Statutes, codes, and regulations
Delaware Administrative Code
Title 1 - Authorities, Boards and CommissionsDelaware State Fire Prevention Commission
Ambulance Service Regulations
Section 710-12.0 - BLS Requirements

1 Del. Admin. Code § 710-12.0

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Current through Register Vol. 28, No. 5, November 1, 2024
Section 710-12.0 - BLS Requirements
12.1 BLS Operational Requirements
12.1.1 Roadway Vehicle Standards
12.1.1.1 All BLS ambulances shall be registered and licensed in the State by the Delaware Division of Motor Vehicles. EXCEPTIONS:
12.1.1.1.1 Those vehicles to which the international registration plan applies.
12.1.1.1.2 Those vehicles properly registered in some other state.
12.1.1.1.3 All ambulances shall have a copy of the vehicle registration and copy of the Commission issued ambulance permit on the ambulance at all times while the unit is in service on the roadways of the State of Delaware. All vehicles will display the Commission issued inspection decal on the left bottom corner of the left rear window of the patient compartment.
12.1.1.2 Vehicles shall have clearly visible letters on both sides and the rear identifying the name of the organization or corporation and the vehicle's specific identifier as specified under permit documentation. The letters shall be at least 3 inches in height.
12.1.1.3 Existing vehicle patient compartment shall conform with the criteria within the most current United States General Services Administration federal specifications for the Star of Life Ambulances. All newly purchased, fabricated, and remounted ambulance components including ambulance compartments, shall conform to the criteria set forth in the most current edition of NFPA 1900 Standard for Automotive Ambulances 2019.
12.1.1.4 Any vehicle not previously permitted in the State of Delaware will be required to conform to the most current edition of NFPA 1900 Standard.
12.1.2 Transports should be made in a safe manner as to prevent further injury, and utilize visual and audible warning devices as appropriate based on the patient's condition and shall meet the requirements of the State of Delaware standing orders and protocols for transport of a patient. The highest medically trained practitioner present shall recommend the appropriate mode of transportation based on the patient's condition.
12.1.3 Equipment Standards
12.1.3.1 Every BLS ambulance shall maintain the required equipment and supplies as specified by the Commission.
12.1.3.2 Required equipment shall be reviewed annually with recommendations from the Commission's designee and the Commission's Medical Director.
12.1.3.1.2 Equipment with an expiration date cannot be removed from its packaging or have the expiration date removed or altered.
12.1.3.2 Bariatric Transport
12.1.3.2.1 Ambulances used for bariatric transport shall have an interior patient compartment size large enough to comfortably transport the patient and provide room for the attending crew to perform patient care as needed.
12.1.3.2.2 Ambulances used for bariatric transport shall have suspensions capable of safely transporting patients between 350 and 1000 pounds and have a crew assisted loading system such as ramps, winch, lifting systems or a combination of those.
12.1.3.2.3 Ambulance providers shall have a written policy for loading and unloading bariatric patients to ensure the safety of the crew and the patient from injury during the loading and unloading process.
12.1.3.2.4 Ambulances used for bariatric transport shall have all the required Commission equipment and any additional equipment as required by the Commission to give proper patient care to bariatric patients.
12.1.3.2.5 Stretchers shall be rated at 1000 pounds or greater.
12.1.3.2.6 Ambulance personnel must have knowledge in the extrication, lifting, transport, and patient care needs for bariatric patients.
12.1.4 Staffing Requirements
12.1.4.1 Minimum acceptable crew staffing when transporting a patient shall consist of a driver and 1 Delaware State certified EMT.
12.1.4.2 A minimum of 1 Delaware State certified EMT or an activated paramedic acting in an ALS capacity licensed in the State of Delaware shall always be in the patient compartment when a patient is present.
12.1.4.3 BLS ambulance service drivers are required to have completed the "Emergency Vehicle Operators" course conducted by the Delaware State Fire School.
12.1.4.4 BLS ambulance service drivers are required to maintain current CPR/AED certification, approved by the Commission.
12.1.4.5 Any member or employee with a BLS ambulance service provider who has been convicted of or adjudicated delinquent of crimes set forth in 16 Del.C. § 6647 or any similar offense under any federal, state, or local law is prohibited from serving as a BLS ambulance service driver in this State.
12.1.4.5.1 The BLS ambulance service provider shall certify, on an annual basis, to the Commission that their members or employees have never been convicted of an offense that constitutes any of the crimes set forth in 16 Del.C. § 6647 or any similar offense under any federal, state, or local law.
12.1.5 Quality Assurance. Each BLS ambulance service provider shall be responsible for monitoring quality assurance in the form of patient care and both mobilization and response times. The method in which this is accomplished is the authority and responsibility of the BLS ambulance service provider per the Quality Assurance and Improvement Program established by the Commission in conjunction with the OEMS and adopted by the Commission. Any corrections to a PCR with regard to patient care provided, EMT impressions, assessed status or narrative found during the Quality Assurance process or any other review of a PCR shall be returned to the EMT who wrote the PCR to make corrections. If the EMT is unavailable they may provide written approval to the supervisor to make corrections on a specified report.
12.1.6 Communications Requirements
12.1.6.1 Dispatch Centers
12.1.6.1.1 Dispatch centers for both BLS ambulance service providers shall meet the criteria established by the Commission.
12.1.6.1.2 BLS ambulance service provider dispatch centers shall be responsible for following call taking protocols as established by the Commission. Calls determined to be ALS in nature shall be transferred to the appropriate public safety answering point (PSAP) within 30 seconds of taking the call utilizing a dedicated phone line to that PSAP.
12.1.6.1.3 Calls determined to be BLS in nature shall not be required to be forwarded to the PSAP.
12.1.6.1.4 Dispatch centers shall follow an Emergency Medical Dispatch System approved by the Commission.
12.1.6.2 Ambulances. All BLS ambulances shall be equipped with reliable communication through the State of Delaware 800 MHz radio system, or have the ability to interface with Delaware 800 MHz radio systems.
12.1.6.3 Private ambulance providers shall have radios (portable or mobile) that are programmed with 8CAL90 and 8TAC91, 92, 93, 94 to allow interfacing with Delaware 800 MHZ radio system. Radio checks of portable and mobile (vehicle mounted) radios shall be conducted at a minimum of every 4 months. These radio checks shall be coordinated with the local public safety answering points (PSAP). A log of the radio tests shall be kept by the provider for inspection by the Commission.
12.1.6.4 Within 3 months of being hired, all ambulance provider employees shall complete a 1-hour radio course through the Delaware State Fire School or a Commission approved class. The course shall include specific instruction on interfacing private provider authorized channels when requesting medical control and ALS intercept.
12.1.6.5 If vehicle mounted communications are used, 1 mobile radio unit shall be located within the patient care compartment of the ambulance and be mounted in such a manner as to allow for the caregiver to provide patient care and use the radio.
12.1.7 AED Requirements. The primary BLS ambulance service provider or secondary BLS ambulance service provider shall comply with the Delaware Early Defibrillation Program administrative policies as established by the Office of Emergency Medical Services.
12.1.8 Infection Control. All primary BLS ambulance service providers and secondary BLS ambulance service providers shall comply with the infection control requirements in Chapter 12A, Title 16 of the Delaware Code.
12.1.9 Medical Control. Primary BLS ambulance service providers and secondary BLS ambulance service providers shall be required to follow all orders issued.
12.1.10 Any certified EMT providing EMT care within accordance of the most recently adopted State of Delaware BLS standing orders and protocols may only do so under the direction of a medical control doctor. EMT's cannot provide care as an EMT outside of medical control.
12.1.11 Center for Medicare Medicaid Services (CMS). All primary BLS ambulance service providers and secondary BLS ambulance service providers shall comply with the Final Rule in the Federal Register (64 F.R. 3637) revising the Medicare policies for ambulance services adopted February 24, 1999, or the most current edition.
12.2.12 All primary BLS ambulance service providers and secondary BLS ambulance service providers shall comply with Health Insurance Portability and Accountability Act of 1996 (HIPAA), or the most current version.
12.2 BLS Water Ambulance Operational Standards
12.2.1 All BLS water ambulances shall be registered and licensed in the State by the Delaware Division of Fish and Wildlife or have valid marine documents issued by the Coast Guard.
12.2.2 The vessel shall have clearly visible Star of Life and letters on both sides identifying the name of the organization or corporation or the vessel's specific identifier as specified under permit documentation. The letters shall be at least 3 inches in height
12.2.3 The vessel shall not have structural or functional defects that may adversely affect the patient, the EMS personnel or the safe operation of the vessel.
12.2.4 The vessel shall have a patient care compartment that:
12.2.4.1 Provides access to the head, torso, and lower extremities of the patient while providing sufficient working space to render patient care;
12.2.4.2 Is covered, on all sides including the top, to protect the patient and EMS personnel from the elements, such as, but not limited to wind and spray;
12.2.4.3 Has an opening sufficient size to permit the safe loading and unloading of a person occupying a litter;
12.2.4.4 Is able to secure a patient litter in the patient compartment of the vessel, must include securing straps for chest, waist and leg area, and must be secured a minimum of 12 inches off the floor of the patient care compartment.
12.2.5 Equipment Standards
12.2.5.1 Each BLS water ambulance must carry all equipment as specified by the U.S.Coast Guard minimum equipment requirements for motorboats.
12.2.5.2 Every BLS water ambulance is required to carry all BLS required equipment and supplies as specified by the Commission.
12.2.5.3 Required equipment must be reviewed annually following recommendations from the Commission's designee and the Commission's Medical Director.
12.2.6 Staffing Requirements
12.2.6.1 Minimum acceptable crew staffing when transporting a patient shall consist of a certified boat operator, 23 Del. C. § 2221, and 1 Delaware State Certified EMT or a Paramedic licensed in the State of Delaware.
12.2.6.2 A minimum of one State certified EMT shall always be in the patient compartment when a patient is present.
12.2.6.3 BLS water ambulance service boat operators and EMTs are required to have completed the "Boaters Safety Education" course approved by the Delaware Division of Fish and Wildlife and are required to carry their certification while operating a vessel, set forth in 23 Del.C. § 2221.
12.2.6.3.1 Exemption for boat operators are as follows, or in the most current list provided in 23 Del.C. § 2222, which would supersede this section:
12.2.6.3.1.1 Any person who holds a valid Coast Guard captain's license; or
12.2.6.3.1.2 Any person who holds a valid Delaware River and Bay pilot's license, or its equivalent from another jurisdiction.
12.2.6.4 BLS water ambulance service boat operators are required to maintain current CPR/AED certification.
12.2.6.5 Any member or employee with a BLS ambulance service provider who has been convicted of or charged, adjudicated delinquent of crimes set forth in 16 Del.C. § 6647 or any similar offense under any federal, state, or local law is prohibited from serving as a BLS water ambulance service boat operator in this State.
12.2.6.5.1 The BLS water ambulance service provider shall certify, on an annual basis, to the Commission that their members or employees have never been convicted of or adjudicated delinquent of an offense that constitutes any of the crimes set forth in 16 Del.C. § 6647 or any similar offense under any federal, state, or local law.
12.2.7 Quality Assurance. Each primary and secondary BLS ambulance service provider shall be responsible for monitoring quality assurance in the form of patient care and both mobilization and response times. The method in which this is accomplished is the authority and responsibility of the primary or secondary water ambulance service provider per the Quality Assurance and Improvement Program established by the Commission in conjunction with the Office of Emergency Medical Services and adopted by the Commission.
12.2.8 Communications Requirements
12.2.8.1 Dispatch Centers
12.2.8.1.1 Dispatch centers for BLS water ambulance service providers shall meet the criteria established by the Commission.
12.2.8.1.2 Secondary BLS water ambulance service provider dispatch centers shall be responsible for following call taking protocols as established by the Commission. Calls determined to be ALS in nature shall be transferred to the appropriate public safety answering point (PSAP) within 30 seconds of taking the call utilizing a dedicated phone line to that PSAP.
12.2.8.1.3 Calls determined to be BLS in nature shall not be required to be forwarded to the PSAP.
12.2.8.1.4 Dispatch centers shall follow an Emergency Medical Dispatch System approved by the Commission.
12.2.8.2 All BLS water ambulances dispatched to handle 9-1-1 emergency responses shall be equipped with reliable communication through the State of Delaware 800 MHz radio system and VHF radio with the marine frequencies listed in The Handbook of Delaware Boating Laws and Responsibilities.
12.2.9 AED Requirements. Upon placing an AED on any water ambulance, the BLS ambulance service providers shall comply with the Delaware Early Defibrillation Program administrative policies as established by the OEMS.
12.2.10 Infection Control. All BLS ambulance service providers shall comply with the infection control requirements in 16 Del.C. Ch. 12A.
12.2.11 Medical Control. BLS ambulance service providers shall be required to follow all orders issued.
12.2.12 Center for Medicare Medicaid Services (CMS). All BLS water ambulance service providers shall comply with the Final Rule in the Federal Register (64 F.R. 3637) revising the Medicare policies for ambulance services adopted February 24, 1999, or the most current edition.

1 Del. Admin. Code § 710-12.0

17 DE Reg. 982 (4/1/2014)
24 DE Reg. 471 (11/1/2020)
25 DE Reg. 957 (4/1/2022)
28 DE Reg. 41 (7/1/2024) (Final)