64J-1.005. Air Ambulances

(1) Each applicant for an air ambulance license shall pay the required fee as specified in Section 401.34(1)(j), F.S., and submit an application to the department on DH Form 1575, 04/09, Air Ambulance Service License Application which is incorporated by reference and available from the department, as defined by subsection 64J-1.001(9), F.A.C., or at http://www.fl-ems.com. The air ambulance license shall automatically expire 2 years from the date of issuance.

(2) Each air ambulance applicant or provider, pursuant to subsection 64J-1.014(1), F.A.C., shall maintain on site and make available to the department at license application, license application renewal, change of insurance carrier or policy renewal, and documentation of the following minimum insurance coverage:

(a) Each aircraft shall be insured for the sum of at least $100,000 for injuries to or death of any one person arising out of any one accident and the sum of at least $300,000 for injuries to or death of more than one person in any one accident. Any such policy on a leased aircraft must identify both the owner and the lessee of the aircraft.

(b) In lieu of the insurance required in paragraph (2)(a), the provider or applicant may furnish a certificate of self-insurance establishing that the provider or applicant has a self-insurance plan to provide coverage identical to what is required in paragraph (2)(a) and that the plan has been approved by the Department of Insurance.

(3) Each licensed air ambulance shall have emergency protocols which address at least, emergency procedures when the aircraft is overdue, when radio communications cannot be established, or when aircraft location cannot be verified. Each licensed rotary wing air ambulance shall document at least every 15 minutes of flight while en route to and from the patient’s location.

(4) Each provider shall maintain in each paramedic’s employment file documentation of successful completion of an initial air crew member (ACM) education program that was conducted in accordance with the 1988 United States (U.S.) Department of Transportation (DOT) Air Medical Crew-Advanced National Standard Curriculum (NSC), which is incorporated by reference and is available for purchase from AAMS; 526 King Street, Suite 415, Alexandria, VA 22314; [phone]. Each provider shall ensure and shall document in its employee records that each EMT and paramedic which it employs holds a current certification from the department.

(5) Each air ambulance provider shall establish a safety committee. The committee shall:

(a) Consist of a membership to include: one pilot, one flight medical crew member, the provider’s medical director, one hospital administrator if the provider is a hospital based program, and a representative of a quality assurance division if one exists;

(b) Develop safety procedures for the provider;

(c) Meet at least quarterly to review safety policies, procedures, unusual occurrences, safety issues, and audit compliance with safety policies and procedures:

(d) Communicate the results of the safety audit to all program personnel; and

(e) Record minutes of the meeting and retain them on file for 2 years.

(6) Each prehospital air ambulance provider shall staff the aircraft with a minimum of one person who shall be a paramedic who meets the criteria in subsection 64J-1.005(4), F.A.C.

(7) Every air ambulance maintained by an air ambulance provider shall meet the structural, equipment and supply requirements listed in Table III.

(8) Each prehospital rotary wing air ambulance when available for call shall meet the structural requirements listed in Table III, and shall be equipped as approved by the medical director of the service in the aircraft minimum equipment list. The aircraft minimum equipment list shall include, at a minimum, one each of the items listed in Table IV and shall be provided to the department upon request.

TABLE III AIR AMBULANCE Structural, Equipment and Supply Requirements
ITEM
Aircraft Requirements
1. Entrance large enough to allow loading of a patient.
2. Interior large enough for two medical crew
members.
3. Cabin illumination of 40 foot-candles at patient
level.
4. FAA approved stretcher system with 2 straps.
5. Isolated aircraft cockpit to protect pilot from
in-flight interference.
6. Each aircraft shall be equipped with FAA approved
communication equipment that operates on
frequencies which allow the flight and medical crew
to communicate with ground and landing zone medical
support exclusive of the air traffic control system.
7. No smoking sign.
8. External search light with a minimum of 400,000
candle power illumination at 200 feet separate from
the aircraft landing lights, movable 90 degrees
longitudinally, 180 degrees laterally and capable of
being controlled from inside the aircraft (Helicopter only).
Medical Equipment Requirements
1. Oxygen sufficient for duration of flight.
2. Oxygen administration equipment.
3. Oropharyngeal airways. Pediatric and adult.
4. Hand operated bag-valve mask resuscitators, adult
and pediatric accumulator, including adult, child
and infant transparent masks capable of use with
supplemental oxygen.
5. Equipment suitable to determine blood pressure of
the adult and pediatric patient during flight.
6. Approved sharps container per Chapter 64E-16, F.A.C.
7. Approved biohazardous waste plastic bag or
impervious container per Chapter 64E-16, F.A.C.
8. Portable suction unit with wide bore tubing and tips,
electric or gas powered, which meets the minimum
standards as published by the General Services
Administration (GSA) in KKK-A-1822C
specifications.
9. Equipment suitable to determine blood pressure of
the adult and pediatric patient during the flight.
TABLE IV Prehospital Rotary Wing Air Ambulances
ITEM
Equipment
1. Laryngoscope handle with batteries.
2. Laryngoscope blades; adult, child and infant size.
3. Pediatric I.V. arm board or splint appropriate for
I.V. stabilization.
4. Disposable endotracheal tubes; adult, child and
infant sizes. Those below 5.5 mm shall be uncuffed.
2.5 mm-5.0 mm uncuffed;
5.5 mm-7.0 mm;
7.5 mm-9.0 mm
5. Endotracheal tube stylets pediatric and adult.
6. Magill forceps, pediatric and adult sizes.
7. Device for intratracheal meconium suctioning in
newborns.
8. Tourniquets.
9. I.V. cannulae between 14 and 24 gauge.
10. Macro drip sets.
11. Micro drip sets.
12. I.V. pressure infuser.
13. Needles between 18 and 25 gauge.
14. Intraosseous needles and three way
stop cocks.
15. Assorted syringes.
16. D.C. battery powered portable monitor
with defibrillation and pacing
capabilities, ECG printout and spare
battery. The unit shall be capable of
delivering pediatric defibrillation (energy
below 25 watts/sec and appropriate equipment).
17. Monitoring electrodes for adults and pediatrics.
18. Glucometer.
19. Pediatric length based measurement device for
equipment selection and drug dosage.
20. Flexible suction catheters assorted sizes.
21. Multitrauma dressings.
22. ABD pads.
23. Sterile gauze pads.
24. Adhesive tape assorted sizes.
25. Patient restraints, wrist and ankle.
26. Soft roller bandages.
27. Bandage shears.
28. Sterile obstetrical kit to include, at minimum, bulb
syringe, sterile scissors or scalpel, and cord clamps
or cord ties.
29. Burn sheets.
30. Flashlight with batteries.
31. Vaseline gauze.
32. Gloves – latex or other suitable material. For all
crew members.
33. Face masks for all crew members.
34. Naso and oropharyngeal airways assorted sizes.
35. Safety goggles or equivalent meeting A.N.S.I.
Z87.1 standard.
36. Bulb syringe separate from obstetrical kit.
37. Thermal, absorbent, reflective blanket.
38. Standing orders.
39. Electronic waveform capnography capable of
real-time monitoring and printing record of the
intubated patient (effective 01/01/2008).
________________________________________________________________________________________
MEDICATION	WT./VOL.
____________________________________________________________________________________
1. Atropine sulfate.
2. Dextrose 50 percent.
3. Epinephrine HCL.	1:1,000
4. Epinephrine HCL.	1:10,000
5. Ventricular dysrhythmic.
6. Sodium Bicarbonate.	50 mEq. or 44.6. mEg.
7. Naloxone (Narcan).	1 mg./m1. 2 mg. amp.
8. Nitroglycerin.	0.4 mg.
9. Benzodiazepine
sedative/anticonvulsant.
10. Inhalant beta adrenergic
agent of choice with
nebulizer apparatus, as
approved by the medical
director.
____________________________________________________________________________________
I.V. Solutions
____________________________________________________________________________________
1. Lactated Ringers or
Normal Saline.

Rulemaking Authority 381.0011, 401.25, 401.251, 401.265, 401.35 FS. Law Implemented 381.0011, 395.405, 401.23, 401.24, 401.25, 401.251, 401.252, 401.26, 401.27, 401.30, 401.31, 401.321, 401.34, 401.35, 401.41, 401.411, 401.414, 401.421 FS. History–New 11-29-82, Amended 4-26-84, 3-11-85, Formerly 10D-66.51, Amended 4-12-88, 8-3-88, 8-7-89, 12-10-92, 11-30-93, 10-2-94, 1-26-97, Formerly 10D-66.051, Amended 1-3-99, 9-3-00, 5-15-01, 12-18-06, Formerly 64E-2.005, Amended 9-2-09.