Ambulance Operations

1

CHAPTER 33
Ambulance Operations
2

Phases of the Ambulance Call
3

Phases of the Ambulance Call

• Preparation for the call
• Dispatch Responding
• Transferring patient to the ambulance
• Transporting the patient
• Terminating the call

4
Preparation for the Call

Check Equipment

• Mechanical/Fluids
• Walk-Around
• Communication
• Treatment Supplies
• Safety Equipment
• Other Supplies

• Is it there?
• Does it work?
• Will it fail?

5
Preparation for the Call

Check Equipment
Mechanical/Fluids

• Under-hood check
• Starts
• Steers
• Stops
• Stays running

(Follow Agency Checklist)
6
Mechanical Inspection Follow your agencys
checklist through a careful mechanical
inspection. Be as sure as you can about your
safety and the publics.

7
Preparation for the Call

Check Equipment
Walk-Around

• New body damage
• Fluid leaks
• Tire wear
• Warning equipment

8
Walk-Around Inspection Start the engine. Turn on
the lighting equipment. Literally walk around the
vehicle, looking and listening. What is your
equipment telling you?

9
Preparation for the Call

Check Equipment
Communications

• Dispatch
• Hand-held
• Medical Control

10
Communications Checks Your radio equipment and
your warning equipment are vital to your
patients and your safety. They need to work
perfectly.

11
Preparation for the Call

Check Equipment
Treatment Supplies
(Follow agency or state checklist)

• Suction
• Oxygen/Resuscitation
• Carrying devices
• Defibrillation

12
Preparation for the Call

Check Equipment
Safety Equipment

• BSI gear
• Binoculars
• Scene wear

13
Preparation for the Call

Other Supplies
Check Equipment

• Carry-in kits
• Maps
• Personal gear

14
Preparation for the Call

• Disease Prevention
• Public Perception
• Personal Pride

Ensure Cleanliness

• Carry-in gear
• Ambulance interior
• Ambulance exterior

15

Your equipment talks about you all the time. Make
sure it refers to you as a professional.
16

Dispatch Responding

• Central Access (9-1-1)
• 24-hour availability
• Trained personnel (EMDs)

17

Dispatch Responding
Information

• Nature of call
• Name, location, callback number
• Location of patient
• Number of patients and severity
• Special problems

18

Dispatch Responding
Procedures

• Notify dispatch when responding.

Personnel Available for Response

• At least one EMTB in patient compartment
  (minimum staffing)
• Two EMTBs preferred

19

En Route to Call
Driving the Ambulance

• Emergency vehicle operations course
  recommended
• Course mandated in some areas

Continued
20

En Route to Call
Driving the Ambulance

• Good Operators
• Mentally/physically fit
• Emotions under control
• Able to perform under stress
• Tolerate other drivers

Continued
21
En Route to Call

Driving the Ambulance

• Wear safety belts.
• Driver and passengers.
• Become familiar with vehicle.

Continued
22
En Route to Call

Driving the Ambulance

• Be alert to road and weather conditions.
• Do not operate under the influence or when
  fatigued.

Continued
23

En Route to Call
Driving the Ambulance

• Use caution when using emergency lights/siren.
• Select appropriate route.
• Maintain safe following distance.
• Have regard for safety of others.

24

En Route to Call
Driving Hazards

• Intersection most common accident type.
• Use caution with escorts and multiple-vehicle
  responses (motorists dont expect second
  emergency vehicle).

25

En Route to Call
Other Procedures

• Obtain additional info from dispatch.
• Assign personnel specific duties.
• Assess equipment needs.

26

Arrival at Scene
Parking the Ambulance

• Park uphill from leaking hazards.
• Park 100 feet from wreckage.
• Set parking brake.

27

Arrival at Scene
Parking the Ambulance

• Utilize warning lights.
• Avoid parking where exit will be hampered.

28

Arrival at Scene
Procedures

• Notify dispatch.
• Size up the scene
• Safety
• Body substance isolation
• Number of patients

29

On Scene
Actions

• Stay organized.
• Move rapidly efficiently towards goal of
  transportation.

30
Transferring Patient to the Ambulance

Procedures

• Prepare patient for transport.
• Complete critical interventions.
• Check dressings and splints.
• Select proper moving device secure patient.

31

Package patient and secure to device.
32
Transporting Patient

• Notify dispatch.
• Continue ongoing assessment.
• Notify receiving facility.
• Reassure patient.
• Prepare for any changes.

33
At Receiving Facility

• Notify dispatch.
• Use caution backing into facility.

34
Patient Transfer at Facility

• Provide verbal and written reports to staff.
• Ensure transfer of care to hospital personnel.

35
Terminating the Call

• Notify dispatch.
• Prepare for the next call.
• Restock equipment.

Continued
36
Terminating the Call

• Refuel unit.
• Complete and file reports.
• Complete cleaning and disinfection.
• Notify dispatch.

37

Air MedicalOperations
38
Utilizing Air Medical Service

• Medical reasons.
• Operational/rescue reasons.
• Know local protocols.

39
Helicopter Landing Zone

• Requires 100 x 100 area.
• Less than 8 slope.
• Free of wires, trees, people, and loose objects.
• Never shine light at pilot.

40

Helicopter Landing Zone
41

Helicopter Danger Area
Main Rotor
Approach Areas
Approach Area
Tail Rotor
42

Approach to Helicopter
Approach Crouched.
Ground
43

Approach to Helicopter on Hillside
Main Rotor
DANGER AREA Do not approach.
Approach from downhill side.
44
Approach to Helicopter

• Follow directions of crew.
• Crew will direct patient loading.
• Stay clear of tail rotor.
• No smoking, traffic, vehicles within 100 of
  helicopter.

45

Review Questions
1. What are the phases of an ambulance call? 2.
What are the procedures for requesting air
medical assistance?
46
STREET SCENES

• When operating an ambulance using the red lights
  and siren, what precautions do you need to take?
• How can speed affect the safety of ambulance
  operation?

47
STREET SCENES

• What driving techniques might be used to make
  driving to this scene safer?

48

Sample Documentation