PARAMEDIC PROVIDER AUTHORIZED STOCK

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Monterey County EMS System Policy Policy Number: 4010 Effective Date: 7/1/2018 Review Date: 6/30/2021 I. PURPOSE PARAMEDIC PROVIDER AUTHORIZED STOCK A. To establish equipment standards for paramedic service providers based in Monterey County II. POLICY A. Every paramedic unit, either first response or ambulance, shall have no less than the specified amount of equipment at all times. An ALS unit shall not respond to a request for service without the equipment and supplies necessary to provide care under Monterey County EMS policies and protocols. B. All equipment and supplies must be clean or sterile as appropriate and in good working order. Medications and supplies shall be replaced prior to their expiration. C. The paramedic service provider shall implement an inventory control program to ensure that all system units have at least the minimum levels of supplies and equipment listed below. Paramedic service providers are encouraged to carry greater amounts of equipment and supplies than the minimum specified in this policy. D. This stocking level is to augment any requirements established by Federal, State, or other regulations. E. Only the items specified on this list may be carried on Monterey County paramedic units. Items carried must be approved in advance by the Monterey County EMS Medical Director. F. Monterey County EMS Agency personnel may inspect any ALS unit, at any time, for compliance with the identified standards for equipment and supplies.

Non- 1 1 Cricothyrotomy set 1 1 Needle Thoracotomy set N/A 1 Main Oxygen Tank. M size or larger. 500psi. 2 2 Portable Oxygen Tank. D size or larger. Mandatory 1000psi 1 1 Regulator for Portable Oxygen Tank 1 2 Adult BVM Resuscitator with Oxygen Supply Tubing 1 2 Child BVM Resuscitator with Oxygen Supply Tubing 1 2 Adult Nasal Cannula 1 2 Pediatric Nasal Cannula 1 2 Adult Nonrebreather Mask 1 2 Pediatric Nonrebreather Mask 1 2 Hand-held Nebulizer for Inhaled Medications 1 2 Nebulizer Mask for Inhaled Medications 1 2 Nebulizer Adapter for BVM 1 2 Oropharyngeal Airways. Each Size 6-10 (or equivalent size) 1 2 Nasopharyngeal Airways. Each Size 28-34Fr 1 2 Endotracheal Tubes cuffed. Each Size 6.0-8.0 (whole sizes only) 1 1 Laryngoscope Handle 1 1 Laryngoscope Blades. Miller. Each Size 0-4 1 1 Laryngoscope Blades. Mac. Each Size 0-4 2 2 Extra Batteries for Laryngoscope (or equivalent) 1 2 ET Stylet. 1 2 ET Securing Device. 1 2 ET Tube Inducer 1 1 Magill Forceps. Each Adult and Pediatric 1 2 10cc Syringe 1 1 Extra Laryngoscope Lightbulbs. Each size 4 4 Water soluble Lubricating Jelly Packets 1 1 CO2 Detector. Adult and pediatric capable 1 2 King Airway. Each 3, 4, 5 1 1 Pulse Oximetry Device 1 1 Pulse Oximetry Sensor. Each for adult and pediatric use N/A 1 Fixed Suction unit with Suction Tubing and Rigid Suction Catheter 1 1 Portable Suction unit with Suction Tubing and Rigid Suction Catheter 1 2 Extra Rigid Suction Catheter 1 2 Extra Suction Tubing 1 2 8, 10, 18fr Flexible Suction Catheter each 1 1 Heart Monitor/defibrillator. 12-Lead with capability to transmit to Monterey County STEMI Receiving Centers.

Non- 1 1 ECG leads 1 1 12-Lead ECG Cables 1 1 ECG Recording Paper-extra 2 2 ECG Defibrillator Pads. Each Size Adult and Pediatric 2 2 Pacing Pads. Each Size Adult and Pediatric May be combination pads 4 sets 4 sets ECG Electrodes. Adult 2 sets 4 sets ECG Electrodes. Pediatric 2 8 Normal Saline for IV. 1000cc 2 4 Normal Saline for IV. 250cc 4 4/2 8 8/4 IV Tubing with Extension Sets if Combination Tubing IV Tubing with Extension Sets if Macrodrip and Minidrip separately 2 8 IV Catheters 14, 16, 18, 20, 22, 24 Gauge. Each Size 1 1 Alcohol Preps. Box (10) 4 8 Tourniquets for IV Start 2 4 Tape Rolls. 1 Inch Plastic to Secure IV or other device 1 1 EZ-IO Driver 1 2 EZ-IO Needles. Each Adult and Pediatric with Connecting Tubing 1 2 IO Needle for Manual Insertion 2 5 Syringes. 1, 3, 5, 10cc. Each Size 2 5 Needles. 18, 20, 25 Gauge. Each Size 2 3 Intra-nasal Atomizer 1 1 Sharps Container 1 1 Glucometer with Test Strips (10) 5 10 Lancets 2 3 Transfer needles 2 3 Activated Charcoal. 25Gm. One (1) without Sorbitol 5 6 Adenosine. 6mg 4 6 Albuterol. 2.5mg Individual Unit Dose 1 1 Aspirin. 81mg Chewable. Bottle. 2 6 Atrovent. 0.5mg Individual Unit Dose 1 3 Atropine. 1mg Pre-load Syringe 1 1 Atropine. 16mg Vial 1 2 Calcium chloride 1Gm 2 2 Diphenhydramine. 50mg Vial 2 4 Dextrose. 25Gm Pre-load Syringe (D50) 2 2 Dextrose. 12.5Gm Pre-load Syringe (D25) 1 2 Dopamine. 400mg Vial or premixed bag 4 8 Epinephrine. 1:10,000. 1mg Pre-load Syringe

Non- 2 2 Epinephrine. 1:1,000. 1mg Ampule 2 4 Fentanyl. 100mcg or equivalent 2 3 Glucagon. 1mg 2 3 Oral Glucose. 30Gm tube 4 8 Lidocaine. 100mg Pre-load Syringe 2 2 Midazolam. 10mg vial or equivalent 2 4 Morphine. 10mg vial or equivalent 3 4 Naloxone. 2mg Pre-load Syringe 1 2 Nitroglycerine. 1 1 Nitroglycerine Ointment. 1 tube with patches 2 4 Sodium Bicarbonate. 50MEQ Pre-load Syringe N/A 1 Gurney N/A 1 Stair Chair N/A 1 Break-away Flat 1 1 Traction Splint 1 1 KED or Short Immobilization Board or Similar Device 1 2 Backboard with adequate strapping materials for each board 2 2 Blanket and Pillow. Each. Blanket only for non-transport units. N/A 4 Pillowcase 2 2 Cervical Collar. Adult Adjustable 2 2 Cervical Collar. Pediatric Adjustable 2 2 Head Immobilizing Device 2 4 Splints. Arm/Leg. Cardboard or Equivalent. Each Size N/A 2 Emesis Basin N/A 1 Bed Pan and Urinal. Each 1 1 Stethoscope 1 1 BP Cuff. Each Size Adult, Child, Infant, Large 1 1 Bite Stick 1 5 Triangular Bandage 12 12 Sterile Dressings 4 6 Roller Bandage (Kerlix) 4 4 Trauma Dressing 2 2 2 Inch Adhesive Tape 2 2 Burn Sheet 6 6 Occlusive Dressing 2 4 Cold Pack 2 4 Hot Pack 1 1 Scissors 1 1 Flashlight

Non- N/A 1 Restraints. Four Point. 1 1 Obstetrical Kit with blanket to preserve neonate warmth 4 4 Sterile Water or Saline for Irrigation 2 2 Tourniquet (Bleeding Control) 1 1 Length-based pediatric treatment tape (Broselow or similar) 5 10 Patient Care Report Form 5 5 Refusal of Care Forms 10 15 Triage Tags 2 2 CPAP with (1 large and 1 medium mask) 1 1 Hard hat for each person. Meets NFPA 1951, ANSI Z89.1-1986 (Class and B), OSHA: 29 CFR 1910.135 &29 CFR 1926.100(b), CSA Z94.1- M1992 (Class G), or equivalent. 1 1 Eye protection-glasses, face shield, goggles, or mask with side protection for each person. Meets NFPA 1999, ANSI Z87.1 1 1 Hearing protection for each person 1 1 Barrier garment for each person. Meets NFPA 1999 such as Tyvek. 3 pairs 3 pairs Exam gloves for each person. Nitrile-type or equivalent. 1 pair 1 pair Boot/shoe covers for each person. Meets NFPA 1999. Chemical Resistant. 1 1 Face shield for each person. Meets NFPA 1999, ANSI Z87.1. 1 pair 1 pair Work gloves for each person. Meets NFPA 1999 2 2 Respirator mask for each person. N-100 or N-95. Meets OSHA 42 CFR 84, 8CCR 5144, NIOSH Respirator Selection Logic 2004.