NOCP 7: Transportation

4 things an ambulance must do

**4Ss

1. Start

2. Steer

3. Stop

4. Stay running

4 types of ambulances

1. Conventional truck-cab, body can transfer to a new chassis

2. Standard van (vanbulance), cab-body

3. Specialty vans, forward control, cab-body

4. Heavy duty, endless application

Things to watch for

1. Belt noise, squealing

2. Brake fade (power/brake loss)

3. Drift (steering wheel wanders)

4. Steering pulls left or right

5. Steering play (looseness turn 10 degrees)

6. Wheel bounce/ vibration

7. Wheel Wobbles (bent wheel)

General rules

1. STOP at all red lights to ensure clear intersection

2. Wait to turn on lights and sirens until after intersection to avoid panic

3. If you cannot safely go through intersection, turn off lights + sirens and wait for green light

4. Escorts are not a good idea, public unaware there are 2 emergency vehicles

5. Do not go over school zone speed

6. Park 1-2 blocks away and out of sight from dangerous scene

7. Turn off emergency headlights while on 2 lane roads or highway to avoid blinding

8. Most collisions due to improper lane changing

9. Due regard = no exemptions from operating safely

10. Service animals ALWAYS ride with patient

11. Family members of unconscious pt ride in front seat

Fixed wing aircraft

For long distances

(EMS, nurse, resp therapist, doctor)

Rotary wing aircraft

Short transport time, goes directly to scene for critically injured (STARS)

*disadvantage: environment and weather can make it dangerous for crew

How big landing space for STARS?

30×30m OR 100×100ft

• If parked on incline, approach from downhill side

• Night landing: do not shine lights on pilot (only landing zone)

• No flares within 50ft/ 15m

Aircraft and flight stressors

(GHOSTBAND)

Gravitational forces

Humidity

Oxygen

Shakes/ vibration

Temp

Barometric pressure

Atmosphere

Noise

Disorientation

Lubricants

Oil: yellow or amber (gas engine), black or gray (diesel)

Transmission and steering fluid: pink or yellow (charcoal smell = burning)

Brake: Clear yellow (fresh), amber (used)

Coolant: red, yellow, bright green

• Sewage smell = battery is about to blow

• Clear fluid dripping from middle engine is AC condensation (normal)

• Always circle check fuel levels first

Minimizing response times

1. 8 mins rural

2. Productivity: “unit hour” utilization

3. Unit costs: responding cost

4. Cost for ambulance service

Parking on scene

• 1st on scene: park to protect scene/ pt (behind/beside) *always consider egress

• 2nd on scene: go past scene and park in a way that is easiest to load pt

**if smoke or hazard park 100m upwind

**MCV: 30m away uphill upwind (no fire/ leaks = 15m)