AMBULANCE OPERATIONS

Operational Aspects are Essential. Rig Checks Need to be More Than a Routine Hum-Drum Task. What Good are You if Your Equipment Doesn’t Work, Your Ambulance Doesn’t Arrive at the Scene, or You Can’t Operate at the Scene Safely.

OVERVIEW

• Phases of an Ambulance Call
• Emergency Driving – Laws & Regulations
• Operating an Emergency Vehicle
• Preparation for a Call
• How to Clean & Disinfect Equipment

PHASES of OPERATIONS

• Preparation
• Dispatch
• Enroute to Scene
• Arriving at Scene
• Transfer to Ambulance
• Enroute to Facility
• At Facility
• Back to Station
• Post Run

PREPARATION FOR A CALL

• Equipment – Rig Check
• Medical
• Basic Supplies
• Patient Transfer Equipment
• Airway Control, O2, Suction
• Medications
• AED
• Non-Medical
• Personal Safety Equipment
• Maps / Pre-Plans

PREPARATION FOR A CALL

• Equipment
• Checked & Maintained
• Restocked & Repaired
• Batteries – EKG/AED, Suction, Flashlights, etc
• Personnel
• Ready to Respond
• Ambulance Staffed Properly
• Paramedic On All "Emergency" Calls

PREPARATION FOR A CALL

• Vehicle Check
• Fuel
• Oil, Cooling System, Tranny Fluid, Battery
• Brakes, Wheels, Tires
• Headlights, Tail Lights, Turn Signals
• Emergency Lights, Audible Alarms
• Door Seals
• Heating, A/C, Ventilation
• Radios

PREPARATION FOR A CALL

• Seat Belt Use

• Need I Say More ?

DISPATCH

• Central Access
• W. C. 911
• To Local Dispatchers
• Coordination
• EMS, FD, PD
• Theory
• Trained Dispatchers
• EMD
• Tone Activation

DISPATCH

• Dispatch Information
• Nature of the Call
• Callers Name, Callback Number, Location
• Location of Call / Patient
• How Many Patients, How Severe
• Other Special Problems

ENROUTE

• First Things First
• Notify Dispatch
• Essential Info
• Where R U 2 Go
• What R U Going 2
• Anything Else I Need to Know

ENROUTE

• Driving the Ambulance
• EVOC Required in PA
• Driver Qualities
• Physically & Mentally Capable
• Perform Under Stress
• No Tunnel Vision
• Tolerant of Other On the Road

ENROUTE

• Safe Driving
• Everybody Secured w/ Seat Belt
• Know Characteristics of the Vehicle
• Be Alert for Changing Weather & Road Conditions
• Select Appropriate Route
• Maintain Safe Following Distances
• Head Lights On Always

ENROUTE

• Safe Driving
• Drive With Due Regard For Everyone’s Safety
• Exercise Caution With Emergency Devices
• Know Appropriateness of Emergency Devices
• Cars Can’t Hear or See You at Times
• Your Headlights Are Most Visible
• Speed Limit
• Stop Signs / Stop Lights
• School Buses

ENROUTE

• Assign Specific Duties
• Assign Specific Equipment
• Who In the Heck is In Charge, Anyhow?
• Cardiac Arrest
• House Fire
• MVA
• MVA w/ Entrapment
• Haz-Mat Incident
• Mass Casualty Incident

ENROUTE

• Parking
• Uphill From Leaking Hazards
• MVA, 100 Feet Away
• Haz-Mat Incident, Approach w/ Wind @ Back
• Use Binoculars to Identify
• Don’t Become Part of the Problem
• Structure Fires, Away From Scene
• Don’t Get Blocked In
• Walk, Keep Someone at Ambulance

ENROUTE

• Parking
• Utility Poles / Wires
• Behind Intact Pole
• Parking Brake
• Wig-Wags Off at Scene
• Exiting In or Around Traffic
• Look Both Ways, Children
• Tunnel Vision

ENROUTE

• Escorts & Multiple Vehicle Response
• Very Dangerous
• Maintain Safe Following Distance
• Be Alert
• Cars Pull Over for First, Pull Out in Front of You
• Intersections
• Look at the Next Slides

AMBULANCE CRASH

AMBULANCE CRASH

ARRIVING ON SCENE

• Notify Dispatch
• Scene Size-Up – Start Getting the BIG Picture
• Scene Safety
• Assess for Hazards
• BSI Now
• Does the Pt Need Immediate Movement ?
• Are You in Danger Doing Movement ?
• At Least One Problem Exists, Don’t Compound

ARRIVING ON SCENE

• Mechanism of Injury / Nature of Illness
• Trauma or Medical
• How Many Patients
• Need Additional Assistance

ARRIVING ON SCENE

• Mass Casualty Incident
• R U the First Unit
• Step Back, Take Deep Breath, Control Your Bodily Functions
• Use Common Sense
• Units In & Out, Triage Area, Placement of Extra Resources
• Need Additional Assistance
• Begin Triage if Needed

ARRIVING ON SCENE

• Actions On Scene
• Organized
• Rapid
• Efficient
• Get Patient From Point A to B – Transport
• Do No Harm
• Go to the Hospital

TRANSFER TO AMBULANCE

• Complete Critical Interventions
• Check Dressings & Splints
• Maintain Pt’s Modesty
• Extricate in Safe, Efficient Manner

ENROUTE to FACILITY

• Notify Dispatch
• On-Going Assessment & Update Vitals
• Notify the Hospital
• E.D. Staff Whines When You Don’t Call
• Keep Reports Short Sweet & to the Point
• Reassure & Talk to the Patient
• Record All Findings

ARRIVAL at FACILITY

• Notify Dispatch
• Transfer Care
• Give Verbal Report
• Complete Written Report

• Computerized Tripsheets to be Forwarded to Hospital Within 24 Hours
• Copy Assessment Sheet for Staff

PATIENT at FACILITY

• While at the Facility
• Clean-Up, Restock, Make Stretcher
• Get Ready for the Next One
• Enroute to Station
• Notify Dispatch
• Post Run
• Restock What Can’t be Acquired at Hospital
• Disinfect
• Refuel
• GET THE PAPERWORK DONE !!!

AEROMEDICAL CONSIDERATIONS

• 60 x 60 or 100 x 100
• Wires, Obstructions
• Flying Debris
• Approach Only by Order of Flight Crew
• Approach From Front
• Tail Rotors Bite
• Cuisinart Food Processors

AEROMEDICAL CONSIDERATIONS

• Medical Command Order
• Specialty Care Needed
• Level 1 Trauma Care
• Burn Centers
• Some Medical Calls

• During Helicopter Operations Don’t Stand Anywhere Near the LZ
• Protect Eyes