OAR 333-255-0081: Air Ambulance Operating Requirements for Interfacility Transfers

(1) As used in this rule, "respiratory therapist (RT)" means a person licensed under ORS chapter 688, actively registered and in good standing with the Oregon Respiratory Therapists and Polysomnographic Technologist Licensing Board. (2) An air ambulance in operation and providing interfacility transfers must have a minimum medical staff of two persons and a pilot: (a) A pilot adhering to all regulations set forth in Federal Aviation Administration (FAA) Part 135 for air medical transport; and (b) Any combination of two medical personnel consisting of a Paramedic, Transitional Paramedic, registered nurse (RN), physician associate (PA), physician or RT having: (A) Documentation that at least one member of the medical crew has successfully completed -employer orientation. The orientation must include emergency care procedures, emergency egress procedures, aircraft safety, altitude physiology and survival procedures. There must be written documentation of an annual review of the orientation course material. The length and content of the review must be established by the emergency medical services (EMS) medical director and be kept on file with the ambulance service; (B) A current Basic Life Support (BLS) Provider card or proof of course completion that meets or exceeds the 2015 American Heart Association (AHA) Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) guidelines or equivalent; (C) If providing care to neonate, infant or pediatric patients, documentation of completing one of the following courses or equivalent: (i) Advanced Pediatric Life Support (APLS); (ii) Pediatric Advanced Life Support (PALS); or (iii) Neonatal Resuscitation Program (NRP); (D) If providing care to adult patients, documentation of completing one of the following courses or equivalent: (i) Advanced Cardiac Life Support (ACLS); or (ii) Prehospital Trauma Life Support (PHTLS); (E) The ability to properly assist in lifting and moving a patient; and (F) The knowledge to properly operate all patient care equipment that may be used. (3) When an interfacility transfer is requested, a representative from both the ambulance service and the hospital must communicate clearly, prior to transfer, the type of aircraft being requested, as well as the type of aircraft that will respond, if different than requested. The patient's medical condition, additional equipment and personnel required, and the weather conditions and aircraft available must be taken into consideration. (4) 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-rebreather masks with tubing in sizes to fit infants to adults; (B) Oxygen nasal cannula with tubing that is transparent and disposable in sizes to fit infants to adults; (C) Bag-valve-mask ventilation device reservoir and masks in sizes to fit neonates to adults. The device(s) must: (i) Have a standard universal adapter; (ii) Be operable with or without an oxygen supply; and (iii) Be manually operated and self-refilling; (c) Airway maintenance devices: (A) Nebulizer, if reflected by current standing orders; (B) Pharyngeal esophageal airway devices in sizes to fit neonates to adults; (C) End-tidal CO2 detection device; (D) Oropharyngeal airways in sizes to fit neonates to adults; and (E) Nasopharyngeal airways in sizes to fit neonates to adults; (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 pediatric 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) Commercial rigid oral and flexible pharyngeal and tracheal suction catheters in sizes to fit neonates to adults; (e) Stretcher. The stretcher must: (A) Be securely fastened to the aircraft in accordance with FAA regulations; and (B) Have restraining devices for the legs, pelvis, torso and two over the shoulder straps; (f) Miscellaneous equipment: (A) Emesis containers; (B) Stethoscope in pediatric and adult sizes; (C) Aneroid sphygmomanometer in pediatric, adult, and bariatric sizes: (D) Bandage shears; (E) Hypothermia thermometer; (F) Chemical heat and cold packs - 4 each; (G) Digital or mechanical means to test blood glucose level; (H) Urinals, female and male - 1 each; (I) Bed pan (Exempt from rotary-wing aircraft); and (J) Commercially available soft restraints - 4; (K) Device to provide continuous waveform capnography; (L) Device to provide pressure infusion of intravenous (IV) fluids; and (M) Equipment suitable for administering a fluid bolus to pediatric patients that limits risk for inadvertent over-administration of fluid; (g) Personal protection equipment sufficient for crew and patient(s) including: (A) Non-latex disposable gloves; (B) Surgical 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) Commercially manufactured arterial tourniquets - 2; (j) Latex-free venous tourniquets; (k) Sterile saline solution for irrigation; (l) Supplies necessary to complete an electronic patient care report (ePCR) as required by OAR 333-250-0310; (m) A copy of standing orders dated within one year and signed by the EMS medical director; and (n) A universal "No Smoking" sign must be conspicuously displayed in the aircraft.