Emergency Vehicle Operations Unit 48 Emergency Vehicle Operations

Overview Readiness Daily preparation Response Arrival

Introduction The ambulance is a crucial part of the EMS system Vehicle should be safe, clean, and comforting environment High priority for EMT to learn to safely operate ambulance EMT must know laws, regulations, and service policies of operating vehicle

Readiness Preparedness helps to do a job well Emergency vehicle classifications EMS must be able to respond to any scene Specialized vehicles required for certain environments EMS call has two components: Emergency response phase Patient transportation phase

Medical Supplies Portable medical supplies: must contain items needed for lifesaving treatments Emergency ambulance supplies: EMT must know where equipment is located Safety equipment: proper preparation and familiarity is essential Maps: use local maps or global positioning systems (GPS)

Medical Supplies (cont’d.) Mobile work station (MWS): provides location and patient information Protocols/procedures manual: should be in a place that is readily available Communications devices: EMT should be familiar with operation of all devices

Daily Preparation Personnel Must be well rested and physically and mentally prepared for emergency operation Ideally two trained providers in patient compartment with high-priority patients Allows multiple interventions to be performed simultaneously

Equipment Preparedness Check to be sure all required items are where they belong and are functioning appropriately Equipment failure Reporting defective equipment ensures patient care will not be compromised while permitting corrective action to be taken

Vehicle Preparedness

Response Alarm and alert Initial information: communications specialist provides information needed to find patient and to decide what equipment is necessary to care for patient Departure: determine route, remove shorelines (power sources connected to building), and make sure crew is wearing seat belts prior to departing

Driving Emergency vehicle operator Driving safety Many states mandate attendance of emergency vehicle operators course (EVOC) Driving safety Safe habits are essential Adjust seat and mirrors, wear seat belt, remain attentive to all surroundings

Driving (cont’d.) Warning devices: alerts other drivers, but does not give right-of-way Markings: “ambulance,” blue star of life, reflective tape Emergency warning lights: sealed beam, LED, strobe Light patterns: forward-facing, each corner of roof, scene lights Audible warning devices: wail and yelp

Priority Response Red lights and sirens tremendously increase risk of collision

Driving Conditions Adverse weather Heavy traffic EMS must make reasonable effort to respond regardless of conditions Assistance of county snowplow invaluable Monitor national weather service reports Heavy traffic Avoid weaving in and out of traffic Wait for traffic to yield right-of-way

Driving Conditions (cont’d.) Controlled intersections Use extreme care Braking Consider patient Crew Look-out for danger Figure 48.8 A complete stop at a red light gives the EVO time to be sure that all other vehicles in the intersection know of his intention to drive through it

Arrival Emergency lights Consider turning off or reducing number of flashing lights Large number of flashing lights from multiple emergency vehicles serves only to confuse other drivers Consider leaving on only corner flashers to illuminate ambulance position

Positioning Always position ambulance in place that is safe for crew Park 100 feet in front of wreckage and leave on warning lights Path of exit must always be available for expedient departure once patient is loaded

Figure 48.10 If the scene is already shielded on arrival, the ambulance should be positioned just beyond the accident scene to allow for an easy exit

Positioning (cont’d.) Backing and parking Emergency vehicles have unintentionally backed over and injured or killed people Avoid backing whenever possible If necessary, use “spotter” (observes ambulance as it reverses) If no one available to spot, perform complete survey of area behind ambulance

Scene Size-Up Keep communications specialist up to date on locations and activities Use appropriate personal protective equipment Determine mechanism of injury or nature of illness Ask for further resources such as police, fire, or air support

On-Scene Actions On-scene stabilization: prepare stretchers, stairchairs Transportation Helicopter transport: be familiar with capabilities of air medical agencies Ambulance transport: use of lights and sirens dictated by patient’s condition; usually not necessary

Arrival at Facility On arrival, immediately notify communications specialist Safely position ambulance at entrance Request person to step out of ambulance to watch vehicle back up Assist medical crew in taking patient out of ambulance and into emergency department

Transfer of Care Complete verbal report should be given to appropriate staff member Charting: written report must be placed in patient’s hospital records Cleaning: decontaminate ambulance before returning to service Restocking: some hospitals provide replacement items for equipment used

Return to Station Restock and refuel: emergency vehicle should be maintained above one-half full at all times Reports: any further paperwork should be completed Debriefing: brief discussion of any problems or concerns may help prevent similar incidents or problems in future

Conclusion Well-trained EMT will not only be effective caregiver, but also will understand safety issues surrounding operation of emergency vehicles Specifics of ground and air medical operations should be part of any EMT training program