Ambulance Operations

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
• 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.

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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 oclock positions
• One hand pulls the other slides
• Neither hand should pass 6 oclock
• 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

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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.

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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

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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

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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 cant 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

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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

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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

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Warning Devices
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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

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