1. Emergency Vehicle Operations
Unit 48
Emergency Vehicle
Operations

2. Overview
Readiness
Daily preparation
Response
Arrival

3. 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

4. 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

6. 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)

7. 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

8. 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

9. 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

10. Vehicle Preparedness

11. 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

12. 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

13. 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

14. Priority Response
Red lights and sirens tremendously increase risk of collision

15. 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

16. 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

17. 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

18. 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

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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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