Each ambulance shall carry the following standard airway maintenance and ventilation equipment:

1. A. Oxygen which meets the following criteria:

   1. (1) For ground ambulances:

      1. (a) Optional onboard cylinders for BLS ambulances have a capacity of at least 3,000 liters;
      2. (b) Portable cylinders have a capacity of at least 400 liters;

      3. (c) 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):

         1. (i) One E size,
         2. (ii) One jumbo D size, or
         3. (iii) Two D size;

      4. (d) 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):

         1. (i) Two E size,
         2. (ii) Two jumbo D size, or
         3. (iii) Three D size;

   2. (2) For air ambulances:

      1. (a) An on-board oxygen system that meets the CAMTS standards, which provide that:

         1. (i) Oxygen is installed according to FAA regulations;
         2. (ii) Medical transport personnel can determine if oxygen is on by in-line pressure gauges mounted in the patient care area;
         3. (iii) Each gas outlet is clearly marked for identification;
         4. (iv) Oxygen flow can be stopped at or near the oxygen source from inside the aircraft;
         5. (v) The indicators for quantity of oxygen remaining and measurement of liter flow are accessible to medical transport personnel while enroute; and
         6. (vi) Oxygen flow meters and outlets must be padded, flush mounted, or so located to prevent injury to medical transport personnel; and
      2. (b) A minimum of one portable oxygen cylinder that has a capacity of at least 400 liters;
   3. (3) All cylinders are properly color coded for U.S.P. grade, medical oxygen;

   4. (4) The system is free of:

      1. (a) Grease,
      2. (b) Oil, or
      3. (c) Other flammable organic material; and

   5. (5) All cylinders have passed hydrostatic testing during the past:

      1. (a) 5 years, or
      2. (b) 10 years, if approved by the inspector based on the condition of the cylinder;

2. B. Regulators which:

   1. (1) Have a reducing valve limiting line pressure to 50 10 psi;
   2. (2) Have a pressure gauge, with a range of 0 to 2,500 psi, to indicate the pressure of oxygen remaining in the cylinder;
   3. (3) Are capable of delivering at least 0 to 15 liters/minute flow in calibrated increments;
   4. (4) Are accurate to within 1 liter/minute when at a setting equal to or less than 5 liters/minute;
   5. (5) Are accurate to within 1.5 liters/minute when at a setting between 6 and 10 liters/minute; and
   6. (6) Are accurate to within 2 liters/minute when at a setting equal to or greater than 11 liters/minute;
3. C. At least one flow smeter dedicated to the portable oxygen system that is not gravity dependent;

4. D. If present, positive pressure demand valves which provide:

   1. (1) 100 percent oxygen;
   2. (2) An instantaneous flow rate not greater than 40 liters/minute;
   3. (3) An inspiratory pressure relief valve that opens at 60-centimeter water pressure; and
   4. (4) A 15/22-millimeter fitting;

5. E. Adult oxygen administration sets which are the following types and quantities:

   1. (1) Four non-rebreather;
   2. (2) Two venturi;
   3. (3) Six nasal cannula;
   4. (4) Disposable, single use design; and
   5. (5) Transparent;

6. F. Pediatric oxygen administration sets which are the following types and quantities:

   1. (1) Two non-rebreather;
   2. (2) Two nasal cannula;
   3. (3) Disposable, single use design; and
   4. (4) Transparent;
7. G. Two sets of oxygen connecting tubing;

8. H. One hand operated, self-reinflating adult bag valve mask with:

   1. (1) Oxygen inlet;
   2. (2) Reservoir tube;
   3. (3) Transparent face mask; and
   4. (4) Selectable pop off valve or no pop off valve;

9. I. One hand operated, self-reinflating, pediatric bag valve mask with:

   1. (1) Oxygen inlet;
   2. (2) Reservoir tube;
   3. (3) One transparent neonatal face mask; and
   4. (4) One transparent pediatric or child face mask;
10. J. One pocket mask with one-way valve; and

11. K. One set of oropharyngeal airways in the following sizes:

    1. (1) Adult;
    2. (2) Child; and
    3. (3) Infant.

Authority: Education Article, §§13-508 and 13-515, Annotated Code of Maryland

Effective date: October 12, 1992 (19:20 Md. R. 1816)

Regulation .04 adopted as an emergency provision effective January 6, 1997 (24:2 Md. R. 114); emergency status expired July 6, 1997

Regulation .04 adopted permanently effective July 7, 1997 (24:10 Md. R. 711)

Chapter recodified from COMAR 14.22.10 to COMAR 30.09.10, August, 1997

Regulation .04A amended as an emergency provision effective July 1, 1998 (25:15 Md. R. 1189); amended permanently effective October 5, 1998 (25:20 Md. R. 1534)

Regulations .01—.04, ALS Service, repealed effective January 10, 2000 (26:27 Md. R. 2017)

Regulations .01—.13, Standard Commercial Ambulance Equipment, adopted effective January 10, 2000 (26:27 Md. R. 2017)

Regulation .02 amended effective October 15, 2004 (31:20 Md. R. 1486)

Regulation .04E amended effective October 15, 2004 (31:20 Md. R. 1486)

Regulation .05 amended effective October 15, 2004 (31:20 Md. R. 1486)

Regulation .09A, C amended effective October 15, 2004 (31:20 Md. R. 1486)