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RESOLUTION OF 'fHE BOARD OF COUNTY COMMISSIONERS RE-
ESTABLISHING, WITH VARIOUS AMENDMENTS FROM PREVIOUS
PROCEDURES, THE COUNTY'S EMER6ENCY MEDICAL REGULATIONS
PERTAININ6 TO AMBULANCE LICENSIN6; SETTING A PUBLIC
NEARING THEREON; AND PERMITTING THIS RESOLUTION TO BE -
PUBLISHED BY TITLE AND SHORT OUTLINE ONLY �'
t';�:
N�.'`�.;,.
RESOLUTZON NO_87,-7
WHEREAS, the General Assembly, at the First Regular Session
; _
:.� of the Fifty-first General Assembly, enacted the Emergency
,
Medical Services Act, being title 25 part 3_5 of the Colorado �i...
� �;..
=;��� Revised Statutes, (Section 25-3_5-301 et sea_, as amended); and � �
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WHEREAS, the legislative directive contained in said Act is
i',=,
�:=�� tfiat the Boards of County Commissioners of each Colorado county
;�:s shall adopt standards, requirements and procedures for the
���� provision of emergency medical services within each county, and,
,;:�
'�p':•.'� specificelly that the Board shall have the responsibility for
,,;
>s>5 �licensing ambulance service within the County; and
�i'�
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.�;.,� WHEREAS, the Board, in its Resolution No_ 78-19 did
<;� initially adopt permanent ambulance regulations, which
regulations were further amended in the Board's Resolutions
,�..:_.
.:,�,� numbered 78-103, 79-8 and 79-129, and
,.�
.� .
-.:,�
WHEREAS, the Emergency Medical Services Council, which is a }
;;� standing subcommittee of the Pitkin County Public Safety Council, ;
-� has recommended additianel amendments to the regulations and the �
'�� present ambulance service providers have accepted these amend- �':���>'"��
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NOW, THEREFORE, BE IT RESOLVED that the provisions of
Resolutions 78-19, 78-103, 79-8 and 79-129 be and are Frereby
:�:. -
repealed and reenacted to read as follows= �:;-,:
Section 1 �-',- -
1_ No person shall operate a public or private ambulance
` service within Pitkin County unless she/he shall hold a
:_;.� � .
valid license to do so issued by the Board of Caunty �
''c'z� � .
Commissioners, pursuant to the authority granted by the K '
�'=j',' Board in 1973, C_R_S_ 25-3_5-301, et se9_, as amended, �...
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`' and supplemental to the requirements of that statute_
`=;_:) This provision does not app1Y to those services
��•E� which may be specifically exempted by proper authority_
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;�;;:�� 2_ There is herebY recognized the Emergency Medical •
;,;:_4.,� Services Council (EMS Council) as a standing sub-
:-',``'1
Committee of the Pitkin County Public Safety Council,
;':>:;,�
.,j the composition of which Council is as follows= ,
;�..;�
.,':'� 1 Physician Advisor from each lice�sed service
,.•-��
-i;µ� 1 physician - head of ER Committee or his designee
_;=i
,=3 1 emergency raom nurse
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�° •1 1 representative of the Board of County Commissioners
T`� 5 law enforcement representatives (One each for Aspen
�I Police, Pitkin County Sheriff, Basalt Police, Snowmass
''{ Palice or CSP) I
�.'� 4 fire department representatives �One each from Aspen, � t��,;
.:I 4�.•:.
Snowmass, Redstone, Basalt)
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'� 1 mental health representative a� �°
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1 representative Prom each licensed ambulance service
1 Mountain Rescue representative ��:'.._-
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1 Air Rescue representative "�-'� '
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1 Communications Center representative �:',." '
2 Ski Patrol representatives (One each from ASC and -
�'� Highlands) F '
1 consumer who personally, or whose spouse, does not
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,-;� derive SOX or more of their income from the provision � ;
; ;i:,
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of emergency medical service_ The Council shall advise Fr'.
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'+ the Board, through the Public Safety Council, on
t
'�4 matters relating to the provision of emergency medical
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services within the Board's statutory and plenary � -
;��
authority, especially on matters of ambulance licens-
ing_ The EMS Council shall have such by-laws and rules
�� and regulations as are established through the Public
'=`" Safety Council_
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�.,�
` 3_ Applications for licenses shall be made to the Board,
�.��
which shall approve the operation of each ambulance
service upon its being satisfied that each service t
, ��
�! meets all of the requirements of the Emergency Medical �
; ;�
'{ Services Act, as amended, the Colorado Motor Vehicle �
a
'� Code, and all applicable Federal Vehicle Requirements_ �
;j �,'
{ For purposes of this Resolution regarding ambulance � `s_,
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' licensing, the Board's responsibility is hereby -'.�;?t"�
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delegated to the Pitkin County Sheriff or his/her ` ,� •..
; designee, who shall recommend licensing aetions to the
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Board for final approvaJ._
4_ In addition tp the minimum equipment required by C_R_S_ _
25-3_5-301 (2)(a), as it may from time to time be '�`s.'•"'
amended, each ambulance shall be required to �;��':,�,.,
i carry the following (Any references to items already on ;` -
the state list sha1Z include the numbers required by
;
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tflB St3t2�; . 5`..�..:
', . ; ��..._ ..
� � a_ one pocket mask with oxygen port ' ��
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:� b_ two oxygen nasal cannulas � ' ' .
t
J c_ vehicle oxygen system capable of delivering oxygen i
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at ten liters per minute for ninety minutes
„" d_ one sc000 stretcher - two pieces or more �
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� e_ one each: large, medium and small cervical collars
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f_ one alfiernate system for cervical immobilization
.•''.;;
+ such as_ sandbags, I_V. bags, foam pads
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`'i� g_ two bite sticks
h_ one pediatric binod pressure cuff
' i_ two stethoscopes
j_ emesis basin(s? with one quart capacity '
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;?;j k_ three b.tankets
''� I_ four each large and small universal dressinas �
'f m_ twenty-four gauze aads (4x4Z � •':
,� n. one universal urinal �
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� o_ four soft roiler banda4es, 4 inch ='
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p_ two ace bandaaes, 4 inch � ��
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q_ tao each 2 inch and 1 inch adhesive taae ���
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.+�a e. a.c �.5�'.c`'R�:.4fi4°�!i. ., t".7ii �... �. ._ . ."tw.�..::�s .
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r_ four vaseline gauze pads
s_ two tubes of glucose
t_ two 30 cc bottles svrup of Ipecac i;� -
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u_ one 50 cc bottle charcoal �,_:,..
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v_ two flashliqhts
' w_ one 10 pound or two 5 pound fire extinquishers
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x_ one pair Militarv Anti-shock Trousers (M_A_S.T J
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- 5_ Whenever the provisions of paragraph 4 will create a �
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Y- .'�;"a practical difficulty or undue hardship for any licensee, the
;.1�1
""'� Board of County Commissioners may, on the receipt of a
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:=��3 recommendation by the Public Safety Cauncil and the Sheriff,
_.sj
•� waive any requirement, except as otherwise provided by state
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„°�':.�
statute_ Any aaiver granted may be accompanied by a
�:;� restriction by the Board as to the scope of the applicant's
^'�� license and/or the length of time for which it is valid.
. ,
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��,;y� 6_ Each ambulance will be staffed by at least two persons
��� at every scene of a call for medical assistance, and at
;::;r
,':� all times that a patient is being transported, by a
i
:�1_"��
� driver and an attendant_ Each ambulance driver shall
'•`1
Y��V' have a valid Colorado Driver's l.icense for ambulance
! i
� operation and current certification in Cardio-pulmonary
Resuscitation (C_P_R_)_ Additionally, each driver shall �•.
; � :,
hold a current certification in, at minimum, American Red �,,,.rt,::;.
.�;.z.
:,j Cross Advanced First Aid, or any equivalent recognized by � `-
� � � �,
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_ the Colorado Department of Health_ Any person responsible F}.�. j.
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�f�'����t •.��,c3Ll���.�fS�.L�L��Y'x.�t, n`'�r� � .�!�'r riu,'y ,u'�,."r�'1.�'�4f� 1. �, a.i�:
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for providing direct medical care and treatment of patients
transported in an ambulance licensed in Pitkin County, known •
as the attendant, shall have a current C.P_R_ Card and shall �'�'`
�'::
be an Emergency Medical Technician with a current certifi- t ;
�
cate issued try the Colorado Department of Health, or a
� Registered Nurse with an additional certificate in Medic '
��
First Aid or any equivalent recoynized by the Colorado
:�'� Department of Health_ ��
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7_ Each ambulance service licensed in Pitkin County shall
:�`-� have a Physician Advisor on retainer at all times that
�1 operations take place under the license_ Each Physician
7 .
��?-'� Advisor shall meet any and all requirements set forth by the `
`�'� Colorado State Legislature, the Colorado Department of
K
`•=.:� Health, and the Colorado Board of Medical Examiners_ Each
�:
Physician Advisor shall establish protocols for any advanced
r:� medical acts to be performed by EMT-Is or Paramedics, and
shall be responsible for the competency and performance of
s.i.;j
all members of that ambulance service_ Eacn ambulance
�
:_r� service shall include the name, Colorado certification �`
number and signature of its Physician Advisor with the >
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annual license application_ (S
, �•
;�. ''
S_ All licensed ambulance services and their personnel �i'�
:� R`,»�;�:r:
shall have the responsibility for realizing their `-'`',`";;;�;;
� :
� medical and practical limitations in the transport or care F �
� ,. �
� of all patients_ They must examine all options for patient Yx;•, -'
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a '�� t j,�I ��I�vFt �v{F r _ .. 4, '� ! �i'' f ..yiii.� i i�� s i� +� �
� � v�4�; 4i f'ry a � �. L�} h �'�1 � �." t f" %����y fJ.I�,� ^� �
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transport and care, both within and outside of their own
service, and they shall take the initiative to upgrade that
S,_..
care when necessary for the welfare of the patient and where +�-:
possible_ �. .
' }<'.
9_ The eoard of County Commissioners shall issue a license to
-:� ' the applicant to provide ambulance service.and a permit for
each ambulance used (both of which license and permits shall
-��� be valid for twelve (12) months from January 1, to December `
i
�Y� 31 of each licensing year) upon recommendation by the
r Sheriff and a finding by the Board that the applicant's
,'::=t
� `� staff, vehicle and equipment comply with the foregoing
,'I�*� requirements_ Each application shall be accompanied by a fee
��:;'� of $25 per vehicle and submitted to the Pitkin County
:,T,�
'`s?r;:i�
' Sheriff's Office for inspection_ Any license or permit,
i,,�'� unless revoked by the Board of County Commissioners, may be
:r '�
.�..'; renewed by the Board an filing of an application as in the
;;:� case of an original application_ Applications for renewal
''`�� shall be filed annually but not Iess than sixty (60) days
�'�"�� before the date the license or permit expires_ No license
y;��
�=���= or permit issued pursuant to this regulation shall be
"1
,.�;>� sold, assigned or otherwise transferred_
",� �
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10_ The provisions of this regulation shall not apply to any of �
the following= � 4f :';
i ��''
a) The exceptional emergency use of a privately or �
�J; � .
publicly-owned vehicle, includi�g search and rescue �•
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��, �. ;, 3 *� r������r�'� c�l,k� � `' i�,,{'�?�'�r�; '�.
�� q" ��!,�� r` 3.` ��j�� �'{ � �r�!,� >v'4,Fa�fe�� � �,�- r#�
..r :'�����:�,<. ���i�E.V,'a:3���*. r:, -. .�.���:: a:���i����.�"�.�:"�r:�"��+i°, •''�,�,�'��
� unit vehicles or aircraft not ordinarily used in the
formal act of transporting patients (provided that ' �
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nothing herein shall be construed to exempt application i '--:�
��.. .
of this regulation to those ambulances servicing ;
` industrial operations located in Pitkin County)_
-_'i� b) A vehicle rendering services as an ambulance in case of
a major catastrophe or emergency when ,'
-;,� �. ';
�-.:4 ambulances with permits based in the area of the k
�::
catastrophe or emergency are insufficient to �
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;:?�j render the services required.
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;-'� 11_ Upon a determination by the Board of County Commissioners
�:� that any person has violated or failed to comply with any
�'-�''�-iy�
provisions of this regulation, the eoard may temporarily �
4i
`' suspend, for a period not to exceed thirty (30) days, any '
�'�._j license or permit issued pursuant to this resolution_ The
;�',_.J licensee shall receive written notice of such temporary
';,1 suspension, and a hearing sha12 be held not later than ten
y�
;��i (10) days after such temporary suspension_ After such
-'-i
°;;k'� hearin9, the Board may suspend any license or permit issued
,7
..� pursuant to this resolution for any portion of or for the
��;;;� remainder of its life_ At the end of such period, the a
� l
� person whose license or permit was suspended may apply for a
new license or permit as in the case of an original applica— r `
i �
tion. Upon a second violation or failure to comply with any �`•'"va=::�
� provision of this regulatiion by any licensee, the Board of � y�`" `
�'r';:
,;�j County Commissioners may permanently revoke such license or "� -�:
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permit_
12_ Each vetiicle utilized by a service licensed under these ''
�'�'' .
regulations shall be inspected at least annually by a
�
Pitkin County Sheriff's Department representative_
_� Unannounced inspections may be conducted by any Pitkin
� County Sheriff's Department representative at any time,
�.`;.
i provided that such inspection does not interfere with S'°�`'
:�I ,�-��:..
,
��'.i,� response ability or provide an unreasonable hardsfiip for tfie `3:.
's'�
'' `t service involved_ Inspections shall be done in accordance
;-;
;:•`I
- � with the inspection list attached as Exhibit A_
;;:i
'i Applications shall be submitted using the form attached as �
°;,� Exhibit B_
:s�
:':i 13_ The following actions are specifically forbidden and without �
_r
;= limitation by this listin9 and will be cause for the .
;� revocation of any license issued pursuant hereto= j
::_�
a) Staff inember under the influence of alcohol or drugs
.,,� f
during an ambulance call ;
b) Unnecessary use of emergency vehicle privileges �
'.� '
c) Loss of services of Physician Advisor 4t,
Section 2 �'F
'� That each ambulance service licensed by Pitkin County is required �-S ,
i
I
i to provide the Pitkin County Public Safety Council with such
_ '_.Y
� information as the Council may deem necessary to update the '
J ::'.�
..� 'y��.r.a':4 i...-:
� area's annual emergency/disaster plan; and, further, required to `'
� +.;...
. L�; `
comply with all provisiotts of said emergency/disaster p1aR which ; +i.�"'
.�' .rt Y'~.,
Y �
pertain to each drill and/or actual emergency/disaster situation ��
_��:
� �
� �
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�;�� " - ._ . ... . -
. _.�
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_
� ��'S�i'�Y.l � . .
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';�g'�:'�: ` � . ' .
_ __ ___.__ .��--
_ �
�r:. . �— . ..,. - . .. , ... ...-_.._ ... .' .. . . Y ,u a � 1, .�i:,.�„ ;.
A �_ . . �•;+� a ��#�` -y {�,�l�t� 1,.
�F . Ers �,�'� �`.��,; � f`
'o �' �', �1. �:i ''� ..'!A".Y � �4
� � '� �'. � . �� xf.��, ;. V �'!,}, �! v .1� �,'U'��� �j FI SLe a�'4
1 1 t ro "P t,� � �.� i ��t- s�' V�. �'�+�.r �
" 'a► . _ . .. .. ��� ro�.._. t q ��,� �,r,��.�. .
.. . '.i:.. . � .. ..
endoYSed by the Pitkin County Public Safety Council_ Fn the event
i;�.
of a declared disaster, all sections of this Resolution pertain- k;" -
i;:`'
ing to training or equipment requirements shall be waived for the '
duration of the disaster declaration. However, it is the intent �•,`�,,,
of tfiis Resolution that eacfi service provide the maximum achiev-
�-':`� able level of inedical care during periods of emergency_ "
'� Section 3 i
'�'f This Resolution shall be published by title and short �'`
i
w ':;� y.
outline on1Y_
;ti First read and set for public hearing by the Board of �
��, County Commissioners of Pitkin County, Colorado, at its regular '
�;:
,^�'.� meeting on the_� DAY OF . 1986 ±
.„��
A:.1
•;�` Adopted, after second reading and public hearing at its
'�r;y regular meeting on the 1�� DAY OF�� 1987
.?��
Jw� i
t
.� ��
THE BOARD OF COUNTY OF COUNTY
i �
_j COMMISSIONERS OF PITKIN COUNTY, �; .
.`.�
� CO ADO
BY-
i .^�]o
CHAIR "Y' -'
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EST❑
Clerk and Rec rder �`�:=.�
RECOMMENDED FOR APPROVAL_ �`.` "
�..
-:;:,i
_- Donald D_ Davis
;�.
i y..
-� �
��'%��'� APPROVED AS TO FORM: i'-
,
"�L. F..
Y ;'� � 2
-:� � 8`Vv
-J�y 6a y E ary, County Attorney
�"� t�5'��
:�,y;,; �
''"'�3•• ACCEPTED AND APPROVED_
1.a��
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r"�`� Pitkin County Sheriff
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EXHIBIT A
PITKIN COUNTY AMBULANCE INSPECTION LIST �.:,'
� .
8'
: Service Name=---------------------------------------------- :� -.
' � Vehicle Designation______________________ '
- �
,.
-._.
..
; License Plate_--_-------_ -------- NCIC---CCIC--- K.
----- Y
<--;:�;::'� Inspected BY=------- _ Date_----------- �
_.::; �
,...•,
� '
%;�;4,,?� Inspector's Si9nature, if passedc___________ ;
----------------------
�i. '� �`
� : -------------------------------
---------------------------------
•".'�x. �
_"ti3 ITEM YES NO
i
����;^� Current Vehicle Registration ____ _�_
+ Proof of Insurance
. . ���:�Y� __'_� �___
���`�:; All vehicle lights working
;:{'�� All emergency lights working _�__ ____
-�:;
= Secure storage of equipment
.`i.:. :. ---- --- .
_y'`� Portable suction apparatus with wide-bore-
: 's
�;.Yj tubing and pharyn9eal suction tip ____ ____
s-,
'�.;�.i Bag-valve-mask with adult, cfiild, and infant masks_
i
,� Must have reservoir capability
,}*.� ---- ----
�;•:�; Oropharyngeal airways: adult, child, infant sizes
;_i ---•- ----
..,
- Nasopharyngeal airways� adult, child, infant ____ ____ s '
-.� Portable oxygen system including_ tank & regulator ___,_ ____ � ::_..
' adult. child, infant valveless masks ____ ____ � `.� ,
� .;.
: � .
' � 2 nasal cannulas t'"��+
---- ---- :�:.
i y..� :
,� Two clean burn sheets ____ ____ k�Y�,
=M1� Triangular bandages with safety pins L '�'
:j ---- ---- ;, �':
�,
r:7
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_ _. ,.. -
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W�rt -----_.... ...-_.°•--rrrwlaY�/�n����nelmlyuNnn mr111nrwwwlRaqYl�Mpp��,w
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..... .�.. .... . .. .
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- r� ,} �i�� ,� � �'� 1 ��"Il)�' y. .'�
. . . ha �./��� .[� ,,�� �• �S�t J .
. . K h � ..*��N^��. ''����7"1
. +y;��! . #: .. -�.����'4�..af�^�•��:�-:ev",T.' ..��. .. ._ � . ._ . st . 'Y. . , '��.1�'��s�.���
, _ �a��;e` .'
Lower extremitY traction splint ____ ____
Extremity immotrilizing device `
Lon9 spine boaYd �__ ____ `� -
���.�t:
Short spine board or equivalent ____ ____ �.�° `
} Sterile obstetrical kit __� ____ �.":;,'.
_� Two-way hospital radio system ____ ____ ' ` `'
` ,
One adult B/P cuff ____ E.,:-
---- F..:;�:<
i�:� One child 8/P cuff �'`:.
,S'� ____ ____ Y.. '
�
Two stethoscopes �
U ..;�� Sterile irrigation solution ____ ____ �� '
::.,;
a
"''? Roll of aluminum foil or space blanket '
''" Shears or heavy scissors
, ,
.� ----
"�'� Two flashlights ____ ____ "
�`�`.'� One 10# or two 5# fire extinguishers ____ ____
:�;;� One pocket mask ____. ____
��:��
'_,•;,yi Vehicle oxygen system capable of delivering
°„<�':! 10 liters for y0 minutes = 900 liters ____ ____ _
<!
,,:"� One scoop stretcher v
:,�� One each: large, medium, small, C-collar ____ ____
��,� One alter�ate system for cervical immobilization
-:=�i ' �
.
.
''`� such as: sand bags, IV bags, foam pads `
.,
::1 ---- ----
,.,�;
`;.:� Two bite sticks `
;� 6mesis basin(s) with one quart capacity ____ ____
� ;. :
'.j Three blankets ____ ___-
! Four each large and small universal dressings ____ ____ � .
�;� � ;
�
-�;� 24 gauze pads (4x4) ---- - �;".
, ___ E t.
One universal urina2 ____ ____ €,�''=
. ��.f . i�.�.
,�
"-`kE
S?�
. > ��_�_���
'�•�f� �. .... /.:... .... . , . .. .� . . ( � .
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,'5..�'i�.•`r�'^� � .
r.-_
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�•e r:�'�.^.''ra-'
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.=�" � �'
_..._ 1 . . . . .._ .-. -__..�� .. ....._... .. . ......._,_. . .:..,,.�„..�.., �,�......,....,,...�,,..,.,....
�... . ._.: _. ........ ... .. ..
r�,' . . . � .. . . - . .... ...-_._ .. . . . . . . . .
"K�-c �,•. , � � � � . ' M y�,���j ��::��'� iSr ���1�°x� �.iti �,i{,,�4r
t
. �c � W�. 1 rN � �.�
. � � '� �},- �"r. x ty�-�. � .. �'t . . ��� '�'• �: ���M�.ja�`'.
.. ..`., ' , . _
. .... ������ . ��.���1�t�A���i�ytFi".��" .+frl.�.. ... .'�7iTryt... t. .t . . �i..:T..�jr1�5Y
4 soft roller bandages, 4 inch _____ ____
Two ace bandages, 4 inch� ____, ____ -
1:
Two each 2 inch and 1 inch adhesive tape ____, ____ ''`
i::-:
4 vaseline gauze pads ____ ____ { `
i�' '
Two tubes of glucose ____ ____
,;�� Two 30cc bottles Syrup of Ipecac
i ---- ---- �_
One SOcc bottle of charcoal �`
' ----- ---- ¢
::':� One pair of M_A_S.T_(pneumatic anti-shock garment) ____ ____ � ' .
- w.
'z:`.': �..
� ``f� Requested Waivers of County required equipment, from application_
;..
�,..
, ..,t ----------------------------------------------------------------
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•':�.�
. . _____________________________________________________
.^a^,t� ___--_—_-- ,
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EXHIBIT B �
..,I• '
PITKIN COUNTY APPLICATION FOR AMBULANCE LICENSE iw"'-^`:
t�.;.r:'__
� ,.
PLEASE 7YPE ALL INFORPIATION '
=� SERVICE NAME________
' ---------------------------------------- �.... _
, �. :
� ADDRESSa--------------------------°------------------------- � ,
...:� OWNERS OR OFFICERSc-----------------------------------------
;,:;. �.;..
-..
:<�
. :� PHONE NUMBERS.---------------------------------------------- �',
7 ;�.� DESCRIPTION OF AMBULANCE_ MAKE, MODEL, YEAR, LICENSE NO_
�'�.y
.�,
..ti
`i ADDRESS Ah1D DESCRIPTION OF BASE OF OPERATIONS: ______ — °
•.�; __ _ _ _
�� ------------------------------------------------
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..�.
�„� .
�� -----------------------------------------------------------------
,
,.,
,,.,
;� PHYSICIAN ADVTSOR:-----------------------------------------,
_�
,^.;
^;.j COLORADO CERTIFICATION NO=�,�____
,' ��
-i'iI PHONE NUMBERSa----------------------------------------------
'� SIGNATURE=------------------
-:
l
, :
.:. � -
`� WAIVER REQUESTS_________ ,
' -----------°---------------------------- �. ,
,... .
: �
; � .
' ----------------------------- �
;-i ----------------------------------- f
,; S
'{ --------------------------------------------- �' ::'-�
� --°--------------- :
, .
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{
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.+ -----------------------------------------------------°---------- `i .:.
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, f�; ,;,
� —°------------°-------------------------------------------•----- ��;.,""
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-"� - ,,v:
� ----------------------------------------------------------•----- -��,:,:
? APPLICANTc--------------------------------- DATE=--------------- �;;_""``
1 �t,
; SIGNATURE_--------------------------------- '-� , �
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. 5,1y � � �'�i H'a� 7 ,p. 1 1-.
r � � ��'.'iC �� ��i} S'�,�. � � �'�4�i� � >.3�'���~ � �jp;} rt.*. �,� ' r�,.f.�i e
� .�w� '� 1y� ..K � .i e n �+ ;.�,�xYe .� �N pa,�, '
� ' .� '�M�I. .. r y ..- /. ' .. . . '�;W: �L..�i.,,..���n��[.+'��1T+tJ..• . :i. . . ki.+7.IV' y ..
GRANT OF LICENSE/PERMIT
The undersigned, representing the Board of County Commissioners * ''
�:.._..-
- .i, -
of Pitkin County, Colorado, does hereby grant a license to the �;.,:;.�
� :_:
above named applicant to provide ambulance service within Pitkin �`;: ..
_ },,'
County_ This license shall have upon it any restrictions listed
•''� below, shall be granted any waivers listed below, and shall be
-.,,
valid for the dates listed below, unless revoked by the Board
:':��� pursuant to the provisions of Resolution No_ 86- .
.:;,
:.:, : ..
�.� �. :
. :
RESTRICTIONS:----------------------------------------------------
Y. :. ' .
;::; !
�..;_2 '
4
' . _____________________________'_________________"'________�______
::�
.�'� _____'____________'___________________________________'________
;,.: �
. .::�
��y�'G WAIVERS GRANTEDo------------------------------------------------
, ;:��
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:`��� THIS LICENSE IS VALID FROM/UNTILc ________________________________ : ''
t
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_. _________________________________________________________________ �� �:
r,-i�
^� 3
:`� DATE --------------
----------------------------------------
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CHAIRMAN, BOARD OF COUNTY COMMISSIONERS ;;._;:�,�-`
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