<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 30.09.10.09" title_num="30" subtitle_num="09" chapter_num="10" heading="Standard Ambulance Ventilation and Airway Maintenance Equipment.">
  <text>Each ambulance shall carry the following standard airway maintenance and ventilation equipment:</text>
  <paragraph num="A.">
    <text>Oxygen which meets the following criteria:</text>
    <paragraph num="(1)">
      <text>For ground ambulances:</text>
      <paragraph num="(a)">
        <text>Optional onboard cylinders for BLS ambulances have a capacity of at least 3,000 liters;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Portable cylinders have a capacity of at least 400 liters;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The following number of cylinders, if on-board oxygen is present, unless more are needed for a particular patient based on COMAR 30.09.07.03A(2)(g):</text>
        <paragraph num="(i)">
          <text>One E size,</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>One jumbo D size, or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Two D size;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>The following number of cylinders, if on-board oxygen is not present, unless more are needed for a particular patient based on COMAR 30.09.07.03A(2)(g):</text>
        <paragraph num="(i)">
          <text>Two E size,</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Two jumbo D size, or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Three D size;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>For air ambulances:</text>
      <paragraph num="(a)">
        <text>An on-board oxygen system that meets the CAMTS standards, which provide that:</text>
        <paragraph num="(i)">
          <text>Oxygen is installed according to FAA regulations;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Medical transport personnel can determine if oxygen is on by in-line pressure gauges mounted in the patient care area;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Each gas outlet is clearly marked for identification;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Oxygen flow can be stopped at or near the oxygen source from inside the aircraft;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>The indicators for quantity of oxygen remaining and measurement of liter flow are accessible to medical transport personnel while enroute; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Oxygen flow meters and outlets must be padded, flush mounted, or so located to prevent injury to medical transport personnel; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>A minimum of one portable oxygen cylinder that has a capacity of at least 400 liters;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>All cylinders are properly color coded for U.S.P. grade, medical oxygen;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The system is free of:</text>
      <paragraph num="(a)">
        <text>Grease,</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Oil, or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Other flammable organic material; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>All cylinders have passed hydrostatic testing during the past:</text>
      <paragraph num="(a)">
        <text>5 years, or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>10 years, if approved by the inspector based on the condition of the cylinder;</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Regulators which:</text>
    <paragraph num="(1)">
      <text>Have a reducing valve limiting line pressure to 50  10 psi;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Have a pressure gauge, with a range of 0 to 2,500 psi, to indicate the pressure of oxygen remaining in the cylinder;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Are capable of delivering at least 0 to 15 liters/minute flow in calibrated increments;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Are accurate to within 1 liter/minute when at a setting equal to or less than 5 liters/minute;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Are accurate to within 1.5 liters/minute when at a setting between 6 and 10 liters/minute; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Are accurate to within 2 liters/minute when at a setting equal to or greater than 11 liters/minute;</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>At least one flow smeter dedicated to the portable oxygen system that is not gravity dependent;</text>
  </paragraph>
  <paragraph num="D.">
    <text>If present, positive pressure demand valves which provide:</text>
    <paragraph num="(1)">
      <text>100 percent oxygen;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An instantaneous flow rate not greater than 40 liters/minute;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>An inspiratory pressure relief valve that opens at 60-centimeter water pressure; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A 15/22-millimeter fitting;</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Adult oxygen administration sets which are the following types and quantities:</text>
    <paragraph num="(1)">
      <text>Four non-rebreather;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Two venturi;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Six nasal cannula;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Disposable, single use design; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Transparent;</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Pediatric oxygen administration sets which are the following types and quantities:</text>
    <paragraph num="(1)">
      <text>Two non-rebreather;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Two nasal cannula;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Disposable, single use design; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Transparent;</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Two sets of oxygen connecting tubing;</text>
  </paragraph>
  <paragraph num="H.">
    <text>One hand operated, self-reinflating adult bag valve mask with:</text>
    <paragraph num="(1)">
      <text>Oxygen inlet;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Reservoir tube;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Transparent face mask; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Selectable pop off valve or no pop off valve;</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>One hand operated, self-reinflating, pediatric bag valve mask with:</text>
    <paragraph num="(1)">
      <text>Oxygen inlet;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Reservoir tube;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>One transparent neonatal face mask; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>One transparent pediatric or child face mask;</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>One pocket mask with one-way valve; and</text>
  </paragraph>
  <paragraph num="K.">
    <text>One set of oropharyngeal airways in the following sizes:</text>
    <paragraph num="(1)">
      <text>Adult;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Child; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Infant.</text>
    </paragraph>
  </paragraph>
</regulation>