PDFWAC 246-976-300
Ground ambulance and aid service—Equipment.
(1) Licensed and verified ground ambulance, aid services, and emergency services supervisory organizations (ESSO) must provide equipment listed in Table A of this section on each licensed vehicle or to their on-site EMS providers for the service levels they are approved by the department to provide when they are available for service.
Table A: Equipment | ||||||
*Means the use of this equipment at this level of service is determined by the MPD. Department-approved and MPD specialized training protocols must be in place. | ||||||
BLS | ILS | ALS | ||||
Ambulance Vehicle | Aid/ESSO | Ambulance Vehicle | Aid/ESSO | Ambulance Vehicle | Aid/ESSO | |
Airway Adjuncts | ||||||
Adjunctive airways, (OPA/NPA) adult and pediatric assorted | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Water-soluble lubricant | 1 | 1 | 1 | 1 | 2 | 2 |
Intubation insertion equipment. Enough for all patient sizes with back up equipment including power sources. | N/A | N/A | Assortment | Assortment | Assortment | Assortment |
Stylet for endotracheal tubes (adult and pediatric) | N/A | N/A | N/A | N/A | 2 each | 2 each |
Bougie (gum-elastic) for all patient sizes | N/A | N/A | N/A | N/A | 1 each | 1 each |
ET tube holder (adult and pediatric) | N/A | N/A | N/A | N/A | 2 each | 2 each |
End-tidal CO2 detector | *1 | *1 | 1 | 1 | 1 | 1 |
Supraglottic airways | *Assortment | *Assortment | Assortment | Assortment | Assortment | Assortment |
Cricothyrotomy equipment | N/A | N/A | N/A | N/A | 1 | 1 |
Chest decompression equipment (to include a nonsafety large bore needle, minimum length of 3.25") | N/A | N/A | N/A | N/A | 1 | 1 |
McGill forceps (adult and pediatric) | N/A | N/A | 1 each | 1 each | 1 each | N/A |
Oxygen saturation monitor | *1 | *1 | 1 | 1 | 1 | 1 |
Suction | ||||||
Portable | 1 | 1 | 1 | 1 | 1 | 1 |
Vehicle mounted and powered, providing: Minimum of 30 L/min. & vacuum ≥ 300 mm Hg | 1 | 0 | 1 | 0 | 1 | 0 |
Spare canister | 1 | 0 | 1 | 0 | 1 | 0 |
Tubing, suction | 1 | 1 | 1 | 1 | 1 | 1 |
Bulb syringe, pediatric | 1 | 1 | 1 | 1 | 1 | 1 |
Rigid suction tips | 2 | 1 | 2 | 1 | 2 | 1 |
Catheters | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment |
Meconium aspirator | N/A | N/A | N/A | N/A | 1 | 1 |
Oxygen/Delivery Devices | ||||||
Oxygen delivery system built in or an alternative system approved by the department | 1 | 0 | 1 | 0 | 1 | 0 |
3000 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system | 1 | 0 | 1 | 0 | 1 | 0 |
300 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system | 2 | 1 | 2 | 1 | 2 | 1 |
Cannula, nasal, adult | 4 | 2 | 4 | 2 | 4 | 2 |
O2 mask, nonrebreather, adult | 4 | 2 | 4 | 2 | 4 | 2 |
O2 mask, nonrebreather, pediatric | 2 | 1 | 2 | 1 | 2 | 1 |
BVM, with O2 reservoir to provide tidal volume appropriate for each (adult, pediatric, infant) | 1 each | 1 each | 1 each | 1 each | 1 each | 1 each |
Nebulizer | *2 | *2 | 2 | 2 | 2 | 2 |
Continuous Positive Airway Pressure (CPAP) | *2 | *2 | *2 | *2 | 2 | 2 |
Patient Assessment and Care | ||||||
Sphygmomanometer (adult large, regular, and pediatric) | 1 each | 1 each | 1 each | 1 each | 1 each | 1 each |
Stethoscope, adult | 1 | 1 | 1 | 1 | 1 | 1 |
Thermometer | 1 | 0 | 1 | 0 | 1 | 0 |
Flashlight, w/spare or rechargeable batteries & bulb | 1 | 1 | 1 | 1 | 1 | 1 |
Automated External Defibrillator (AED) | 1 | 1 | 1 | 1 | 0 | 0 |
12 lead ECG monitor with defibrillator | 0 | 0 | 0 | 0 | 1 | 1 |
Defibrillator pads - multifunction | 2 each | 2 each | 2 each | 2 each | 2 each | 2 each |
Tool for estimating pediatric medication and equipment sizes | 1 | 1 | 1 | 1 | 1 | 1 |
Glucometer | 1 | 1 | 1 | 1 | 1 | 1 |
Glucose measuring supplies | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Wound Care | ||||||
Dressing, sterile | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Dressing, sterile, trauma | 2 | 2 | 2 | 2 | 2 | 2 |
Roller gauze bandage | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Medical tape | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Self-adhesive bandage strips | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Cold packs | 4 | 2 | 4 | 2 | 4 | 2 |
Hot packs | 2 | 2 | 2 | 2 | 2 | 2 |
Occlusive dressings | 2 | 2 | 2 | 2 | 2 | 2 |
Trauma shears | 1 | 1 | 1 | 1 | 1 | 1 |
Irrigation solution | 2 | 1 | 2 | 1 | 2 | 1 |
Commercial tourniquet | 2 | 2 | 2 | 2 | 2 | 2 |
Extrication and Splinting | ||||||
Collars, rigid. Adult (small, medium, large) or adjustable | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Collars, rigid. Pediatric or functionally equivalent sizes | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Immobilization device, cervical/thoracic, adult | 1 | 0 | 1 | 0 | 1 | 0 |
Immobilization device, cervical/thoracic, pediatric | 1 | 1 | 1 | 1 | 1 | 1 |
Backboard with straps | 1 | 1 | 1 | 1 | 1 | 1 |
Head immobilization equipment | 1 | 1 | 1 | 1 | 1 | 1 |
Splint, traction, adult w/straps | 1 | 0 | 1 | 0 | 1 | 0 |
Splint, traction, pediatric, w/straps | 1 | 0 | 1 | 0 | 1 | 0 |
Splint, adult (arm and leg) | 2 each | 1 each | 2 each | 1 each | 2 each | 1 each |
Splint, pediatric (arm and leg) | 1 each | 1 each | 1 each | 1 each | 1 each | 1 each |
IV Access | ||||||
Intravenous fluid type per protocols | *4 | *2 | 4 | 2 | 4 | 2 |
Intravenous drip sets per protocols | *4 | *2 | 4 | 2 | 4 | 2 |
Intravenous start supplies (venous tourniquet, transparent film dressing, antiseptic swab) | *4 | *2 | 4 | 2 | 4 | 2 |
Catheters, intravenous (14-24 gauge) | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment |
Intraosseous (Equipment sufficient to perform IO insertion and infusion adult and pediatric) | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment |
Pediatric volume control device | *2 | *1 | 2 | 1 | 2 | 1 |
Pressure infusion device | *1 | 0 | 1 | 0 | 1 | 0 |
Syringes | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment |
Needles | ||||||
Hypodermic | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment | *Assortment |
Medications | ||||||
Epinephrine for anaphylaxis adult and pediatric dose | 1 each | 1 each | 1 each | 1 each | 1 each | 1 each |
Medications consistent with department-approved MPD protocols | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Storage and handling of pharmaceuticals in ambulances and aid vehicles must be in compliance with the manufacturers' recommendations | ||||||
Personal Protection Equipment | ||||||
Eye protection | 2 | 2 | 2 | 2 | 2 | 2 |
Mask | 5 | 5 | 5 | 5 | 5 | 5 |
Exam gloves (assortment of sizes) | Assortment | Assortment | Assortment | Assortment | Assortment | Assortment |
Gowns (isolation) | 3 | 3 | 3 | 3 | 3 | 3 |
Trauma Emergencies | ||||||
Triage identification tags | 12 | 12 | 12 | 12 | 12 | 12 |
General | ||||||
Gurney, wheeled, collapsible, with a functional restraint system per the manufacturer | 1 | 0 | 1 | 0 | 1 | 0 |
Pillows, plastic covered or disposable | 1 | 0 | 1 | 0 | 1 | 0 |
Pillowcase, cloth or disposable | 2 | 0 | 2 | 0 | 2 | 0 |
Sheets, cloth or disposable | 4 | 2 | 4 | 2 | 4 | 2 |
Blankets | 2 | 2 | 2 | 2 | 2 | 2 |
Towels, cloth or disposable 12" x 23" minimum | 4 | 2 | 4 | 2 | 4 | 2 |
Emesis collection device | 5 | 1 | 5 | 1 | 5 | 1 |
Urinal | 1 | 0 | 1 | 0 | 1 | 0 |
Bed pan | 1 | 0 | 1 | 0 | 1 | 0 |
OB kit | 1 | 1 | 1 | 1 | 1 | 1 |
Patient care restraints (commercial) | 2 pair | 0 | 2 pair | 0 | 2 pair | 0 |
Garbage bags | 2 | 2 | 2 | 2 | 2 | 2 |
Safety vest or equivalent gear | 2 | 1 | 2 | 1 | 2 | 1 |
Sharps container mounted | 1 each | 0 | 1 each | 0 | 1 each | 0 |
Sharps container portable | 1 each | 1 each | 1 each | 1 each | 1 each | 1 each |
(2) A licensed service that provides interfacility transport of patients needing specialty level care (SCT) must make available equipment and medications consistent with the scope of practice and care required for the transport type. Equipment must include all the following:
(a) ALS equipment required in Table A of this section;
(b) Multimodality ventilators capable of invasive ventilation appropriate to all age groups transported;
(c) Invasive hemodynamic monitoring; transvenous pacemakers, central venous pressure, and arterial pressure;
(d) Controlled delivery devices for IV infusions;
(e) Medications consistent with scope of practice and care required for the transport type; and
(f) Neonatal and pediatric equipment sufficient for all aspects of prehospital interfacility specialized care if the ambulance service provides transport to this population.
[Statutory Authority: RCW 18.71.205, 18.73.081, 43.70.040, 70.168.050, 2017 c 70, 2017 c 295, 2020 c 76, 2021 c 276, 2019 c 314, 2021 c 69, and 2022 c 136. WSR 24-15-104, § 246-976-300, filed 7/22/24, effective 9/30/24. Statutory Authority: Chapters 18.71, 18.73, and 70.168 RCW. WSR 11-07-078, § 246-976-300, filed 3/22/11, effective 5/15/11; WSR 00-08-102, § 246-976-300, filed 4/5/00, effective 5/6/00. Statutory Authority: RCW 43.70.040 and chapters 18.71, 18.73 and 70.168 RCW. WSR 93-01-148 (Order 323), § 246-976-300, filed 12/23/92, effective 1/23/93.]