Section R9-25-807. Minimum Standards for an Air Ambulance (A.R.S. §§ 36-2202(A)(3), (4), and (5); 36-2209(A)(2); and 36-

2212)

A.      An  applicant  or  certificate   holder  shall  ensure  that  an  air ambulance has:

1.        A climate control system to prevent temperature extremes that would adversely affect patient care;

2.        If a fixed-wing air ambulance, pressurization capability;

3.        Interior lighting that allows for patient care and monitor- ing without interfering with the pilot’s vision;

4.        For each place where a patient may be positioned, at least one electrical power outlet or other power source that is capable of operating all electrically powered medical equipment without compromising the operation of any electrical aircraft equipment;

5.        A back-up source of electrical power or batteries capable of operating all electrically powered life-support equip- ment for at least one hour;

6.        An entry that allows for patient loading and unloading without rotating a patient and stretcher more than 30 degrees about the longitudinal axis or 45 degrees about the lateral axis and without compromising the operation of monitoring systems, intravenous lines, or manual or mechanical ventilation;

7.        A configuration that allows each medical team member sufficient access to each patient to begin and maintain treatment modalities, including complete access to the patient’s head and upper body for effective airway man- agement;

8.        A configuration that allows for rapid exit of personnel and patients, without obstruction from stretchers and medical equipment;

9.        A configuration that protects the aircraft’s flight controls, throttles, and communications equipment from any inten- tional or accidental interference from a patient or equip- ment and supplies;

10.     A padded interior or an interior that is clear of objects or projections in the head strike envelope;

11.     An installed self-activating emergency locator transmit- ter;

12.     A voice communications system that:

a.         Is capable of air-to-ground communication, and

b.        Allows the flight crew and medical team members to communicate with each other during flight;

13.     Interior patient compartment wall and floor coverings that are:

a.         Free of cuts or tears,

b.        Capable of being disinfected, and

c.         Maintained in a sanitary manner; and

14.     If a rotor-wing air ambulance, the following:

a.         A searchlight that:

i.         Has a range of motion of at least 90 degrees vertically and 180 degrees horizontally,

ii.        Is capable of illuminating a landing site, and

iii.      Is located so that the pilot can operate the searchlight without removing the pilot’s hands from the aircraft’s flight controls;

b.        Restraining devices that can be used to prevent a patient from interfering with the pilot or the air- craft’s flight controls; and

c.         A light to illuminate the tail rotor.

B.       An applicant or certificate holder shall ensure that:

1.        Except as provided in subsection (C), each air ambulance has the equipment and supplies required in Table 1 for each mission level for which the air ambulance is used; and

2.        The equipment and supplies on an air ambulance are secured, stored, and maintained in a manner that prevents hazards to personnel and patients.

C.      A certificate holder may conduct an interfacility critical care mission using an air ambulance that does not have all of the equipment and supplies required in Table 1 for the mission level if:

1.        Care of the patient to be transported necessitates use of life-support equipment that because of its size or weight or both makes it unsafe or impossible for the air ambu- lance to carry all of the equipment and supplies required in Table 1 for the mission level, as determined by the cer- tificate holder based upon:

a.         The individual aircraft’s capabilities,

b.        The size and weight of the equipment and supplies required in Table 1 and of the additional life-support equipment,

c.         The composition of the required medical team, and

d.        Environmental factors such as density altitude;

2.        The certificate holder ensures that, during the mission, the air ambulance has the equipment and supplies neces- sary to provide an appropriate level of medical care for the patient and to protect the health and safety of the per- sonnel on the mission;

3.        The certificate holder ensures that, during the mission, the air ambulance is not directed by the air ambulance service or another person  to conduct another mission before returning to a base location;

4.        The certificate holder ensures that the air ambulance is not used for another mission until the air ambulance has all of the equipment and supplies required in Table 1 for the mission level; and

5.        Within five working days after each interfacility critical care mission conducted as permitted under subsection (C), the certificate holder creates a record that includes the information required under R9-25-710(A)(8), a description of the life-support equipment used on the mis- sion, a list of the equipment and supplies required in Table 1 that were removed from the air ambulance for the mission, and the justification for conducting the mission as permitted under subsection (C).

Historical Note

New Section made by exempt rulemaking at 8 A.A.R. 2633, effective June 1, 2002 (Supp. 02-2). Amended by

exempt rulemaking at 10 A.A.R. 239, effective January 3,

2004 (Supp. 03-4). Section recodified to R9-25-507 at 10

A.A.R. 4192, effective September 21, 2004 (Supp. 04-3). New Section made by final rulemaking at 12 A.A.R. 656,

effective April 8, 2006 (Supp. 06-1).