Module 1 Transport Options

How many patients fit in the patient compartment of an ambulance?

2 Supine patients + EMTs

Basic Ambulance Designs

Type 1: Basic truck-cab

Type 2: Standard van

Type 3: Specialty van

Where are ambulances when they are not deployed?

Depends on the system

In San Mateo, ambulances stay at ambulance posts until they are called

Emergency Chain (6)

The blue star symbol on ambulances represents this:

Detection: untrained civilians observe scene, understand problem, id dangers to themselves and others, and take measures to ensure their safety

Reporting: Call for professional help is made + those on-scene are connected with dispatch

Response: First rescuers provide care to the best of their abilities based on their level of training

On-Scene Care: EMS arrives and provides care according to their training

Care in Transit: EMS personell transports patients

Transfer to Definitive Care: Appropriate, specialized care is provided at the hospital

Phases of an Ambulance Call: Preparation

Ensure equipment + supplies are in their proper places

Should be durable and standardized

Store equipment and supplies according to how often they are used

At least 1 EMT in the patient section at all times (2 is recommended)

Daily inspections of all equipment + ensure it is all in working order

Review safety precautions:

Equipment Placement

Items for Life-Threatening Conditions: Head of the stretcher

Items for Cardiac Care, External Bleeding, and Blood Pressure: Side of the stretcher

Jump Bag: Other equipment + PPE

Phases of an Ambulance Call: Dispatch

Dispatch will get the following information:

• Nature of the call

• Name, location, and call-back number of caller

• location of patient

• number of patients + severity of their conditions

• relay instructions on patient care to bystanders while EMTs are on the way

Phases of an Ambulance Call: En Route

Most dangerous phase

Wear safety restraints

Review dispatch information

Prepare to assist in patient care

Phases of an Ambulance Call: Arrival on Scene

Scene size-up: BNAMES

For an MCI: Estimate + communicate # of patients to incident commander (if there isn’t one yet, request additional units through dispatch)

Park 100ft before or past the crash scene (not alongside)

Park uphill or upwind of smoke or hazards

Leave warning lights on

Provide care and ensure scene safety before traffic control

Ask someone to monitor traffic around site of the crash

Phases of an Ambulance Call: Where to Park

If you are first on scene, park before the accident

If there are other emergency vehicles, park after the accident

Set parking brake

Phases of an Ambulance Call: Transfer

Secure patient w/ at least 3 straps (or as designated)

Phases of an Ambulance Call: Transport

Tell dispatch

• Number of patients

• Name of receiving hospital

• Code 2 or 3 transport

• Additional Crew (brining them with you)

Recheck Vitals (15min for stable, 5 for unstable)

Hospital radio report (sooner rather than later)

explain everything to patient

Phases of an Ambulance Call: Delivery Phase

Notify dispatch that you have arrived at the hospital

Report arrival to triage nurse

Transfer patient to bed/wheelchair

Handover

Restock

Phases of an Ambulance Call: Post Run

Primary Care Report

Inform dispatch of status, location, and availability

Perform routine inspections

Refuel vehicle

Disinfect all non-disposable equipment

Phases of an Ambulance Call: Post Run (cleaning)

Cleaning: Process of removing dirt, dust, blood, or visible contaminants from a surface or equipment

Phases of an Ambulance Call: Post Run (Disinfection)

Killing pathogenic agents by directly applying a chemical made to serve that purpose

Phases of an Ambulance Call: Post Run (Sterilization)

Process using heat that removes all microbial contamination

Siren Syndrome

Other drivers drive faster due to increased anxiety when they hear sirens

Notes on Driving an Ambulance

Accidents often occur when backing up, so use a spotter

Increased size and weight lengthen breaking distance for ambulances

Unevenly distributed weight increases chance of rollover

You can NEVER drive passed a stopped school bus that has their stop sign out

Turning an ambulance

Enter high in the lane, exit low?

Driving through ntersections

Come to a momentary stop before crossing intersections, even if you cannot wait for a red light to change

Highways

Shut down lights and sirens while you are entering the highway until you are in the farthest left lane

Unpaved Roads

Slower w/ firm grip on the wheel

School Zones

You cannot exceed the speed-limit in a school zone

When you are fatigued

Be placed out of service until the fatigue passes and you can safely operate the vehicle again

Air Medical Operations

Fixed-wing units (airplanes)

Rotor wing (helicopter)

When to call for Medivac)

• Transport time is too long

• Road, traffic, or environmental conditions make it unsafe to use ground transport

• Patient needs advanced care

• Multiple patients will overwhelm resources at the hospital reachable by ground transport