NORTH COAST EMERGENCY MEDICAL SERVICES Policy # 2204

POLICIES AND PROCEDURES

Subject: Medical Direction

LALS Supply and Equipment List

Associated Policies: 2202, 2203, 2205 02/05/98

  1. Authority and Reference (incorporated herein by reference)
  1. Title 22, California Code of Regulations, Section 100126.
  2. Division 2.5, Sections 1797.107, 1797.171, and Chapter 4 of the Health and Safety Code.
  3. State Emergency Medical Services Authority "Recommended Ambulance Equipment", contained in the California Highway Patrol Ambulance Driver's Handbook (# CHP-894).
  4. North Coast Emergency Medical Services Policies and Procedures.
  1. Purpose

To establish the regional minimum supply and equipment standard for any ambulance or emergency vehicle which responds as, or is held out as, an ALS or LALS unit. ALS or LALS units may exceed the equipment and supply quantities listed herein for procedures and medications which are within the certificate holder's scope of practice described in North Coast EMS Policy and Procedures. This policy is also intended to develop a mechanism for base hospitals to establish supply and equipment requirements which exceed the minimum standard for LALS provider within the Base Hospital's zone. Supplies and materials listed are in addition to those specified in the First Responder / BLS Supply and Equipment List.

  1. Minimum Equipment and Supplies
  1. Minimum Equipment:

Equipment referred to in Section I. C. of this policy. All equipment referred to in this reference, including but not limited to "suggested" equipment, is mandatory.

  1. One (1) mobile or portable FCC approved radio which is capable of two-way communication on Med-Net frequencies 1 through 7.
  2. One (1) three chambered pneumatic anti-shock garment.
  3. One (1) portable DC cardiac monitor/defibrillator which is capable of adult and pediatric monitoring and defibrillation through adult and pediatric sized electrodes.
  4. One (1) each, laryngoscope with handle, spare batteries, and a spare light bulb.
  5. One (1) each, #4 straight and curved laryngoscope blades with light.
  6. One (1) each, #1 and #2 straight laryngoscope blades with light.
  7. One (1) each, adult and pediatric Magill forceps.
  8. One (1) each, adult and pediatric malleable stylets.

 

 

 

 

  1. Minimum Supplies:

All supplies referred to in Section I.C. of this policy. All supplies referred to in this reference, including but not limited to "suggested" supplies, are mandatory.

  1. One (1) esophageal obturator airway with mask, or esophageal gastric tube airway with mask and stomach tube.
  2. Electrodes and conductive medium for adult and pediatric monitoring and defibrillation.
  3. Four (4) each, 14 gauge, 16 gauge, 18 gauge, 20 gauge, 22 gauge, and 24 gauge catheter-over-needle intravenous catheters.
  4. One (1) venous constricting band with a width of at least one inch.
  5. Alcohol preps, water resistant tape, and 2"x 2" gauze pads.
  6. One (1) 20 ml syringe.
  7. One (1) 10 ml syringe.
  8. One (1) 3 ml syringe.
  9. One (1) each, red, blue, green, and purple top Vacutainer tubes, or equivalent.
  10. One (1) each, 18 gauge by 1 1/2 inch, 23 gauge by 1 inch, and 25 gauge by 5/8 inch hypodermic needles.
  11. One (1) I.V. cap.
  12. One (1) each, 2.5 mm through 9.0 mm endotracheal tubes (in 0.5 mm increments).
  13. One (1) sterile suction catheter and glove pack for endotracheal suctioning.
  14. Two (2) Epinephrine 1 mg in 1 ml (1:1000) ampules.
  15. Four (4) Epinephrine 1 mg in 10 ml (1:10,000) pre-loads.
  16. Two (2) 0.083% Albuterol sulfate solution for inhalation in 3 ml unit dose bottles or equivalent.
  17. Four (4) children’s chewable Aspirin (81 mg).
  18. Four (4) Atropine 0.5 mg in 5 ml pre-loads or two (2) 1.0 mg in 10 ml pre-loads.
  19. One (1) multi dose vial Atropine 0.04mg/ ml containing at least 20 mls.
  20. One (1) Calcium Chloride 1 gm in 10 ml pre-load.
  21. Two (2) Dextrose 50% in 50 ml pre-loads.
  22. Two (2) Dextrose 25% in 10 ml pre-loads or equivalent.
  23. Two (2) Diazepam 10 mg in 2 ml or equivalent.
  24. Two (2) Furosemide 20 mg in 2 ml ampules or equivalent.
  25. One (1) 30 ml bottle Syrup of Ipecac.
  26. Three (3) Lidocaine HCl 100 mg in 5 ml or 10 ml pre-loads.
  27. One (1) Lidocaine HCl 2 gm in 10 ml pre-load or pre-mixed Lidocaine Drip 4mg/ ml.
  1. Two (2) Morphine Sulfate 10 mg in 1 ml vial, or 10 mg in 10 ml pre-loads.
  2. One (1) bottle Nitroglycerin 0.4 mg (1/150 grain) sublingual tablets, or one (1) canister aerosol spray delivering 0.4 mg per meter-dosed spray.
  3. Two (2) Sodium Bicarbonate 44.6 mEq in 50 ml pre-load.
  4. Four (4) Naloxone 1mg/ ml ampules or one (1) multi-dose vial.
  5. Two (2) Normal Saline, 250 or 500 ml in a plastic container. (The Base Hospital Medical Director may at his/her option substitute 5% Dextrose in water 250 or 500 ml in a plastic container. If this option is exercised, the Medical Director of North Coast EMS shall be notified in writing.)
  6. Four (4) Normal Saline 1000 ml in plastic containers.
  7. Two (2) D5 1/2 NS 500 ml or one (1) D5 1/2 NS 1,000 ml in plastic containers.
  8. Two (2) each, 60 gtt/ml, 15 gtt/ml, and 10 gtt/ml intravenous infusion sets or equivalent micro, macro and blood sets.
  9. One (1) small volume nebulizer, Puritan Bennett #0001140 or equivalent.
  10. Fifteen (15) triage tags, Met Tag or equivalent.
  1. Additional Base Hospital Requirements

A Base Hospital may require an LALS provider within the Base Hospital's zone to maintain supplies and equipment which exceed these minimum requirements. If a Base Hospital seeks to require any additional inventory requirements, the Base Hospital shall:

  1. Propose the additional requirements in writing with reasons and justification to the North Coast EMS Medical Director and,
  2. Copy the proposal to the affected LALS provider(s).
  3. The North Coast EMS Medical Director will return a decision within forty-five days unless additional time is required to receive comments regarding the Base Hospital proposal. All decisions will be made within ninety days of receipt of proposal.