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Agency filings affecting this section
(Effective until September 30, 2024)

PDFWAC 246-976-300

Ground ambulance and aid service—Equipment.

Ground ambulance and aid services must provide equipment listed in Table A of this section on each licensed vehicle, when available for service.
Note: "asst" means assortment
ambulance
aid
vehicle
table a: equipment
 
 
airway management
Airway Adjuncts
 
 
Oral airway adult and pediatric
asst
asst
Suction
 
 
Portable
1
1
Vehicle mounted and powered, providing: Minimum of 30 L/min. & vacuum ˃ 300 mm Hg
1
0
Tubing, suction
1
1
Bulb syringe, pediatric
1
1
Rigid suction tips
2
1
Catheters as required by local protocol
 
 
Water-soluble lubricant
1
1
Oxygen delivery system built in
1
0
3000 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system
1
0
300 L Oxygen supply, with regulator, 500 PSI minimum, or equivalent liquid oxygen system
2
1
Cannula, nasal, adult
4
2
O2 mask, nonrebreather, adult
4
2
O2 mask, nonrebreather, pediatric
2
1
BVM, with O2 reservoir
 
 
Adult, pediatric, infant
1 ea
1 ea
patient assessment and care
Assessment
 
 
Sphygmomanometer
 
 
Adult, large
1
1
Adult, regular
1
1
Pediatric
1
1
Stethoscope, adult
1
1
Thermometer, per county protocol
1
0
Flashlight, w/spare or rechargeable batteries & bulb
1
1
Defibrillation capability appropriate to the level of personnel
1
1
Personal infection control and protective equipment as required by the department of labor and industries
 
 
Length based tool for estimating pediatric medication and equipment sizes
1
1
trauma emergencies
 
 
Triage identification for 12 patients per county protocol
Yes
Yes
Wound care
Dressing, sterile
asst
asst
Dressing, sterile, trauma
2
2
Roller gauze bandage
asst
asst
Medical tape
asst
asst
Self adhesive bandage strips
asst
asst
Cold packs
4
2
Occlusive dressings
2
2
Scissors, bandage
1
1
Irrigation solution
2
1
Splinting
 
 
Backboard with straps
2
1
Head immobilization equipment
1
1
Pediatric immobilization device
1
1
Extrication collars, rigid
 
 
Adult (small, medium, large)
asst
asst
Pediatric or functionally equivalent sizes
asst
asst
Immobilizer, cervical/thoracic, adult
1
0
Splint, traction, adult w/straps
1
0
Splint, traction, pediatric, w/straps
1
0
Splint, adult (arm and leg)
2 ea
1 ea
Splint, pediatric (arm and leg)
1 ea
1 ea
General
Litter, wheeled, collapsible, with a functional restraint system per the manufacturer
1
0
Pillows, plastic covered or disposable
2
0
Pillow case, cloth or disposable
4
0
Sheets, cloth or disposable
4
2
Blankets
2
2
Towels, cloth or disposable 12" x 23" minimum
4
2
Emesis collection device
1
1
Urinal
1
0
Bed pan
1
0
OB kit
1
1
Epinephrine and supplies appropriate for level of certification per MPD protocols
Adult
1
1
Pediatric
1
1
Storage and handling of pharmaceuticals in ambulances and aid vehicles must be in compliance with the manufacturers' recommendations
 
 
Extrication plan: Agency must document how extrication will be provided when needed.
[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.]
(Effective September 30, 2024)

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.]
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