Ambulance Module

1
Ambulance Module

• Operations
• Reporting
• Record Keeping

2
EMT Roles - Driver

• Responsible for mechanical check
• Tires
• Gas level
• Oil
• brakes, etc..

3
EMT Roles - Attendant

• Responsible for medical supplies
• Back boards
• Oxygen
• Splints
• Bandages, etc..

4
EMT Roles - other

• Paperwork
• Radio reporting
• Verbal to ER staff

5
EMT Roles - on-scene

• Patient Contact
• Scene Manager
• THESE ARE 2 DISTINCT ROLES

6
Driving

• CODE 2 Non Emergency
• (normal driving)
• CODE 3 Emergency
• (operating as an emergency vehicle)

7
Code 3 driving

• MUST BE ABLE TO JUSTIFY!
• Valid reasons ABC problems
• Airway Obstruction
• Respiratory Distress
• Shock

8
Code 3 driving

• Decision to Operate CODE 3
• Dispatch decides initially
• You decide how to transport to Hospital (ABC
  problem?)

9
Code 3 driving

• Operating Code 3 - EMERGENCY
• Exempt from most traffic regulations
• 10 MPH over the posted speed limit
• Beware intersections

10
You are NEVER exempt from operating safely

• You can be charged with a crime if you operate
  unsafely

11
Responding

• Always use maps - BEFORE you begin to move!
• The attendant should help with the response.
• Make eye contact with other drivers and STILL
  DONT TRUST THEM

12
Freeway Response

• No Light bar
• Forward steady red and Rear flashers only (think
  CHP)
• Can use all lights once parked (safety)

13
Scene Approach

• VIOLENT? Approach slow and silent
• Consider Staging 1-2 blocks away
• Beware dead ends and long alleys
• Park as a TACTIC, not as if you were shopping

14
Radio requests

• Composed
• Brief
• Be specific what you want
• State purpose of request

15
Radio reports

• Be composed
• Be prepared before you start
• Be structured - same format every time

16
Radio Report

• Unit to Base
• Location
• Age - sex - weight
• Chief Complaint (C/C)
• Expanded Chief Complaint
• Level of consciousness (LOC)

17
Radio Report

• Pupils Skin signs
• Vital signs
• Past Medical History (PMH)
• Physical Exam (PE)
• Treatment given (RX)
• Destination
• Estimated Time of Arrival (ETA)

18
Verbal Reports

• Patient name
• C/C
• Expanded C/C
• LOC if altered
• Vital signs
• Treatment given

19
Documentation

• EMS Form - Run Sheet - Patient Chart
• It is a legal document, same as a will, trust
  deed, arrest record, etc
• It is a reflection of the care you provide

20
Documentation rules

• If you did not write it down, you did not do it.
• Incomplete paperwork equals incomplete care.
• Sloppy paperwork equals sloppy care.

21
Scene Safety and Personal Protection

• Prepare yourself when dispatched
• Inspect surroundings
• Mark the scene
• Check vehicle stability
• Take proper night time precautions

22
Communicable Diseases

• Transmitted from one person to another
• Minimize risk with proper protection
• Immunizations

23
Routes of Transmission

• Direct
• Vector-borne
• Vehicle (indirect)
• Airborne

24
Common Terms

• Exposure
• Universal precautions
• Body Substance Isolation (BSI)
• Exposure Control Plan

25
Body Substance Isolation (BSI)

• Hand washing
• Gloves
• Eye protection
• Mask
• Gowns

26
Immunizations

• Recommended
• Tetanus-diphtheria boosters (every 10 years)
• Measles, mumps, rubella (MMR)
• Influenza vaccine (yearly)
• Hepatitis B vaccine

27
Duty to Act

• Cannot deny care to a patient with a suspected
  communicable disease
• Abandonment / breach of duty / negligence

28
Diseases of Special Concern

• HIV infection
• Hepatitis
• Meningitis
• Tuberculosis

29
General Post Exposure Management

• See a doctor immediately
• Ryan White law

30
Clinical Ride-a-longs

• Arrive in proper uniform
• Arrive a few minutes early
• Ask questions
• Remember your scope of practice
• Patient information is confidential

31
Sign Ups

• If you sign up for a clinical or schedule a
  ride-a-long you are expected to be there.
• If you have to reschedule you will lose your
  priority

32
Sign ups

• If you fail to show up for a field experience the
  will be a penalty (50 points)
• Bring lunch money or a sack lunch

33
Paperwork

• Field Evaluation Form
• Patient Summary Sheet
• Notebook to take notes (when appropriate)

34
Thank You for Coming

• The END