SECTION 310:641-11-11. Specialty care air ambulance aircraft

(a)   An air ambulance aircraft may be fixed wing, single or multi-engine; or rotary wing, single or multi-engine.

(b)   Operations of the aircraft shall be under the appropriate provisions of the Federal Aviation Regulations (FARs).

(c)   The interior of the patient compartment of their aircraft shall have the capability of being climate controlled to avoid adverse effects on patients and medical personnel on board by a means other than flight operations and flying to an altitude.

(d)   The aircraft design and configuration shall not compromise patient stability in loading, unloading, or in- flight operation to include:

(1)   the aircraft shall have an entry that allows loading and unloading without excessive maneuvering (no more than 45 degrees about the lateral axis and 30 degrees about the longitudinal axis) of the patient and does not compromise functioning of monitoring systems, intravenous lines, and manual or mechanical ventilation;

(2)   a minimum of one stretcher shall be provided that can be carried to the patient;

(3)   aircraft stretchers and the means of securing it in-flight must be consistent with applicable Supplemental Type Certificates (STCs).

(4)   the type and model of stretcher indicates the maximum gross weight allowed (inclusive of patient and equipment) as labeled on the stretcher;

(5)   the stretcher shall be large enough to carry an American adult male .

(6)   the stretcher shall be sturdy and rigid enough that it can support cardiopulmonary resuscitation. If a backboard or equivalent device is required to achieve this, such device will be readily available;

(7)   the head of the stretcher is capable of being elevated at least 30 degrees for patient care and comfort;

(8)   if the ambulance stretcher is floor supported by its own wheels, there is a mechanism to secure it in position under all conditions. These restraints permit quick attachment and detachment for patient transfer.

(e)   Patients transported by air will be restrained with a minimum of three straps, including shoulder straps, which must comply with FAA regulations. The following additional requirements shall apply to achieve patient stability:

(1)   patients less than 60 pounds (27kg) shall be provided with an appropriately sized restraining device (for patient's height and weight) which is further secured by a locking device. All patients less than 40 pounds must be secured in a five-point safety strap device that allows good access to the patient from all sides and permits the patient's head to be raised at least 30 degrees. Velcro straps are not encouraged for use on pediatric devices;

(2)   if a car seat is used, it shall have an FAA approved sticker;

(3)   there shall be some type of restraining device within the isolette to protect the infant in the event of air turbulence.

(f)   A supplemental lighting system shall be installed in the aircraft/ambulance in which standard lighting is insufficient for patient care, and a self-contained lighting system powered by a battery pack or portable light with a battery source must be available.

(g)   An electric power outlet shall be provided with an inverter or appropriate power source of sufficient output to meet the requirements of the complete specialized equipment packages without compromising the operation of any other system or equipment. A back-up power source to enable use of equipment may be provided by an extra battery of appropriate voltage and capacity.

(h)   There shall be access and necessary space to ensure any onboard patient's airway is maintained and to provide adequate ventilatory support from the secured, seat-belted position of medical transport personnel.

(k)   Medical transport personnel shall be able to determine if medical oxygen is on in the patient care area.

(1)   Each gas outlet shall be clearly marked for identification.

(2)   Oxygen flow shall be capable of being started and stopped at or near the oxygen source from inside the aircraft.

(3)   The following indicators shall be accessible to medical transport personnel while en route:

(A)   quantity of oxygen remaining; and

(B)   measurement of liter flow.

(l)   A variety of medical oxygen delivery devices consistent with the service's medical protocols shall be available.

(m)   An appropriately secured portable medical oxygen tank with a delivery device shall be carried on the aircraft. Portable medical oxygen tank may not be secured between patient's legs while the aircraft is in motion.

(n)   There shall be a back-up source of medical oxygen sufficient to allow completion of the transport in the event the main system fails. For air transports, this back-up source can be the required portable tank as long as the portable tank is accessible in the patient care area during flight.

(o)   Storage of oxygen shall comply with applicable standards.

(p)   Oxygen flow meters and outlets shall be located to prevent injury to medical transport personnel to the extent possible.

(q)   The licensee shall notify the Department prior to placing a substitute aircraft into operation. Any vehicle initially placed in service after a purchase, lease, contract and/or refurbish shall be inspected, approved, and permitted by the Department.

[Source: Added at 33 Ok Reg 1529, eff 9-11-16]