N.J. Admin. Code § 8:40-6.6

Current through Register Vol. 56, No. 19, October 7, 2024

Section 8:40-6.6 - Oxygen administration

(a) Each BLS ambulance shall be equipped with both an installed and a portable oxygen system, as well as one reserve oxygen cylinder with a capacity of at least 300 liters.

1. Each oxygen system shall be capable of delivering oxygen to a patient at a rate of at least 15 liters per minute during the entire time the patient is aboard the vehicle.

2. Each oxygen system shall have an oxygen flowmeter. Each flowmeter shall have a gauge or dial with a range of at least 0 to 15 liters per minute (lpm) in calibrated increments. The flowmeter on the portable system shall not be gravity dependent. Flowmeters shall be accurate to within 1.0 lpm when at a setting equal to or less than 5.0 lpm, 1.5 lpm when at a setting between 6.0 lpm and 10 lpm and within 2.0 lpm when at a setting equal to or greater than 11 lpm. Non-dial-type flowmeters shall take at least one full turn to go from 0 to 15 lpm. Indicators on dial-type flowmeters shall be securely seated at each flow rate position.

3. Each oxygen cylinder shall:

i. Contain only medical grade oxygen;

ii. Be color-coded green;

iii. Be contained in a U.S. Department of Transportation (U.S.D.O.T.) approved cylinder that has a valid hydrostatic testing date on it, in accordance with U.S.D.O.T. regulations; and

iv. Be tagged ("Full," "In Use," "Empty") or have a pressure indicating gauge attached to the cylinder.

4. The installed oxygen system shall be capable of safely storing and supplying a minimum of 3,000 liters of medical oxygen. The oxygen cylinder controls shall be accessible from inside the vehicle. Cylinder opening handles or wrenches shall be affixed to, or shall be chained and clipped with, the oxygen cylinder. Any oxygen piping and/or hose shall be nonferrous and shall be suitable for medical oxygen. All installed oxygen cylinders shall be retained in an oxygen tank holder certified by the manufacturer to comply with AMD Standard 003-Oxygen Tank Retention System.

5. The portable oxygen system shall be capable of safely storing and supplying 300 liters of medical oxygen. Cylinder opening handles or wrenches shall be chained to the regulator or affixed to the cylinder. All oxygen storage arrangements shall comply with applicable provisions of Federal Specifications for Ambulances, KKK-A-1822, "Portable Oxygen Unit."

6. Consistent with 8:40-4.4(d)7, the portable oxygen system, reserve oxygen cylinder and any portable positive pressure flow-restricted oxygen-powered ventilation devices (FROPVDs) shall be stored in a crashworthy manner.

(b) Each BLS ambulance shall be equipped with at least one each adult, pediatric and infant sized bag-valve-mask devices.

1. Each bag-valve-mask device shall:

i. Have a self-refilling bag without sponge rubber inside;

ii. The mask shall be constructed of clear material, shall be clean and free of contamination and leaks, shall have an oxygen supply (reservoir) system and shall be capable of providing adequate resuscitation pressures. Bag-valve-mask devices for adult patients shall be capable of deflating/refilling at least 20 times per minute at room temperature and shall have a minimum volume of 1,600 mL. Bag-valve-mask devices for pediatric patients shall be capable of deflating/refilling at least 30 times per minute at room temperature and shall have a minimum volume of 1,000 mL. Bag-valve-mask devices for infant patients shall be capable of deflating/refilling at least 40 times per minute at room temperature and shall have a minimum volume of 450 mL;

iii. Any bag-valve-mask device that has a "pop off" valve shall have a device to easily defeat the valve; and

iv. Be equipped with a true non-rebreathing valve and have 15/22 mm fittings.

(c) Each BLS ambulance shall be equipped with at least three transparent domed resuscitation facemasks (one each in large adult, medium adult and pediatric size) with 22 mm fittings for utilization with the bag-valve-mask device and/or positive pressure flow-restricted oxygen-powered ventilation devices (FROPVD).

1. There shall be at least three clear adult size non-rebreathing valve inhalation masks with an oxygen reservoir of the single service type as approved for pre-hospital utilization and two single service cannulas. If oxygen humidifiers (or nebulizers) are utilized, a new, unused single service humidifier (or nebulizer) shall be utilized for each patient.

(d) A BLS ambulance may, but need not, carry an installed and/or portable positive pressure FROPVD. If carried, the positive pressure FROPVD shall provide 100 percent oxygen, have an instantaneous flow rate between 35 and 45 liters per minute, deliver an inspiratory pressure between 55 and 65 cm water pressure and have standard 15/22 mm fittings.

N.J. Admin. Code § 8:40-6.6