The document discusses various procedures and safety considerations for ambulance operations, including: 1) Performing regular equipment checks and vehicle inspections before each call to ensure everything is functioning properly. 2) Driving safely and using lights and sirens appropriately when responding to calls. 3) Parking in safe locations upon arrival at the scene and receiving facility.

1. Chapter Ambulance Operations Twenty-Six

2. Equipment carried on ambulance and importance of shift checks Basics of most states’ emergency driving laws and regulations Proper emergency vehicle operation Proper transfer of patient to the ED staff Usefulness of aeromedical evacuation where available CORE CONCEPTS Chapter Twenty-Six

3. Walk-around Communications Mechanical/fluids Life-sustaining Safety Other medical Check Equipment Is it there? Does it work? Will it fail? (Continued) Preparation for the Call

4. Check Equipment New body damage Fluid leaks Tire wear Warning equipment Walk-around (Continued) Preparation for the Call

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

6. Check Equipment Dispatch Handheld Medical control Walk-around Communications (Continued) Preparation for the Call

7. Check Equipment Starts Steers Stops Stays running Walk-around Communications Mechanical/fluids (Follow Agency Checklist) (Continued) Preparation for the Call

8. Mechanical Inspection Follow your agency’s checklist through a careful mechanical inspection. Be as sure as you can about your safety — and the public’s.

9. Check Equipment Suction Oxygen/resuscitation (Medication) (Defibrillation) Walk-around Communications Mechanical/fluids Life-sustaining (Continued) Preparation for the Call

10. BSI gear Binoculars Scene wear Check Equipment Walk-around Communications Mechanical/fluids Life-sustaining Safety (Continued) Preparation for the Call

11. Communications Checks Your radio equipment — and your warning equipment — are vital to your medicine and your safety. They need to work perfectly.

12. Check Equipment Carry-in kits Cabinet stock Personal gear Preparation for the Call Walk-around Communications Mechanical/fluids Life-sustaining Safety Other medical (Continued)

13. Ensure Cleanliness Carry-in gear Ambulance interior Ambulance exterior Preparation for the Call (Continued) Disease prevention Public perception Personal pride

14. Not Good Enough Your equipment talks about you, all the time. Make sure it refers to you as a professional.

15. Check Equipment Medical Nonmedical Personal safety Maps Preparation for the Call (Continued)

16. Personnel Available for Response At least one EMT-B in patient compartment (minimum staffing) Two EMT-Bs preferred Preparation for the Call (Continued)

17. Vehicle Inspection Preparation for the Call Engine, belts, hoses, fluids, tires All lights, sirens Communication equipment

18. The new EMT-B must realize that the most modern, well-equipped ambulance is not worth the room it takes in the garage if it’s not ready to respond. A state of readiness results from a planned preventive maintenance program, periodic servicing of the vehicle, and serious daily shift checks. P RECEPTOR P EARL

19. Central access (911) 24-hour availability Trained personnel (emergency (Continued) Dispatch medical dispatchers)

20. Information Nature of call Name, location, callback number Location of patient Number of patients and severity Special problems Dispatch

21. Procedures Wear safety belts. Notify dispatch. (Continued) En Route to Call

22. Driving the Ambulance Emergency vehicle operations course is recommended. Course is mandated in some areas. (Continued) En Route to Call

23. Driving the Ambulance Good operators: Mentally/physically fit Positive attitude Capable of performing under stress Tolerant of other drivers (Continued) En Route to Call

24. Driving the Ambulance Wear safety belts: Driver and passengers Become familiar with vehicle. Be alert to road and weather conditions. (Continued) En Route to Call

25. Driving the Ambulance Use caution when using red lights/siren. Select appropriate route. Maintain safe following distance. Have regard for safety of others. (Continued) En Route to Call

26. Driving Hazards Intersection most common collision type (72%) Escorts and multiple-vehicle responses. (Motorists don’t expect second emergency vehicle.) (Continued) En Route to Call

27. Other Procedures Obtain additional info from dispatch. Assign personnel specific duties. Assess equipment needs. En Route to Call

28. Parking the Ambulance Park uphill from leaking hazards. Park 100 feet from wreckage. Set parking brake. (Continued) Arrival at Scene

29. Parking the Ambulance Use warning lights. Avoid parking where exit will be hampered. (Continued) Arrival at Scene

30. Procedures Notify dispatch. Size up the scene: Safety Body substance isolation Number of patients (Continued) Arrival at Scene

31. Studies have shown that red revolving beacons attract intoxicated or tired drivers. Remind new EMT-Bs to consider pulling off the road, turning off headlights, and using just amber rear-sealed beam blinkers that blink in tandem or unison to identify the size of their vehicles. P RECEPTOR P EARL

32. Actions Organized Rapid/efficient Toward goal of transportation Arrival at Scene

33. Procedures Prepare patient for transport. Complete critical interventions. Check dressings and splints. Secure patient to moving device. Transferring to the Ambulance

34. Tell new EMT-Bs that under NO circumstances should they simply wheel a nonemergency patient into a hospital, place him or her in a bed, and leave! Unless the EMT-B transfers care of the patient directly to a member of the hospital staff, the EMT-B may be open to a charge of abandonment. P RECEPTOR P EARL

35. Notify dispatch. Continue ongoing assessment. Notify receiving facility. Reassure patient. Complete reports. En Route to Receiving Facility

36. Notify dispatch. Use caution backing into facility. At Receiving Facility

37. Verbal and written reports Transfer of care to hospital personnel Patient Transfer at Facility

38. En Route to Station Notify dispatch. Prepare for next call.

39. After the Call Refuel unit. Complete and file reports. Complete cleaning and disinfection. Notify dispatch.

40. Using Air Medical Service Medical reasons Operational/rescue reasons Know local protocols.

41. Requires 100 foot x 100 foot area Less than 8 degree slope Free of wires, trees, people, and loose objects (Continued) Helicopter Landing Zone

42. Helicopter Landing Zone

43. Main Rotor Approach Area Approach Areas Tail Rotor Helicopter Danger Area DANGER AREA DANGER AREA

44. Approach crouched. Ground Approach to Helicopter

45. DANGER AREA: Do Not Approach Main Rotor Approach from downhill side Approach to Helicopter on Hillside

46. Follow directions of crew. Crew will direct patient loading. Stay clear of tail rotor. No smoking, traffic, vehicles within 100 feet of copter. Approach to Helicopter

47. 1. What are the phases of a call? 2. What is the danger of an escort? 3. How big should an LZ be? 4. Give five examples of patients who could R EVIEW QUESTIONS benefit from aeromedical transportation.