1. Ambulance Operations

2. Ambulance Standards State administrative rules
Minimum standard vs. Gold standard

3. Ambulance Standards Vehicle Design GSA KKK 1822D specs
Type I: truck-cab chassis/modular body
Type II: standard van, integral cab/body
Type III: specialty van, integral cab/body
Medium duty ambulance/rescue

4. Ambulance Standards Medical Equipment Standards OSHA NFPA
Local medical direction

5. Ambulance Standards Additional Guidelines
Commission on Accreditation of Ambulance Services (CAA)
American College of Surgeons “Essential Equipment”

6. Checking Ambulances Vehicle/Equipment Checklist Stretcher Days
Medication Expiration Dates
Vehicle Cleaning/Disinfecting
Medical Equipment Tests/Calibration

7. Ambulance Deployment Deployment = Strategy used to:
Position ambulances, personnel
Reduce response times
Factors influencing
Location of EMS stations
Location of hospitals
Anticipated call volume
Geographic, traffic considerations

8. Ambulance Deployment Peak load staffing
Fluid deployment (Primary areas of responsibility, Posting)
System Status Management
Computer Assisted Dispatch

9. Ambulance Deployment Tiered Responses System Reserve Capacity
Fire/Police First Response
BLS Units
ALS Units
Paramedic Quick Response Units
System Reserve Capacity

10. Emergency Vehicle Laws
The driver of an authorized emergency vehicle may:
Park or stand irrespective of the provisions of this chapter;
Proceed past a red light or stop signal, but only after slowing down as may be necessary for safe operation;
Exceed the maximum speed limits so long as he does not endanger life or property
Disregard regulations governing direction of movement or turning in specified directions.

11. Emergency Vehicle Laws
The exemptions herein granted to an authorized emergency vehicle shall apply only when such vehicle is making use of audible and visual signals meeting the requirements of this Act.

12. Emergency Vehicle Laws
The foregoing provisions shall not relieve the driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons.

13. Driving Excellence

14. Good Driving Basics Wear seat belts Practice; Become familiar with:
Acceleration
Deceleration
Braking
Cornering
Fender and bumper clearance

15. Good Driving Basics Hand position
9-3 o’clock positions
One hand pulls; the other slides
Neither hand should pass 6 o’clock
Keep to the left (other traffic should be to the right)
Never rely on what another motorist will do

16. Maintaining Control Braking Pump brakes slowly, smoothly
NEVER brake on curve
Brake going into curves; accelerate moving out of them

17. Maintaining Control Railroads
Plan alternate routes for grade crossings
Wait out long trains if there is no over or underpass in a reasonable distance

18. Maintaining Control School buses
There is NO emergency vehicle exemption from laws pertaining to school buses
If red lights are flashing, stop and wait until driver motions you on.

19. Maintaining Control Bridges and Tunnels Ability to pass may be limited
Consider alternative routes if traffic is heavy
Be sure height of roadway will accommodate ambulance

20. Maintaining Control Traffic Patterns
Learn traffic flow patterns in your area based on time of day, day of week, locations
Plan for alternative routes through or past specific problem areas

21. Maintaining Control Road Surface
Pay attention to irregularities in road surface (bumps, potholes)
Inner lanes of multi-lane highways usually are smoothest

22. Maintaining Control Hydroplaning
Occurs on wet roads at speeds >35mph
Water causes loss of contact between tire and road surface
If you can’t see tread marks of car ahead of you in water on highway, there is risk of hydroplaning
Slow down; lightly tap brakes to ensure dryness

23. Maintaining Control Backing Up
ALWAYS have someone spot for driver while ambulance is backing
Move slowly, carefully

24. Maintaining Control Escorts Extremely dangerous
Use only when unfamiliar with location of patient or hospital
Allow safe distance between escort vehicle and ambulance

25. Intersection Collisions
Most common form of ambulance collision
Causes:
Other drivers “timing” lights
Emergency vehicles following each other
Multiple emergency vehicles converging on same location
Motorists going around stopped traffic
Vision of pedestrians in crosswalk obstructed by other vehicles

26. Intersection Collisions
Slow down at intersections.
Ensure other drivers have seen you and stopped before you proceed.

27. Parking and Loading
At least 50 feet from wrecked vehicles if no fire, other hazards
100 feet uphill, upwind if fire, other hazards present
Park 100 feet in front of wreck if first unit on scene
Park 100 feet beyond wreck if police already have control of scene
Shut off headlights unless needed to illuminate scene

28. Standard Operating Procedures
Operator qualification
Handling, reporting collisions
Investigating, reviewing collisions
QA in collision aftermath
Backing vehicles, spotters
Seat belt use; child transport
Emergency response procedures
Prudent speed, use of oncoming lanes, intersection negotiation
Use of police escort
Drug, alcohol policy

29. Warning Devices

30. Warning Lights Use at all times when responding to emergency calls
Also, turn on headlights during daylight hours
Use minimal lighting in heavy fog or when parked

31. Siren Usually not audible until 50 to 100 ft from vehicles
Motorists less inclined to yield when sirens sound continuously
Motorists feel units with sirens are abusing right-of-way privileges
Drivers increase speed 10 to 15 mph
Sirens increase patient anxiety
Drivers develop anxiety, hearing problems

32. Give other drivers time to notice, react to warning devices.