SECTION 310:641-13-9. Air ambulance vehicle

(a)   An air ambulance vehicle (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 (FAR) within 14 CFR, Part 1 et seq.

(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 operations.

(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 FAR's.

(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 that 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 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)   Medical transport personnel shall be able to determine if medical oxygen is on 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.

(B)   Measurement of liter flow.

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

(i)   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.

(j)   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.

(k)   Storage of oxygen shall comply with applicable OSHA standards within 29 CFR, Part 19 D.

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

(m)   In the event the licensee will be utilizing a substitute aircraft not previously permitted by the Department for a period of more than five (5) days, the licensee shall notify the Department to have the aircraft inspected and permitted by the Department.

(1)   Licensees with a substitute aircraft utilized for periods of five (5) days or less, the licensee shall complete an agency specific equipment log documenting the transfer of all required equipment onto the substitute aircraft at the time of transfer.

(2)   The agency will maintain documentation of the transfer in accordance with 310:641-13-21 Air ambulance service records and files.

(n)   Any vehicle initially placed in service after a purchase, lease, contract and/or refurbish shall be inspected, approved, and permitted by the Department as detailed within this section of 310:641 Subchapter 13.

[Source: Amended and renumbered from 310:641-3-32 at 33 Ok Reg 1529, eff 9-11-16; Amended at 37 Ok Reg 1423, eff 9-11-20]