The document discusses ambulance services at R.N. Cooper Hospital in Mumbai, India. It notes that there are currently only 2 ambulances operated by the Brihanmumbai Municipal Corporation at the hospital, down from 4 previously. One is a basic life support ambulance equipped for emergencies. The other is an advanced life support or cardiac ambulance fitted with equipment like defibrillators and ventilators for serious cases. Ambulance services through the hospital are free to transfer patients to other public hospitals in Mumbai but private transfers require arranging private ambulances.

1. AMBULANCE SERVICE

2. INTRODUCTION
An ambulance is a vehicle for transportation of sick or injured peopleto,
from or between places of treatment for an illness OR injury and in some
instances will also provideoutof hospital medical care to the patient.
The word isoften associated with road going emergency ambulances which
form part of an emergency medical service, administeringemergency care to
those with acute medical problems.
The term ambulance does, however, extend to a wider rangeof vehicles other
than those with flashing warninglights and sirens. The term also includesa
large number of non-urgentambulanceswhich are for transportof patients
without an urgentacute condition.
The term ambulance comes from the Latin word "ambulare"as meaning"to
walk or moveabout which is a referenceto early medicalcare where patients
were moved by lifting or wheeling. The word originally meant a moving
hospital, which followsan army in its movements.
TYPES OF AMBULANCES
Ambulancescan be grouped into types dependingon whether or not they
transportpatients, and under whatconditions.
 Emergency ambulance – The most common type of ambulance, which
provide care to patients with an acute illness or injury. These can be
road-going vans, boats, helicopters, fixed-wing aircraft (known as air
ambulances).
 Patient transport ambulance – A vehicle, which has the job of
transporting patients to, from or between places of medical treatment,
such as hospital or dialysis center, for non-urgent care. These can be
vans, buses or other vehicles.
 Response unit – Also known as a fly-car or a [Quick Response
Vehicle], which is a vehicle which is used to reach an acutely ill patient
quickly, and provide on scene care.
 Bariatric ambulance – A special type of patient transport ambulance
designed for extremely obese patients equipped with the appropriate
tools to move and manage these patients.

3. Equipment
In addition to the equipmentdirectly used for the treatment of patients,
ambulancesmay be fitted with a rangeof additionalequipmentwhich is used
in order to facilitate patient care. This could include
Two-way radio – Oneof the most importantpieces of equipmentin modern
emergency medical services as it allowsfor the issuingof jobs to the
ambulance, and can allow the crew to passinformation back to controlor to
the hospital.
Traumalighting – In addition to normalworking lighting, ambulancescan be
fitted with special lighting.
Air conditioning – Ambulancesare often fitted with a separate air
conditioningsystem to servethe workingarea from that which servesthe cab.
This helps to maintain an appropriatetemperaturefor any patients being
treated, but may also feature additionalfeatures such as filtering against
airborne pathogens.
Data Recorders – These are often placed in ambulancesto record such
information as speed, braking power and time, activation of active emergency
warningssuch as lights and sirens, as well as seat belt usage.
Active visual warnings
The active visual warnings are usually in the form of flashing lights. These flash in order
to attract the attention of other road users as the ambulance approaches, or to provide
warning to motorists approaching a stopped ambulance in a dangerous position on the
road. Common colors for ambulance warning beacons are blue, red, amber, and white
(clear).

4. Audible warnings
In addition to visualwarnings, ambulancescan be fitted with audible
warnings, sometimes known as sirens, which can alert peopleand vehicles to
the presenceof an ambulance before they can be seen.
Service providers
Government Ambulance Service – Operating separately from (although alongside) the
fire and police service of the area, these ambulances are funded by local or national
government.
Volunteer Ambulance Service – Charities or non-profit companies operate ambulances,
both in an emergency and patient transport function.
Private Ambulance Service – Normal commercial companies with paid employees, but
often on contract to the local or national government. Private companies may provide only
the patient transport elements of ambulance care.
Charity Ambulance – This special type of ambulance is provided by a charity
for the purposeof taking sick children or adultson other hospital .

5. Cardiac Ambulance
Cardiac Ambulance provides a network of Fully Equipped Life Support Ambulances in the
city of Mumbai. In case of a medical emergency, any Mumbai resident may accessing a fully
equipped Advanced Life Support Ambulance within the shortest possible time. Ambulances
are located in strategic locations. After recieving the call in the shortest possible time, the
nearest free Ambulance will reach at your place to rescue the patient / victim.
Cardiac Ambulances are equipped with international quality instruments for international
standards of service & care. The Emergency physicianon board are trained usually working
in the city ICU's and Emergency department and are adequately experienced to handle all
kinds of Emergencies.
Cardiacambulancecontains:-
 Doctor   Trained Nurse
 E. C. G.   Cardiac Monitor
 Defibrillator   Portable Ventilator
 Suction machine   Pulse Oxymeter
 Oxygen   Emergency Medicines
 Resuscitation kit   Nebuliser
 Syringe Pump   Bipap
 Pace Maker   Spine Board
The Ambulance has air-conditioning, mild sound proofing and silicon sealing in joints. It
also has on board a collapsible trolley stretcher and a stair chair. The Ambulance crew
usually consists of a physician, nurse, driver and a helper. Cardiac Ambulance are available
for transferring the patients all over India.

6. 108 Emergency Service
Howit works:-
When an emergency is reported through 108, the call taker gathers the needed basic
information and dispatches appropriate services. Basic information obtained includes:-
 Where the call is placed from. ( district / taluka /city / town/ exact location/ landmark)
 The type of emergency.
 Number of people injured and the condition of the injured.
 The caller's name and contact number – for location guidance if required.
Emergency help dispatched through this process is expected to reach the site of the
emergency in an average of 18 minutes. Pre-hospital care will be given to patients being
transported to the nearest hospital. The service is normally free to patients.
108 is managed by the EMRI ( Emergency Management and Research
Institute) across more than ten states in India.
During an emergency situation, knowing what to do might save someone’s life. Here
are a few tips on what you should tell the emergency dispatcher while calling for an
ambulance:
1. Be calm and tell the emergency operator the details about the type of emergency
2. You will be asked to tell him/her the address to where the ambulance should
reach, including postal code.
3. Your phone number may also be asked for, in case the operator needs to contact
you for directions.
4. He/she will also require the patient’s age, sex and any medical history you might
remember.
5. The operator will also need to know if the person is bleeding, if he/she is
conscious, has chest pain and is breathing.
6. You will also be asked to explain the type of injury or emergency and what caused
the incident.

7. AMBULANCE SERVICES IN R.N. COOPER HOSPITAL
The CooperHospital isa public hospital located in Juhu, Mumbai, India. Itis owned by the
Brihanmumbai Municipal Corporation and is operated under a public-private partnership.
It was started in 1969 as a maternity home before it was converted into a fullfledged general
hospital in 1970.
The hospital underwent massive reconstruction after the original building was declared unfit for
use in 1999. The new upgrade, at a cost of ₹321 crore, includes more beds, as well as systems for
rainwater harvesting and sewerage treatment.[1] The new hospital design includes an infection
controldesignto prevent doctors from contracting tuberculosis while on duty.
A medical college has been planned at the hospital by the BMC. Since the hospital does not have the
required 800 bed strength, it has been proposed to jointly run it at Cooper as well as the Bal
Thakeray Trauma Care Hospital in Jogeshwari.

8. There are only 2 BMC ambulance in R.N. copper
hospital24/7.
Early there was 4 ambulance but right now there is only 2
ambualnce and one 108 ambulance is there.
1. Basic Life Support (BLS) Ambulance
2. Advanced Life Support (ALS) Ambulance also called as
Cardiac Care Ambulance
Basic Life Support (BLS) Ambulance
A basic life support ambulance is equipped with life support
equipment like an oxygen cylinder, BP monitor and stethoscope. This
type of ambulance can be used for emergencies when the patient can
be transported to the hospital quickly.
Advanced Life Support (ALS) Ambulance
This ambulance is fitted with advance life support machines such as
defibrillators (a machine used to restart the heart), ECG machine
(used to keep a check on the heart rate of a person), Ventilators,
Oxygen cylinders, Pulseoxymeter(used to check for the mount of
oxygen in the blood) , Resuscitation kit, suction machine, Nebuliser
and BP apparatus.
This kind of ambulance can be used in cases where the patient is
either unconscious, has had a heart attack or is a known patient of
heart disease. It can also be used in cases the patient has to be
transferred to a hospital that is far away, or he/she is immobile and
on life support.

9. Extentionno.:-116
It is free of cost service for patients means
the hospital not charging a single rupees
for transportation.
If patients have to shifted in any other
government hospital in Mumbai it is free
of cost service for them.
If patients have to shifted in any private
hospital then ambulance service is not
applicable for them.
Than The patients relatives have to
arrange private ambulance service and
have to pay the decided charges.
Process of arranging ambulance for
patients in cooper hospital:-
If patient is admitted in ward or in
casualty and he/she have to shifted in
other government hospital than the
respected Dr. given in written that the
patients have to shifted in respected
hospital to the medical officer or to the
r.m.o.

10. Than r.m.o. call to the service department
and arrange the required ambulance.
After that the shift the patient in respected
hospital.
 If the oxygen cylinder is not working in the
BLS ambulance then they take oxygen
cylinder form wards.
There is one 108 emergency cardiac
ambulance in cooper hospital.
Which is a the araea ambulance.
If there is no ambulance available at the
time of emergency than the hospital again call
the 108 and they provide the another cardiac
ambulance.
Ambulance reach at the site within 10 to 15 min.

11. MANPOWER/STAFFS
STAFF MORNING SHIFT
7.AM TO 3.PM
AFTERNOON SHIFT
3.PM TO 11.PM
NIGHT SHIFT
11.PM TO 7.AM
DRIVER
=06
02 02 02
ATTENDENT
=3 TO 4
01 01 02
DOCTOR AND NURSES it is dependent upon
the patient’s condition.
If patient’s condition is more critical then
three is 1 doctor and 2 staff nurse.
Generally there is one Dr. and one nurse
should be there in the ambulance with
patients till the patient is shifted to another
hospital.
The no. of Attendants is also dependent upon
the patient’s condition.
All the audio visuals (sirens) are working properly.

12. Record maintainance
In cooper hospital they are maintaining the
records of ambulance services provided to the
patients for translocation in the other
municipal hospital.
It is free service for patients.
The record book
In cooper hospital the driver and attendant
are using mobile phone for conversation with
hospital department about the current status
of ambulance means where it reaches.
DAT
E
PATIENT
S NAME
WARD/REGI NO.
OF PTS
VAN
NO.
OUT
TIME
INTIME DESTINATIO
N
FREE AMBUA
LCE
TYPE
SIGN
12-
04-
16
SOMUBAI
JADAV
GYN/0258 MHO2
58
10.30
AM
12.45
PM
KEM
-
BLS
-

13. Repairing of mechanical parts of
ambulance/ servicing
 If any problem occurs in ambulance
then they send the ambulance for
servicing and repairing in the garage.
 There is a municipal garage in Bandar
east where they send the ambulance
for servicing and repairing.
 It is free service for cooper hospital
means they are not charging money for
servicing of ambulance.
 They get the funds from government.

14. PROBLEMS in AMBULANCE SERVICE OF R.N.
COOPER HOSPITAL
1. The hospital should increase the no. of
ambulance.
2.There is no machine/equipment properly
working in Cardiac Ambulance.
3.If any patient is in sever condition then they
call/use 108 emergency ambulance service.
4.Because it is easily available that’s why the
hospital n not increasing the no. of ambulance.
5. The payment of Driver and attendant is not
paid on time.