 DEAS 1184: 2023 ICS 11.160  
© EAC 2023                                                                                                                          First Edition 2023  
DRAFT EAST AFRICAN STANDARD Emergency Medical Services — Water ambulance — Requirements 
EAST AFRICAN COMMUNITY        DEAS 1184:2023 
© EAC 2023 – All rights reserved ii  Copyright notice This EAC document is copyright-protected by EAC. While the reproduction of this document by participants in the EAC standards development process is permitted without prior permission from EAC, neither this document nor any extract from it may be reproduced, stored or transmitted in any form for any other purpose without prior written permission from EAC. Requests for permission to reproduce this document for the purpose of selling it should be addressed as shown below or to EAC’s member body in the country of the requester: © East African Community 2022 — All rights reserved East African Community P.O. Box 1096, Arusha Tanzania Tel: + 255 27 2162100 Fax: + 255 27 2162190 E-mail: eac@eachq.org         Web: www.eac-quality.net  Reproduction for sales purposes may be subject to royalty payments or a licensing agreement. Violators may be prosecuted. DEAS 1184:2023 
© EAC 2023 – All rights reserved iii  Foreword  Development of the East African Standards has been necessitated by the need for harmonizing requirements governing quality of products and services in the East African Community. It is envisaged that through harmonized standardization, trade barriers that are encountered when goods and services are exchanged within the Community will be removed. The Community has established an East African Standards Committee (EASC) mandated to develop and issue East African Standards (EAS). The Committee is composed of representatives of the National Standards Bodies in Partner States, together with the representatives from the public and private sector organizations in the community. East African Standards are developed through Technical Committees that are representative of key stakeholders including government, academia, consumer groups, private sector and other interested parties. Draft East African Standards are circulated to stakeholders through the National Standards Bodies in the Partner States. The comments received are discussed and incorporated before finalization of standards, in accordance with the Principles and procedures for development of East African Standards. East African Standards are subject to review, to keep pace with technological advances. Users of the East African Standards are therefore expected to ensure that they always have the latest versions of the standards they are implementing. The committee responsible for this document is Technical Committee EASC/TC 076, Services. Attention is drawn to the possibility that some of the elements of this document may be subject of patent rights. EAC shall not be held responsible for identifying any or all such patent right 
© EAC 2023 – All rights reserved   1 Emergency Medical Services — Water ambulance — Requirements 1 Scope  1.1 This Draft East African Standard establishes the requirements for water Ambulance Services. 1.2 The standard is applicable to ambulances capable of referring at least one person on a stretcher. 1.3 It does not cover the requirements for approval and registration, this is the responsibility of the relevant authority in the country where the water ambulance is to be registered. 2 Normative references  There are no normative references in this document. 3 Terms and definitions For the purposes of this document, the following terms and definitions apply. ISO and IEC maintain terminological databases for use in standardization at the following addresses: — IEC Electropedia: available at http://www.electropedia.org/ — ISO Online browsing platform: available at http://www.iso.org/obp 3.1  water ambulance vessel used for emergency medical care in islands, coastal areas and water ways 3.2   Emergency Ambulance Services (EAS) services provided in accordance with this standard for medical cases to the time the patient arrives at a place of appropriate care 3.3   appropriate care hospital emergency department, accident and medical clinic or other such treatment facility that is able to offer specialist emergency care   NOTE: Effectively this means that transport to another facility within three hours of arriving at the first is included in the service provided under this contract. 3.4   clinical advisor registered medical practitioner who holds an appropriate post-graduate specialist qualification or relevant experience, appointed by an ambulance service to undertake specified duties. These should include: overseeing and advising on patient care, authorising in writing delegated medical procedures and drug regimes carried out by ambulance officers, and being responsible for medical audit of patient care. 3.5   emergency DEAS 1184:2023 
© EAC 2023 – All rights reserved   2 situation in which a prudent layperson has identified a potential medical threat to life or limb such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of bodily organ  3.6   patient condition a description of objective clinical signs that includes the results of an at-scene triage assessment, clinical signs (relevant positives, significant negatives) and the patient’s presenting condition 3.7   patient stability a statement of the assessed likelihood or risk of clinically significant change in the patient’s condition over time 3.8  potential to deteriorate the probability that a patient will deteriorate in health status without immediate medical intervention  3.9 Helmsman person who steers a vessel using handle, wheel or joystick  NOTE: vessel can be a ship, sailboat, submarine, other type of maritime vessel, or water ambulance  3.10  Ambulance Services Providers  ASP organization, entities or body that is licensed, dedicated, staffed and equipped to operate ambulance in order to provide emergency medical care, transportation, and preventive care to mitigate loss of life or exacerbation of illness or injury  3.11  emergency ambulance services  transport using ambulances, any individual suffering, or believed to be suffering, from an injury or condition of acute or sudden onset and of an emergency nature 4. Requirements  4.1 General requirements  4.1.1 All water ambulances shall be duly registered with the relevant authority under the name of the water ambulance service provider prior to application for License to Operate.  4.1.2 Water ambulance shall only be used for the purpose by which it was granted a license to operate.  4.1.3 No water ambulance of any kind shall bear on its body the label or marking of the word "AMBULANCE" unless it has been duly licensed and categorized as water ambulance by the relevant authority.  4.1.4 Water ambulance service provider shall be organized to provide safe, quality, effective and efficient water ambulance services for patients which shall be made available at all times.  DEAS 1184:2023 
© EAC 2023 – All rights reserved   3 4.1.5 Water ambulance service provider shall have documented policies and procedures on its administrative and technical Standard Operating Procedures (SOP) for the provision of its water ambulance services.  4.1.6 Water ambulance service provider shall have documented policies and procedures on the establishment of its referral system.  4.1.7 Water ambulance service provider shall maintain a system of communication, recording and reporting of the patient's condition as well as the results of examinations which may include electronic communications or otherwise.  4.1.8 The water ambulance operator shall ensure that safety appliances and equipment are provided and maintained on board the vessel in accordance with the requirements of the second schedule and other requirements of that schedule are compiled with in relation to the vessel.  4.1.9 The water ambulance operator shall ensure Procedures and training is to be in place to ensure that the meaning of alarms and the subsequent action to take is known by all crew and shore crew  4.1.10   Water ambulance provider shall ensure water ambulance services network is integrated to ensure the most appropriate response is made to meet the goals of waterside to medical facility;  4.1.11 Water ambulance provider shall ensure water ambulance services provide a range of service and capability levels to most appropriately meet the needs of their communities within available resources;  4.1.12   Water ambulance provider shall ensure appropriate back up for each of its water ambulance stations from either prime practitioner, other stations operated by that provider or from stations operated by another provider.  4.2 Specific requirements To be permitted as Ambulance Services Providers, the following requirements shall be met: 4.2.1 Water ambulance requirements  4.2.1.1 The water ambulance shall have a patient care area that:  a) Provides access to the head, torso, and lower extremities of the patient while providing sufficient working space to render patient care; b) Is covered to protect the patient and water ambulance personnel from the elements of weather; c) Has an opening of sufficient size to permit the safe loading and unloading of a person occupying a litter.  4.2.1.2 The water ambulance shall have on board patient care equipment and supplies. The equipment and supplies shall be clean, in working order, and secured in the vessel.   4.2.1.3 Water ambulances shall have the name of the ASP of lettering not less than seven and half (7.5) cm in height and provider identification mark permanently displayed on each side of the water ambulance.   DEAS 1184:2023 
© EAC 2023 – All rights reserved   4 4.2.1.4 Water ambulance shall bear emblem ambulance and markings on each side of the patient compartment has the “Star of Life,” not less than thirty (30) cm in height, the word “AMBULANCE”, not less than fifteen (15) cm in height.  4.2.1.5 Water ambulances shall have a 360-degree beacon warning light in addition to warning devices.   4.2.1.6 Water ambulances shall be equipped with:  a) Two floatable rigid long backboards with proper accessories for securing infant, paediatric, and adult patients and stabilization of the head and neck; b) One floatable litter with patient restraining straps and capable of being secured to the water ambulance; c) One fire extinguisher mounted in a quick release bracket that is either a dry chemical or all-purpose type and has a pressure gauge; d) Lighted compass; e) Radio navigational aids such as ADF (automatic directional finder), Satellite Global Navigational System, navigational radar, or other comparable radio equipment suited for water navigation; f) Water ambulance operators should apply for marine VHF radio operation license from relevant authority to report to water accidents whenever they occur for assistance. g) The availability of one pediatric restraint device to safely transport pediatric patients under 20 kg in the patient compartment of the ambulance. 4.2.1.7 The water ambulance shall not have structural or functional defects that may adversely affect the patient, the water ambulance personnel, or the safe operation of the water ambulance.  4.2.1.8 Water ambulances shall have a copy of the providers system patient care treatment protocols.  4.2.2 Personnel requirements  4.2.2.1 Ambulance Services Providers shall ensure that all staff are appropriately trained and are available to provide adequate coverage to meet the level of service to be provided.  4.2.2.2 The ASP Agency shall ensure personnel’s uniforms and clothing are clean or changed if they become soiled, contaminated, or exposed to vomitus, blood, or other potentially infectious material (OPIM).  4.2.2.3 The boat crew shall consist of an emergency care nurse, two emergency first level medical care technicians to bring patients on and off board and water ambulance captain. Where life threatening calls are classified as code red, an emergency physician gets on board with the rest of the crew.   4.2.2.3.1 Water ambulance captain 4.2.2.3.1.1 water ambulance captain shall be able to perform the tasks as stipulated below: a) External boat inspection; DEAS 1184:2023 
© EAC 2023 – All rights reserved   5  b) Checking the levels of technical fluids and their possible supplementation;  c) Starting the engines and controlling their parameters;  d) Starting and checking the functionality of the helm, radar, GPS, electronic map, and radio station by establishing contact with the MD (medical dispatcher) and harbour master;  e) Maintaining safe docking and securing of the vessel (control of lines and power supply from land).  f) Ensure safety of people on board  4.2.2.3.1.2 The water ambulance captain shall have the minimum qualifications and experience as follows:  a) Senior helmsman certification;  b) Certificate of training in the use of radar and ARPA (Automatic Radar Plotting Aid), operating level;  c) Short-range communications operator certification;  d) Qualification to personal safety and joint responsibility training;  e) Certificate of training in individual rescue techniques;  f) Qualification to elementary medical training;  g) Qualification to basic fire protection training;  h) Qualification to use short-distance transport equipment.  i) Qualification to water rescue skills.   j) Certificate of rating forming part of navigational watch or engineering watch  4.2.2.3.2 Emergency care nurse  4.2.2.3.2.1 The emergency care nurse shall have the minimum qualifications and experience as follows: a) shall hold a valid practising certificate, and be assessed by the relevant authority  b) shall be registered with the relevant authority as a registered nurse and hold valid certifications issued by a centre accredited by relevant authority.  c) Qualification to water rescue skills.  4.2.2.3.2.2 The emergency care nurse shall be able to perform the tasks as stipulated below:  a) assess and independently manage trauma and non-trauma emergencies in patients of all age groups in accordance with the Ambulance-SP’s medical protocols;  DEAS 1184:2023 
© EAC 2023 – All rights reserved   6 b) organise and prioritise treatment and evacuation in multiple casualty incidents;  c) use various types of stretchers and body immobilisation devices provided by the Ambulance Service;  d)  carry out emergency basic procedures to control external haemorrhage, apply dressings, bandages, slings and splints;  e) provide immediate care to casualties during the process of extrication and disentanglement from entrapments;  f) assess and maintain the patient’s airway, including the use of adjuncts such as the oropharyngeal airway or Laryngeal Mask Airway (LMA) and endotracheal intubation (ETT);”  g) perform basic life support on infants, children and adults;  h) perform a 12-lead electrocardiogram, monitor the patient’s electrical rhythm and transmit the 12-lead electrocardiogram to the receiving hospital, if appropriate and required;  i) independently initiate the use of an Automated External Defibrillator (AED);  j) obtain intravenous access, administer designated intravenous medications and perform intravenous infusions as per ambulance care protocols;  k) obtain capillary blood glucose sample and institute treatment for hypoglycaemia;  l) assess and manage an emergency childbirth;  m) administer basic emergency medications including nebulisation;  n) identify abnormal chest sounds through auscultation;   4.2.2.3.3 Medical care technicians  4.2.2.3.3.1 Medical care technicians shall have the minimum qualifications and experience as follows:  a) Certificate of personal safety and joint responsibility training;  b) Certificate of marine basic mandatory safety courses  c) Certificate of training in individual rescue techniques;  d) Certificate of basic fire protection training.  e) Qualification to water rescue skills.  f) be certified through an Emergency Medical Technician (EMT) course, as approved by relevant authority.  g) hold valid certification in Basic Cardiac Life Support (BCLS) issued by a centre accredited by the relevant authority for the purpose; and  DEAS 1184:2023 
© EAC 2023 – All rights reserved   7 h) be certified in AED usage and first aid by a centre accredited by the relevant authority for the purpose.  4.2.2.3.3.2 Medical care technicians shall be able to perform the tasks as stipulated below:  a) be familiar with and be able to properly handle and operate all equipment on board of the Ambulance and be familiar with the Ambulance-SP’s medical protocols;  b) use various types of stretchers and body immobilization devices;  c)  perform basic life support on infants, children and adults and be proficient in the use of bag valve mask;  d) independently initiate the use of an AED;  e) perform standard first aid and give oxygen supplement;  f) measure and monitor the patient’s vital signs, i.e. pulse rate, blood pressure, temperature and respiratory rate and give oxygen saturation;  g) monitor intravenous peripheral lines and flow of drip of stable patients;  h) transfer and maintain patients with nasogastric tubes, tracheostomy tubes, and/or urinary catheters;  i) perform basic emergency procedures such as control of external bleeding and application of dressings, bandages, slings and splints;  j) establish contact with the receiving hospital if the need arises;  k) appropriately use Personal Protective Equipment (PPE) and apply standard precautions to prevent the transmission of infectious agents during patient care;  a) assist the crew leader in the conduct of the various procedures for the care of the patient who is being managed.  4.2.3 Equipment requirements  4.2.3.1 All equipment required for a set procedure shall be stowed in a specified location.  4.2.3.2 All equipment shall be securely and safely stowed to prevent damage or injury whilst the water ambulance is in motion.   4.2.3.3 Essential equipment required for use outside the vessel shall be easily accessible via normally used doors.   4.2.3.4 The equipment to be used shall be as specified in Annex A.  4.2.4 Pollution prevention  4.2.4.1 The provider shall meet international, national, regional and local requirements for the prevention of marine pollution which are applicable to the area in which the boat is operating.  4.2.4.2 To prevent pollution, automatic bilge pumps shall not be fitted in compartments containing pollutants. DEAS 1184:2023 
© EAC 2023 – All rights reserved   8  4.2.4.3 The following issues shall be given special consideration:  4.2.4.3.1 Garbage  a) If garbage or waste is generated on board it shall be retained and dealt with at appropriate facilities ashore.  b)  No garbage or waste should be discharged overboard and every boat greater than 12m in length overall shall have a sign permanently displayed aboard to this effect.  4.2.4.3.2 Oil  c) No oil shall be discharged overboard.  d) Means to prevent pollution by oil should be acceptable to Administrations /authorities in the area in which a boat operates.  e) Water ambulance s shall retain on board oil or oily mixtures for appropriate discharge ashore.  4.2.4.3.3 Chemicals No discharge into the water bodies shall contain chemicals or other substances in quantities or concentrations which are hazardous to the marine environment or chemicals or other substances introduced for the purpose of circumventing the conditions of the allowed discharge 4.2.4.4 The above shall not apply to:  a) The discharge into the sea of oil or oily mixture necessary for the purpose of securing the safety of a ship or saving life at sea; or  b) The discharge into the sea of oil or oily mixture resulting from damage to a ship or its equipment:  c) Provided that all reasonable precautions have been taken after the occurrence of the damage or discovery of the discharge for the purpose of preventing or minimising the discharge; and  d) Except if ASP or the captain acted either with intent to cause damage, or recklessly and with knowledge that damage would probably result; or  e) The discharge into the sea of substances containing oil, when being used for the purpose of combating specific pollution incidents in order to minimize the damage from pollution  4.2.4.5 Operation During Pollution Incidents.  4.2.4.5.1 Water ambulances shall be called to incidents involving hazardous substances (Hazchem incidents). In such cases the Water ambulance shall standoff upwind and seek urgent advice from the Co-ordinating Authority.  4.2.4.5.2 Procedures and training shall to be in place to cover the safe operation of a water ambulance in a polluted environment. This shall include: - a) Communications with the Co-ordinating Authority  b) Go/no go to entering polluted area DEAS 1184:2023 
© EAC 2023 – All rights reserved   9  c) Identifying hazards associated with pollution types  d) Use of adequate PPE  e) Need for inoculations before and after operating in the polluted area  f) Administering First Aid to those exposed to hazardous pollution covering the range of likely pollutants  g) The need to modify operation in polluted areas  4.2.5 Performance of the services  4.2.5.1 The water ambulance providers shall manage all matters associated with the provision of effective and efficient water ambulance services.  4.2.5.2 The water ambulance providers shall ensure that all staff are appropriately trained and are available to provide adequate coverage to meet the level of service to be provided.  4.2.5.3 The water ambulance providers shall have vessels, equipment and technology that are capable, well maintained and specified for the performance of the service, enabling communication and tracking systems and compatibility with the Control centre.  4.2.5.4 The water ambulance providers shall respond to ambulance incidents having been dispatched by the ambulance control centre.  4.2.5.5 The water ambulance providers shall travel safely to the scene; locate the patient; triage, treat and/or transport, and deliver in consultation with and based on the control centre, or clinical advisor protocols.  4.2.5.6 The water ambulance providers shall collate and provide information for audit upon which to assess the performance and effectiveness of the service.  4.2.5.7 The water ambulance providers shall co-ordinate with neighbouring control centre providers where inter-regional incidents occur.  4.2.5.8 The water ambulance providers shall maintain and fund relationships with ground ambulance services providers and other organisations for the provision of paramedics, ambulance officers, doctors and nurses.  4.2.5.9 The water ambulance providers shall liase with the community to ensure the delivery of a service that meets local community needs.   4.2.5.10 The water ambulance providers shall ensure that the vessel is inspected by “relevant authority” in accordance with the relevant Act and certificate of Sea worthiness issued to water ambulance operator to ensure safety.  4.2.5.11 The water ambulance providers have a control center that:  a) is  fully aware of the resources of the network in its region.  b) Service capability levels describe the crewing and equipment specifications of the ambulances in service. DEAS 1184:2023 
© EAC 2023 – All rights reserved   10  c) ensure that back-up services are available from another control centre operator in the event of failure.  d)  resourced with trained staff familiar with ground, air and water ambulance services, at all times.  e) dispatches or manages all ambulance services defined in this service specification. The call sign should be assigned to every caller for any communications done.  4.2.6 Access to services  4.2.6.1 Water ambulance services is to be available to all eligible people.  4.2.6.2 Access to water ambulance services will be by way of a call received and allocated by a contracted control centre.   4.2.6.3  Any person or agency believing that a person has suffered a medical emergency or has suffered personal injury may make requests.  4.2.6.4 For people who have suffered a personal injury as a result of an accident, access to ambulance services is limited to the 24-hour period following the injury or within 24h of being found after the original injury (whichever is the later).  4.2.7 Boat Recovery  4.2.7.1  The operation of recovery equipment should be subject to local risk assessment.  4.2.7.2 Procedures to cover all nominated means of recovering the boat should be developed and training provided to all personnel involved.  4.2.7.3 Contingency plans should be in place to cover alternative recovery sites. Training to meet the contingency plans should be undertaken.  4.2.8 Restoring the Boat to a Ready Status  4.2.8.1  Maintenance and operational procedures and training should be in place to ensure that the Water ambulance is made ready for service, following an operation or shift.  4.2.8.2 These procedures shall include: -  a) Cleaning and protection of boat and equipment from environmental degradation (UV, temperature extremes, salt water, pollution etc)  b) Checking buoyancy tube pressures (in changing weather conditions)  c) Equipment checks  d) Watertight/structural integrity checks  e) Refuelling  f) Re-charging batteries  DEAS 1184:2023 
© EAC 2023 – All rights reserved   11 4.2.8.3 Defects and missing equipment and any necessary reduction in the operational capability of the Water ambulance shall be logged and effectively communicated to the Launching Authority.  4.2.8.4 The co-ordinating Authority shall be informed of the operational state of the Water ambulance, crew and shore crew.  4.2.8.5 Records of Service/Patrol shall be completed at the earliest opportunity.  4.2.8.6 An inventory of standard parts and items and the quantities for which spares shall be held at the water ambulance facility is to be prepared and procedures put in place to ensure that the inventory is maintained.  4.2.9  Other services  4.2.9.1 Maintenance  4.2.9.1.1 The provider shall be able to provide a maintenance and survey plan.  4.2.9.1.2 The plan shall cover the planned maintenance, preventative maintenance, unplanned maintenance and corrective maintenance.  4.2.9.1.3 The maintenance and survey plan shall determine the approach of the provider, taking into account the following:  a) Manufacturers maintenance instructions  b) Operation  c) Equipment storage  d) Risks associated with different maintenance approaches for each item  4.2.9.1.4 The maintenance plan is likely to involve elements of both planned routine preventative maintenance and unplanned corrective maintenance at sea or ashore.  4.2.9.1.5 A routine maintenance plan shall vary from a simple collection of manufacturers maintenance requirements, to a specific maintenance schedule incorporating perhaps daily, weekly, monthly and longer periodic job cards.   4.2.9.1.6 The corrective maintenance plan shall be used to determine the tools and spares to be carried at sea, and associated training requirements.   4.2.9.1.7 All aspects of the water ambulance, systems and equipment shall be designed to allow specified routine maintenance and anticipated corrective maintenance to take place.  4.2.9.1.8 Water ambulance shall carry a basic tool kit and an appropriate level of spares to allow for corrective maintenance at sea. Floating tools are beneficial, and lanyards shall be used.  4.2.9.1.9 As a minimum, the following corrective maintenance action shall be considered:  a) Post immersion/ capsize engine restart  b) Emergency engine re-start (manual/electric)   DEAS 1184:2023 
© EAC 2023 – All rights reserved   12 c) Spark plug replacement (kit in sealed container)  d) Water repellent spray  e) Propeller clearing and replacement/blade straighten – address engine lock-up pin  f) Emergency buoyancy tube or hull repair  g) Steering repair and emergency steering  h) Fuel line repair  i) Oil filter replacement.  j) Aerial replacement  k) Light bulbs and fuses/circuit breakers  l) Propeller debris clearance – jet propulsion  4.2.9.2  Complaints and feedback management  4.2.9.2.1 The ASP shall record and analyse complaints and feedback to improve quality of care provided to the patients and provide patients with information about the process of making a complaint.  4.2.9.2.2 The ASP shall have a system for monitoring, assessing and responding to complaints and feedback contemplated in sub -clause 4.2.10.2.1.   4.2.9.3 Security services  4.2.9.3.1 Appropriate security measures shall be in place to protect patients, personnel and property from security threats and risks.  4.2.9.3.2 The ASP shall implement a security plan to protect patients and personnel in high risk environment  4.2.9.4 Linen services  4.2.9.4.1 Clean linen shall be provided as required for the type of services provided.  4.2.9.4.2 The ASP shall;   a) monitor the station linen stock, or manage the service provider effectively where laundry services are outsourced.  b) ensure that each Water ambulance stores and maintains dry, clean linen.   c)  ensure each Water ambulance is equipped with at least six (6) sets of freshly laundered or disposable linens to be used on cots and pillows and changed after each Patient is transported.   DEAS 1184:2023 
© EAC 2023 – All rights reserved   13 d)  ensure soiled linen is transported on the Water ambulance in a closed plastic bag or container and removed from the Water ambulance as soon as possible.   e) ensure each Water ambulance maintains blankets and towels that are intact, in good repair, and cleaned or laundered after each patient use.  f)  ensure that the blankets are a hypoallergenic material designed for easy maintenance  g) ensure all linen used during any transport is removed from the cot and properly disposed of, or immediately placed in a designated, leak-proof bag or container and sealed until cleaned.  h)  ensure all used linen is treated as contaminated and handled as per standard precautions.  4.2.10  Building engineering and infrastructure services  4.2.10.1 The building engineering and infrastructure services shall be functional and enable safe and uninterrupted delivery of emergency medical services.  4.2.10.2 The ASP shall ensure routine and emergency electrical and water supplies are available on a continuous basis.                 DEAS 1184:2023 
© EAC 2023 – All rights reserved   14 Annex A Normative  Minimum Equipment for Water Ambulance  The ASP Agency shall ensure the following equipment are available and maintained on all in-service ambulances             in accordance with the response: • Auto loading stretcher + holdings +belt dimensions: 193 cm x 56 cm x 22 cm, 33 kg  • Weight, 170 kg load • Adjustable backrest 0-90 degrees, with wheels: 81cm height, 63 cm max. load height, 45 cm min. load height mattress with anti-tear water proof cover. • Additional folding stretcher for second patient: dimensions: 192 cm x 56 cm x 11 cm, 8.5 kg weight, 170 load • First aid kit • Surgical instrument set • Ambulance bag and mask • Laryngoscope set • Trauma board • Spider harness and head blocks • Spinal board • Scoop stretcher • Oxygen cylinder 5 litre + holders • Manometer for O2 • Stethoscope • Masks adult+ Child • Sphyganometer • Glucometer • Case for ampullae • Digital stop watch • Cervical collar set • Air splint set • Trash cans – stainless steel • Head adjustment • Hand lamp c/w 12 V battery • Defibrillator/AED • ECG monitor • Syringe pump • Suction pump • Foldable table • Bandages • Plasters • Syringes, selection with needles • Handheld VHFs • Eagle horn loudspeaker • Fixed VHF/DSC with AIS • Search and Rescue (SAR) Equipment as Thermal Binocular, Crane   DEAS 1184:2023 
© EAC 2023 – All rights reserved   15 Annex B (Informative) Description of services The water ambulance provider should deliver the following services: B-1 Dispatch The provider shall ensure that all call outs are dispatched or managed by the control centre. The provider shall liaise with the control centre over any issues likely to impede the dispatch of the service, location of the incident and patient. The provider may be requested by the control centre to transport a treatment provider(s) to and from the scene of the incident where the patient cannot be safely moved, (e.g. emergency physician, anaesthetist, lead maternity career, etc). B-2 At scene The provider shall triage and assess the patient to determine their treatment need using Table 1 upon arrival at the scene of the incident. Table 1 — Triage and assessment of the patient to determine their treatment need  Status one Status two Status three Status four Status zero Patient condition Critical, extreme Serious Moderate Minor Dead Patient stability Unstable  Unstable Stable Stable  Potential to deteriorate Obvious Probable Unlikely None  Special criteria Under active resuscitation to maintain airway, breathing or circulation; may have uncontrolled haemorrhage Not under active resuscitation, but airway, breathing or circulation at risk. No immediate risk to airway, breathing or circulation.  Need for acute treatment remains. Need of urgent treatment is unclear or no need.  
Emergency transport Ground, water or air. Response (Priority 1) immediate. Ground, water, or air. Response (Priority 1 or 2a) immediate. Ground or water, or air with exceptional circumstances.  Response Priority 2 or as requested. Emergency transport by ground or water may only be considered when urgent No emergency transport. DEAS 1184:2023 
© EAC 2023 – All rights reserved   16 transport is warranted, otherwise use ACC non-emergency transport (if appropriate) or other. Delivery to Public health acute treatment facility (ED) unless for reasons of clinical safety treatment at another treatment facility (e.g.: A&M Clinic) is appropriate, provided that facility has appropriately qualified personnel and is able to provide appropriate emergency medical treatment.  a Priority 1 and 2 are assessed according to patients’ condition.  NOTE 1 Exceptional circumstance are defined as situations where the patient is at risk of becoming unstable without immediate medical attention and unable to utilise other forms of private or public transport because of the geographic location and/or circumstances of the injury/illness. NOTE 2  Emergency Inter-Hospital Transfer by ambulance shall be dispatched by the ambulance control centre and is expected to be provided: ¾ Having taken account of the clinical needs of the patient as detailed by the sending hospital; ¾ First by ground ambulance unless the geographic location of the patient prevents simple extraction or the clinical needs of the patient make the timeliness of road impracticable; ¾ Or by fixed-wing air ambulance aircraft where use of ground ambulance is impracticable; ¾ Or by rotary-wing air ambulance where use of ground ambulance and use of fixed-wing air ambulance is impracticable for the above reasons or due to no available fixed wing landing site. The provider shall provide appropriate care and treatment within the relevant guidelines and protocols in order to immobilise, stabilise and provide necessary and appropriate interventions and pain relief for the patient. B-3 Transportation of patient The provider and, if possible, the patient shall decide if the patient requires transportation to a treatment provider. The provider shall transport the patient, having regard for his/her condition and need for oversight during the transportation, to the most appropriate treatment facility in consultation with the control centre’s delivery protocol, or to a waiting road or air ambulance for connecting transportation. The provider shall develop a policy for situations where emergency transport is inappropriate as indicated in this standard, so that other appropriate transport and treatment options are explored. The provider shall Provide the treatment facility with a copy of the water ambulance patient record form.The provider shall advise the treatment provider of the patient’s condition, any treatment, procedures and/or DEAS 1184:2023 
© EAC 2023 – All rights reserved   17 medications administered and any change in status during transportation including those noted on the water ambulance patient record.                           DEAS 1184:2023 
© EAC 2023 – All rights reserved   18 Bibliography  •  KS 2429, Minimum ground ambulance requirements • KS 2603, water ambulance requirements • SOLAS, The International Convention for the Safety of Life at Sea.   