Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 30. MIEMSS |
Subtitle 09. COMMERCIAL AMBULANCE SERVICES |
Chapter 30.09.10. Standard Commercial Ambulance Equipment |
Sec. 30.09.10.09. Standard Ambulance Ventilation and Airway Maintenance Equipment
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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.