Section 515.830  Ambulance Licensing Requirements

 

a)         Vehicle Design

 

1)         Each new vehicle used as an ambulance shall comply with the criteria established by the U.S. General Services Administration's Specification for Ambulance (KKK-A-1822E), with the exception of Section 3.16.2, Color, Paint and Finish.

 

2)         A licensed vehicle shall be exempt from subsequent vehicle design standards or specifications required by the Department in this Part, as long as said vehicle is continuously in compliance with the vehicle design standards and specifications originally applicable to that vehicle, or until said vehicle's title of ownership is transferred. (Section 3.85(b)(8) of the Act)

 

3)         The following requirements listed in Specification KKK-A-1822E shall be considered mandatory in Illinois even though they are listed as optional in that publication:

 

A)        3.7.7.1 Each vehicle will be equipped with either a battery charger or battery conditioner (see 3.15.3 item 7).

 

B)        3.8.5.2 Patient compartment checkout lights will be provided (see 3.15.3 item 9).

 

C)        3.12.1 An oxygen outlet will be provided above the secondary patient (see 3.15.4 M9).

 

D)        3.15.4M3 Electric clock with sweep second hand will be provided.

 

b)         Equipment Requirements – Basic Life Support Vehicles

Each ambulance used as a Basic Life Support vehicle shall meet the following equipment requirements, as determined by the Department by an inspection:

 

1)         Stretchers, Cots, and Litters

 

A)        Primary Patient Cot

Must meet the requirements of sections 3.11.5, 3.11.8.1 of KKK-A-1822E.

 

B)        Secondary Patient Stretcher Must meet the requirements of sections 3.11.5, 3.11.5.1, 3.11.8.1 of KKK-A-1822E.

 

2)         Oxygen, portable

Must meet the operational requirements of section 3.12.2 of KKK-A-1822-E.

 

3)         Suction, portable

 

A)        Must meet the operational requirements of section 3.12.4 of KKK-A-1822E.

 

B)        A manually operated suction device is acceptable if approved by the Department.

 

4)         Medical Equipment

 

A)        Squeeze bag-valve-mask ventilation unit with adult size transparent mask and child size bag-valve-mask ventilation unit with child and infant size transparent masks

 

B)        Lower-extremity traction splint, adult and pediatric sizes

 

C)        Blood pressure cuff, one each, adult, child and infant sizes and gauge

 

D)        Stethoscopes, two each

 

E)         Pneumatic counterpressure trouser kit, adult size, optional

 

F)         Long spine board with three sets of torso straps, 72" x 16" minimum

 

G)        Short spine board (32" x 16" minimum) with two 9-foot torso straps, one each chin and head strap or equivalent vest type (wrap around) extrication device optional

 

H)        Airway, oropharyngeal – adult, child, and infant sizes

 

I)          Airway, nasopharyngeal with lubrication, sizes 12-30F

 

J)         Bandage shears, one each

 

K)        Extremity splints, adult, two each long and short

 

L)         Extremity splint, pediatric, two each long and short

 

M)       Rigid cervical collars – one each, pediatric, small, medium, and large sizes.  Shall be made of rigid material to minimize flexation, extension, and lateral rotation of the head and cervical spine when spine injury is suspected

 

N)        Patient restraints, arm and leg, sets

 

5)         Medical Supplies

 

A)        Trauma dressing – six each

 

B)        Sterile gauze pads – 20 each, 4 inches by 4 inches

 

C)        Bandages, soft roller, self-adhering type, ten each, 4 inches by 5 yards

 

D)        Vaseline gauze – two each, 3 inches by 8 inches

 

E)         Adhesive tape rolls – two each

 

F)         Triangular bandages or slings – five each

 

G)        Burn sheets – two each, clean, individually wrapped

 

H)        Sterile solution (normal saline) – four each, 500 cc or two each, 1,000 cc plastic bottles or bags

 

I)          Aluminum foil roll or Silver Swaddler – one each with head cover

 

J)         Obstetrical kit, sterile – one each, pre-packaged with instruments

 

K)        Cold packs, three each

 

L)         Hot packs, three each, optional

 

M)       Emesis basin – one each

 

N)        Drinking water – 1 quart, in nonbreakable container; sterile water may be substituted

 

O)        Ambulance emergency run reports – ten each, on a form prescribed by the Department or one that contains the data elements from the Department-prescribed form as described in Section 515.Appendix E of this Part

 

P)         Pillows – two each, for ambulance cot

 

Q)        Pillowcases – two each, for ambulance cot

 

R)        Sheets – two each, for ambulance cot

 

S)         Blankets – two each, for ambulance cot

 

T)         CPR mask – one each, with safety valve to prevent backflow of expired air and secretions

 

U)        Urinal

 

V)        Bedpan

 

W)       Remains bag, optional

 

X)        Nonporous disposable gloves

 

Y)        Impermeable red biohazard-labeled isolation bag

 

Z)         Face protection through any combination of masks and/or eye protection and/or field shields

 

AA)     Suction catheters – sterile, single use, two each, 6, 8, 10, 12, 14 and 18F, plus three each tonsil tip semi-rigid pharyngeal suction tip catheters; all must have a thumb suction control port

 

BB)      Child/infant car seat

 

CC)     Equipment/drug dosage sizing tape or pediatric equipment/drug age/weight chart

 

DD)     Poison Control Resource Phone Number

 

EE)      Plastic baby bottle with nipple for glucose feeding

 

FF)      Flashlight, one each, for patient assessment

 

GG)     One each adult, child and neonate sized oxygen masks that are semi-open, valveless, transparent and disposable

 

HH)     Three each nasal cannulas

 

c)         Equipment Requirements – Intermediate and Advanced Life Support Vehicles

Each ambulance used as an Intermediate Life Support vehicle or as an Advanced Life Support vehicle shall meet the requirements in subsections (b) and (d) of this Section and shall also comply with the equipment and supply requirements as determined by the EMS Medical Director in the System in which the ambulance and its crew participate.  Drugs shall include both adult and pediatric dosages.

 

d)         Equipment Requirements – Rescue and/or Extrication

The following equipment will be carried on the ambulance, unless it is routinely accompanied by a rescue vehicle:

 

1)         Wrecking bar, 24"

 

2)         Goggles for eye safety

 

3)         Flashlight – one each, portable, battery operated

 

4)         Fire Extinguisher – 2 each, ABC dry chemical, minimum 5 pound unit with quick release brackets.  One mounted in driver compartment and one in patient compartment

 

e)         Equipment Requirements – Communications Capability

Each ambulance must have ambulance-to-hospital radio communications capability and meet the requirements provided in Section 515.400 of this Part.

 

f)          Equipment Requirements – Epinephrine

A person currently licensed as an EMT-B, EMT-I, or EMT-P who has successfully completed a Department-approved course in the administration of epinephrine shall be required to carry epinephrine (both adult and pediatric doses) with him or her in the ambulance or drug box as part of the EMT medical supplies whenever he or she is performing the duties of an emergency medical technician, within the context of the EMS System plan.  (Section 3.55(a-7) of the Act) \

 

g)         Personnel Requirements

 

1)         Each ambulance shall be staffed by a minimum of two EMTs, Pre-Hospital RNs or physicians on all emergency calls.

 

2)         Each Basic Life Support vehicle using automated defibrillation shall be staffed by a minimum of one EMT-B approved by the EMS Medical Director for automated defibrillation, a Pre-Hospital RN or physician and one other EMT, Pre-Hospital RN or physician.

 

3)         Each ambulance used as an Intermediate Life Support vehicle shall be staffed by a minimum of one EMT-I, Pre-Hospital RN or physician and one other EMT, Pre-Hospital RN or physician.  Each ILS vehicle using automated defibrillation shall be staffed by a minimum of one EMT-I approved by the EMS Medical Director for automated defibrillation, a Pre-Hospital RN or physician and one other EMT, Pre-Hospital RN or physician.  Each ambulance used as an Advanced Life Support vehicle shall be staffed by a minimum of one EMT-P, Pre-Hospital RN or physician and one other EMT, Pre-Hospital RN or physician.

 

4)         Each ambulance provider that operates an emergency transport vehicle shall ensure through written agreement with the EMS System that the agency providing emergency care at the scene and enroute to a hospital meets the requirements of this Subpart.

 

h)         Operational Requirements

 

1)         Any operation of an ambulance while transporting a patient to a hospital shall be done in accordance with the requirements of the Act and this Part.

 

2)         A licensee shall operate its ambulance service in compliance with this Part, 24 hours a day, every day of the year.  Except as required below, each individual vehicle within the ambulance service shall not be required to operate 24 hours a day, as long as at least one vehicle for each level of service covered by the license is in operation at all times.  An ALS vehicle can be used to provide coverage at either an ALS or BLS level, and such coverage will meet the requirements of this Section.

 

A)        At the time of application for initial or renewal licensure, the applicant or licensee shall submit to the Department for approval a list containing the anticipated hours of operation for each vehicle covered by the license.

 

i)          A current roster shall also be submitted, which lists the EMTs, Pre-Hospital RNs and/or physicians who are employed or available to staff each vehicle during its hours of operation.  The roster shall include each staff person's name, license number, and daytime telephone number, and shall state whether such person is generally scheduled to be on site or on call.

 

ii)         An actual or proposed four-week staffing schedule shall also be submitted, which covers all vehicles, includes staff names from the submitted roster, and states whether each staff member is scheduled to be on site or on call during each work shift.

 

B)        Licensees shall be required to obtain the EMS Medical Director's approval of their vehicles' hours of operation prior to submission to the Department.  An EMS Medical Director may require specific hours of operation for individual vehicles to assure appropriate coverage within the System.

 

C)        A licensee that advertises its service as operating a specific number of vehicles or more than one vehicle shall state in such advertisement the hours of operation for those vehicles, if individual vehicles are not available 24 hours a day.  Any advertised vehicle for which hours of operation are not stated shall be required to operate 24 hours a day.

 

3)         For each patient transported to a hospital, the ambulance staff shall, at a minimum, measure and record the information required in Section 515.Appendix E.

 

4)         A licensee shall provide emergency service within the service area on a per-need basis without regard to the patient's ability to pay for such service.

 

5)         A licensee shall provide documentation of procedures to be followed when a call for service is received and a vehicle is not available, including copies of mutual aid agreements with other ambulance providers.  (See Section 515.810(h) of this Part.)

 

6)         A licensee shall operate its ambulance at a level not exceeding the level for which it is licensed (basic life support, intermediate life support, advanced life support), unless such vehicle is operated pursuant to an EMS System-approved in-field service level upgrade.

 

7)         The Department shall relicense ambulances each year.  If the licensee has attained 90 percent compliance with the requirements of this Section on inspections for the previous five years and has no substantiated complaints against it, the Department shall inspect the licensee's ambulances in alternate years, and the licensee shall self-inspect its ambulances in the other years.  The Department's inspection form shall be used for self-inspection by the licensee.

 

i)          A licensee may use a replacement vehicle for up to ten days without a Department inspection provided that the Department is notified of the use of the vehicle by the second working day.

 

j)          Patients, individuals who accompany a patient, and emergency services personnel may not smoke while inside an ambulance or SEMSV.  The Department of Public Health shall impose a civil penalty on an individual who violates this subsection in the amount of $100.  (Section 3.155(h) of the Act)

AGENCY NOTE:  Any provider may request a waiver of any requirements in this Section under the provisions of Section 515.150.

 

(Source:  Amended at 27 Ill. Reg. 1276, effective January 10, 2003)