Sec. 30.09.12.06. Equipment Requirements

A. A licensed neonatal commercial ambulance shall comply with COMAR 30.09.10.

B. There shall be a written maintenance plan for all medical devices used on neonatal commercial ambulances approved by SOCALR, which shall provide that:

(1) All specialized medical devices used during transport shall:

(a) If provided by the hospital, be maintained by the hospital; or

(b) If provided by the licensed commercial ambulance service, be maintained as recommended by the manufacturer; and

(2) The licensed commercial service providing specialized medical devices used during transport shall maintain records documenting maintenance and repair services.

C. All on-board medical devices shall be secured.

D. If the ambulance is also licensed as a specialty care ambulance under COMAR 30.09.14, the vehicle does not need to carry duplicates of required items.

E. The following equipment shall be carried in a neonatal ambulance:

(1) Onboard piped oxygen that meets the criteria in COMAR 30.09.10.09;

(2) Onboard piped air that meets the criteria in COMAR 30.09.10.09;

(3) One onboard suction unit which meets the criteria in COMAR 30.09.10.06A;

(4) One electrically powered portable suction that meets the criteria in COMAR 30.09.10.06B;

(5) One neonatal transport incubator for each patient which:

(a) Is powered by internal batteries and alternating current; and

(b) Meets the U.S. General Services Administration standard for ambulance litter fasteners and anchorages;

(6) One patient thermometer;

(7) Four infant blankets;

(8) Two infant caps;

(9) Two chemically activated heat packs;

(10) One cardiorespiratory monitor for each patient with neonatal electrodes and leads;

(11) One pulse oximeter with neonatal sensor;

(12) One oxygen analyzer;

(13) One neonatal stethoscope;

(14) Ventilation and airway maintenance equipment including:

(a) One neonatal bag and mask equipment, including peep valve, capable of delivering 90 percent to 100 percent oxygen; with:

(i) A manometer; and

(ii) Face masks, newborn and premature sizes (cushion rim preferred);

(b) One intubation kit with:

(i) One size 0 Miller laryngoscope blade;

(ii) One size 1 Miller laryngoscope blade;

(iii) One pediatric laryngoscope handle;

(iv) Spare batteries and bulbs for laryngoscope;

(v) Two of each size 2.5, 3.0, 3.5, and 4.0 millimeter uncuffed endotracheal tubes;

(vi) One stylette; and

(vii) One meconium aspirator;

(c) Suction catheters 5F or 6F, 8F, 10F, and 12F or 14F; and

(d) One portable mechanical ventilator for each patient as age appropriate;

(15) Two infusion pumps for each patient as appropriate;

(16) One blood pressure monitor with 5 neonatal size cuffs;

(17) One umbilical vessel catheterization tray with two of each size 3.5 and 5 French umbilical artery catheters;

(18) Four three-way stopcocks;

(19) Two of each size 5 and 8 French oral gastric tubes and 20 ml syringe;

(20) Site preparation materials;

(21) Venipuncture needles and catheters sizes 25, 21, and 18 gauge, or puncture device for

needleless system;

(22) Syringes sizes 1, 3, 5, 10, 20, and 50 ml, along with sterile gloves, scalpel, or scissors,

and antiseptic solution;

(23) Two syringes size 25 cubic centimeters or larger;

(24) One of each size 10 and 12 French Salem sump tubes;

(25) One 10 French repogle tube;

(26) One sterile bowel bag;

(27) Protective skin barrier;

(28) Two one-way flutter valves;

(29) Four neonatal armboards;

(30) Two blood product infusion sets;

(31) Four intravenous infusion sets;

(32) Two sterile gauze pads, maximum 2 inches by 2 inches; and

(33) Medications including:

(a) All ALS medications listed in the Maryland Medical Protocols for Emergency Medical Service Providers; and

(b) Additional medications approved for use by the neonatal service medical director to meet the needs of the types of patients being transported.

F. A list of the additional medications used by the neonatal service shall be provided to SOCALR and shall be available on each ambulance when in use for a neonatal transport.

G. SOCALR shall be notified in writing of any changes to the list of additional medications used by the neonatal transport service within 7 days of the change.

H. There shall be sufficient quantities of medications to care for one neonatal patient for the longer of:

(1) 1 hour; or

(2) Two times the estimated time of transport.