Transport operation

1. Transport operation Dr. Miada Mahmoud Rady

2. Topics • Introduction. • Emergency Vehicle Design. • Ambulance Equipment. • Checking the Ambulance. • Ambulance Staffing and Development. • Minimizing Hazards Throughout the Call. • Defensive Ambulance Driving Techniques.

3. Introduction • Today’s ambulances are equipped with state-of-the-art technology : 1. Defibrillators and monitors that can transmit information to the emergency department 2. Blood and oxygen testing equipment 3. Automatic ventilators 4. Automated cardiopulmonary resuscitation (CPR) machines 5. Global positioning systems (GPS) 6. Computer-aided dispatch consoles

4. Driving an ambulance or service vehicle requires good technique and judgment : Need to be aware of the safety of your crew and passengers. Responsible for the safe passage of other vehicles on the road.

5. Emergency Vehicle Design • The US General Services Administration is responsible for determining ambulance standards. • Design and manufacturing guidelines are outlined by the DOT KKK 1822 and reviewed and updated every 5 years. • DOT KKK 1822 (star of life ambulance standard) : standard was created by the general Services administration of the united states federal government as a guideline for the proper construction of an ambulance.

6. The KKK standards established three main ambulance designs : Type I: Conventional Type II: Standard van Type III: Specialty van

7. Ambulance Equipment • Every inch of space on an ambulance stores and secures equipment. • Organizations influence the list of supplies and equipment that should be carried : • The Occupational Safety and Health Administration (OSHA ) : makes recommendations regarding infection control practices. • The American College of Surgeons (ACS) : developed the first standardized list of equipment in 1970. • The National Fire Protection Association (NFPA) : develops ambulance safety standards .

8. Checking the Ambulance • Prior to a call, crew members are responsible for ensuring the unit is capable of responding and that the proper equipment and supplies are available : 1. Each time supplies and equipment are used; they should be properly cleaned or replaced. 2. Medication expiration dates must be checked regularly. 3. Diagnostic equipment must be tested or calibrated regularly .

9. A daily check of the ambulance should ensure that it can: Start. Steer. Stop. Stay running. 4 S

10. Warning signs Belt noise . Break fade . Brake pull . Drift . Steering pull . Pulsating brake . Steering play . Tire squeal . Wheel bounce . Wheel wobble . Checking the Ambulance

11. Ambulance Staffing and Development • Ambulance staffing : • In order to Maximize productivity and minimize response times , high performance EMS systems analyze the following : • Response times. • Productivity. • Unit costs. • Taxpayer subsidies.

12. Ambulance and EMS system : • In US, most first-response EMS and ambulance service is delivered by the fire department. • Other models include: Private, for-profit agencies . Public agency . Public-private partnerships . • Staffing of ambulances varies.

13. System status and management • Goals : to maximize efficiency and reduce response time. • Data is collected and used to determine ambulance service demands. • Strategic deployment is used to minimize response times when demand is higher. • SSM helps organize peak demand staffing. SSM

14. Ambulance stationing • Goals: to maximize efficiency and minimize response times. • Factors include: • Distance vs. call volume . • Special facilities that create increased ambulance demand . Example: Long-term care facilities . • Need for maintenance of vehicles and equipment . • Storage . • Classrooms for training and meetings . • Sleeping quarters for personnel who spend the night .

15. Minimizing Hazards Throughout the Call

16. as you prepare to respond While driving on route Prepare to assess and care for the patient. Review dispatch information. Assign duties and tasks. Decide which equipment to take. En route to the scene • Fasten seatbelts and shoulder harnesses. • Inform dispatch you are responding. • Confirm nature and location of call. • Ask for other information

17. Arrival at the scene • perform scene size up and inform dispatch : • Ensure scene safety and check hazards presence. • Secure access to patient . • If hazards are present , follow standard precaution and remove patient before you begin. • In case of trauma determine the MOI and in medical case determine nature of illness.

18. If you are the first responder at MCI : • Estimate the number of victims . • Inform dispatch and order any additional unit or resources . • Activate ICS ( assign EMT personnel to different tasks .e.g. Triage ,treatment and transportation ) .

19. Purpose : to ensure orderly traffic flow and prevent another crash. • place reflectors and other warning devices on both sides of crash. Traffic control

20. Securing equipment Make sure all equipment is secured before placing a vehicle in motion. Driving rapidly can cause items to shift. Some equipment can become lethal projectiles if not secured properly.

21. Safe Patient Transfer • Excessive speed is unnecessary and dangerous. • Secure the patient with at least three straps across the body. • Deceleration or stopping straps over the shoulders prevent forward movement if the ambulance suddenly slows or stops .

22. Postrun Activities: Restocking, Cleaning, and Disinfection • Clean and disinfect ambulance and equipment used. • Perform routine inspections. • Restock supplies. • Refuel vehicle and check the oil.

23. Learning how to properly operate your vehicle is important . • An ambulance involved in a crash : • Delays patient care. • Could take the lives of EMS providers and public . Defensive Ambulance Driving Techniques

24. Driver Characteristics • Diligence and caution. • Positive attitude about your ability . • Tolerance of other drivers . • Physical fitness . • Emotional fitness . • Proper attitude . • Good judgment and knowledge.

25. Route planning and navigation . • Fatigue . • Distractions . • Use of safety restraints . • Speed . • Siren risk-benefit analysis • Driver anticipation . • Cushion of safety • Vehicle size and distance judgment . • Backing up the emergency vehicle . • Parking at an emergency scene 2 - Safe driving practices

26. 1- Route planning and navigation : • Have access to street and area maps even if you have GPS. • Become familiar with the roads and traffic patterns in your area in order to : • Avoid heavy traffic areas. • Know ways around → to avoid possible delay area as construction sites , schools and rail road crossing. • Be familiar with special facilities and locations in your area e.g. medical facilities , chemical planes .

27. 2 - Fatigue Place yourself out of service until fatigue has passed. 3 - Distractions Never attempt to: Type Text Operate personal data devices Listen to music Eat or drink

28. 4 - Use of safety restraints • All passengers, including EMS personnel (unless critical for patient care), should wear seatbelts. 5 - Speed • Do not allow the type of call to affect how you respond while driving. • Always drive with caution. 6 - Siren risk-benefit analysis • Should never be used to transport a nonemergency patient. • EMT riding in rear of ambulance with patient should make decision. • Decision should not be guided by surrounding traffic.

29. 7 - Driver anticipation : • All other drivers are unpredictable. • Maintain a safe travel distance behind vehicles. • Do not respond aggressively to drivers. • Do not accelerate through intersections. • Make eye contact with fellow drivers. • Use turn signals. • Never force a vehicle into oncoming traffic to avoid it.

30. 8 - Cushion of safety : • Maintain a safe distance from vehicles. • Avoiding being tailgated. • Be aware of blind spots. • View ahead . • Rear of vehicle . • Side of vehicle .

31. 9 - Vehicle size and distance judgment Vehicle length and width are critical when: • Maneuvering • Driving • Parking • Braking and passing Use someone outside of the vehicle as a guide when backing up.

32. 10 - Backing up the emergency vehicle : • Should be avoided as possible • Done with the help of spotter.

33. 11. Parking at an emergency scene : • Allow for efficient traffic control and flow. • Do not block other emergency vehicles. • Stay away from structures that might collapse. • Always use your parking brake. • Park where your departure will not be hampered.

34. Turn off headlights to avoid blinding oncoming traffic at night. • Always wear visible protective clothing. Its all about safety

35. summary • Today’s ambulances are equipped with state-of-the-art technology . • Driving an ambulance or service vehicle requires good technique and judgment . • The US General Services Administration is responsible for determining ambulance standards via DOT KKK 1822. • Well checked ambulance could be the only difference between life and death so make sure that is always ready.

36. Any questions ?