EMT-Ambulance Operations
What supplies should be carried in an ambulance in order to address patient infection control, comfort, and protection?
(2) pillows||(4) pillowcases||(2) spare sheets||(4) blankets||(6) disposable emesis (vomit) bags or basins||(2) boxes of facial tissues||Disposal bedpan, urinal, and toilet paper||(1) package of drinking cups||(1) package of wet wipes||(4) liters of sterile water or saline||(4) soft restraining devices (one for each extremity)||Packages of large and small red biohazard bags||(1) package of large yellow bags for linen and garbage||EPA-registered intermediate-level disinfectant (can kill TB)||EPA-registered low-level disinfectant||A blood spill kit containing an empty plastic spray bottle with lines at the 1:100 level, a plastic bottle of water, and a plastic bottle of bleach.||Eye shields for every crew member||Sharps container||Drug box (ALS only)||Disposable vinyl or other synthetic gloves -- 1 box each size||N-95 or HEPA respirator for each crew member
Explication
* Interpreting the meaning of a text|* Often involves annotating or documenting (i.e. recording) the interpretation
What is the minimum number of EMTs or Paramedics to stay in the patient compartment?
1 (2 preferred)
What steps are involved in transferring the patient to emergency department staff?
1) If patient is non-critical, check first what is to be done with the patient. You may leave a medic with the patient in the patient compartment while the other goes into the ER and determines what to do.||2) Assist emergency department staff as needed and provide a verbal report||3) Prepare the prehospital care report as soon as you're done with patient-care activities||4) Transfer patient's personal effects||5) Obtain release from the hospital
What tasks should you undertake in quarters after a call?
1) Place badly contaminated linens in a biohazard container and noncontaminated linens in a hamper||2) Clean any equipment that touched the patient||3) Clean and disinfect used nondisposable respiratory-assist equipment||4) Clean and sanitize the patient compartment||5) Prepare yourself for service||6) Replace expendable items||7) Replace or refill oxygen cylinders||8) Replace patient-care equipment||9) Carry out post-operation vehicle maintenance procedures||10) Clean the vehicle||11) Complete any paperwork
What steps must you take when returning to quarters and preparing for your next call?
1) Radio the EMD and let him/her know you're returning to quarters||2) Air the ambulance if necessary||3) Refuel the ambulance
In what cases might you call for air rescue?
1) To speed transport to a distant trauma center or specialty facility||2) When extrication of a high-priority patient is prolonged and air transport can speed transport||3) When a patient must be rescued from a remote location that can only be reached by helicopter||4) Other medical reasons
Describe the required landing zone (LZ) for a helicopter
100'x100' with a slope of less than 8º
What supplies should be carried in an ambulance in order to address immobilization of suspected bone injuries?
Adult and pediatric traction splints||Padded board splints||Variety of other splints||Tongue depressors||Triangular bandages||Several rolls of self-adhering roller bandage||Six chemical cold packs||Two long spine boards||Rigid cervical collars in variety of sizes||One KED board or similar||Six 9"x2" web straps for securing patients to carrying devices||Head immobilizer device
What supplies should be carried in an ambulance in order to address initial and focused assessment needs?
Airways||Suction||Infection control||Stethoscope||Pocket mask w/ one-way valve and oxygen inlet||BVM||Oxygen and oxygen delivery devices||BP cuff||Bandages and dressings||Occlusive dressings||AED||Rigid cervical collars||Scissors||Blankets||Pulse oximiter||Thermometer and hypothermia thermometer||Pen light
If there is fire or fumes at the scene of a collision, how far away should you park the ambulance?
At least 100'
If there is no fire or fumes at the scene of a collision, how far away from the wreckage should you park your ambulance?
At least 50'
Where should you position your ambulance if the collision scene has already been secured by other emergency units?
Beyond the wreckage
What are the steps in inspecting an ambulance after starting the engine?
Check all indicators for problems||Check gauges for proper operation||Test brakes||Test parking brake||Turn steering wheel from side to side||Check operation of wipers||Turn on warning lights, have your partner check each light||Test all other lights||Check heating and AC||Check transmission fluid||Test communications equipment
What are the steps in inspecting patient compartment supplies and equipment?
Check the interior of the compartment for damage and contamination||Check treatment supplies||Complete inspection report||Clean the ambulance
What can an ambulance driver do when it becomes apparent that they will be delayed in reaching a sick or injured person?
Choose an alternative route||Request support from other units
What steps do you take in preparing the ambulance for the next call?
Clean the patient compartment||Prepare respiratory equipment for service||Replace expendable items||Exchange equipment based on local policy||Make up the ambulance cot
Who do you notify when responding to a call?
Dispatch
What supplies should be carried in an ambulance in order to address poisoning, chemical burns, and diabetic emergencies?
Drinking water||Activated charcoal||Paper cups||Eye irrigation equipment||Constriction bands||Blood glucose meter||Instant glucose paste
What supplies should be carried in an ambulance in order to address oxygen therapy and suction
Fixed oxygen delivery system||(2) portable oxygen delivery systems with at least 350 liter capacity||Spare D, E, or Jumbo D oxygen cylinders with an intact test seal||(6) adult and (4) pediatric nonrebreather masks||(6) adult and (4) pediatric nasal cannulas||(1) FROPVD||(1) Automatic transport ventilator (optional)||(1) plastic colorful or comic cup for administering blow-by oxygen to a child||Fixed suction system capable to provide 30 liters per minute of airflow, with a vacuum of at least 300 mmhg, fitted with a nonkinking tube and a Yankauer tip||Assorted suction catheters
Where should you position your ambulance if you're the first unit on the scene of a collision?
In front of the wreckage to put your unit between traffic and the scene with lights flashing
What are the steps in inspecting an ambulance, engine-off, in quarters?
Inspect the body||Inspect the wheels and tires||Inspect windows and mirrors||Check the operation of every door and latches and locks||Inspect the components of the cooling system||Check fluids||Check battery||Inspect interior||Test the horn||Test the siren||Check seat belts||Adjust driver's seat||Check fuel level
An EMD is responsible to carry out what four tasks?
Interrogate the caller and assign a priority to the call||Provide prearrival instructions to callers and information to crews||Dispatch and coordinate EMS resources||Coordinate with other public safety agencies
When should you walk around the tail rotor area of a helicopter?
Never!
When should you approach a helicopter?
Only when escorted by helicopter crew.
What are some privileges that most states give emergency vehicle operators?
Operator may park the vehicle anywhere as long as it's not hurting people or property||Operator may proceed past stop signals and signs||Operator may exceed the posted speed limit, safely||Operator may pass vehicles in no-passing zones||Operator may break other rules with discretion -- the rules vary from state to state. The operator must ALWAYS be safe about it, though.
What are some typical laws regarding ambulance operators?
Operator must have a valid license||Operator must have completed training program||Operator must drive like any other vehicle when off-duty or not responding to a call
What supplies should be carried in an ambulance in order to address airway maintenance, ventilation, and resuscitation?
Oropharyngeal airways of all sizes||Soft rubber nasopharyngeal airways sizes 14 through 30||Two pocket face masks w/ one-way valves and filters||Three manually operated, self-refilling bag-valve-mask units (infant, child, adult)
Where would you position your ambulance if you're the first to arrive on the scene of a domestic violence call?
Park at a staging area out of sight of the scene
Where would you position your ambulance if you're the first unit arriving at the scene of a railroad car derailment?
Park uphill and upwind if possible, and at least 100' away. Be cautious due to possibility of explosion and presence of hazardous materials
What are the five phases of an ambulance call?
Preparing for the call||Dispatch and responding||Transferring patient to the ambulance||Transporting the patient||Terminating the call
What lights can actually attract drunk or tired drivers?
Revolving red beacons
What are the four steps involved in transferring a patient to the ambulance?
Select the proper patient-carrying device||Package the patient for transfer||Move the patient to the ambulance||Load the patient into the ambulance
What supplies should be carried in an ambulance in order to address childbirth?
Several pairs of sterile surgical gloves||Four umbilical cord clamps or umbilical tape||One pair of sterile surgical scissors||One rubber bulb syringe (3 oz)||(12) 4"x4" gauze pads||(4) pairs of sterile disposable gloves||Five towels||One baby blanket||Infant swaddler||Sanitary napkins||(2) large plastic bags||(2) stockinette infant caps||(2) surgical gowns||(2) surgical caps||(2) surgical masks||(2) pairs of goggles or eye shields
What supplies should be carried in an ambulance in order to address cardiac resuscitation?
Spine board||AED||Mechanical CPR compressor AKA thumper (optional)
What supplies should be carried in an ambulance in order to address wound care and treatment of shock?
Sterile gauze pads (2"x2" and 4"x4")||5"x9" combine dressings||Sterile universal dressings (multitrauma dressings) approx. 10"x36"||Self-adhering roller bandages in 4" and 6" width x 5 yards||Occlusive dressings||Aluminum foil||Sterile burn sheets or a burn kit||Adhesive strip bandages (big and little band-aids)||Hypoallergenic adhesive tape (1" and 3" rolls)||Large safety pins||Bandage scissors||PASG||Aluminum blankets
What components of the landing zone (LZ) should you describe to the air rescue service before they arrive?
Terrain||Major landmarks||Estimated distance to nearest town||Other pertinent information
What other miscellaneous equipment should an ambulance carry?
The most current Emergency Response Guidebook||Binoculars||Clipboard and documentation forms||Ring cutter||Portable radio||Multiple-casualty incident management logs||Triage tags and destination logs||Command vests||Tarps in red, green, black, and yellow||Disposable Tyvek jumpsuits||Flares||Jumper cables||Turnout gear for each member||Floodlight||Sports drink||Center punch||Glas-master or flathead ax||Small sledgehammer and other tools for gaining access||Wheel chocks||Utility rope||Stuffed animal
What are some pitfalls of using the siren?
The siren can stress out patients and worsen their condition||The siren can hamper the driver's abilities to drive safely||The siren can cause hearing loss
What are some factors that affect the likelihood of an ambulance collision?
Time of day||Day of the week||Weather||Road maintenance and construction||Railroads||Bridges and tunnels||Schools and school buses
What are some basic guidelines to follow regarding siren use?
Use the siren sparingly, and only when you must||Never assume that motorists will hear your siren||Always assume that some motorists will ignore your siren||Be prepared for erratic maneuvers on the part of other drivers||Do not engage siren when you're close behind another vehicle||Never use the siren to scare somebody||These same guidelines apply to the horn
What questions will an EMD ask a caller?
What is the exact location of the patient?||What is your call back number?||What's the problem?||How old is the patient?||What's the patient's gender?||Is the patient conscious?||Is the patient breathing? What questions will an EMD ask a caller in the case of a motor vehicle collision? How many and what kinds of vehicles are involved?||How many people do you think are injured?||Do the victims appear trapped?||What is the exact location of the collision?||Is traffic moving?||How many lanes are open?||How far is traffic backed up?||Are any vehicles on fire?||Are any vehicles leaking fuel?||Are any electrical wires down?||Do any vehicles appear unstable?||Are any vehicles on their side or top?||Does a truck appear to be carrying hazardous cargo?
What supplies should be carried in an ambulance in order to address transfer of patients?
Wheeled ambulance stretcher that can be set in Fowler's, supine, or Trendelenburg position.||Reeves stretcher||Stair chair||Scoop/ortho stretcher||Stokes/basket stretcher||Child safety seat
When should you engage all of your ambulance's emergency lights?
When you're in emergency response mode
When should you turn your ambulance's headlights on?
Whenever you're driving
What characteristics must you fulfill in order to be a safe ambulance operator?
You must be physically fit||You must be mentally fit||You must be able to perform under stress||You must have a positive attitude about your ability as a driver||You must be tolerant of other drivers