16- 163 C.M.R. ch. 3, § 13 - Ground Ambulance Design Requirements

1. A ground ambulance vehicle must meet the following standards to be licensed:

A. Federal/state safety requirements. It must meet the applicable federal and Maine safety requirements including the State's periodic motor vehicle inspection requirements listed in the current edition of the Maine State Police Motor Vehicle Inspections Manual.

B. Interior size. It must meet the chassis manufacturer's specifications, and must have a minimum inside height of 60 inches at the center of the patient compartment, a minimum width of 48 inches at the center of the patient compartment, a walkway parallel to the length of the primary cot adequate to allow an attendant to walk from head to foot of the cot; and a minimum inside patient compartment length of 122 inches at the cot level.

C. Interior storage accommodations. The interior of the patient compartment must provide adequate stowage space for medical supplies, devices and installed systems. For purposes of this paragraph, "stowage" is defined as the storing, packing, or arranging of ambulance contents in a secure manner so as to protect the contents from damage and the personnel from injury. Interior compartment doors, latches and operating mechanisms must operate in accordance with the manufacturer's design.

D. Seat belts. Seat belts shall be provided in all permanent seat positions in the vehicle, including the squad bench. For purposes of this paragraph, "squad bench" is defined as a permanent, non-removable seat that is located in the patient compartment and which can serve as a seat for crew members or as a surface on which a patient may lie down.

E. Patient restraint. The ambulance must be equipped with a multilevel patient stretcher designed for ambulances, mounted in, and detachable from the vehicle. The head of the stretcher must elevate. At least three strap-type restraining devices (chest, hip, lower extremity), not less than 2 inches wide, shall be provided for each stretcher, cot or litter. Additionally, the head of the cot shall be furnished with upper torso (over the shoulder) restraints designed to prevent motion of the patient during severe braking or in an accident. Restraining straps shall incorporate metal-to-metal quick release buckles. The use of all lateral and shoulder straps is required while transporting a patient.

F. Stretcher fasteners. The installed stretcher fastener device(s) for wheeled stretchers shall meet the performance requirements of the following two standards, which this rule incorporates by reference:

a. Ambulance Litter Integrity, Retention, and Patient Restraint Fasteners, (J3027), July 14, 2014 edition, which is available at cost from SAE International, 400 Commonwealth Drive, Warrendale, PA 15096; and

b. Chapter 6 (6.22) "Patient Cot Retention" of Standard for Automotive Ambulances (NFPA 1917), 2019 edition, published May 24, 2018, which is available at cost from the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA.

Provision shall be made for the required portable stretchers to be secured in safe positions for transport. Stretcher fasteners must be installed according to the stretcher fastener manufacturer's directions. All ambulances licensed after July 1, 2030 will need to meet these requirements.

G. Patient compartment environmental equipment. The patient compartment shall be adequately heated, air-conditioned, and ventilated to provide for patient comfort.

H. Communications equipment shall be adequate to allow the vehicle to contact on the regional radio frequency the hospitals to which it regularly takes patients. The ambulance shall also be able to maintain two-way communications contact with a full-time dispatching facility. All vehicles licensed or authorized by Maine EMS shall be capable of communications utilizing the designated Maine EMS statewide frequency, 155.385

I Attendants/driver communication. The driver and the attendants, in their working positions, must be able to speak to one another.

J. Warning devices. All ambulances shall be equipped with a functional siren and with functional emergency warning lights, rotating or flashing, visible from 360 degrees at all times. Colors of ambulance lights are fixed by 29-A M.R.S. §2054.

K. Patient compartment illumination. Normal white illumination shall be provided in the patient area so as to provide a minimum of 35-foot candles of illumination measured on at least 90 percent of the cot's surface area.

L. Name of service. Ground vehicles must display the name of the service licensing the vehicle on the left (driver) and right (passenger) side of the vehicle in letters no less than 6 inches high or display a logo that adequately identifies the service. Vehicles temporarily transferred to a service under the provision of Chapter 3 § 12 are exempt from this requirement.

M. Main oxygen supply. The ambulance shall have a hospital type piped medical oxygen system capable of storing and supplying a minimum of 3,000 liters ("M" size tank). The oxygen pressure regulator must be a medical oxygen pressure reducing and regulator valve with an inlet filter at the cylinder and shall have a line relief valve set at 1378 kPa (200 psi) maximum, and a gauge range of 0 to 17225 kPa (0 to 2500 psi). The flow meter must be a pressure compensated type.

N. Suction aspirator, permanently mounted. The ambulance vehicle shall have an electrically or (engine) vacuum-powered suction unit capable of providing a free air flow of at least 20 L.P.M. and achieving a minimum of 300 mm Hg within 4 seconds after the suction tube is closed.

O. Exterior compartments and doors. Exterior compartments, exterior compartment doors and exterior patient/passenger doors must be equipped with latches, gaskets and operating mechanisms which operate in accordance with the manufacturer's design.

2. All ambulances newly manufactured after July 1, 2021 must at a minimum comply with one of the following standards, which this rule incorporates by reference;

A. National Fire Protection Agency (NFPA) NFPA 1917(2019)

a. Standard for Automotive Ambulances (NFPA 1917), 2019 edition, published May 24, 2018, which is available at cost from the National Fire Protection Association, 1 Batterymarch Park, Quincy, MA.

B. Federal Specification for Star-Of-Life Ambulances (KKK-A-1822F through Change notices 13) July 2020

a. Federal Specifications for Star-Of-Life Ambulances (KKK-A-1822F (August 2007) with change notices; #8 July 2015, #9 July 2016, #10 July 2017, #11 July 2018, #12 July 2019, & #13 July 2020), which is available at cost from the Office of Motor Vehicle Management, Vehicle Publishing Division

C. Commission on Accreditation of Ambulance Services, Ground Vehicle Standards 2.0 (July 1, 2019)

a. Commission on Accreditation of Ambulance Services, Ground Vehicle Standards 2.0 (July 1, 2019) is available at cost from Commission on Accreditation of Ambulance Services 1926 Waukegan Road - Suite 300, Glenview, IL 60025.

Notes

16- 163 C.M.R. ch. 3, § 13