Ambulance

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Ambulance

  1. 1. Ambulance Module Operations Reporting Record Keeping
  2. 2. EMT Roles - Driver <ul><li>Responsible for mechanical check </li></ul><ul><li>Tires </li></ul><ul><li>Gas level </li></ul><ul><li>Oil </li></ul><ul><li>brakes, etc.. </li></ul>
  3. 3. EMT Roles - Attendant <ul><li>Responsible for medical supplies </li></ul><ul><li>Back boards </li></ul><ul><li>Oxygen </li></ul><ul><li>Splints </li></ul><ul><li>Bandages, etc.. </li></ul>
  4. 4. EMT Roles - other <ul><li>Paperwork </li></ul><ul><li>Radio reporting </li></ul><ul><li>Verbal to ER staff </li></ul>
  5. 5. EMT Roles - on-scene <ul><li>Patient Contact </li></ul><ul><li>Scene Manager </li></ul><ul><li>THESE ARE 2 DISTINCT ROLES </li></ul>
  6. 6. Driving <ul><li>CODE 2 Non Emergency </li></ul><ul><li>(normal driving) </li></ul><ul><li>CODE 3 Emergency </li></ul><ul><li>(operating as an emergency vehicle) </li></ul>
  7. 7. Code 3 driving <ul><li>MUST BE ABLE TO JUSTIFY! </li></ul><ul><li>Valid reasons = ABC problems </li></ul><ul><li>Airway Obstruction </li></ul><ul><li>Respiratory Distress </li></ul><ul><li>Shock </li></ul>
  8. 8. Code 3 driving <ul><li>Decision to Operate CODE 3 </li></ul><ul><li>Dispatch decides initially </li></ul><ul><li>You decide how to transport to Hospital (ABC problem?) </li></ul>
  9. 9. Code 3 driving <ul><li>Operating Code 3 - EMERGENCY </li></ul><ul><li>Exempt from most traffic regulations </li></ul><ul><li>10 MPH over the posted speed limit </li></ul><ul><li>Beware intersections </li></ul>
  10. 10. You are NEVER exempt from operating safely You can be charged with a crime if you operate unsafely
  11. 11. Responding <ul><li>Always use maps - BEFORE you begin to move! </li></ul><ul><li>The attendant should help with the response. </li></ul><ul><li>Make eye contact with other drivers and STILL DON”T TRUST THEM </li></ul>
  12. 12. Freeway Response <ul><li>No Light bar </li></ul><ul><li>Forward steady red and Rear flashers only (think CHP) </li></ul><ul><li>Can use all lights once parked (safety) </li></ul>
  13. 13. Scene Approach <ul><li>VIOLENT? Approach slow and silent </li></ul><ul><li>Consider Staging 1-2 blocks away </li></ul><ul><li>Beware dead ends and long alleys </li></ul><ul><li>Park as a TACTIC, not as if you were shopping </li></ul>
  14. 14. Radio requests <ul><li>Composed </li></ul><ul><li>Brief </li></ul><ul><li>Be specific what you want </li></ul><ul><li>State purpose of request </li></ul>
  15. 15. Radio reports <ul><li>Be composed </li></ul><ul><li>Be prepared before you start </li></ul><ul><li>Be structured - same format every time </li></ul>
  16. 16. Radio Report <ul><li>Unit to Base </li></ul><ul><li>Location </li></ul><ul><li>Age - sex - weight </li></ul><ul><li>Chief Complaint (C/C) </li></ul><ul><li>Expanded Chief Complaint </li></ul><ul><li>Level of consciousness (LOC) </li></ul>
  17. 17. Radio Report <ul><li>Pupils & Skin signs </li></ul><ul><li>Vital signs </li></ul><ul><li>Past Medical History (PMH) </li></ul><ul><li>Physical Exam (PE) </li></ul><ul><li>Treatment given (RX) </li></ul><ul><li>Destination </li></ul><ul><li>Estimated Time of Arrival (ETA) </li></ul>
  18. 18. Verbal Reports <ul><li>Patient name </li></ul><ul><li>C/C </li></ul><ul><li>Expanded C/C </li></ul><ul><li>LOC if altered </li></ul><ul><li>Vital signs </li></ul><ul><li>Treatment given </li></ul>
  19. 19. Documentation <ul><li>EMS Form - Run Sheet - Patient Chart </li></ul><ul><li>It is a legal document, same as a will, trust deed, arrest record, etc </li></ul><ul><li>It is a reflection of the care you provide </li></ul>
  20. 20. Documentation rules <ul><li>If you did not write it down, you did not do it. </li></ul><ul><li>Incomplete paperwork equals incomplete care. </li></ul><ul><li>Sloppy paperwork equals sloppy care. </li></ul>
  21. 21. Scene Safety and Personal Protection <ul><li>Prepare yourself when dispatched </li></ul><ul><li>Inspect surroundings </li></ul><ul><li>Mark the scene </li></ul><ul><li>Check vehicle stability </li></ul><ul><li>Take proper night time precautions </li></ul>
  22. 22. Communicable Diseases <ul><li>Transmitted from one person to another </li></ul><ul><li>Minimize risk with proper protection </li></ul><ul><li>Immunizations </li></ul>
  23. 23. Routes of Transmission <ul><li>Direct </li></ul><ul><li>Vector-borne </li></ul><ul><li>Vehicle (indirect) </li></ul><ul><li>Airborne </li></ul>
  24. 24. Common Terms <ul><li>Exposure </li></ul><ul><li>Universal precautions </li></ul><ul><li>Body Substance Isolation (BSI) </li></ul><ul><li>Exposure Control Plan </li></ul>
  25. 25. Body Substance Isolation (BSI) <ul><li>Hand washing </li></ul><ul><li>Gloves </li></ul><ul><li>Eye protection </li></ul><ul><li>Mask </li></ul><ul><li>Gowns </li></ul>
  26. 26. Immunizations <ul><li>Recommended: </li></ul><ul><ul><li>Tetanus-diphtheria boosters (every 10 years) </li></ul></ul><ul><ul><li>Measles, mumps, rubella (MMR) </li></ul></ul><ul><ul><li>Influenza vaccine (yearly) </li></ul></ul><ul><ul><li>Hepatitis B vaccine </li></ul></ul>
  27. 27. Duty to Act <ul><li>Cannot deny care to a patient with a suspected communicable disease </li></ul><ul><li>Abandonment / breach of duty / negligence </li></ul>
  28. 28. Diseases of Special Concern <ul><li>HIV infection </li></ul><ul><li>Hepatitis </li></ul><ul><li>Meningitis </li></ul><ul><li>Tuberculosis </li></ul>
  29. 29. General Post Exposure Management <ul><li>See a doctor immediately </li></ul><ul><li>Ryan White law </li></ul>
  30. 30. Clinical & Ride-a-longs <ul><li>Arrive in proper uniform </li></ul><ul><li>Arrive a few minutes early </li></ul><ul><li>Ask questions </li></ul><ul><li>Remember your scope of practice </li></ul><ul><li>Patient information is confidential </li></ul>
  31. 31. Sign Ups <ul><li>If you sign up for a clinical or schedule a ride-a-long you are expected to be there. </li></ul><ul><li>If you have to reschedule you will lose your priority </li></ul>
  32. 32. Sign ups <ul><li>If you fail to show up for a field experience the will be a penalty (50 points) </li></ul><ul><li>Bring lunch money or a sack lunch </li></ul>
  33. 33. Paperwork <ul><li>Field Evaluation Form </li></ul><ul><li>Patient Summary Sheet </li></ul><ul><li>Notebook to take notes (when appropriate) </li></ul>
  34. 34. Thank You for Coming The END

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