Ambulance Operations

1. Ambulance Operations Emergency Medical Technician Programme

2. Ambulance Operations Insight into to the requirements, knowledge and judgements required to work as a team member and also as an individual and competent EMT

4. The functions of a Command & Control Centre • A C & C Centre is typically a secure room or building in a government facility that operates as the agency's dispatch centre & coordination office all in one. Command and control centres are operated by a government or state run agency.

5. The role and responsibility of the EMC • The Emergency Medical Controller operates a C & C Centre in order to control efficiently and effectively the emergency ambulance, patient transport and First Responder services for service users and to cater for the communications needs of the Health Service.

6. The role and responsibility of the EMC • The EMC has a key role in delivering an effective response to emergencies within an established set of performance indicator response times. • The EMC will play a lead role in improving communication within and externally to the service, by performing their duties in line with the ethos of customer / client service.

7. Describe the pre-arrival instructions • The EMC can assist the caller with pre-arrival instructions to help the victim, using standardised protocols developed in AMPDS, PHECC & with a medical director. • Such instructions may consist of simple advice to keep the patient calm and comfortable or to gather additional background information for responding practitioners. • The instructions can also become more complex, providing directions for CPR, as an example.

8. Functions of a Medical Priority Dispatch System (MPDS) • AMPDS provides a unified system used to dispatch appropriate aid to medical emergencies. • It includes systematised caller interrogation and pre-arrival instructions. • Each call is also assigned a sub-category or code. • It also helps when analysing the calls for how the call was described and managed.

9. The time phases of an ambulance call in response to an incident • Date of call • the specific day, month and year the call is received at the C & C. • Time of call • the time recorded at the precise moment when the call is answered by a call taker in the CC. Time is recorded in HH/MM/SS.

10. The time phases of an ambulance call in response to an incident • Time call passed • the time the dispatch details of the call are passed to the crew. Time is recorded in HH/MM/SS. • Time mobile • the time the emergency ambulance/vehicle with appropriate crew, mobile (on dispatch) and on way to the scene. Time is recorded in HH/MM/SS.

11. The time phases of an ambulance call in response to an incident • Time at scene • the time of the arrival of the emergency ambulance/vehicle at scene. Time is recorded in HH/MM/SS. • Time at patient • the time of arrival at the patient side to provide emergency care.

12. The time phases of an ambulance call in response to an incident • Time departs scene • the time the patient departs the scene to travel to the destination point/hospital. Time is recorded in HH/MM/SS. • Time of handover • the time of completed handover of the patient to another member of the health care team at the destination point/hospital.

13. The time phases of an ambulance call in response to an incident • Time at destination point/hospital • the time patient arrives at the destination point/hospital Time is recorded in HH/MM/SS. • Time clear • the time the vehicle, crew and equipment is available for the next dispatch. Time is recorded in HH/MM/SS.

14. PHECC Priority Despatch Dispatch standards Calls received for emergency medical assistance shall be prioritised using ProQA from AMPDS The dispatch cross reference (DCR) table six level priority classification as approved by PHECC shall be utilised The principles for dispatchers shall be applied when dispatching resources to an emergency medical incident

15. Dispatch Codes

16. Principles for Dispatchers The nearest available ambulance shall be tasked to the highest priority incident The 'recommended response' other than an ambulance shall be dispatched if resources are available Dispatchers shall have discretion to override ProQA to assign a higher priority to an incident An ambulance tasked to lower priority incident may be diverted to higher priority incident when resources are limited

17. Principles for Dispatchers The Dispatcher may preserve the availability ofambulances by queuing Alpha and Omega priority incidents until sufficient resources are available When response is delayed Dispatchers shall inform the caller of estimated time of arrival The Dispatcher shall make contact with caller if ambulance response is delayed (> 20 minutes) to verify patient's condition and review priority of incident

18. Principles for Dispatchers Any recommended resource should only be deployed if it has a reasonable expectation of making patient contact.

19. Dispatch Codes The Command, Control & Communications Centre, when activating a response to an incident, shall give the DCR code for the information about the incident to the Practitioners. Dispatchers and Practitioners must be made aware that DCR code and dispatch response levels may differ

20. Time Phase of Ambulance Call • Pre-dispatch • Dispatch • Travel to the Scene • Actions at the Scene • Travel to the Hospital • Actions at the Hospital

21. Service and maintenance of ambulance. Fuel, oil, water, condition of ambulance Equipment. Checked for serviceability Re-stocked Pre-Dispatch

22. Local Topography. Temporary street closures, road works, etc Alternative routes based on traffic patterns Pre-Dispatch

23. Dispatch • Exact address (landmarks if any) • Exact nature of call • How many patients are there? • Any dangers at the scene. (Hazmat) • Additional Resources or Services also mobilised

24. Carefully and rapidly respond, ie amb ID “Mobile” Activation Time Response time Time Limit Choose the fastest and safest route. Travel to the Scene

25. Obtain any additional information Make any additional decisions re backup Emergency / Urgent / Special Journeys Travel to the Scene

26. Factors which effect response times • Day of the Week • Time of Day • Weather • Road Maintenance and Construction • Railroad Crossings • Bridges, Toll-Bridges and Tunnels • Schools, and School Buses

27. Physician on Scene If the doctor assumes responsibility for the patient, then the care of the patient cannot be handed back to persons of lesser qualifications, especially if invasive procedures have been initiated by the doctor. This will require that the doctor is transported along with the patient to the hospital

28. Physician on Scene • If the doctor assumes responsibility for the patient, the ambulance crew shall work as a team with the doctor

29. Travel to Hospital • Transport to appropriate facility • Provide continuous care and monitoring • Give an ETA and any special needs to control to pass on to the hospital

30. Actions at the Hospital • Hand over to appropriate individual • DO NOTleave patient unattended • Provide a brief but thorough report • Hand over paper work - get a signature

31. NAME and AGE of the Patient Chief Complaint Mechanism of injury SAMPLE Clinical status Report any abnormal vital signs Clinical impression Actions at the HospitalVerbal Report on Hand-Over of Patient

32. Garda Escorts Requesting a Garda escort must be done through the control and local protocols should be strictly adhered to Consider category of patient and risk to rescuers and road users

33. Finding an Address on a Map If received RT confirm Phonetic spelling with your control Look up address in rear of map O/S book Locate page number and Grid reference Be aware of other sections in book If vehicle is fitted with a GPS – become familiar with your make and model

34. QUESTIONS