SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY VEHICLE EQUIPMENT & SUPPLY LIST

Transcription

1 SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY VEHICLE EQUIPMENT & SUPPLY LIST Policy Reference No.: 4001 Effective January 30, 2017 Supersedes: August 1, 2016 I. PURPOSE To establish consistent minimum equipment and supplies standards for Basic Life Support and Advanced Life Support vehicles in the City and County of San Francisco. II. POLICY A. This policy does not supersede the California Vehicle Code or the California Code of Regulations requirements for ambulance equipment. B. All ambulances shall be inspected by the EMS Agency to receive a permit to operate in the City and County of San Francisco. Inspections shall be done at the time of issuing the initial permit, then annually thereafter. Ambulances must demonstrate compliance to the equipment standards in this policy to qualify for a permit. C. All first responder units, ambulances and supervisory units shall minimally stock the equipment and supplies as listed in the attachment to this policy. Actual quantities stocked should take into consideration the amounts typically used in a shift(s) plus additional quantities to maintain adequate supplies for periods of high demand or re-stocking delays. D. Every ALS and BLS first response, ambulance and supervisory units shall have an 800MHz radio in compliance with Policy 3010 EMS Communications Equipment and Procedures. E. Every BLS and ALS mobile team (foot, bicycle or gator) ALS units and field supervisor units shall have the appropriate medical supplies and equipment to provide patient care. F. First responder vehicles, supervisor vehicles, or ambulances may not stock any medications, or medical devices or equipment that is not approved, in advance, by the EMS Agency Medical Director. G. Each ambulance company provider shall create a par-list check out sheet (or electronic equivalent) for every first responder unit, ambulance and engine that identifies the minimum number of each piece of equipment required on each unit. Crew members shall inspect their unit at least once every 24-hour period to verify Page 1

2 that the minimum level of equipment is present on the vehicle. A crew member shall attest to the completed inspection, by signing the check out sheet. The ambulance provider company shall maintain document as a record for six months. III. AUTHORITY San Francisco Health Code, Article 14, Section 903 California Vehicle Code, Section California Health and Safety Code, Section California Code of Regulations, Title 13, Division 2, Chapter 5, Article 1, 1100 Page 2

3 SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY Policy Reference No.: 4001 Effective January 30, 2017 Supersedes: August 1, 2016 VEHICLE EQUIPMENT & SUPPLY LIST Line # Attachment: Policy 4001 Minimum Equipment Requirements AIRWAY / RESPIRATORY 1 M, or H oxygen cylinder Oxygen Flowmeter capable of delivering 2-15 LPM D or E size oxygen cylinders Regulators for D/E Oxygen Cylinders capable of delivering 2-15 LPM Nasal Cannulas - Adult Nasal Cannulas - Pedi Simple Oxygen Masks - Infant Non-Rebreather Masks - Adult Non-Rebreather Masks - Pedi Bag Valve Masks - Adult Bag Valve Masks - Pedi Bag Valve Masks - Infant Oral Airway, Set, with sizes 0, 1, 2, 3, 4, 5, & Nasal Pharyngeal Airways Set of sizes 26, 28, 30, 32, & 34 Fr Tongue Depressors Portable Suction Device - Manual Pump Type OR Battery Operated Rigid Pharyngeal Tonsil Tip (Yankauer Suction) Suction Tubing Pediatric Suction Bulb (sterile) Suction Catheters 6, 8, 10, 12, & 14 Fr Supra-Glottic Laryngeal Airway (King Tube), Adult, Sizes 3, 4 & Page 3

4 22 Supra-Glottic Laryngeal Airway (King Tube), Pedi/Infant, Size 2.0, Uncuffed Endotracheal Tubes, 2.0, 2.5, Meconium Aspirator Cuffed Endotracheal Tubes, 6.0, 6.5, 7.0, 7.5, 8.0, & ET Tube holder or ties Laryngoscope Blades w/ extra bulbs, Miller Type: 0, 1, 2, 3, & Laryngoscope Blades w/ extra bulbs, Macintosh Type: 1, 2, 3, & (Optional:) Video Laryngoscope Blades (Vivid Trac, Glidescope, CMAC), Adult and Child Sizes 30 Large Laryngoscope Handle Small Laryngoscope Handle Stylettes: Adult (If not in ETT) Magill Forceps, Adult Magill Forceps, Pedi Beck Airway Airflow Monitor (BAAM) Whistle Cetacaine Spray bottle Lidocaine gel 2% tube or bottle Phenylephrine HCL 0.25% or 0.50% nasal spray bottle Handheld Nebulizer Needle Cricothyroidotomy Kit (WITHOUT scalpel) CPAP Device able to deliver PEEP of 10 cm H2O, breathing circuits, 41 masks Electronic Capnography device (may be integrated in cardiac 42 monitor) Capnography filterline with adapter to connect to ET tube Pulse Oximeter (may be integrated into cardiac monitor) (Optional:) Carboxyhemoglobin Monitor (may be integrated into cardiac monitor) 46 Adult Finger Probes for pulse oximetry (reusable) Page 4

5 47 Pediatric Finger Probes for pulse Oximetry Infant Finger Probes for pulse Oximetry Jet Insufflation Ventilator for Needle Cricothyroidotomy CARDIOVASCULAR 50 Semi-automatic defibrillator Semi-automatic defibrillator pads Adult (disposable razors are recommended as optional stock) 52 Semi-automatic defibrillator pads - Pedi Stethoscope Blood Pressure Cuff - Adult Blood Pressure Cuff - Obese or Thigh Blood Pressure Cuff - Pedi Blood Pressure Cuff - Infant Portable Cardiac Monitor-Defibrillator w/ cables capable of monitoring, defibrillation, transcutaneous pacing, printing 12-lead EKG and electrical discharge < 25 joules 59 ECG recording paper, compatible with monitor Multi-function defibrillation pads - Adult, compatible with monitor Multi-function defibrillation pads - Pedi, compatible with monitor BURNS / TRAUMA / WOUND CARE 62 Burn Sheets - Sterile (disposable type) Quick Clot Combat Gauze (No Size) Sterile gauze pads 4" x 4," 12 per box Nonsterile 4" x 4" gauze pads, 200 per box Abdominal Dressing, 8" x 10" or 5"x9" or similar size Trauma Dressings, 10" x 30" or larger Stretch-style Sterile Gauze Rolls 4" or 5" Page 5

6 69 Petroleum Gauze Pads, 4" x 6" or 3" x 9" (or similar size) Triangular Bandages Cloth Tape 2" Combat Application Tourniquets OR approved equivalent* Elastic Bandages 3" Band-Aids 1, 10 strips Instant Cold Packs (8 reserved for ROSC pts on s) *Acceptable equivalent includes Combat Application Tourniquet, Emergency and Military Tourniquet, or Special Operations Forces Tactical Tourniquet IMMOBILIZATION / EXTRICATION 76 Spine Board Lightweight head immobilizer blocks (set) seatbelt type straps, 3 long/box straps, or 1 set of spider straps Cervical Collars: Adult Cervical Collars: Pedi Extremity splint, cardboard or similar product, small 12-18" Extremity splint, cardboard or similar product, medium 18-24" Extremity splint, cardboard or similar product, large 24-36" Traction Splints : Sager or HARE, adult and pedi size 1 each size 1 each size 1 each size 1 each size 85 Kendrick Extrication Device (KED) Pediatric Spinal Immobilization Device Breakaway OR Flat Stretcher Patient Gurney with shoulder harness and limb belts Stair chair (OR feature that allows gurney to adjust to seated position) 90 (OPTIONAL:) Scoop Stretcher Extremity Restraints - Wrist & Ankle Page 6

7 INFECTION CONTROL / CREW PPE 92 Disinfectant Solution or Spray Disinfectant Wipes Hand sanitizer Long-sleeve impermeable gowns - 1/crew member - 1/crew member 96 Pair of heavy duty gloves - 1/crew member - 1/crew member 97 Safety glasses or goggles - 1/crew member - 1/crew member 98 Plastic trash bags Infectious waste bags (red biohazard bags) Spit socks or hoods Helmet: OSHA approved "hard hat" or equivalent - 1/crew member - 1/crew member 102 N-95 Masks, in sizes for all crew members a P100 Masks, as Required for Interventions On Supervisor Rig, ONLY (if available): DuoDote Autoinjectors On Supervisor Rig, ONLY: Level C PPE Suit On Supervisor Rig, ONLY: PAPR (OR SCBA with extra air cylinders) for each Level C Suit PEDIATRIC 106 Pediatric Length-Based Resuscitation Tape Stuffed toy for children OBSTETRIC Obstetrical Kit w/ umbilical cord clamps; receiving blanket; infant bunting blanket; infant warming cap; sterile scissors or scalpel; suction bulb; OB pad; plastic bag for placenta Page 7

8 MISCELLANEOUS 109 Digital Thermometer Trauma Shears Water soluble lubricant, small packets Penlights Roll of Paper Towels, OR Equivalent of Disposable Towels Disposable Blankets Wool blend blankets Chemical Heating Blanket (Ready-Heat Blanket or equivalent) Sealable bags, gallon-size (e.g. Ziploc) Emesis (Kidney) Basins or Bags Urinal Bedpan Sharps Container Flashlight with extra batteries or entire extra flashlight Drinking water - 1 gallon San Francisco County Map or GPS Device San Francisco EMS Agency Protocol Manual, current version on Paper or Electronic Format (e.g. Protocol App on Mobile Device) 126 Pre-hospital Care Report (paper) OR 1 E-PCR Device In Supervisor Rig ONLY: Cooler or refrigerator capable of maintaining ALS Supervisor 4 one-liter IV bags of NS at constant temperature of 4 degrees Vehicles and / or Celsius 127 (OR may substitute line# 75 cold packs) 128 Fire Extinguisher, A/B/C rated, w/maintenance tag < 1 year Road Flares Page 8

9 MEDICATIONS NOTE: The quantities (mg/gms) listed below only represent the total amount of a medication STOCK. It does NOT represent medication dosages. Refer to Treatment Protocols for medication dosages. 130 Activated Charcoal (Aqueous suspension) gms 50 gms 131 Adenosine mgs 18 mgs 132 Albuterol Unit Dose, 2.5mg/3mL solution mgs 20 mgs 133 Amiodarone mgs 600 mgs 1620 mgs 1620 mgs 134 Aspirin (chewable), 81mg tablet - - (20 tabs) (20 tabs) 135 Atropine Sulfate, 1mg/10mL preload mgs 3 mgs 136 Atropine Sulfate, 8mg/20ml multi-dose vial mgs 8 mgs 137 Calcium Chloride (10%), 1g/10mL gm 1 gm 138 Dextrose 10%, 25 gm premixed solution in 250mL bag gms 50 gms 139 Diphenhydramine IV mgs 100 mgs Dopamine 400mg premixed in 250mL D5W OR equivalent (NOTE: Supply 250 ml D5W in addition to Dopamine vials if you do mg 800 mgs 140 not stock premix) 141 Epinephrine 1:1,000, 1mg/1mL mgs 6 mgs 142 Epinephrine 1:10,000, 1mg/10mL mgs 4 mgs 143 (optional for EMTs) Adult epinephrine auto-injector prefilled dose prefilled dose (optional for EMTs) Pediatric epinephrine auto-injector prefilled dose prefilled dose Glucagon mg 1 mg 146 Glucose Paste (approx. 30g/tube) 2 tubes 2 tubes 2 tubes 2 tubes 147 Lidocaine 2% in 5 ml vial (for use w/ intraosseus insertion) Magnesium Sulfate 50%, 5 g/10 mls gms 5 gms 149 Midazolam mgs 10 mgs 150 Morphine Sulfate IV mgs 20 mgs Page 9

10 151 Naloxone IV mgs 4 mgs 152 Nitroglycerine, 0.4mg/dose metered spray OR Tablets (see Line#151) Nitroglycerine, 0.4mg/tablet tabs 25 tabs 154 Ondansetron 4mg ODT OR 4mg/2ml vial mgs 12mgs 155 Sodium Bicarbonate, 50 meq/50 ml meq 100 meq 156 Sterile Water for Injection, 20 ml vials vials 2 vials IV SUPPLIES 157 Normal Saline 0.9% 1000 ml bag D5W 100 ml bag IV Administration Set 10 or 15 drops/ml IV Administration Set 60 drops/ml (Optional) IV Extension Tubing IV Catheter (Safety type), 14G IV Catheter (Safety type), 16G IV Catheter (Safety type), 18G IV Catheter (Safety type), 20G IV Catheter (Safety type), 22G Syringes, 1mL each 2 each 168 Syringes, 3mL each 2 each 169 Syringes, 5 or 6mL each 2 each 170 Syringes, 10 or 12mL each 2 each 171 Syringes, 30 or 35mL each 2 each 172 Needles (Safety type), 18G, 20/21G, 25G (OR equivalent) each 2 each way stopcock Manual Intra-Osseous needle 16G OR (See Line# 173) EZ-IO Needles, small, medium, & large (or other approved mechanical insertion needles) with Page 10

11 176 EZ-IO Driver (or other approved insertion device) Pressure Bag Infuser Alcohol prep pads or swabs Povidone Iodine prep pads or swabs Blood Glucose Monitor Blood Glucose Monitor Test Strips Lancets (safety type) Mucosal Atomizing Device (MAD) Needle Thoracostomy Kit (e.g. Cook Emergency Pneumothorax Set or equivalent) MCI KIT 185 Bag or Case to hold MCI Equipment Mylar Blankets (Space Blankets) Bullhorn or Battery Powered Megaphone Combat Application Tourniquets or approved equivalent* Compression Bandage with ties (e.g. Bloodstopper Dressings) Cone masks Felt tip markers Glasses or Goggles Heavy Duty Gloves Oral Airways, sizes 0, 1, 2, & Oral Airways, sizes 4, 5, & Pens Pencils (pre-sharpened) Pencil Sharpener Ruled paper tablet Trauma Shears Page 11

12 201 Triage Tags Vests - Kelly Green or Blue: "EMT-1" or "EMT-P" Vests - Orange: "Medical Group Supervisor" Vests - Orange: "Medical Supply Officer" Vests - Orange: "Staging Officer" Vests - Orange: "Transport Officer" Vests - Orange: "Treatment Officer" Vests - Orange: "Triage Officer" Worksheets/Board: Helicopter Operations Worksheets/Board: Medical Branch Director Worksheets/Board: Medical Group Supervisor Worksheets/Board: Transport Worksheets/Board: Treatment *Acceptable equivalent includes Combat Application Tourniquet, Emergency and Military Tourniquet, or Special Operations Forces Tactical Tourniquet Page 12