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Ambulance Inspection Form - (PDF)

310:641-3-23. Equipment for ground transport vehicles
(a) Each ambulance vehicle, except for stretcher aid vans, shall carry the following:
(1) In addition to the on-board suction unit, a functioning portable suction apparatus with
wide-bore tubing (1/4"), rigid and soft suction catheters for adults, children and infants,
which may be electronically, manual or oxygen powered;
(2) A minimum of two (2) each, single use adult, pediatric and infant bag-valve mask
resuscitators with an adult, child, and infant clear masks;
(3) Oropharyngeal airways, set or a minimum of one (1) of each size for adult (size 7,8,or
9), child (size 3,4,5,or 6), and infant (sizes 0,1,or 2), -- nasal pharyngeal airways are
optional;
(4) Portable and wall mounted oxygen sets, with variable flow regulators and adequate
length tubing, and an extra bottle of portable oxygen;
(5) A minimum of two (2) each adult, child, and infant size oxygen masks, and a
minimum of two (2) adult nasal cannulas;
(6) Bandaging materials, as follows:
(A) Two (2) burn sheets, clean, wrapped, and marked in a plastic bag that need
not be sterile;
(B) Fifty (50) sterile 4"x4" dressings;
(C) Six (6) sterile 6"x8" or 8"x10" dressings;
(D) Ten (10) roller bandages, 2" or larger, such as kerlix, kling, or equivalent;
(E) Four (4) rolls of tape (1/2" and larger);
(F) Four (4) sterile occlusive dressings, 3" x 8" or larger;
(G) Eight (8) triangular bandages, and;
(H) One (1) pair of bandage scissors must be on the ambulance or must be a
required personal carry item for the EMS crew.
(7) Fracture immobilization devices, as follows:
(A) One (1) traction splint for lower extremity, with limb support slings, padded ankle
hitch, padded pelvic support, traction strap;
(B) Upper and lower extremity splints for joint above and below fracture (such as
pneumatic, wire ladder, wood, cardboard);
(C) Short spine board or vest type immobilizer, including straps and accessories;
(D) Two (2) long spine board including straps and head immobilization device;
(E) Two (2) rigid or adjustable extrication collars in large, medium, small adult sizes,
and pediatric sizes for children ages 2 years or older and one (1) infant collar. Collars
shall not be foam or fiber filled.
(8) Pediatric equipment including:
(A) Oropharyngeal airways, sizes 00-5, two (2) each;
(B) Self-inflating resuscitation bag, two (2) each infant and child sizes;
(C) Masks for bag-valve mask device, two (2) each neonate, infant and child sizes;
(D) Oxygen masks, two (2) each infant and child sizes;
(E) Nonrebreathing mask, two (2) pediatric size; O.A.C. 641 Oklahoma State Department of Health
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(F) Stethoscope, one (1) pediatric size;
(G) Backboard, one (1) pediatric size;
(H) Cervical immobilization device infant, child and adolescent sizes, two (2) each;
(I) Blood pressure cuff, two (2) each infant and child sizes;
(J) Suction catheters, one (1) each tonsil-tip and 6-14 French catheters;
(K) Extremity splints, one (1) complete set of pediatric sizes;
(L) Bulb syringes, sterile, two (2);
(M) Obstetric pack, sterile, one (1);
(N) Thermal blankets, two (2);
(O) Water-soluble lubricant packets, two (2);
(P) Blood glucose analysis system; and,
(Q) CO2 detection devices, either electronic or two (2) disposable.
(9) Pediatric Equipment and Supplies for Advanced Life Support Ambulances Only
Including:
(A) One (1) transport monitor;
(B) One (1) defibrillator with pediatric paddles;
(C) Monitoring electrodes, two (2) set pediatric sizes;
(D) Laryngoscope with straight blades, two (2) sets 0-2, curved blades two sets 2-4;
(E) Endotrachael tube stylets, two sets of pediatrics sizes;
(F) Endotracheal tubes, two (2) sets of uncuffed 2.5 – 5.5, two (2) sets of cuffed 6.0-
8.0;
(G) Magill forceps, one (1) pediatric size;
(H) Nasogastric tubes, two (2) each 8F-16F;
(I) Nebulizer, one (1) pediatric size;
(J) IV catheters, 14 to 26 gauge, Six (6) each;
(K) Interosseous needles, two (2) each;
(L) One (1) Length/weight-based drug dose chart or tape (eg. Broselow Tape);
(M) Resuscitation drugs (ACLS & PALS) and IV fluids (NS and/or LR) per Departmentapproved
protocols.
(10) Miscellaneous medical equipment, as follows:
(A) Portable blood pressure set in adult, child, and infant sizes;
(B) Stethoscope;
(C) Obstetrical kit, with towels, 4"x4" dressing, umbilical tape, bulb syringe, cord
cutting device, clamps, sterile gloves, aluminum foil, and blanket;
(D) Universal communicable disease precaution equipment including gloves, mask,
goggles, gown, and other universal precautions;
(E) Blood-glucose measurement equipment per medical direction and
Department approval;
(F) CPAP per medical direction and Department approval; and
(G) Semi-automatic advisory defibrillator (SAAD).
(11) Other mandatory equipment, as follows:
(A) Trash receptacle which shall include a sufficient number of replacement bags and
a receptacle for containment of medical wastes that displays the "biological hazard"
emblem.
(B) Two way radio communication equipment on VHF; with a minimum of 155.340
MHz for hospital communications.
(C) One (1) sturdy, lightweight, all-level cot for the primary patient; O.A.C. 641 Oklahoma State Department of Health
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(D) A crash stable side or center mounting cot fastener and/or anchorage assembly
of the quick release type;
(E) At least three (3) strap type restraining devices (chest, hip, and knee), and
compliant shoulder harness shall be provided per stretcher, cot, and litter (not less
than two (2") inches wide, nylon, easily removable for cleaning, two (2) piece
assembly with quick release buckles)
(F) Patient run reports;
(G) Two (2) fire extinguishers, mounted with quick release in cab and patient
compartment (each dry powder, ABC, five (5#) pound);
(H) Two (2) operable flashlights;
(I) All ambulance equipment and supplies shall be maintained in accordance with
OAC 310:641-3-60. Additionally, sterility shall be maintained on all sterile packaged
items.
(J) Digital or strip type thermometers and single use probes.
(K) Six (6) instant cold packs.
(b) Intermediate equipment, in addition to the basic equipment the ALS ambulance shall
carry the following:
(1) Intravenous administration equipment in a sufficient quantity to treat multiple
patients requiring this level of care;
(2) Interosseous administration equipment if approved by local medical control;
(3) Appropriate quantities of sterile fluid as approved by local medical control;
(4) Adequate advanced airway equipment per medical control;
(5) Blood sampling equipment if approved by medical control;
(6) One (1) Occupational Safety and Health Administration (OSHA) approved sharps
container;
(7) Pulse oximetry device if approved by medical control; and
(8) End tidal CO2 monitoring device
(c) Paramedic equipment, in addition to the required basic and intermediate equipment,
the ALS ambulance will carry the following:
(1) Cardiac monitor/defibrillator with printout, defibrillator pads, quick-look paddles, EKG
leads, chest attachment pads. Telemetry capability is optional. Monitor must be recalibrated
every twelve months and;
(2) Drugs (pre-load when available) approved by medical control, including those which
are compatible with the recommendations of the American Heart Association's
Emergency Cardiac Care Committee, as reflected in the Advanced Cardiac Life Support
and Pediatric Advanced Life Support guidelines. Expired medications shall be
immediately removed.
(d) Extrication equipment shall be available for each ambulance service by either mutual
aid assistance with a fire department, other ambulance service, rescue squad, or carried in
total on the service's vehicle.
(1) All ambulance vehicles shall carry the following equipment:
(A) Three (3) reflectors (triangular) or battery powered warning lights;
(B) Two (2) OSHA approved hard hats, with goggles or face shield; and
(C) Gauntlet leather gloves, two (2) pair of heavy work gloves; and
(D) One (1) spring-loaded window punch.
(2) All ambulance services shall have available either on board the ambulance or
through mutual aid agreement with a fire department rescue unit, the following O.A.C. 641 Oklahoma State Department of Health
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extrication equipment:
(A) One (1) hammer (3# to 5# with 15" handle);
(B) One (1) fire ax, flat head
(C) One (1) crowbar, (51" pinch point)
(D) One (1) bolt cutter (minimum 18")
(E) One (1) power jack, portable, hydraulic or pneumatic, and one (1) spreader
tool kit, hand powered, at least of four (4) ton capacity and one (1) air gun kit, air
cutting tools, (250psi with cylinder and chisels); "Jaws of Life" may be substituted
(F) One (1) shovel, pointed blade
(G) One (1) tin snip, double action (at least 8")
(H) Two (2) ropes, synthetic, kernmantle (50' x 3/4")
(I) Protective goggles, one (1) per occupant
(J) Two (2) utility knives, curved blade
(K) Two (2) lights, portable, battery operated;
(L) One (1) blanket (large 5'x 6' for patient protection during extrication)
(M) Two (2) baling hooks;
(N) One (1) spring loaded window punch;
(O) Twelve (12) blocks, hardwood shoring, (2"x4"x12" blocks with rope handles);
(P) Four (4) blocks, hardwood cribbing, (4"x4"x12" blocks with rope handles);
(Q) Four (4) blocks, hardwood cribbing, (wedge shaped with rope handles);
(R) One (1) come-along (2 ton, chain type and two (2) pull chains, alloy steel,
rescue type (10' at least with grab hooks and rings);
(S) Two (2) extrication straps, synthetic fabric, (9' with quick release buckles)
(T) One (1) loop sling, extrication, (1" wide nylon or equal x 6' circumference with
closure ring)
(e) Equipment shall be clean, in good working condition, and appropriately secured.
(f) Optional equipment:
(1) Portable battery powered ventilator per local medical direction.
(2) Pneumatic anti shock garment (PASG), compartmentalized (legs and abdomen
separate), control valves (closed/open), inflation pump per local medical direction.
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