The Oregon Administrative Rules contain OARs filed through January 15, 2010

DEPARTMENT OF HUMAN SERVICES, PUBLIC HEALTH DIVISION

333-255-0000

Definitions

(1) "Ambulance" or "Ambulance Vehicle" means any privately or publicly owned motor vehicle, aircraft, or watercraft that is regularly provided or offered to be provided for the emergency transportation of persons suffering from illness, injury, or disability.

(2) "Ambulance Service" means any person, governmental unit, corporation, partnership, sole proprietorship, or other entity that operates ambulances and that holds itself out as providing prehospital or medical transportation to sick, injured or disabled persons.

(3) "Ambulance Service Area (ASA)" means a geographic area served by one ground ambulance service provider, and may include all or portion of a county, or all or portions of contiguous counties.

(4) "Business day" means Monday through Friday when the Division is open for business, this excludes holidays.

(5) "Division" means the Oregon Public Health Division, Emergency Medical Services and Trauma System Section, within the Department of Human Services.

(6) "Emergency Care" means the performance of acts or procedures under emergency conditions in the observation, care and counsel of the ill, injured or disabled; in the administration of care or medications as prescribed by a licensed physician, insofar as any of these acts is based upon knowledge and application of the principles of biological, physical and social science as required by a completed course utilizing an approved curriculum in prehospital emergency care. However, "emergency care" does not include acts of medical diagnosis or prescription of therapeutic or corrective measures.

(7) "EMS" means Emergency Medical Services.

(8) "EMS Medical Director" has the same meaning as "Supervising Physician" in ORS 682 .025.

(9) "Emergency Medical Technician (EMT)" means a person who has received formal training in prehospital emergency and non-emergency care and is state-certified to attend any ill, injured or disabled person. Police officers, firefighters, funeral home employees and other personnel serving in a dual capacity, one of which meets the definition of "emergency medical technician" are "emergency medical technicians" within the meaning of ORS chapter 682.

(10) "EMT-Basic" means a person who completes an EMT-Basic course as prescribed by OAR 333-265-0010 and is certified by the Division.

(11) "EMT-Intermediate" means a person who completes an EMT-Intermediate course as prescribed by OAR 333-265-0010 and is certified by the Division.

(12) "EMT-Paramedic" means a person who completes an EMT-Paramedic course as prescribed by OAR 333-265-0010 and is certified by the Division.

(13) "In Operation" means the time beginning with the initial response of the ambulance and ending when the ambulance is available to respond to another request for service. An ambulance which transports a patient becomes available to respond when the care of the patient has been transferred to the staff of a hospital or other health care facility.

(14) "License" means the documents issued by the Division to the owner of an ambulance service when the service and its ambulances are found to be in compliance with ORS chapter 682, OAR chapter 333, division 250 and these rules.

(15) "Non-emergency Care" means the performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24-hours, including but not limited to observation, care and counsel of a patient and the administration of medications prescribed by a physician licensed under ORS chapter 677, insofar as any of those acts are based upon knowledge and application of the principles of biological, physical and social science and are performed in accordance with scope of practice rules adopted by the Board of Medical Examiners in the course of providing prehospital care as defined by this rule.

(16) "Owner" means the person having all the incidents of ownership in an ambulance service or an ambulance or, where the incidents of ownership are in different persons, the person, other than a security interest holder or lessor, entitled to the possession of an ambulance or operation of an ambulance service under a security agreement of a lease for a term of ten or more successive days.

(17) "Patient" means an ill, injured or disabled person transported in an ambulance.

(18) "Person" means any individual, corporation, association, firm, partnership, joint stock company, group of individuals acting together for a common purpose, or organization of any kind and includes any receiver, trustee, assignee, or other similar representatives thereof.

(19) "Physician" means a person licensed under ORS chapter 677, actively registered and in good standing with the Board of Medical Examiners as a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO).

(20) "Physician Assistant (PA)" means a person licensed under ORS chapter 677, actively registered and in good standing with the Board of Medical Examiners.

(21) "Prehospital Care" means that care rendered by emergency medical technicians as an incident of the operation of an ambulance as defined by ORS chapter 682 and that care rendered by emergency medical technicians as incidents of other public or private safety duties, and includes, but is not limited to "emergency care" as defined by ORS chapter 682.

(22) "Prehospital Care Report Form (PCRF)" means a Division-approved form or electronic field data format that is completed for all patients receiving prehospital assessment, care or transportation to a medical facility.

(23) "Registered Nurse (RN)" means a person licensed under ORS chapter 678, actively registered and in good standing with the Oregon Board of Nursing.

(24) "Sanitary" means being free from all body fluids, dirt, dust, grease or other extraneous matter.

(25) "Scope of Practice" means the maximum level of emergency or non-emergency care that an emergency medical technician may provide.

(26) "Specialty Care Transport (SCT)" means interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including medically necessary supplies and service, at a level of service beyond the scope of the EMT-Paramedic. SCT is necessary when a beneficiary's condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, for example nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training. Any skill or medication in addition to or not found in the Department of Transportation curriculum for EMT-Paramedics would be defined as additional training and is defined by the EMS Medical Director.

(27) "Standing Orders" means the written detailed procedures for medical or trauma emergencies issued by the EMS Medical Director to be performed by appropriate certificate holders or licensees in conformance with the scope of practice and level of certification.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0600; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0000; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0010

Application Process to Obtain an Ambulance License

(1) An ambulance service owner that wishes to obtain an ambulance license must apply for and receive an ambulance license from the Division before placing an ambulance into operation.

(2) The Division shall issue an ambulance license to the owner of an ambulance service that is not subject to disqualification from licensure for any reason specified in ORS chapter 682, OAR chapter 333, division 250 or these rules. The ambulance service owner must:

(a) Have a current ambulance service license;

(b) Have paid the fees required by ORS chapter 682 and these rules;

(c) Agree to comply with all applicable federal, state and local laws and regulations governing the operation of a licensed ambulance; and

(d) Submit a completed application in a form specified by the Division in accordance with ORS 682.045 and these rules.

(3) A completed application form for the licensing of an air ambulance must contain, at a minimum:

(a) The name and address of the person or public entity owning the aircraft;

(b) If other than the applicant's true name, the name under which the applicant is doing business;

(c) The description of the ambulance:

(A) Indication if the aircraft was purchased from an ambulance service in Oregon;

(B) Type of aircraft:

(i) Fixed-wing; or

(ii) Rotary-wing.

(C) Number of engines:

(i) One;

(ii) Two; or

(iii) Three or more.

(D) Make of aircraft;

(E) Model of aircraft;

(F) Year of manufacture;

(G) Federal Aviation Authority (FAA) registration number;

(H) Indication if a major repair and alteration has been made to the aircraft. If so, a FAA Form 337 must be on file in the licensee's office for each repair or alteration made;

(I) Aircraft colors:

(i) Fuselage;

(ii) Stripe; and

(iii) Lettering.

(J) Insigne name, monogram or other distinguishing characteristics. A photo of the air ambulance may be submitted to show these characteristics.

(d) A signed and dated statement that the application contains truthful information.

(4) A completed application form for the licensing of a ground ambulance must contain, at a minimum:

(a) The name and address of the person or public entity owning the ambulance;

(b) If other than the applicant's true name, the name under which the applicant is doing business;

(c) The description of the ambulance:

(A) Indication if the ground ambulance was purchased from an ambulance service in Oregon;

(B) Make of vehicle;

(C) Model type of vehicle;

(D) Year of manufacture;

(E) Indication if the vehicle is a remounted chassis;

(F) Conversion manufacturer;

(G) Vehicle Identification Number;

(H) Vehicle license plate number;

(I) Mileage at the time of licensing;

(J) Ambulance colors:

(i) Body;

(ii) Stripe; and

(iii) Lettering.

(K) Insigne name, monogram or other distinguishing characteristics. A photo of the ground ambulance may be submitted to show these characteristics.

(d) A copy of the ground ambulance manufacturers authenticated Star-of-Life certificate or Final Stage Vehicle Manufacturing Certification of compliance;

(A) A previously owned ambulance must have, at a minimum, a January 1, 1995, Star-of-Life certificate; or

(B) A newly constructed ambulance must have at a minimum a Star-of-Life certificate or a Final Stage Vehicle Manufacturing Certificate of compliance.

(e) A signed and dated statement that the application contains truthful information.

(5) A completed application for the licensing of a marine ambulance must contain, at a minimum:

(a) The name and address of the person or public entity owning the ambulance;

(b) If other than the applicant's true name, the name under which the applicant is doing business;

(c) The description of the ambulance:

(A) Indication if the marine craft was purchased from an ambulance service in Oregon;

(B) Indication if the patient-care area is covered or uncovered;

(C) Number of engines:

(i) One;

(ii) Two; or

(iii) Three or more.

(D) Type of engines:

(i) Inboard;

(ii) Outboard; or

(iii) Both inboard and outboard.

(E) Make of marine craft;

(F) Model of marine craft;

(G) Year of manufacture;

(H) Marine craft registration number;

(I) Marine craft license plate number;

(J) Ambulance colors:

(i) Hull;

(ii) Stripe; and

(iii) Lettering.

(K) Insigne name, monogram or other distinguishing characteristics. A photo of the marine ambulance may be submitted to show these characteristics.

(d) A signed and dated statement that the application contains truthful information.

(6) The completed ambulance license application must be submitted to the Division with a nonrefundable ambulance licensing fee of:

(a) $45, when the service has a maximum of four full-time paid positions; and

(b) $80, when the service has five or more full-time paid positions.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0020

Issuance of License to Operate an Ambulance

(1) When the completed ambulance license application with a nonrefundable ambulance license fee as specified in OAR 333-255-0010(6)(a) or (6)(b) has been received by the Division and if it is found that the submitted data complies with the requirements of ORS chapter 682 and these rules, the Division shall issue an ambulance license for the specified ambulance within 10 business days.

(2) The ambulance license:

(a) Shall be valid until June 30 of each year, unless sooner revoked or suspended. The initial licensing period may not exceed 15 months;

(b) If issued between April 1 and June 30, shall expire on June 30 of the following year; and

(c) Must be conspicuously displayed in the operator's or patient compartment of the ambulance, or otherwise as directed by the Division.

(3) Except when specifically exempted by ORS 682.035 and OAR 333-250-0030(3)(a) through (3)(d), an out-of-state licensed ambulance that operates in Oregon must be licensed by the Division:

(a) An ambulance license shall be granted when the ambulance is currently licensed in another state, the standards of which meet or exceed those of Oregon; and

(b) The owner submits to the Division:

(A) A completed Oregon ambulance license application;

(B) A non-refundable ambulance licensing fee as specified in OAR 333-255-0010(6)(a) or (6)(b); and

(C) A copy of the current home-state ambulance license.

(4) An ambulance license is not transferable to a replacement ambulance or to a new owner.

(5) An ambulance license shall be issued to an owner of an ambulance used as a reserve, so long as the ambulance meets all construction and mechanical requirements at the time of manufacture. A reserve ambulance shall not be required to have patient care equipment on-board at all times. However, when the ambulance is placed in operation, it must meet all ambulance licensing requirements.

(6) If an ambulance license becomes lost, damaged or destroyed, the licensee must obtain an application for a replacement license from the Division. The licensee must submit the completed application with a nonrefundable fee of $10 to the Division for each replacement license and shall receive a replacement license within ten business days.

(7) When an ambulance is found to be in non-compliance with ORS chapter 682 or these rules, the Division may deny, suspend or revoke the ambulance license as authorized by ORS 682.220.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0605; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0005; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0030

Denial, Suspension or Revocation of an Ambulance License

(1) The Division may, in compliance with proper administrative procedures as prescribed in ORS chapter 183, deny, suspend, or revoke an ambulance license issued under these rules, or an ambulance service license issued under OAR 333-250-0030, if the Division determines:

(a) A violation of ORS chapter 682 or of these rules has occurred which poses a significant threat to the health and safety of the public;

(b) The ambulance owner makes a material omission or misrepresentation of facts on an application for a license or waiver, or in response to an inquiry or investigation. This includes the intentional misrepresentation or misstatement of a material fact, concealment of or failure to make known any material fact or any other means by which misinformation or false impression is knowingly given or deceit in obtaining or attempting to obtain a license or waiver or in any other transaction with the Division;

(c) Defacing, altering, removing or obliterating any portion of any official entry upon a license, licensing decal, or waiver issued by the Division;

(d) Failure to have the appropriate personnel, medical equipment and supplies required for operation at the highest level of service provided when the ambulance is in operation as prescribed by these rules;

(e) When an ambulance, upon inspection by the Division, manifests evidence of a mechanical or equipment deficiency which poses a significant threat to the health or safety of patients or crew, the Division shall immediately suspend that ambulance from operation. No ambulance which has been suspended from operation may be operated as an ambulance until the licensee has certified and the Division has confirmed that the deficiency has been corrected; and

(f) Other reasons determined by the Division to pose a significant threat to the Division and safety and the well being of patients.

(2) The licensee must return all indications of licensing, including certificates and the remains of ambulance license decals to the Division by registered mail, posted within 48-hours of either receipt of notification of suspension or revocation or the effective date of revocation, whichever is later.

(3) The Division must provide appropriate public notification of the suspension or revocation of an ambulance license.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0006; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0040

Surrender of License to Operate an Ambulance

(1) The ambulance license in the owner's possession must be surrendered to the Division immediately upon notification by the Division of the suspension or revocation of an ambulance service or ambulance license, or upon the sale of an ambulance, or upon the termination of operations.

(2) An ambulance license is non-transferable. When the owner sells, trades, or donates an ambulance, or terminates the business, the licensee must notify the Division within ten days of the transaction by listing the date that the sale was completed and the full name and address of the purchaser of the ambulance on the back of the ambulance license and surrendering all ambulance licenses for that ambulance to the Division.

(3) When an ambulance is decommissioned and not sold to another licensed ambulance service, the owner of the ambulance shall be responsible for the removal of the ambulance license decals. Ambulance license decals shall be returned to the Division within ten business days. In addition to the removal of the ambulance license decals, the owner of the vehicle shall remove any emblems or markings as defined in OAR 333-255-0060(5) identifying the vehicle as an ambulance.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0610; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0010; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0050

Right of Entry and Inspection of an Ambulance

(1) The Division may conduct an inspection for the purpose of evaluating the eligibility of an ambulance service to receive or retain an ambulance license and to ensure the health, safety, and welfare of the persons who utilize ambulances. Ambulance services that are accredited by a nationally recognized EMS service program accreditation entity that meets or exceeds Oregon requirements may be exempted from the inspection process. A copy of the inspection report from the nationally recognized EMS service program accreditation entity must be filed with the Division for approval.

(2) Initial and routine inspections of an ambulance must be scheduled with the management of the ambulance service at least 72 hours in advance of the inspection unless otherwise mutually agreed upon by the Division and ambulance service representative.

(3) Inspections for the purpose of investigating a complaint do not require giving advanced notice to the licensee. Unless the Division gives written approval, no person may give advanced notice of an unannounced inspection.

(4) Upon request of the Division, an ambulance service owner, manager, employee, volunteer or agent must, at a reasonable time and without delay, permit entry by the Division onto all premises housing an ambulance for the purpose of an ambulance inspection. No one, including but not limited to, the owner, the manager, employees, volunteers, and agents, may impede the Division in conducting a lawful inspection of an ambulance to evaluate compliance with ORS chapter 682 and these rules.

(5) In conducting an inspection, the Division must:

(a) Identify him or herself by presenting Division identification to the owner, manager, ranking employee, or volunteer present at the site of an inspection;

(b) Inform the ambulance service representative of the purpose for the inspection; and

(c) Inform the ambulance service representative when the inspection has been completed and the results of the inspection.

(6) The Division may inspect an ambulance at any reasonable time including, but not limited to, whenever the ambulance is present at the ambulance service office or any satellite-office location.

(7) The Division shall conduct an inspection without impeding patient care or unreasonably delaying patient transport unless, in the judgment of the Division, the lack of properly operating patient care equipment, the safety condition of the ambulance, or the patient care being rendered is detrimental or is reasonably likely to be detrimental to the patient's health, safety, or welfare.

(8) When an ambulance is found to be in violation with ORSchapter 682 or these rules, and requires a second or subsequent on-site inspection, the Division may impose a civil penalty as authorized in ORS 682.224:

(a) A subsequent on-site inspection must be conducted and passed on the same day as the initial inspection if the ambulance is to remain available for operation;

(b) If the subsequent on-site inspection reveals that all violations have not been corrected and those violations constitute an immediate danger or threat to the public, the Division may immediately suspend the ambulance license. The suspension shall remain in force until all violations have been corrected;

(c) The Division shall immediately notify the county health department and the administrator of the county ASA plan of any ambulance license suspension; and

(d) A copy of the completed inspection form shall be given to a representative of the ambulance service and one copy each shall be sent to the county health department and administrator of the county ASA plan.

(9) A Division representative may accompany an ambulance crew on a call for the purpose of evaluating compliance with the requirements of ORS chapter 682 and these rules.

(10) The Division shall have the authority to make photographic or video-graphic documentation as part of an inspection for or investigation of non-compliance with ORS chapter 682 and these rules.

(11) Failure of the licensee to produce records for inspection or to permit examination of an ambulance or patient care equipment by the Division shall be grounds for the denial, suspension or revocation of an ambulance license.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 18-1994, f. 6-30-94, cert. ef. 7-1-94; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0060

Ground Ambulance Construction Criteria

(1) The construction criteria for a new ground ambulance shall comply with June 1, 2002 Federal Specifications for the Star-of-Life Ambulance Certification or the Final Stage Vehicle Manufacturing Certification of compliance. Copies of the specifications are available through the Division.

(2) The construction criteria for a previously owned ambulance must comply with the November 1, 1994 Federal Specifications for the Star-of-Life Ambulance Certification, or standards as defined by the Final Stage Vehicle Manufacturing Certification of compliance. Copies of the specifications are available through the Division.

(3) The construction criteria for remounting a Type I or Type III ambulance is:

(a) The patient compartment must have been built after November 1, 1994; and

(b) The remounting must be done by a recognized ambulance manufacturer, a recognized vehicle modifier, a remount center, or licensee with an established in-house remount program. The agency doing the remounting must utilize current nationally recognized vehicle modification techniques and industry standard parts and components. The agency doing remounting shall provide a notarized statement that the structural integrity of the specific patient compartment was not compromised during the remounting, and the remounting has not invalidated the Star-of-Life Certification or Final Stage Vehicle Manufacturing Certificate of compliance.

(4) A licensee may establish an in-house remount program by obtaining the necessary training, appropriate equipment and facilities to remount a vehicle to the described standard.

(5) The owner of an ambulance must select an exterior color, emblems, and markings for the ambulance that will ensure the prompt recognition of that vehicle as an ambulance. All ambulance vehicles shall be clearly identified by appropriate emblems and markings on the front, side, roof, and rear of the vehicle.

(a) The size, number and locations of the "Star-of-Life" emblems are:

(A) Sides -- a 12 to 16-inch emblem must be located on the left and right side panels.

(B) Roof -- a 32-inch emblem must be located on the roof.

(b) The size, number and locations of the word "AMBULANCE" are:

(A) Front -- centered, in block letters, not less than four inches high, must be in mirror image and centered above the grille;

(B) Rear -- in block letters of not less than six-inches in height and centered on the rear door panels or an approved alternative; and

(C) Acceptable alternatives for the word "AMBULANCE" includes generic terms that do not connote any particular level of service, limited to "MEDIC UNIT", "FIRE MEDIC UNIT", "EMERGENCY MEDICAL SERVICES", "EMS UNIT" or other phrases as the Division, in its sole discretion, may permit.

(c) The locations of additional markings are:

(A) An ambulance shall display the service or organization name or logo on the vehicle;

(B) An ambulance may not display on its exterior any level of service which is not provided at all times when that ambulance is in operation.

(6) An ambulance in operation and a reserve ambulance must be reasonably equipped and maintained, and maintenance records must be kept and made available for inspection by the Division. An ambulance must be equipped with the following items in satisfactory working condition:

(a) Audio/visual devices must be in compliance with the Star-of-Life Certification or the Final Stage Vehicle Manufacturing Certificate of compliance;

(b) An ambulance shall comply with Federal Motor Vehicle Safety Standards (FMVSS) and Department of Transportation (DOT) vehicle equipment standards for the ambulance at the time of manufacture;

(c) In case of dual batteries, batteries located in the engine compartment must have heat shields. If the batteries are located elsewhere, they must be sealed off from the occupants' compartment in a ventilated area.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0655; HD 16-1986, f. & ef. 9-9-86; HD 19-1991, f. & cert. ef. 10-18-91; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0055; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0070

Ground Ambulance Operating Requirements

(1) A ground ambulance in operation and providing basic level care must have a staff of at least two persons:

(a) A driver, 18 years of age or older, who:

(A) Has a valid driver's license;

(B) Operates the ambulance in compliance with ORS 820.300 through 820.380 and any other applicable motor vehicle statutes;

(C) Has completed a Division-approved emergency vehicle operators course of instruction. The course must meet or be equivalent to the 2003 standards of the National Safety Council for Emergency Vehicle Operators Course, (CEVO II-AMB).

(D) Has not had his or her EMT certification denied, suspended or revoked for any of the reasons specified in ORS 682.220 within the last ten years;

(E) Has not been convicted of a felony within the past ten years;

(F) Has not been convicted of driving under the influence of intoxicants or impaired in the past three years;

(G) Has not consumed any alcoholic beverages in the eight hours prior to operating an ambulance; and

(H) Is not taking any medications that could impair the safe operation of the ambulance.

(b) A person who is at or above the EMT-Basic certification level and who must be in the patient compartment when a patient is being transported. The person attending the patient must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(c) If the driver is not a certified EMT, the driver must meet the requirements specified in section (1)(a)(A) through (1)(a)(C) and (1)(a)(E) through (1)(a)(H) of this rule and have:

(A) A copy of certificate of course completion that the driver has demonstrated knowledge and skills in the performance of one and two-person rescuer cardiopulmonary resuscitation (adult, child and infant) and relief of foreign body airway obstruction. The course must meet the the 2005 American Heart Association or equivalent standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care;

(B) A signed statement by the driver that he or she is not addicted to alcohol or controlled substances;

(C) A signed statement by the driver that he or she is free from any physical or mental defect that could impair the ability to operate an ambulance; and

(D) A signed statement by the training director that the driver has demonstrated the ability to properly assist in the extrication, lifting and moving of a patient.

(2) To assure basic life support patient care equipment is available, a ground ambulance in operation and providing basic level care must have the following patient care equipment in a satisfactory working condition, stored in a sanitary and secure manner, and be readily accessible to the medical personnel:

(a) Medical oxygen cylinders and regulators:

(A) Installed medical oxygen cylinder with a capacity of at least 3,000 liters and having not less than 500 psi:

(i) The installed medical oxygen cylinder must be located in a vented compartment; and

(ii) The compartment shall not be utilized for storage of any non-secured equipment. No combustible items shall be stored in the oxygen compartment.

(B) Oxygen pressure regulator:

(i) The oxygen must be delivered by a single-stage regulator which is set to at least 50 psi;

(ii) The pressure regulator controls must be accessible from inside the patient compartment; and

(iii) The pressure regulator or other display must be visible from inside the patient compartment.

(C) Oxygen flow meter, mounted -- 2:

(i) The flow meter must be readable from the EMT seat and squad bench; and

(ii) The flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.

(D) Portable medical oxygen cylinder with a capacity of at least 300 liters and having not less that 500 psi;

(i) The oxygen must be delivered by a yoke regulator with a pressure gauge and non-gravity-dependent flow meter that is visible and accessible to the medical personnel; and

(ii) The flow meter must be adjustable over a minimum range of 0 to 15 liters per minute.

(E) Spare portable oxygen cylinder that is full, tagged, sealed and securely mounted.

(b) Medical oxygen administration equipment:

(A) Oxygen non-rebreathing masks with tubing:

(i) Pediatric -- 3; and

(ii) Adult -- 3.

(B) Oxygen nasal cannula with tubing that are transparent and disposable, adult -- 3;

(C) Bag-valve-mask ventilation device with reservoir. The device must:

(i) Have a standard universal adapter;

(ii) Be operable with or without an oxygen supply;

(iii) Be manually operated and self-refilling;

(iv) Have valves that operate effectively at temperatures down to 0° F; and

(v) Have bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid in assorted sizes to include adult, child, and newborn/infant.

(c) Airway maintenance devices:

(A) Pharyngeal esophageal airway devices in assorted sizes if the agency EMS Medical Director approved use;

(B) Endtidal CO2 detection device in assorted sizes;

(C) Oropharyngeal airways in assorted sizes to include adult, child, and newborn/infant; and

(D) Nasal airways in assorted sizes.

(d) Suction equipment:

(A) The onboard suction system may be an electrically operated portable unit in addition to the portable unit required below.

(i) The mounted or portable, engine-vacuum operated or electrically powered complete suction aspirator system must have two sealable and disposable collection bottles or sealable liners;

(ii) The unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds after the suction tube is closed;

(iii) The unit must provide a free air flow of at least 20 liters per minute;

(iv) The unit must be adjustable for use on children and intubated patients; and

(v) Clean, clear liquid for rinsing the suction tubing.

(B) Portable suction aspirator. Note: In addition to the mounted or portable unit required above on the ambulance.

(i) The unit must be capable of being operated from either the vehicle's 12 volt DC electrical system, an independent battery supply which can operate continuously for 20 minutes and is rechargeable, or be a manually-powered unit;

(ii) The unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds after the suction tube is closed;

(iii) The unit must provide a free air flow of at least 20 liters per minute;

(iv) The unit must be adjustable for use on children and intubated patient; and

(v) The unit must include at least a 300 ml collection bottle.

(C) Suction connecting tubing and catheters:

(i) Suction connecting tubing that is at least 1/4 inch in diameter, translucent and must not kink or collapse under high suction -4; and

(ii) Suction catheters in assorted sizes and types for adult, child, and newborn/infant.

(e) Cardiac Monitoring equipment. Automatic or semi-automatic defibrillator. The portable unit must be capable of operating independently of an electrical outlet and delivering a total defibrillation energy sufficient to meet the number of shocks and power settings prescribed in the EMS Medical Director's standing orders and be inclusive of the 2005 American Heart Association or equivalent standards and guidelines for emergency cardiac care;

(f) Stretchers:

(A) Wheeled stretcher:

(i) Be capable of securely fastening to the ambulance body;

(ii) Have a minimum of three restraining devices and an upper torso (over the shoulder) restraint;

(iii) Contain a standard size waterproof foam mattress; and

(iv) Be capable of having the head of the stretcher tilted upwards to a 60-degree semi-sitting position.

(B) Folding stretcher. The number required is based on the stretcher-carrying capacity of the ambulance. An additional long backboard may be substituted for a folding stretcher.

(i) Be capable of securely fastening to the squad bench when carrying a patient; and

(ii) Have a minimum of three restraining devices and an upper torso (over the shoulder) restraint.

(g) Fracture immobilization equipment:

(A) Traction splints in assorted adult sizes and/or adult child combination;

(B) Extremity splints in assorted sizes;

(C) Extrication collars in assorted pediatric through adult sizes;

(D) Scoop stretcher, folding or non-folding type with necessary restraining devices with sufficient supplies for head immobilization;

(E) Short backboard or equivalent with necessary restraining devices with sufficient supplies for head immobilization;

(F) Long backboard with necessary restraining devices with sufficient supplies for head immobilization; and

(G) Pediatric backboard with necessary restraining straps with sufficient supplies for head immobilization.

(h) Bandages and dressings in assorted sizes, sterile and non-sterile.

(i) Adhesive or hypo-allergenic tape in assorted sizes;

(j) Miscellaneous equipment:

(A) Emesis containers;

(B) Stethoscope, pediatric and adult;

(C) Aneroid sphygmomanometer in assorted sizes;

(D) Bandage shears;

(E) Hypothermia thermometer;

(F) Disposable obstetrical kit;

(G) Chemical heat and cold packs assorted;

(H) Urinals, female and male, one each;

(I) Bedpan;

(J) Set of extremity restraining devices;

(K) Blood glucose level testing kit or blood glucose level test strips;

(k) Personal protection equipment sufficient for crew and patient(s) including:

(A) Disposable gloves;

(B) Disposable face masks;

(C) Protective eyewear;

(D) Disposable isolation gowns;

(E) Hand cleaning solution or foam;

(F) Surface cleaning disinfectant;

(G) Sharps container for the patient care compartment and a separate container for each kit that contains needles; and

(H) Infectious waste disposal bags.

(l) Medications and fluids authorized for use by an EMT-Basic as required by the EMS Medical Director;

(m) Linen supplies and replacements sufficient to cover wheeled stretcher;

(n) Security and rescue equipment:

(A) Fire extinguisher, 5lb. (2A-10BC type) - mounted and readily accessible in either the driver's or patient compartment;

(B) Road flares, red colored chemical lights, the number and burning time to equal at least 180 minutes, or a minimum of six reflective triangles;

(C) Flashlight; and

(D) Leather gloves sufficient for crew;

(E) 24" crowbar -- 1; and

(F) 51" wrecking bar -- 1.

(o) The 2004 Department of Transportation Emergency Response Guidebook, (Initial Response to Hazardous Materials Incidents);

(p) Triage tags -- 25;

(q) Oregon Trauma Systems Identification Bracelets -- 5;

(r) Communication equipment. An ambulance must contain two-way radio communication equipment which shall provide reliable contact between the ambulance and central dispatch, the receiving hospital, and on-line medical direction;

(s) Prehospital Care Report Forms or electronic field data form;

(t) A copy of standing orders for EMT-Basics dated within one year and signed by the EMS Medical Director; and

(u) A universal "No Smoking" sign conspicuously displayed in the driver's and patient compartment.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist. HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650; HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91, Former 333-028-0050(3) Renumbered to 333-028-0051, former 333-028-0050(4) & (5) Renumbered to 333-028-0052; HD 8-1993, f. 6-22-93, cert. ef. 7-1-93; HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0050; OHD 5-2001, f. & cert. ef. 2-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0071

Ground Ambulance Operating Requirements When Providing Intermediate Level Care

(1) A ground ambulance in operation and providing intermediate life support care must have a minimum staff of two certified EMTs:

(a) A driver who complies with the requirements specified in OAR 333-255-0070(1)(a)(A) through (1)(a)(H) or (1)(c)(A) through (1)(c)(D);

(b) A person who is at or above the EMT-Intermediate certification level must be in the patient compartment when a patient is receiving intermediate level life support care. If the driver is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both in the ambulance and on scene; and

(c) The EMTs must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(2) A ground ambulance in operation and providing intermediate level care must have the following items in satisfactory working condition; kept in a sanitary manner, stored in a secure manner and be readily accessible to the medical personnel;

(a) All items specified in OAR 333-255-0070(2)(a) through (2)(u);

(b) Cardiac Monitoring Equipment:

(A) Manual monitor/defibrillator; The portable unit must be capable of operating independently of an electrical outlet and be capable of delivering a total defibrillation energy sufficient to meet the number of shocks and power settings prescribed in the EMS Medical Directors standing orders and be inclusive of the 2005 American heart Association guidelines for emergency cardiac care or equivalent standards:

(B) Defibrillator paddle sizes -- Pediatric and Adult

(C) Contact gel -- 1 tube; or

(D) 3 sets of pre-gelled defibrillator pads -- Pediatric and Adult;

(E) Monitoring electrodes; infant and adult;

(F) Patient cables -- 2; and

(G)ECG paper.

(c) Any physiologic isotonic crystalloid solution or combinations thereof -- 6000 cc in any size containers;

(d) Medications and fluids authorized for use by an EMT-Intermediate as required by the EMS Medical Director. Storage of controlled substances in an ambulance must adhere to the signed and dated procedures as specified in OAR 333-250-0047(2)(a) and (b);

(e) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24-gauge through 14-gauge; and

(B) Specifically-designed needles for intraosseous infusions.

(f) A copy of standing orders for EMT-Intermediates dated within one year and signed by the EMS Medical Director.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0072

Ground Ambulance Operating Requirements When Providing Advanced Level Care

(1) A ground ambulance in operation and providing advanced life support level care must have a minimum staff of two persons:

(a) A driver who complies with the requirements specified in OAR 333-255-0070(1)(a)(A) through (1)(a)(H) or (1)(c)(A) through (1)(c)(D); and

(b) A person who is at the EMT-Paramedic certification level, or an RN, PA or physician who is trained in prehospital emergency medical care must be in the patient compartment when a patient is receiving advanced life support care. If the driver is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both in the ambulance and on scene. The EMT, RN, PA or physician must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(c) When a RN, PA or physician is staffing an ambulance in lieu of an EMT-Paramedic and providing advanced level life support care he or she must have:

(A) A current American Heart Association "Health Care Provider," American Red Cross "Basic Life Support for the Professional Rescuer" or other Division-approved equivalent CPR course completion document;

(B) A current Advanced Cardiac Life Support course or other Division-approved equivalent completion document;

(C) A pediatric advanced life support course or other Division-approved equivalent completion document;

(D) A Prehospital Trauma Life Support, Basic Trauma Life Support, Trauma Emergency Assessment Management or Trauma Nurse Core Course completion document. The Trauma Emergency Assessment Management and Trauma Nurse Core Course must include a supplemental prehospital rapid extrication training session;

(E) The ability to properly assist in extricating, lifting and moving a patient; and

(F) The knowledge to properly operate all patient care equipment carried on an ambulance.

(2) Advanced life support patient care equipment. A ground ambulance in operation and providing advanced level care must have the following advanced life support equipment in satisfactory working condition, kept in a sanitary manner and which is readily accessible to medical personnel:

(a) All items specified in OAR 333-255-0070(2)(a) through (2)(u);

(b) Nasogastric tubes in assorted sizes:

(c) Cardiac monitoring equipment:

(d) Advanced airway care equipment:

(A) Laryngoscope handle and assorted blade sizes, adult and pediatric;

(B) Spare dated batteries for the laryngoscope handle;

(C) Spare bulbs for the laryngoscope blades;

(D) Endotracheal tubes in assorted sizes, adult and pediatric;

(E) Magill Forceps -- adult and child;

(F) Intubation stylettes -- adult and child;

(G) Endtidal CO2 detection device;

(H) Oxygen saturation monitor; and

(I) Chest decompression equipment.

(e) Sterile intravenous agents and medications authorized by the EMS Medical Director:

(f) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24-gauge through 14-gauge; and

(B) Specifically-designed needles for intraosseous infusions.

(g) Storage of controlled substances in an ambulance must adhere to the signed and dated procedures as specified in OAR 333-250-0047(2)(a) and (b); and

(h) A copy of standing orders for EMT-Paramedics, RNs and PAs dated within one year and signed by the EMS Medical Director.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0073

Ground Ambulance Operating Requirements When Providing Only Specialty Level Care

(1) A ground ambulance in operation and providing only specialty level care during inter-facility transfers must have a minimum staff of two qualified persons as defined by the Center for Medicare Services or additional staff, the number and type, requested by the transferring physician:

(a) A driver who complies with the requirements specified in OAR 333-255-0070(1)(a)(A) through (1)(a)(H) or (1)(c)(A) through (1)(c)(D); and

(b) A person who is at the EMT-Paramedic certification level, RN, PA, physician or other qualified persons who have additional specialty care training and who must be in the patient compartment when a patient is receiving specialty level care.

(2) The EMT-Paramedics, RNs, PAs, physicians or other qualified persons must have the:

(a) Training to properly operate all patient care equipment carried on an ambulance, including specialty care equipment necessary to care for the patient during the transfer;

(b) Training to do titration of intravenous medications necessary to care for the patient during transfer; and

(c) Ability to properly assist in lifting and moving a patient.

(3) The personnel staffing an ambulance must not:

(a) Have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(b) Be taking any medications that could impair the giving of proper patient care.

(4) A ground ambulance in operation and providing only specialty level care must have the following patient care equipment in a satisfactory working condition, stored in a sanitary and secure manner, and be readily accessible to the medical personnel:

(a) All patient care equipment specified in OAR 333-255-0072(2)(a) through (2)(h); and

(b) Any other patient care equipment or supplies anticipated or required for patient care.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0079

Exception to the Two Person Staffing Requirement

(1) The Division may, on application from any full volunteer or part volunteer ambulance service, authorize an exception to the two-person requirement as prescribed by ORS 682.068 and OAR 333-255-0070(1), 333-255-0071(1) or 333-255-0072(1) if provisions acceptable to the Division have been made to assure timely arrival of the two-person crew as required by ORS 682.068 and OAR 333-255-0070(1), 333-255-0071(1) or 333-255-0072(1).

(2) A full volunteer or part volunteer ambulance service making application for an exception under this rule must submit an application to the Division in a format prescribed by the Division:

(a) The application must be approved by the EMS Medical Director of the ambulance service, the governing body of each municipality for which the exception is being requested and by the county ambulance service planning authority. The application must contain written approval of all such bodies prior to submission to the Division;

(b) An application for an exception to this provision must provide for and include a description of:

(A) An alerting system which shall make known to the intended responders the location of the emergency and either two-way radio communication between responders such that response can be coordinated by responding personnel, or a fixed schedule of assigned personnel, with designation of the parties who are to respond directly to the scene of an emergency and parties who are to operate the ambulance;

(B) Personnel who respond directly to the scene of an emergency must be individually equipped with equipment necessary to provide initial patient care, including uniform or personal protective clothing, disposable gloves and a pocket ventilation mask or other appropriate ventilatory adjuncts;

(C) Copies of approved standard operating procedures or general orders which address the number of personnel to respond to the scene, organizational policies regarding the operation of motor vehicles by personnel responding to the scene and prohibiting entry into dangerous scenes; and

(D) A method of assuring that neither of the following shall be permitted to occur:

(i) An ambulance driven by a person not certified as an EMT arrives at an emergency scene but an EMT fails to arrive or arrives substantially later than the responding ambulance; or

(ii) An ambulance driven by an EMT arrives at the scene but no other qualified driver, as specified by these rules, arrives at the scene to operate the ambulance.

(c) Wherever possible, an agency operating under an exception to the general rule granted pursuant to this rule must endeavor to assure that an ambulance driver who is not certified at least to the EMT-Basic level is trained to the First Responder level and meets the requirements for a non-EMT driver as specified in OAR 333-255-0070(1)(c)(A) through (1)(c)(D).

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0080

Air Ambulance Configuration and Survival Equipment Requirements

(1) An air ambulance in operation must be in compliance with all Federal Aviation Administration (FAA) contained in Part 135, and ORS chapter 682, and must be maintained and maintenance records must be kept and made available for inspection by the Division:

(a) The aircraft must have:

(A) A climate control system to prevent temperature extreme that would adversely affect patient care;

(B) Interior lighting, so that patient care can be given and patient status monitored without interfering with the pilot's vision. The cockpit must be sufficiently isolated, by protective barrier, to minimize in-flight distraction or interference;

(C) At least one outlet per patient and current for 110 volts (50/60 cycle) alternating current or other current which is capable of operating all electrically-powered medical equipment;

(D) A back-up source of electric current or batteries capable of operating all electrically-powered life support equipment for one-hour;

(E) An adequate door to allow loading and unloading of a patient without rotating the patient and stretcher more than 30 degrees about the longitudinal (roll) axis or 45 degrees about the lateral (pitch) axis;

(F) A configuration that allows the medical personnel access to the patient in order to begin and maintain treatment modalities. There must always be complete access to the patient's head and upper body for effective airway management;

(G) The stretcher and medical equipment placed in a manner that shall not impede rapid egress by personnel or patient from the aircraft;

(H) Communications equipment to ensure both internal crew and air-to-ground exchange of information between individuals and agencies appropriate to the mission. Scene response aircraft must be able to communicate with EMS and law enforcement personnel at the scene; and

(I) An installed self-activating emergency locator transmitter.

(b) The aircraft must have survival equipment for crew members and patient consisting of:

(A) Clothes for the season and area to be served;

(B) Thermal (space) blanket;

(C) Plastic tarp, at least 5' x 7';

(D) Signal mirror;

(E) Compass;

(F) Canned smoke signal, or flare pistol and flares or pencil-flares;

(G) Large flashlight;

(H) Orange signal banner;

(I) Noise maker (whistle);

(J) Drinkable water or intravenous fluid;

(K) Tea;

(L) Salt and sugar;

(M) Beef jerky or granola bars;

(N) Waterproof matches; and

(O) Fire extinguisher (ABC rating).

(2) The aircraft owner who does not own their medical equipment or employ their medical personnel, must have on file with the Division a copy of the signed and dated agreement or contract with the agency that does provide either the medical personnel or medical equipment to be used on the air ambulance. The signed and dated agreement or contract must be filed annually or whenever substantive changes are made, whichever is more frequent.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650; HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91, Renumbered from 333-028-0050(3); HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0051; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0081

Air Ambulance Operating Requirements for Prearranged Inter-Facility Transfers

(1) Fixed-wing aircraft in operation and providing pre-arranged inter-facility transfers requiring basic level care must have a minimum staff of two persons:

(a) A pilot adhering to all regulations set forth in FAA Part 135 for air medical transport; and

(b) One EMT-Paramedic, RN, PA or physician having:

(A) Documentation that at least one member of the medical crew has successfully completed the 2004 Association of Air Medical Services (AAMS) Curriculum Guidelines or equivalent. The curriculum must include emergency care procedures, aircraft safety and altitude physiology. There must be written documentation of an annual review of the Air Medical Crew course material. The length and content of the review must be established by the EMS Medical Director and be kept on file with the ambulance service;

(B) A current American Heart Association "Health Care Provider", American Red Cross "Basic Life Support for the Professional Rescuer" or other Division-approved equivalent CPR course completion document;

(C) The ability to properly assist in lifting and moving a patient; and

(D) The knowledge to properly operate all patient care equipment that may be used.

(2) Fixed or rotary-wing aircraft in operation and providing pre-arranged inter-facility transfers requiring advanced life support care must have a minimum staff of two persons:

(a) A pilot adhering to all regulations set forth in FAA Part 135 for air medical transport; and

(b) One EMT-Paramedic, RN, PA or physician meeting the requirements specified in section (1)(b)(A) through (1)(b)(D) of this rule.

(3) Fixed or rotary-wing aircraft in operation and providing pre-arranged inter-facility transfers requiring specialty level care must have a minimum staff of two persons:

(a) A pilot adhering to all regulations set forth in FAA Part 135; and

(b) One EMT-Paramedic, RN, PA, physician or other qualified person(s), who must:

(A) Meet the requirements specified in section (1)(b)(A) through (1)(b)(D) of this rule;

(B) Have documentation of completing additional specialty care training as defined by the EMS Medical Director;

(C) Have training to properly operate specialty care equipment necessary to care for the patient during the transfer; and

(D) Have training to do titration of intravenous medications necessary to care for the patient during the transfer.

(4) An air ambulance in operation and providing specialty level care must have the following patient care equipment in a satisfactory working condition, stored in a sanitary and secure manner, and be readily accessible to the medical personnel:

(a) All patient care equipment specified in section (7)(a) through (7)(k) of this rule;

(b) All patient care equipment specified in OAR 333-255-0082(3)(d) through (3)(i); and

(c) Any other patient care equipment required during the transfer.

(5) Any pilot, EMT, Respiratory Therapist, RN, PA, physician or qualified person staffing an air ambulance, must not:

(a) Have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(b) Be taking any medications that could impair the giving of proper patient care or the safe operation of the air ambulance.

(6) When an inter-facility transfer is requested, a representative from the ambulance service must contact the attending physician at the sending facility, prior to the transfer, to determine which type of aircraft; fixed-wing, rotary-wing, pressurized or non-pressurized, is needed based on the patient's medical condition and which additional equipment and personnel are required.

(7) Patient Care Equipment. The following patient care equipment, in satisfactory working condition and kept in a sanitary manner, is required on all air ambulance flights. The equipment may be kept separate from the aircraft in modular pre-packaged form, so as to be available for rapid loading, easy securing and easy access aboard the aircraft:

(a) Medical oxygen cylinders and regulators:

(A) Medical oxygen cylinder with a capability of at least 600 liters and having not less than 500psi:

(i) The oxygen cylinder(s) must be securely fastened to the aircraft while in flight;

(ii) The oxygen must be delivered by a yoke regulator with a pressure gauge and a non-gravity-dependent flowmeter that is visible and accessible to the medical personnel; and

(iii) The flowmeter must be adjustable over a minimum range of 0 to 15 liters per minute.

(B) A spare portable oxygen cylinder that is full, tagged, sealed, and securely mounted.

(b) Medical oxygen administration equipment:

(A) Oxygen non-rebreathing masks with tubing:

(i) Pediatric -- 2; and

(ii) Adult -- 2.

(B) Oxygen nasal cannula with tubing that are transparent and disposable, adult -2;

(C) Bag-valve-mask ventilation device with reservoir. The device must:

(i) Have a standard universal adapter (15 mm tracheal tube/22 mm mask);

(ii) Be operable with or without an oxygen supply;

(iii) Be manually operated and self-refilling;

(iv) Have valves that operate effectively at temperatures down to 0° F;

(v) Have bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid in assorted sizes to include adult, child, and newborn/infant.

(c) Airway maintenance devices:

(A) Pharyngeal esophageal airway devices in assorted sizes;

(B) Endtidal CO2 detection device in assorted sizes;

(C) Oropharyngeal airways in assorted sizes to include adult, child, and newborn/infant; and:

(D) Nasal airways in assorted sizes.

(d) Suction equipment:

(A) Portable suction aspirator:

(i) The unit must be either a self-contained battery or oxygen-powered unit that can operate continuously for 20 minutes and is rechargeable or be a manually-powered unit;

(ii) The unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds after the suction tube is closed;

(iii) The unit must provide a free air flow of at least 20 liters per minute;

(iv) The unit must be adjustable for use on children and intubated patients;

(v) The unit must include at least a 300 ml collection bottle; and

(vi) A secondary suction apparatus.

(B) Suction connecting tubing and catheters:

(i) Suction connecting tubing that is at least 1/4 inch in diameter, translucent and will not kink or collapse under high suction -2; and

(ii) Suction catheters in assorted sizes and types for adult, child, and newborn/infant.

(e) Stretcher. The stretcher must:

(A) Be securely fastened to the aircraft in accordance with FAA Part 135; and

(B) Have a minimum of three restraining devices and an upper torso (over the shoulder) restraint.

(f) Miscellaneous equipment:

(A) Emesis containers;

(B) Stethoscope, adult and pediatric;

(C) Aneroid sphygmomanometer in assorted sizes:

(D) Bandage shears;

(E) Hypothermia thermometer;

(F) Chemical heat and cold packs, assorted;

(G) Blood glucose level testing kit or blood glucose level test strips;

(H) Urinals, female and male, one each;

(I) Bed pan (Exempt from rotary-wing aircraft); and

(J) Set of extremity restraining devices.

(g) Personal protection equipment sufficient for crew and patient(s) including:

(A) Disposable gloves;

(B) Disposable face masks;

(C) Protective eyewear;

(D) Disposable isolation gowns;

(E) Hand cleaning solution or foam;

(F) Surface cleaning disinfectant;

(G) Sharps container for each kit that contains needles; and

(H) Infectious waste disposal bags.

(h) Linen supplies and replacements to cover stretcher;

(i) Prehospital Care Report Form or electronic field data form;

(j) A copy of standing orders for EMTs, RNs and PAs dated within one year and signed by the EMS Medical Director; and

(k) A universal "No Smoking" sign must be conspicuously displayed in the cockpit and patient compartment.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0082

Air Ambulance Operating Requirements for Scene Response

(1) Rotary-wing aircraft in operation and providing scene response care must have a minimum staff of two persons:

(a) A pilot adhering to all regulations set forth in FAA Part 135; and

(b) One EMT-Paramedic, RN, PA, or physician having:

(A) Documentation that at least one member of the medical crew successfully completed the 2004 Association of Air Medical Services (AAMS) Curriculum Guidelines or equivalent. The curriculum must include emergency care procedures, aircraft safety and altitude physiology. There must be written documentation of an annual review of the Air Medical Crew course material. The length and content of the review must be established by the EMS Medical Director and be kept on file with the ambulance service;

(B) The ability to properly assist in extricating, lifting and moving a patient; and

(C) The knowledge to properly operate all patient care equipment that may be used.

(c) When a RN, PA or physician is staffing an air ambulance in lieu of an EMT-Paramedic and is providing advanced level life support care, he or she must also have:

(A) A current Advanced Cardiac Life Support course or other Division-approved equivalent completion document;

(B) A pediatric advanced life support course or other Division -approved equivalent completion document; and

(C) A Trauma Emergency Assessment Management, Trauma Nurse Core Course, Prehospital Trauma Life Support or Basic Trauma Life Support course completion document. The Trauma Emergency Assessment Management or Trauma Nurse Core Course must include a supplemental prehospital rapid extrication training session.

(2) Any pilot, EMT, Respiratory Therapist, RN, PA, physician, or other qualified personnel staffing an air ambulance must:

(a) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(b) Not be taking any medications that could impair the giving of proper patient care or the safe operation of the air ambulance.

(3) The following prehospital scene patient care equipment is required on all prehospital scene responses:

(a) All patient care equipment specified in OAR 333-255-0081(7)(a) through (7)(k);

(b) Fracture immobilization equipment:

(A) Traction splints in assorted adult and/or adult-child combination;

(B) Extremity splints in assorted sizes;

(C) Extrication collars in assorted pediatric through adult sizes;

(D) Short backboard or equivalent with necessary restraining devices with sufficient supplies for head immobilization;

(E) Long backboard with necessary restraining devices with sufficient supplies for head immobilization;

(F) Scoop stretcher with necessary restraining devices with sufficient supplies for head immobilization; and

(G) Pediatric backboard with necessary restraining devices with sufficient supplies for head immobilization.

(c) Bandages and dressings in assorted sizes, sterile and non-sterile.

(d) Adhesive or hypo-allergenic tape in assorted sizes;

(e) Cardiac monitoring equipment:

(A) Manual monitor/defibrillator;

(B) Monitoring electrodes, infant and adult:

(C) Patient cables -- 2; and

(D) ECG paper.

(f) Advanced airway care equipment:

(A) Laryngoscope handle and assorted blade sizes, adult and pediatric;

(B) Spare dated batteries for the laryngoscope handle;

(C) Spare bulbs for the laryngoscope blades;

(D) Endotracheal tubes in assorted sizes, adult and pediatric;

(E) Magill Forceps, child and adult;

(F) Intubation stylettes, child and adult;

(G) Endtidal CO2 detection device;

(H) Oxygen saturation monitor; and

(I) Chest decompression kit;

(g) Sterile intravenous agents and medications authorized by the EMS Medical Director;

(h) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24-gauge through 14-gauge; and

(B) Specifically-designed needles for intraosseous infusions.

(i) Nasogastric tubes in assorted sizes;

(j) Storage of controlled substances in an ambulance must adhere to the signed and dated procedures as specified in OAR 333-250-0047(2)(a) and (2)(b);

(k) Oregon Trauma System's Identification Bracelets -- 5;

(l) Miscellaneous equipment:

(m) The 2004 Department of Transportation Emergency Response Guidebook (Initial Response to Hazardous Materials Incidents); and

(n) A copy of standing orders for EMT-Paramedics, RNs and PAs dated within one year and signed by the EMS Medical Director.

(4) In a prehospital resuscitation, when no other practical means of transportation, including any other properly equipped license-holder, is reasonably available, a license-holder may deviate from the rules to the extent necessary to meet the rescue situation.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0090

Marine Ambulance Configuration and Survival/Rescue Equipment Requirements

(1) A marine ambulance in operation must be in compliance with all the requirements which relate to marine ambulances, any applicable federal navigation regulations, ORS chapter 682, and these rules. Maintenance records must be kept and made available for inspection by the Division:

(2) Marine craft size and configuration. The marine craft must be of sufficient size to accommodate, at a minimum, the operator, two EMTs, one patient, and the required supplies and equipment and be configured to allow full access to the patient. The marine craft must have:

(a) Adequate lighting, so that patient care can be given and patient status be monitored;

(b) At least one outlet per patient and current for 110 volts (50/60 cycle) alternating current or other current which is capable of operating all electrically-powered medical equipment;

(c) An adequate door or opening to allow loading and unloading of the patient without rotating the patient and stretcher more than 30 degrees about the longitudinal (roll) axis or 45 degrees about the lateral (pitch) axis;

(d) A configuration that allows the medical personnel access to the patient in order to begin and maintain treatment modalities. There must always be complete access to the patient's head and upper body for effective airway management; and

(e) The stretcher or litter and medical equipment placed in a manner that must not impede rapid egress by personnel or patient from the marine craft.

(3) Marine craft equipment. A marine craft ambulance must have the following items in good working condition:

(a) Anchor with line that is three times the maximum depth of water in areas of usual operation;

(b) Docking fenders -- 2;

(c) Mooring lines -- 2;

(d) Self or mechanical bailer;

(e) Search light with a minimum of 200,000 candle power of illumination;

(f) Swim harness and 75-foot tethering line;

(g) Waterproof flashlight, six volt minimum;

(h) Navigational charts for service area and navigational aids, including a compass;

(i) A cold water protection device for each crew member;

(j) Life jackets -- 2 adult and 2 child; and

(k) Boat hook with minimum of 10 foot capability.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: HD 63, f. 6-6-74, ef. 6-25-74; HD 1-1981, f. & ef. 1-14-81; Renumbered from 333-023-0650; HD 14-1981(Temp), f. & ef. 8-7-81; HD 19-1984, f. & ef. 9-10-84; HD 16-1986, f. & ef. 9-9-86; HD 9-1987, f. & ef. 7-21-87; HD 19-1991, f. & cert. ef. 10-18-91, Renumbered from 333-028-0050(4) & (5); HD 18-1994, f. 6-30-94, cert. ef. 7-1-94, Renumbered from 333-028-0052; OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0091

Marine Ambulance Operating Requirements When Providing Basic Level Care

(1) A marine ambulance in operation and providing basic level care must have a staff of at least two persons:

(a) An operator, who:

(A) Has a valid US Coast Guard pilot's license;

(B) Operates the marine ambulance in compliance with any applicable marine craft statutes;

(C) Has not consumed any alcoholic beverages in the eight hours prior to operating an ambulance; and

(D) Is not taking any medications that could impair the safe operation of the ambulance.

(b) A person who is at or above the EMT-Basic certification level who must be with the patient at all times. The EMT attending the patient must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(c) If the operator is not a certified EMT, the operator must meet the requirements specified in sections (1)(a)(A) through (1)(a)(D) of this rule and have:

(A) A copy of certificate of course completion that the non-EMT operator has demonstrated knowledge and skills in the performance of one and two-person rescuer cardiopulmonary resuscitation (adult, child and infant) and relief of foreign body airway obstruction. The course must meet the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care or equivalent standards approved by the Division.

(B) A signed statement by the operator that he or she is not addicted to alcohol or controlled substances;

(C) A signed statement by the operator that he or she is free from any physical or mental defect that could impair the ability to operate an ambulance; and

(D) A signed statement by the training officer that the operator has the ability to properly assist in extricating, lifting and moving a patient.

(2) Basic life support care equipment. A marine ambulance in operation and providing basic level care must have the following patient care equipment in a satisfactory working condition, kept in a sanitary manner, stored in a secure manner and be readily accessible to the medical personnel:

(a) Medical oxygen cylinders and regulators:

(A) Medical oxygen cylinder with a minimum capacity of 600 liters;

(i) The oxygen must be delivered by a yoke regulator with a pressure gauge and a non-gravity-dependent flowmeter that is visible and accessible to the medical personnel; and

(ii) The flowmeter must be adjustable over a minimum range of 0 to 15 liters per minute.

(B) A spare portable oxygen cylinder that is full, tagged, sealed and securely mounted.

(b) Medical oxygen administration equipment:

(A) Oxygen non-rebreathing masks with tubing.

(i) Pediatric -- 2; and

(ii) Adult -- 2.

(B) Oxygen nasal cannulas with tubing that are transparent and disposable, adult -- 2;

(C) Bag-valve-mask ventilation device with reservoir. The device must:

(i) Have a standard universal adapter (15 mm tracheal tube/22 mm mask);

(ii) Be operable with or without an oxygen supply;

(iii) Be manually operated and self-refilling;

(iv) Have valves that operate effectively at temperatures down to 0° F; and

(v) Have bag-valve-mask ventilation devices with reservoir that are transparent and semi-rigid in assorted sizes to include adult, child, and newborn/infant.

(c) Airway maintenance devices:

(A) Pharyngeal esophageal airway devices in assorted sizes if the EMS Medical Director approved use;

(B) Endtidal CO2 detection device in assorted sizes;

(C) Oropharyngeal airways in assorted sizes to include adult, child and newborn/infant; and

(D) Nasal airways in assorted sizes.

(d) Suction equipment:

(A) Portable suction aspirator:

(i) The unit must be either a self-contained battery or oxygen-powered unit that can operate continuously for 20 minutes and is rechargeable or be a manually-powered unit;

(ii) The unit must be capable of developing a minimum vacuum of 300 mm Hg within four seconds after the suction tube is closed;

(iii) The unit must provide a free air flow of at least 20 liters per minute;

(iv) The unit must be adjustable for use on children and intubated patients;

(v) The unit, including at least a 300 ml collection bottle; and

(vi) A secondary suction apparatus.

(B) Suction connecting tubing and catheters:

(i) Suction connecting tubing that is at least 1/4 inch in diameter, translucent and will not kink or collapse under high suction - 2; and

(ii) Suction catheters that are in assorted sizes and types for adult, child and newborn/infant.

(e) Cardiac monitoring equipment: Automatic or semi-automatic defibrillator. The unit must be capable of operating independently of an electrical outlet, and delivering a total defibrillation energy sufficient to meet the number of shocks and power settings prescribed in the EMS Medical Director 's standing orders and be inclusive of the 2005 American Heart Association guidelines for emergency cardiac care or equivalent standards as approved by the Division.

(f) Stretcher. The stretcher must:

(A) Be a plastic or metal basket stretcher with a four-point bridle;

(B) Have a locking mechanism which can be securely fastened to the craft below the gunwale level; and

(C) Have a minimum of four restraining devices, one of which shall be a torso (over the shoulder) restraint.

(g) Fracture immobilization equipment:

(A) Traction splints in assorted adult sizes and/or adult/child combination;

(B) Extremity splints in assorted sizes;

(C) Extrication collars in assorted pediatric through adult sizes;

(D) Short backboard or equivalent with necessary restraining devices with sufficient supplies for head immobilization;

(E) Long backboard with necessary restraining devices with sufficient supplies for head immobilization; and

(F) Pediatric backboard with necessary restraining devices with sufficient supplies for head immobilization.

(h) Bandages and dressings in assorted sizes, sterile and non-sterile;

(i) Adhesive or hypo-allergenic tape in assorted sizes;

(j) Miscellaneous equipment:

(A) Emesis containers;

(B) Stethoscope, pediatric and adult;

(C) Aneroid sphygmomanometer in assorted sizes:

(D) Bandage shears;

(E) Hypothermia thermometer;

(F) Disposable obstetrical kit;

(G) Chemical heat and cold packs assorted;

(H) Urinals, female and male, one each;

(I) Bed pan;

(J) Set of extremity restraining devices; and

(K) Blood glucose level testing kit or blood glucose level testing strips.

(k) Personal protection equipment sufficient for crew and patient(s) including:

(A) Disposable gloves;

(B) Disposable face masks;

(C) Protective eyewear;

(D) Disposable isolation gowns;

(E) Hand cleaning solution or foam;

(F) Surface cleaning disinfectant;

(G) Sharps container for the patient compartment and a separate container for each kit that contains needles;

(H) Infectious waste disposal bags; and

(I) The 2004 Department of Transportation - Emergency Response Guidebook (Initial Response to Hazardous Materials Incidents.)

(l) Medications and fluids authorized for use by an EMT-Basic as required by the EMS Medical Director;

(m) Linen supplies and replacements sufficient to cover stretchers;

(n) Communication equipment. Communications equipment must consist of a VHF/FM marine radio with at least 25 watts of power. In addition, the radio must have the capability to have reliable contact between the marine ambulance and a ground or air ambulance and with a hospital having on-line medical direction;

(o) Prehospital Care Report Form or electronic field data;

(p) Oregon Trauma System Identification Bracelets -- 5;

(q) A copy of standing orders for EMT-Basics dated within one year and signed by the EMS Medical Director; and

(r) A universal "No Smoking" sign conspicuously displayed in the pilot's and patient area.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117 & 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0092

Marine Ambulance Operating Requirements When Providing Intermediate Level Care

(1) A marine ambulance in operation and providing intermediate life support care must have a minimum staff of two persons:

(a) An operator who complies with the requirements specified in OAR 333-255-0091(1)(a)(A) through (1)(a)(D) or (1)(c)(A) through (1)(c)(D); and

(b) A person who is at or above the EMT-Intermediate certification level and who must be with the patient at all times. If the operator is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both in the marine ambulance or on scene; and

(c) The EMTs attending the patient must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(2) Intermediate life support care equipment. A marine ambulance in operation and providing intermediate level care must have the following patient care equipment in a satisfactory working condition, kept in a sanitary manner, stored in a secure manner and be readily accessible to the medical personnel:

(a) All of the items specified in OAR 333-255-0091(2)(a) through (2)(r);

(b) Any physiologic isotonic crystalloid solution or combinations thereof -- 6000 cc in any size containers;

(c) Medications and fluids authorized for use by an EMT-Intermediate as required by the EMS Medical Director;

(d) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 24 gauge through 14 gauge; and

(B) Specifically-designed needles for intraosseous infusions.

(e) A copy of standing orders for EMT-Intermediates dated within one year and signed by the EMS Medical Director.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

333-255-0093

Marine Ambulance Operating Requirements When Providing Advanced Level Care

(1) A marine ambulance in operation and providing advanced level care must have a minimum staff of two persons:

(a) An operator who complies with the requirements specified in OAR 333-255-0091(1)(a)(A) through (1)(a)(D) or (1)(c)(A) through (1)(c)(D); and

(b) A person who is at the EMT-Paramedic certification level or an RN, PA or physician who is trained in prehospital emergency medical care must be attending to the patient when a patient is receiving advanced life support care. If the operator is not a certified EMT, then a second EMT, Basic or above, must be available for patient care both on the marine ambulance and on scene. The EMT-Paramedic, Respiratory Therapist, RN, PA, physician, or other qualified personnel must:

(A) Not have consumed any alcoholic beverages in the eight hours prior to working on an ambulance; and

(B) Not be taking any medications that could impair the giving of proper patient care.

(c) When a RN, PA or physician is staffing an ambulance in lieu of an EMT-Paramedic and is providing advanced level care he or she must have:

(A) A current American Heart Association "Health Care Provider", American Red Cross "Basic Life Support for the Professional Rescuer" or other Division-approved equivalent CPR course completion document;

(B) A current Advanced Cardiac Life Support course or other Division-approved equivalent completion document;

(C) A pediatric advanced life support course or other Division-approved equivalent completion document;

(D) A Prehospital Trauma Life Support, Basic Trauma Life Support, Trauma Emergency Assessment Management or Trauma Nurse Core Course completion document. The Trauma Emergency Assessment Management and Trauma Nurse Core Course must include a supplemental prehospital rapid extrication training session;

(E) The ability to properly assist in extricating, lifting and moving a patient; and

(F) The knowledge to properly operate all patient care equipment that may be used.

(2) A marine ambulance in operation and providing advanced level care must have the following advanced life support patient care equipment in a satisfactory working condition, kept in a sanitary manner and which is readily accessible to medical personnel:

(a) All items specified in OAR 333-255-0091(2)(a) through (2)(r);

(b) Cardiac monitoring equipment:

(A) Manual monitor/defibrillator;

(B) Monitoring electrodes, infant and adult;

(C) Patient cables -- 2; and

(D) ECG paper.

(c) Advanced airway care equipment:

(A) Laryngoscope handle and assorted blade sizes, adult and pediatric;

(B) Spare dated batteries for the laryngoscope handle;

(C) Spare bulbs for the laryngoscope blades;

(D) Endotracheal tubes in assorted sizes, adult and pediatric.

(E) Magill Forceps, adult and child;

(F) Intubation stylettes, adult and pediatric;

(G) Endtidal CO2 detection device; and

(H) Chest decompression equipment;

(d) Sterile intravenous agents and medications authorized by the EMS Medical Director;

(e) Vascular access devices:

(A) Over-the-needle catheters in assorted sizes 14-gauge through 24-gauges; and

(B) Specifically-designed needles for intraosseous infusions.

(f) Nasogastric tubes in assorted sizes;

(g) The storage of controlled substances in a marine ambulance must adhere to the procedure specified in OAR 333-250-0047(2)(a) and (b); and

(h) A copy of standing order for EMT-Paramedics, RNs and PAs dated within one-year and signed by the EMS Medical Director.

(3) The special equipment required for a marine ambulance may be kept separate from the craft in modular watertight and buoyant containers for rapid loading and easy access aboard the marine craft.

Stat. Auth.: ORS 682.017
Stats. Implemented: ORS 682.017 - 682.117, 682.991
Hist.: OHD 5-2001, f. & cert. ef. 4-24-01; PH 2-2007, f. & cert. ef. 2-1-07

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