Md. Code Regs. 30.09.10.09

Current through Register Vol. 51, No. 24, December 2, 2024

Section 30.09.10.09 - Standard Ambulance Ventilation and Airway Maintenance Equipment

Each ambulance shall carry the following standard airway maintenance and ventilation equipment:

A. Oxygen which meets the following criteria:

(1) For ground ambulances:

(a) Optional onboard cylinders for BLS ambulances have a capacity of at least 3,000 liters;

(b) Portable cylinders have a capacity of at least 400 liters;

(c) The following number of cylinders, if on-board oxygen is present, unless more are needed for a particular patient based on COMAR 30.09.07.03A(2)(g):

(i) One E size,

(ii) One jumbo D size, or

(iii) Two D size;

(d) The following number of cylinders, if on-board oxygen is not present, unless more are needed for a particular patient based on COMAR 30.09.07.03A(2)(g):

(i) Two E size,

(ii) Two jumbo D size, or

(iii) Three D size;

(2) For air ambulances:

(a) An on-board oxygen system that meets the CAMTS standards, which provide that:

(i) Oxygen is installed according to FAA regulations;

(ii) Medical transport personnel can determine if oxygen is on by in-line pressure gauges mounted in the patient care area;

(iii) Each gas outlet is clearly marked for identification;

(iv) Oxygen flow can be stopped at or near the oxygen source from inside the aircraft;

(v) The indicators for quantity of oxygen remaining and measurement of liter flow are accessible to medical transport personnel while enroute; and

(vi) Oxygen flow meters and outlets must be padded, flush mounted, or so located to prevent injury to medical transport personnel; and

(b) A minimum of one portable oxygen cylinder that has a capacity of at least 400 liters;

(3) All cylinders are properly color coded for U.S.P. grade, medical oxygen;

(4) The system is free of:

(a) Grease,

(b) Oil, or

(c) Other flammable organic material; and

(5) All cylinders have passed hydrostatic testing during the past:

(a) 5 years, or

(b) 10 years, if approved by the inspector based on the condition of the cylinder;

B. Regulators which:

(1) Have a reducing valve limiting line pressure to 50 +/- 10 psi;

(2) Have a pressure gauge, with a range of 0 to 2,500 psi, to indicate the pressure of oxygen remaining in the cylinder;

(3) Are capable of delivering at least 0 to 15 liters/minute flow in calibrated increments;

(4) Are accurate to within 1 liter/minute when at a setting equal to or less than 5 liters/minute;

(5) Are accurate to within 1.5 liters/minute when at a setting between 6 and 10 liters/minute; and

(6) Are accurate to within 2 liters/minute when at a setting equal to or greater than 11 liters/minute;

C. At least one flow smeter dedicated to the portable oxygen system that is not gravity dependent;

D. If present, positive pressure demand valves which provide:

(1) 100 percent oxygen;

(2) An instantaneous flow rate not greater than 40 liters/minute;

(3) An inspiratory pressure relief valve that opens at 60-centimeter water pressure; and

(4) A 15/22-millimeter fitting;

E. Adult oxygen administration sets which are the following types and quantities:

(1) Four non-rebreather;

(2) Two venturi;

(3) Six nasal cannula;

(4) Disposable, single use design; and

(5) Transparent;

F. Pediatric oxygen administration sets which are the following types and quantities:

(1) Two non-rebreather;

(2) Two nasal cannula;

(3) Disposable, single use design; and

(4) Transparent;

G. Two sets of oxygen connecting tubing;

H. One hand operated, self-reinflating adult bag valve mask with:

(1) Oxygen inlet;

(2) Reservoir tube;

(3) Transparent face mask; and

(4) Selectable pop off valve or no pop off valve;

I. One hand operated, self-reinflating, pediatric bag valve mask with:

(1) Oxygen inlet;

(2) Reservoir tube;

(3) One transparent neonatal face mask; and

(4) One transparent pediatric or child face mask;

J. One pocket mask with one-way valve; and

K. One set of oropharyngeal airways in the following sizes:

(1) Adult;

(2) Child; and

(3) Infant.

Md. Code Regs. 30.09.10.09

Regulations .09, Standard Commercial Ambulance Equipment, adopted effective January 10, 2000 (26:27 Md. R. 2017)
Regulation .09A, C amended effective October 15, 2004 (31:20 Md. R. 1486)