Q:  Where can I find the ambulance equipment lists and ALS medication list?

A:  The BLS Equipment List (AR 5-401) and ALS Equipment List (AR 5-402) is posted on our Administrative Requirements Table of Contents page. (The ALS medication list is an OEMS memo, not an AR, but it's posted under the ALS Equpment List for convenience).

Q:  Is there a state law or regulation on when to use the stair chair versus a stretcher?

A: OEMS has released an  advisory on cot (stretcher) safety but has not issued one specifically for the stair chair. The cot safety advisory was a result of an issue where EMTs did not use a stretcher properly and a patient sustained a fall.

Each ambulance service should have its own policy on stair chair use; but a good rule-of-thumb is to secure a patient to a stair chair if the patient needs to be moved over more than 3 steps. When a patient is secured to a stretcher, an increased incline causes the center of gravity to be high, the weight distribution is uneven, and the stretcher becomes unwieldy. This puts the patient and EMTs at a much greater risk of fall and/or injury.

Q: Is there a state definition for "intubation attempt"? Is it merely placing the blade in the mouth or is it the attempt to pass an ET tube?

A: In accordance with national guidelines, it is "blade in mouth."

Q: We don't have "Mark-1 kits" on our ambulance. What should we do?

A: Nerve Agent Antidotes (such as Mark-1 kits) are optional. Your service may choose to purchase them for the ambulance(s), but they are not required to do so. There are stockpiles of Nerve Agent Antidotes within the region/state in case they're needed for a disaster type incident, in which case your service would contact CMED to request deployment of this resource.

Q: What is the para gravida scale for pregnancies?

A: Gravida/para status refers to a woman's obstetric history. Gravida indicates the total number of pregnancies a woman has had (including the current one if applicable), regardless of whether they were carried to term. Para (in general) indicates the number of offspring.  Para can be further broken down into the numbers that were term, pre-term, aborted, or living (TPAL).  Example: G2 P0111 would mean the patient was pregnant twice, did not carry any to full-term, had one pre-term ("pre-mature"), had one abortion (or spontaneous abortion which is commonly referred to as miscarriage), and one (the twin to the one delivered pre-term) is living.  For the purposes of EMS personnel; simply indicating the number of pregnancies and the number of full-term/successful births is sufficient.  Example:  a woman who has had two pregnancies (both of which were carried to full-term) would be noted as G2P2.

Q: Is there a maximum temperature for IV fluids?

A: 104° - 108°F (40°- 42°C); this is the recommended temperature for the treatment of hypothermia.

Q: Are vents allowed to be used on an emergent call?

A: When responding to an emergency call where a patient is found on a vent, the individual assisting the patient with the vent (e.g., either a family member at home, or staff at a nursing facility) must accompany the patient in the ambulance to attend to the vent. EMTs should be prepared to provide manual ventilation (BVM) in the event of mechanical failure.

Q: Does OEMS approve/recommend certain glucometers for use in the field?

A: OEMS requires that a service use a glucose monitoring device that is:

  1. approved by the FDA;
  2. utilizes capillary action;
  3. measures whole blood;
  4. uses one-time lancet;
  5. uses small specimen size to decrease the risk of bloodborne pathogen exposure, and;
  6. requires minimal calibration and cleaning

Q: Can we remove MAST from our ambulances? I have been told by our med control doc that we need to keep them but can't find them on the state ambulance list of required equipment.

A: MAST (Medical Anti-Shock Trousers) and/or PSAG (Pneumatic Anti-Shock Garment) are not listed on either the required ambulance equipment list or the optional devices list and should not be carried.  Although the National EMS Scope of Practice includes PSAG for fracture stabilization, MA has chosen not to adopt this skill.

 Q: Are there restrictions on who can carry or administer oxygen?

A: According to the U.S. Food and Drug Administration (FDA), oxygen for administration to humans is a prescription drug and is therefore, a controlled substance in Massachusetts. Oxygen does not meet the FDA criteria to be sold as an over-the-counter-drug. All administration of oxygen to a human must be done in accordance with state and federal law. In brief, such oxygen must be manufactured by a registered manufacturer, properly labeled and administered only pursuant to the order or prescription of a practitioner and administered only by an individual authorized by the law to administer oxygen using only approved medical devices. Any manufacture, possession, dispensing or administration of oxygen that does not follow state and federal law is not legal. (Source: MDPH/DCP)

link icon  Advisory on cot (stretcher) safety