X Fentanyl 100 mcg/2 ml Ampule (6) 0 2 X X Glucagon 1 mg/1 ml Vial 1 0 X X X Glucose - Oral 31gm 1 0 X X X Haloperidol 5 mg/1 ml Ampule 2 0 X X Ipratropium Bromide 500 ug/2.5 ml or 3 3 X X Ipratropium Bromide & Albuterol Ketamine 100 mg/1 ml (6) 2 0 X Ketorolac 30 mg/1 ml Vial 2 0 X X 4

5 CNY Minimum Required Equipment Ambulance Equipment/ Supplies Portable Bag Ambulance AEMT EMT-CC EMT-P Lidocaine 100 mg/5 ml 3 0 X X Magnesium Sulfate 1 0 X X (Total 8gm per vehicle) Metoprolol 5 mg/5 ml Ampule 1 1 X X Midazolam 5 mg/5 ml (6) 0 4 X X Morphine Sulfate 10 mg/1 ml (6) 0 2 X X Naloxone 2 mg/2 ml 1 1 X X X Nitroglycerin 0.4mg Tablet and/or 1 Bottle 1 Bottle X X Nitroglycerin Spray (1) 1 1 X X 1 or Nitrous Oxide 50/50 (1) 0 1 X X X Norepinephrine 4 mg/4 ml 1 1 X X Ondansetron 4 mg/2 ml Vial 1 2 X X Ondansetron 4 mg Tablets or Bottle 0 X X 4 mg Orally Disintegrating Tabs (ODT) (1) Unit Dose Packs Rocuronium 50 mg/5 ml Vial (1) (7) 2 0 X Sodium Bicarbonate 44.6 meq Syringe 1 1 X Succinylcholine 100 mg/5 ml Syringe (1) (7) 2 0 X Vecuronium 10 mg/10 ml Vial (1) (7) 2 0 X (1) Optional Regional Equipment or Medication. (2) A current New York State Department of Health Limited Service Laboratory Registration is required for glucometers. Registration Form (3) The agency will create a paper version of the protocol PDF provided by the CNY Region to carry in the ambulance. (4) Providers must be trained on this procedure prior to agency implementation. (5) Adult electrodes can be used to fulfill the minimum pediatric electrode requirements provided the electrodes are 40 mm (skin contact size) or smaller. (6) Controlled Substance License is required to carry these medications. Fentanyl and Ketamine are optional controlled substance medications. (7) Agency and providers must be approved by the CNY Region to perform RSI. Note: Agencies must have a DOH-4362 Medical Director Verification form on file with the CNY Program Agency. The quantity of items indicated in the ambulance is in addition to what is to be carried in the portable bag. The agency may opt to carry the entire quantity (portable bag + ambulance) in the portable bag. 5

6 CNY Minimum Required Equipment First Response Vehicles Equipment/ Supplies Portable Bag AEMT EMT-CC EMT-P Cardiac Monitor/Defibrillator 1 X X AED 1 X 12-Lead Transmission (1) 1 X X Continuous Waveform Capnography 1 X X X Glucometer (2) 1 X X X Length-Based Resuscitation Tape 1 X X Protocol Book (3) 1 X X X Pulse Oximetry Monitor (Requirement is met if device is supplied with cardiac monitor.) 1 X X X Endotracheal Tubes X X X X X X X X X X X X X X X X X X X X X X X X X X X Water Soluble Jelly Tube or 1 X X X Packets 4 X X X 10 cc Syringe for endotracheal tube 2 X X X Alternative Airway Device Adult Set 1 X X X Pediatric Set 1 X Adult Stylet (can be packaged with ETT) 2 X X X Pediatric Stylet (can be packaged with ETT) 2 X X Laryngoscope Handle 1 X X X Laryngoscope Blades Curved 2 1 X X X Curved 3 1 X X X Curved 4 1 X X X Straight 0 1 X Straight 1 1 X Straight 2 1 X X X Straight 3 1 X X X Straight 4 1 X X X Adult Magill Forceps 1 X X X Pediatric Magill Forceps 1 X X 6

7 CNY Minimum Required Equipment First Response Vehicles Equipment/ Supplies Portable Bag AEMT EMT-CC EMT-P End Tidal CO 2 Detector Adult 1 X X X End Tidal CO 2 Detector Pediatric 1 X X X Esophageal Detector Device 1 X X X Nebulizers 3 X X X Atomizer 2 X X X Gum Elastic Boogie 1 X X X Pelvic Stabilizer Device (1) 1 X X X Arterial Tourniquet 2 X X X Surgical Airway Device (4) 1 X CPAP 1 X X X (adult set specified by the manufacturer) Suction Catheters 8 French 2 X X X 10 French 2 X X X 12 French 2 X X X Yankauer 2 X X X 14 gauge x 3 IV Catheter 2 X X Orogastric Tubes 14 French 1 X 16 French 1 X 1000 ml Normal Saline 2 X X X 100 ml Normal Saline 2 X X Macrodrip IV Admin. Set 2 X X X Microdrip IV Admin. Set 2 X X Large Bore Saline Lock Kit 4 X X X Protective IV Catheter 14G X 1¼ 2 X X X Protective IV Catheter 16G 2 X X X Protective IV Catheter 18G 2 X X X Protective IV Catheter 20G 2 X X X Protective IV Catheter 22G 2 X X Protective IV Catheter 24G 2 X X Intraosseous Needle Adult (powered device) 1 X X X Intraosseous Needle Peds 1 X X X 1cc Syringe with 25G Needle 2 X X 3cc Syringe 2 X X 5cc Syringe 2 X X 10cc Syringe 2 X X 18G Hypodermic Needle 2 X X (If packaged with a syringe, this will count toward the 22G Hypodermic Needle 2 X X (If packaged with a syringe, this will count toward the Disposable Razors 1 X X X 7

8 CNY Minimum Required Equipment First Response Vehicles Equipment/ Supplies Portable Bag AEMT EMT-CC EMT-P Disposable IV Tourniquets (If packaged with a 2 X X X saline lock kit, this will count toward the Alcohol Prep Pads (If packaged with a saline 12 X X X lock kit, this will count toward the minimum quantity.) Transparent Dressings (If packaged with a 2 X X X saline lock kit, this will count toward the 2 x 2 Gauze Pads (If packaged with a saline 12 X X X lock kit, this will count toward the minimum quantity.) Iodine Pads or Chlorhexidine Wipes 3 X Band-aids 12 X X X 9 Padded IV Armboard 1 X X X Spare Patient Monitor Cables 1 X X EKG Electrode Set Adult 2 X X EKG Electrode Set Pediatric (5) 2 X X AED Pad Adult 2 X AED Pad - Pediatric 2 X Pacing/Defibrillation Pad Adult 2 X X Pacing/Defibrillation Pad Pediatric 2 X X Medications: Adenosine 6 mg/2 ml 6 X X Albuterol 2.5 mg/3 ml 4 X X X Amiodarone 150 mg/3 ml Ampule 4 X X Aspirin 81 mg Chewable Tablets 1 Bottle X X X Atropine Sulfate 1 mg/10 ml Syringe 2 X X Calcium Chloride 100 mg/ 1 ml 2 X Dexamethasone 10 mg / 1 ml 2 X X Dextrose 10% 25 grams/ 250 ml 2 X X X Diltiazem 5 mg/1 ml 2 X X Diphenhydramine 50 mg/1 ml 2 X X Epi-Pen Autoinjector Adult 1 X Epi-Pen Autoinjector Pediatric 1 X Epinephrine 1:10,000 1 mg/10 ml 6 X X X Epinephrine 1:1,000 1 mg/1 ml Ampule 3 X X Etomidate 20 mg/10 ml Vial 3 X X Fentanyl 100 mcg/2 ml Ampule (6) 2 X X Glucagon 1 mg/1 ml Vial 1 X X X Glucose - Oral 31gm 1 X X X Haloperidol 5 mg/1 ml Ampule 2 X X Ipratropium Bromide 500 ug/2.5 ml or 3 X X Ipratropium Bromide & Albuterol Ketamine 100 mg/1 ml (6) 2 X Ketorolac 30 mg/1 ml Vial 2 X X 8

9 CNY Minimum Required Equipment First Response Vehicles Equipment/ Supplies Portable Bag AEMT EMT-CC EMT-P Lidocaine 100 mg/5 ml 3 X X Magnesium Sulfate 1 X X (Total 8gm per vehicle) Metoprolol 5 mg/5 ml Ampule 1 X X Midazolam 5 mg/5 ml (6) 4 X X Morphine Sulfate 10 mg/1 ml (6) 2 X X Naloxone 2 mg/2 ml 2 X X X Nitroglycerin 0.4mg Tablet and/or 1 Bottle X X Nitroglycerin Spray (1) 1 X X 1 or Nitrous Oxide 50/50 (1) 1 X X X Norepinephrine 4 mg/4 ml 1 X X Ondansetron 4 mg/2 ml Vial 3 X X Ondansetron 4 mg Tablets or Bottle X X 4 mg Orally Disintegrating Tabs (ODT) (1) Unit Dose Packs Rocuronium 50 mg/5 ml Vial (1) (7) 2 X Sodium Bicarbonate 44.6 meq Syringe 2 X Succinylcholine 100 mg/5 ml Syringe (1) (7) 2 X Vecuronium 10 mg/10 ml Vial (1) (7) 2 X (1) Optional Regional Equipment or Medication. (2) A current New York State Department of Health Limited Service Laboratory Registration is required for glucometers. Registration Form (3) The agency will create a paper version of the protocol PDF provided by the CNY Region to carry in the ambulance. (4) Providers must be trained on this procedure prior to agency implementation. (5) Adult electrodes can be used to fulfill the minimum pediatric electrode requirements provided the electrodes are 40 mm (skin contact size) or smaller. (6) Controlled Substance License is required to carry these medications. Fentanyl and Ketamine are optional controlled substance medications. (7) Agency and providers must be approved by the CNY Region to perform RSI. Note: Agencies must have a DOH-4362 Medical Director Verification form on file with the CNY Program Agency. 9