Authority: IC 16-31-2-7; IC 16-31-3-14; IC 16-31-3-14.5; IC 16-31-3-20

Affected: IC 16-31-3

Sec. 3. (a) Each paramedic ambulance service provider organization shall comply with the ambulance service provider organization operating procedures of 836 IAC 1-2-3. The paramedic nontransport provider organization shall comply with the operating procedures listed in 836 IAC 1-1-8.

(b) Each paramedic provider organization shall establish daily equipment checklist procedures to ensure the following:

1. (1) Electronic and mechanical equipment are in proper operating condition.
2. (2) Emergency response vehicles are maintained in a safe operating condition at all times.
3. (3) All required medications and intravenous fluids approved by the medical director of the paramedic provider organization and the supervising hospital are on board all nontransport emergency medical services vehicles and ambulances when used for the provision of advanced life support and available to the paramedic.
4. (4) Equipment, medication, fluid, and supplies have not exceeded the manufacturer's specified expiration date.

(c) A copy of the medication list and protocols signed by the medical director shall be maintained by the paramedic provider organization and the supervising hospital emergency department. Any changes to the medications list shall be forwarded to the agency within thirty (30) days.

(d) All medications and advanced life support supplies are to be supplied by order of the medical director. Accountability for:

1. (1) distribution;
2. (2) storage;
3. (3) ownership; and
4. (4) security;

of medications is subject to applicable requirements as determined by the medical director, pharmacist, and the United States Department of Justice Drug Enforcement Administration.

(e) The paramedic provider organization shall ensure that all ambulances used for the provision of advanced life support contain the emergency care equipment required in 836 IAC 1-3-5, the rescue equipment required in 836 IAC 1-3-4, and communication equipment required in 836 IAC 1-4-2. The advanced life support emergency medical services vehicles shall also carry the following equipment:

1. (1) Portable defibrillator with self-contained cardiac monitor and ECG strip writer and equipped with defibrillation pads or paddles appropriate for both adult and pediatric defibrillation. This may be the defibrillator listed in 836 IAC 1-3-5(1)(L).

2. (2) Endotracheal intubation devices, including the following:

   1. (A) Laryngoscope with extra batteries and bulbs.
   2. (B) Laryngoscope blades (adult and pediatric, curved and straight).
   3. (C) Disposable endotracheal tubes, a minimum of two (2) each, sterile packaged, in sizes 3, 4, 5, 6, 7, 8, and 9 millimeters inside diameter.
3. (3) Intravenous fluids, medication, and administration supplies approved by the medical director.
4. (4) A current copy of advanced life support protocols shall be maintained on board the emergency medical services vehicle at all times.
5. (5) A copy of the medication list, including quantities and concentrations approved by the medical director.

(f) The paramedic provider organization shall do the following:

1. (1) Ensure that all nontransport emergency medical services vehicles used for the provision of advanced life support meet all of the requirements in 836 IAC 2-14.
2. (2) Follow the rigid sanitation procedures listed in 836 IAC 1-1-8.

(g) All scheduled medications shall be stored in a locked container within a locked compartment. Medications storage shall be approved in writing by medical director or issuing pharmacy.

(h) A paramedic provider organization shall not do the operating [sic, following]:

1. (1) Operate an ambulance or other emergency medical service vehicle unless it is in full compliance with this article.
2. (2) Transport any emergency patient or patient receiving advanced life support in any vehicle except an ambulance certified under IC 16-31.

(i) Provisions for temporary vehicle certification are addressed in 836 IAC 1-2-3 and 836 IAC 2-14-2(e).

(j) Paramedics are prohibited from having in their possession, or maintained on board emergency response vehicles, any advanced life support equipment or supplies that have not been approved by the paramedic provider organization medical director.

(k) A paramedic provider organization is considered to be providing specialty care transport when the level of service or procedures required:

1. (1) exceed the procedures identified in the Indiana paramedic curriculum;
2. (2) are those in which the paramedic has received additional medical director approved training; and
3. (3) have been approved by the organization medical director.

(Indiana Emergency Medical Services Commission; Advanced Life Support Rule I, C; filed Jan 21, 1977, 11:30 a.m.: Rules and Regs. 1978, p. 204; filed Nov 3, 1980, 3:55 p.m.: 3 IR 2219; filed Oct 13, 1981, 10:05 a.m.: 4 IR 2437; errata, 5 IR 400; filed Dec 2, 1983, 2:43 p.m.: 7 IR 367; errata, 7 IR 1254; filed Dec 13, 1985, 9:13 a.m.: 9 IR 1065; filed Aug 18, 1986, 1:00 p.m.: 10 IR 43; filed Oct 11, 1988, 11:05 a.m.: 12 IR 360; filed May 15, 1998, 10:25 a.m.: 21 IR 3896; filed Jun 30, 2000, 4:18 p.m.: 23 IR 2736; filed Jun 11, 2004, 1:30 p.m.: 27 IR 3538; filed Jul 31, 2007, 10:01 a.m.: 20070829-IR-836060011FRA; readopted filed Jul 29, 2010, 8:07 a.m.: 20100825-IR- 836100267RFA; readopted filed Oct 31, 2016, 1:48 p.m.: 20161130-IR-836160328RFA; readopted filed Nov 28, 2022, 2:51 p.m.: 20221228-IR-836220299RFA; readopted filed Jul 24, 2024, 3:48 p.m.: 20240821-IR-836230827RFA)