1. AMBULANCE OPERATIONS

2. Lesson Objective: Describe basic rules and techniques associated with the ambulance operations.

3. Overview: u Phases of an Ambulance Call u Guidelines for safe ambulance operations u Air Medical Operations u Aeromedical Consideration

4. Phases of an Ambulance Call u Preparation for the call - –Availability and readiness of equipment and supplies.

5. Equipment u EMT - B will have access to a large variety of equipment and supplies.

6. Medical u Basic supplies –Airways - oropharyngeal for adults, children, and infant –Suction Equipment - both portable and “on board” –Oxygen inhalation equipment - portable-300 L capacity, on-board 3,000 L of oxygen

7. Medical supplies u Artificial ventilation devices - pocket and BVM u CPR equipment - CPR board -so that you can give effective chest compression u Basic wound care supplies u Splinting supplies u Childbirth supplies

8. Medical supplies u Medications - activated charcoal, Tubes of oral glucose, oxygen, snakebite kit depends on local protocol. u Automated external defibrillator u Jump Kit - light, durable, waterproof, a “5 minute kit”

9. Equipment u Non-medical –Personal safety equipment – Maps

10. Preparation for the call u Personnel – Available for response –Minimum one EMT-B in patient compartment u Daily inspection –Inspection of vehicle systems

11. Preparation for the call u Equipment –Checked and maintained – Restocked and repaired –Batteries - operated equipment daily

12. Dispatch u Readily accessible- 24-hour availability, operated by EMS itself or shared with law enforcement, and fire dept.. u a. Trained personnel - familiar with both the geography of service area an the capabilities of the agencies they are dispatching.

13. Dispatch u Dispatched information –Nature of call – Name, location and callback number of caller – Location of patient – Number of patients and severity – Other special problems - Hazards or weather conditions

14. Response Phase u Before you move the unit make sure you and your partner fasten seatbelts and shoulder harness. u Notify dispatch/medical control center (MCC) - Inform dispatch your unit is responding, confirm nature and location, ask any other available information about location.

15. Response Phase u Characteristics of good ambulance drivers – Physically fit - not taking medications. –Never drive or provide medical care after drinking alcohol – Mentally fit - Emotion stability - ability to operate under stress. – Attitude - Positive attitude,have confidence, shows responsibility.

16. Response Phase u Safety- safe vehicle operations - – First rule in the safe driving of an emergency vehicle is that speed does not save lives. u Weather and road condition - –Hydroplaning –Water on the Roadway –Decrease Visibility –Ice and slippery surface.

17. Vehicle operations u Use of lights and siren u Safe following distance u Parking considerations u Laws and regulations u Use of escort u Intersections hazards

18. Arrival Phase u Report to dispatch u Conduct a scene size-up u Determine Mechanism of injury/nature of illness u Provide emergency medical care

19. Departure from scene u Package for transport u Notify dispatch/receiving hospital u Monitor patient/perform on-going assessment u Prepare written report

20. Delivery and Postrun Phase u Notify dispatch upon arrival- Priority is transfer of the patient and patient information to the hospital staff. Restocking unit is second

21. Air Medical Operations u Fixed wing - Interhospital transfer, for distances greater than 100 miles. u Rotary wing - Shorter distances, more efficient u Military - C-9, C-141, C- 130, H-60, H-53 u Safety - Good common sense and constant awareness

22. Aeromedical Consideration u FOD inspection - Inspect vehicle tires u Flightline Hazards –Propellers- stay away –Jet Engines - no more than 25 feet in front 200 feet behind while in operations –Ejection seats and canopies –Approaching aircraft - stay in visual contact with pilot or Aircrew directing approach

23. Aeromedical consideration u Flightline driving –Speed limit 15 MPH u Around /near aircraft 5 MPH –Crossing active -Never without clearance of tower

24. Summary u Phases of an Ambulance call u Response Phase u Safe vehicle operations u Law and regulations u Arrival Phase u Air Medical Operations u Aeromedical Considerations

25. QUESTIONS???