Chapter Trans 309

Trans 309.15 Trans 309.15 Exterior ambulance lighting.

Trans 309.15(1) (1) General lamps. Ambulances shall be equipped with headlamps, directional signal lamps, tail lamps, stop lamps, parking lamps, sidemarker lamps, license plate lamps, backup lamps, hazard warning lamps and clearance lamps meeting the requirements of ch. 347, Stats.

Trans 309.15(2) (2) Emergency warning lamps.

Trans 309.15(2)(a) (a) All ambulances shall be equipped with warning lamps consisting of:

Trans 309.15(2)(a)1. 1. Except as provided in par. (b), 2 top-corner mounted alternating flashing red lamps facing forward with a white flashing light mounted at an equal distance between them;

Trans 309.15(2)(a)2. 2. Except as provided in par. (c), 2 top-corner mounted alternating flashing red lights facing to the rear;

Trans 309.15(2)(a)3. 3. Two top-corner mounted alternating flashing red lights facing to the right side;

Trans 309.15(2)(a)4. 4. Two top-corner mounted alternating flashing red lights facing to the left side; and

Trans 309.15(2)(a)5. 5. At least 2, red or red and white, flashing or rotating warning lamps located in, on, behind or in front of the vehicle’s radiator grill. The lamps shall be designed and mounted so as to be plainly visible and understandable from a distance of 500 feet during both normal sunlight and hours of darkness.

Trans 309.15(2)(b) (b) The lights required in par. (a) 1. may be replaced with a light bar with 2 or more rotating or flashing red or red and white lights which covers the same area.

Trans 309.15(2)(c) (c) The lights required in par. (a) 2. may be replaced with rotating red or red and white lights revolving or flashing on a horizontal plane.

Trans 309.15(2)(d) (d) Emergency warning lamps may not be obstructed by open doors.

Trans 309.15(2)(e) (e) Ambulance service providers may not be required to alter emergency warning lamps already installed on ambulances in service prior to November 1, 1986.

Trans 309.15(2)(f) (f) The lamps shall be designed and mounted to be plainly visible and recognizable as emergency vehicle lights from a distance of 500 feet during both normal sunlight and hours of darkness.

Trans 309.15(2)(g) (g) A flashing amber light may be installed to the rear top, positioned equally between the 2 top mounted corner flashing red lights, or 2 amber lights may be installed to the rear mounted to the insides of the 2 corner flashing red lights.

Trans 309.15(3) (3) Floodlamps. Sealed flood lighting units shall be located at the rear and on the left and right sides of the ambulance. Floodlamps shall be integrally mounted below the roof line but not less than 75 inches above the ground and may not be obstructed by open doors. Each flood lamp shall have a minimum of 800 candlepower output. Flood lighting at the rear shall be arranged to illuminate the ground area immediately surrounding the loading doors. The switches shall be shielded and shall control each side separately.

Trans 309.15(4) (4) Figure. Lighting requirements described in this section are illustrated in figure 1.

Figure 1 – Emergency Lighting

Trans 309.15 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 1987, No. 376; am. (1), (2) (a) 5., (b) and (e), Register, April, 1994, No. 460, eff. 5-1-94; am. (2) (b), (c) and (e), cr. (f), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (1), (2) (c), cr. (2) (g), (4), (Figure 1) Register October 2020 No. 778, eff. 11-1-20; correction in (2) (g) made under s. 35.17, Stats., and (4) (title) created under s. 13.92 (4) (b) 2., Stats. Register October 2020 No. 778.

Trans 309.16 Trans 309.16 Interior ambulance lighting.

Trans 309.16(1) (1) Driver compartment. The driver compartment shall be equipped with a dome lamp, instrument panel lamps and indicators, master switch panel or console lamps and door-open indicator. The lighting shall be designed and located so that no glare is reflected from surrounding areas to the driver’s eyes or line of vision from instrument and switch control panels or other areas that are illuminated while the vehicle is in motion.

Trans 309.16(2) (2) Patient compartment. The patient compartment shall be equipped with overhead or dome lighting and switch panel lighting. Only white or a combination of white and red colored lamps or lenses may be used in the patient compartment. Patient compartment lights shall be automatically activated when the entrance doors are opened or when otherwise controlled by the driver’s master switch. Interior light fixtures may not protrude more than 1.5 inches. Fluorescent lights that operate on 12 volts may be used, but they may not extend more than 4 inches from the mounting surface. Fluorescent fixtures may be mounted at the intersection of the ceiling and walls, and shall be equipped with removable covers that positively lock in place.

Trans 309.16(3) (3) Illumination levels. Normal illumination in all patient areas shall be not less than 15 foot candle intensity measured along the entire center line of the clear floor without any outside ambient light. The primary cot and squad bench shall be provided with 35 to 55 foot candles of illumination measured on at least 90% of their surface. Lighting levels shall be controlled by the EMT with switches or with a fireproofed underwriter’s laboratory approved rheostat.

Trans 309.16 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am. (2) and (3), Register, April, 1994, No. 460, eff. 5-1-94; am. (2), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (2) Register October 2020 No. 778, eff. 11-1-20.

Trans 309.17 Trans 309.17 Siren and public address system.

Trans 309.17(1) (1) Each ambulance shall have an electric or electronic siren and amplified public address system. The siren or siren speakers shall be mounted below the windshield and forward of the front wheels. The siren shall produce wail and yelp sound patterns. The wail sound pattern shall have both automatic and manual controls.

Trans 309.17(1m) (1m) The siren shall be activated by the steering wheel horn. The emergency light control panel shall have a switch marked “horn/siren” to activate either the vehicle’s horn or siren. This subsection applies to all ambulances that are put in service July 1, 1999.

Trans 309.17(2) (2) Ambulance service providers may not be required to alter siren mountings already installed on ambulances in service prior to May 1, 1994.

Trans 309.17 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; r. and recr. Register, April, 1994, No. 460, eff. 5-1-94; am. (1) and (2), cr. (1m), Register, February, 1999, No. 518, eff. 4-1-99.

Trans 309.18 Trans 309.18 Communications.

Trans 309.18(1) (1) Each ambulance shall have a permanently mounted radio in the cab of the ambulance capable of contacting the hospital emergency department of the hospital it serves. In the rear compartment of the ambulance there shall be two way communications in the form of a radio capable of communication with the hospitals it serves. These radios shall comply with ch. DHS 110.

Trans 309.18(2) (2) Each ambulance service provider operating ambulances staffed either wholly or partially with EMTs practicing advance skills shall have remote 2-way communications for personnel when they are away from the ambulance.

Trans 309.18 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; am., Register, April, 1994, No. 460, eff. 5-1-94; am. (2), Register, February, 1999, No. 518, eff. 4-1-99; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register December 2010 No. 660; CR 19-074: am. (1) Register October 2020 No. 778, eff. 11-1-20.

Trans 309.19 Trans 309.19 Lettering and markings on ambulances.

Trans 309.19(1) (1) Ambulances may be painted any color or combination of colors and shall bear the lettering and markings prescribed in sub. (2).

Trans 309.19(2) (2) The material for lettering and marking shall be a color contrasting with the color of the ambulance. The use of reflectorized material for the lettering and markings is preferred, but is not mandatory. The lettering and markings shall be of the type, size and location as follows:

Trans 309.19(2)(a) (a) The word “AMBULANCE” or “RESCUE SQUAD” in block letters not less than 6 inches high shall be placed on each side and on the rear of the vehicle body.

Trans 309.19(2)(b) (b) Reflectorized striping totaling not less than 4 inches shall encircle the entire ambulance body excluding the front end. The top edge of this stripe shall be no higher than 48 inches above the ground. This stripe may be broken up by wheel wells, hinges, handles, windows or lights. Reflective designs or materials can replace the 4 inch stripe in this paragraph if it covers an area equal or greater than the area covered by the 4 inch stripe and is incorporated into both sides and rear and begins no higher than 48 inches above the ground. Reflectorized lettering may be included as part of this striping. Reflectorized chevrons may also cover the rear of the ambulance from top to bottom and may be included as part of the striping encircling the body. This striping requirement shall apply to all units placed in service after November 1, 2020.

Trans 309.19(2)(c) (c) The name of the ambulance service provider shall be displayed on each side of the ambulance.

Trans 309.19 History History: Cr. Register, October, 1986, No. 370, eff. 11-1-86; renum. from Trans 309.20 and am., Register, April, 1994, No. 460, eff. 5-1-94; am. (1) and (2) (b), Register, February, 1999, No. 518, eff. 4-1-99; CR 19-074: am. (2) (b), cr. (2) (c) Register October 2020 No. 788, eff. 11-1-20; corrections in (2) (b) made under s. 13.92 (4) (b) 14. and 35.17, Stats., Register October 2020 No. 778.

Trans 309.20 Trans 309.20 Smoking in ambulances. No smoking may be allowed in any area of the ambulance at any time.

Trans 309.20 History History: Cr. Register, February, 1999, No. 518, eff. 4-1-99.

Trans 309.205 Trans 309.205 Standard mandatory miscellaneous equipment.

Trans 309.205(1) (1) An ambulance shall be equipped with the following:

Trans 309.205(1)(a) (a) Fire extinguishers, including 2 ABC-capable fire extinguishers able to control the following fires: A - capable of extinguishing fires involving paper, wood, textiles and plastics; B - capable of extinguishing fires involving flammable liquids; and C - capable of extinguishing fires involving live electrical equipment, dry chemical or carbon dioxide. These fire extinguishers shall each be a minimum 5-pound unit, in a quick-release bracket, one mounted in the driver-cab compartment or in the body reachable from outside the vehicle and one in the patient compartment. The mounting bracket shall be a stable design.

Trans 309.205(1)(c) (c) “No Smoking” signs placed conspicuously in the cab and patient compartment.

Trans 309.205(1)(d) (d) Two portable, battery-operated lights.

Trans 309.205(1)(e) (e) Three reflectors or 3 noncombustible red light sticks with a minimum of one-hour service duration.

Trans 309.205(1)(f) (f) One current U.S. Department of Transportation Emergency Response Guidebook, which provides general safety and environmental information for hazardous materials.

Trans 309.205(1)(i) (i) One personal portable carbon monoxide detector.

Trans 309.205(2) (2) Unless the ambulance routinely responds with or is an agency that provides extrication assistance, the ambulance shall carry the following equipment or its equivalent:

Trans 309.205(2)(a) (a) One 12-inch adjustable wrench.

Trans 309.205(2)(b) (b) One screwdriver for slot head screws.

Trans 309.205(2)(c) (c) One Phillips screwdriver.

Trans 309.205(2)(d) (d) One hacksaw with 12-inch blades.

Trans 309.205(2)(e) (e) One 10-inch locking grip pliers.

Trans 309.205(2)(f) (f) One 16 ounce hammer.

Trans 309.205(2)(g) (g) One 24-inch wrecking bar.

Trans 309.205(2)(h) (h) Impact resistant eye protection.

Trans 309.205(2)(i) (i) One pair of leather gloves.

Trans 309.205(2)(j) (j) One roll of 2-inch duct tape.

Trans 309.205(2)(k) (k) A spring loaded center punch.

Trans 309.205(3) (3) Small hand tools shall be stored in an easily accessible area.

Trans 309.205 History History: CR 19-074: cr. Register October 2020 No. 778, eff. 11-1-20; correction in (1) (a), (2) (d) to (f) made under s. 35.17, Stats., Register October 2020 No. 778.

Trans 309.207 Trans 309.207 Vehicle safe operating conditions.

Trans 309.207(1) (1) The vehicle shall be in safe operating condition. The vehicle and all required vehicle equipment shall be functional and operable when the vehicle is in service.

Trans 309.207(2) (2) All equipment shall be maintained in full operating condition and in good repair and be free from rips, tears, holes, grease, dirt, and other offensive matter and shall not be carried beyond expiration dates. The finish of the entire patient compartment, including interiors of storage cabinets, shall be impervious to soap, water, and disinfectants and easily cleaned/disinfected (carpeting, cloth, and fabrics are not acceptable).

Trans 309.207(3) (3) All equipment carried in an ambulance must be securely stored so that, in the event of a sudden stop or movement of the vehicle, the patient and all occupants are not injured by moving equipment.

Trans 309.207(4) (4) During the calendar year when the required biennial ambulance inspection is not completed by the ambulance inspector with the department, the ambulance service provider shall obtain a department-approved inspection for each ambulance. The inspection shall be performed by a technician qualified to perform department annual inspections. Ambulance service providers may perform the required annual inspection themselves with a qualified technician. The original or a copy of the periodic inspection report for each ambulance must be retained by the ambulance service provider for 14 months from the report date and shall be made available to the department.

Trans 309.207 History History: CR 19-074: cr. Register October 2020 No. 778, eff. 11-1-20; correction in (2) made under s. 35.17, Stats., and correction in (4) made under s. 13.92 (4) (b) 12., Stats., Register October 2020 No. 778.

Trans 309.209 Trans 309.209 Safety belts and child safety restraint systems.

Trans 309.209(1) (1) Every ambulance shall be equipped with safety belts for the driver and each passenger in the driver compartment and at each seating position in the rear or patient compartment.

Trans 309.209(2) (2) All seatbelts, seatbelt use, child restraints and use shall comply with s. 347.48, Stats.

Trans 309.209(3) (3) Every ambulance shall carry a child restraint system appropriate for children under the age of 8 years old. When a child under the age of 8 years old is transported, that child shall be transported in a front or rear oriented direction.

Trans 309.209 History History: CR 19-074: cr. Register October 2020 No. 778, eff. 11-1-20; change in numbering of (2), (3) under s. 13.92 (4) (b) 1., Stats., and corrections in (2) made under s. 13.92 (4) (b) 7. and 35.17, Stats., Register October 2020 No. 778.

subch. III of ch. Trans 309 Subchapter III—Medical Equipment Standards

Subch. III of ch. Trans 309 Note Note: Pursuant to s. Trans 309.25, this subchapter is repealed upon promulgation by the department of health services of administrative rules establishing standards and inspections, as well as legislative appropriation of resources for such inspections.

Trans 309.21 Trans 309.21 Stretcher and chair stretcher and restraints.

Trans 309.21(1) (1) Every ambulance shall be equipped with one commercial elevating wheeled cot maintained in good working order made up with a sheet and a blanket and a stair chair or carry chair, designed to permit a patient to be carried on stairways and through other narrow areas. Each ambulance shall be equipped with a crash stable slide, center mounted, or equivalent cot fastener assembly of the quick-release type to secure the elevating wheeled cot to the ambulance body. The cot fastener assembly shall be the manufacturer’s approved bracket for the cot used.

Trans 309.21(2) (2) At least 3 strap-type restraining devices for the chest, hip and knee shall be provided for each stretcher, capable of preventing longitudinal or transverse dislodgement of the patient during transit. Shoulder straps shall be required on the cot stretcher. Restraining straps shall be made of nylon or equivalent material and shall be at least 2 inches wide. The straps shall be constructed as a 2-piece assembly with quick-release buckles and shall be removable for easy cleaning. If a second patient is transported in the patient compartment on a long spine board the ambulance shall be equipped with the manufacturer’s approved securement for a long spine board and 3 strap-type restraining devices for the chest, hip and knee.

Trans 309.21 Note Note: Pursuant to s. Trans 309.25, this section is repealed upon promulgation by the department of health services of administrative rules establishing standards and inspections, as well as legislative appropriation of resources for such inspections.

Trans 309.21 History History: CR 19-074: r. and recr. Register October 2020 No. 778, eff. 11-1-20; correction in (2) made under s. 35.17, Stats., Register October 2020 No. 778.

Trans 309.22 Trans 309.22 Suction aspirator system. An electrically powered suction aspirator system shall be furnished with an illuminated switch and a panel-mounted, labeled, quick disconnect inlet device on the panel. The suction pump shall be located in an area that is accessible, but the patient compartment shall be insulated from the pump’s sound and vibration. The pump shall be vented to the vehicle’s exterior. A vacuum control and a shut-off valve, or combination thereof, shall be provided to adjust vacuum levels. A vacuum indicator gauge of 3 inches +/-0.5 inches in diameter, with numerical markers at least every 100 mm Hg and a total range of 0 to 760 mm Hg, shall be provided. The collection bottle or bag shall be nonbreakable and transparent with a minimum 1,000 ml capacity. The minimum inside diameter for the suction tubing connectors shall be at least 1/4 inch. One spare, non-breakable suction collecting bottle shall be stored nearby if a disposable bag is not used. The following accessories shall be furnished and stored to be readily available, and shall be a single-patient use item: one suction rinsing water bottle; one semi-rigid non-metallic pharyngeal suction tip; at least one spare suction tip and at least one adult and one infant catheter; and one 6-foot length or more of translucent wide bore, non-kinking suction tubing, reasonably thick walled to prevent its collapse under high suction. The suction aspirator system shall provide a minimum of 30 liters per minute flow at the catheter tip. The suction aspirator system shall achieve a minimum of 300 mm Hg vacuum within 4 seconds after the suction tube is closed.

Trans 309.22 Note Note: Pursuant to s. Trans 309.25, this section is repealed upon promulgation by the department of health services of administrative rules establishing standards and inspections, as well as legislative appropriation of resources for such inspections.

Trans 309.22 History History: CR 19-074: r. and recr. Register October 2020 No. 778, eff. 11-1-20; correction made under s. 35.17, Stats., Register October 2020 No. 778.

Trans 309.23 Trans 309.23 Oxygen equipment.

Trans 309.23(1) (1) The ambulance shall have a hospital-type piped oxygen system capable of storing and supplying a minimum of 120 cubic feet of medical oxygen. The main oxygen supply shall have a minimum of 500 PSI. The oxygen containers shall be secured in a storage compartment. The cylinder controls shall be accessible from inside the vehicle. The pressure readout shall be visible inside the patient compartment. The piped oxygen system shall include a pressure regulator preset to 50 PSI, +/- 5 PSI, line pressure installed at the cylinder, and nonferrous piping and low pressure hoses suitable for medical oxygen. Oxygen piping shall be concealed and not exposed to the elements or damage, be securely supported, and be readily accessible for inspection and replacement. Oxygen shall be piped to self-sealing outlets. One duplex oxygen outlet station for the primary patient shall be located on the action wall and at least one other oxygen outlet shall be located in the patient compartment. Two oxygen outlets shall be equipped with a plug-in flowmeter and delivery tube. The flowmeter shall be capable of delivering at least 15 liters per minute.