EMT Chapter 37 Knowledge Objectives

Discuss the guidelines for safely and defensively driving an ambulance.

1. Don't speed 2. Seatbelts/straps 3. Stay in fast lane 4. Siren-benefit analysis: *siren syndrome* causes people to drive faster and not better 5. Driver anticipation 6. Cushion of safety (safe following distance)

List the three factors that dictate the use of lights and siren to the scene and to the hospital; include the risk-versus-benefit analysis regarding their use.

1. Must be on true emergency call 2. Must use audible and visual simultaneously 3. Unit must be operated with due regard for safety Decision: 1. Local protocols 2. Patient condition 3. Anticipated outcome of patient

List the minimum dispatch information required by EMS to respond to an emergency call

1. Nature of call 2. Name, present location, call-back number of caller 3. Location of patient 4. Number of patients/severity 5. Any other pertinent info

Name the safety and operations equipment carried on an ambulance; include examples of how each item might be used by EMTs in an emergency.

1. PPE: face shields/gowns/turnout gear/helmets/etc 2. Equipment for work areas: Flashlights/warning devices/fire extinguishers/flood lights 3. Preplanning/navigation: GPS devices 4. Extrication equipment: Only for simple, light extrication

List the nine phases of an ambulance call; include examples of key tasks EMTs perform during each phase.

1. Preparation phase: making sure you have all equipment 2. Daily inspections: Vehicle maintenance 3. Dispatch: Do nothing? 4. En route: Most dangerous phase. Inform dispatch you're responding and confirm call details. Prepare for the assessment 5. Arrival: Scene size up and report to dispatch. Do some scene safety work, triage? 6. Transfer/transport phase: secure patient with at least 3 straps and drive carefully 7. Delivery phase: Hand off patient with report and signature 8. En route: clean and disinfect, restock 9. Postrun: File any reports

Summarize the tasks EMTs must complete in the postrun phase.

1. Strip linens 2. Discard medical waste 3. Wash contaminated areas w/soap and water 4. Clean stretcher w germicidal/virucidal or bleach/water at 1:100 dilution 5. Disinfect all nondisposable equipment 6. Clean spillage

Describe the capabilities, protocols, and methods for accessing air ambulances.

A medivac is good for cutting down transport time, when you need ALS from far away, or local hospitals are clogged up Medivacs are resereved for people with time-sensitive injuries. Dispatch will do da rest

Define the terms cleaning, disinfection, high-level disinfection, and sterilization.

Cleaning: process of removing dirt, dust, blood or other visible contaminants Disinfection: Process of killing pathogenic agents by applying a chemical made for that purpose to a surface or equipment High-level disinfection: the killing of pathogenic agents by the use of potent means of disinfection Sterilization: a process, such as the use of heat, that removes *all* microbial contamination

Highway protocols

Don't go lights and siren until you're in the far left lane.

Describe some high-risk situations and hazards during both pre-transport and transport that may affect the safety of the ambulance and its passengers

Driving

Fatigue

If you're fatigued, you should be placed out of service for remainder of shift until fatigue has passed

When are fixed-wing ambulances used?

Interhospital transfers for distances over 100-150 miles

Intersection hazards

Intersections are most common crash spots and most serious type of collision for ambulances If you can't wait for light to change, at least come to a brief stop at the light and check for others

School zones

It's illegal to speed in school zones, even if pt is critical

What about excessive speed?

It's unnecessary, dangerous, doesn't increase chance of survival Makes it hard to provide care in the back Hinders reaction time Increases time and distance to stop ambulance

How to approach heli

Only come near when requested Always approach from front *never from tail rotor* Wear eye protection

Describe the specific, limited privileges that are provided to emergency vehicle drivers by most state laws and regulations

You're allowed to park in illegal locations can proceed through red light or stop sign *but not without stopping first* can Drive faster than speed limit Can drive against flow of traffic Make illegal passes *Can't pass schoolbus* or speed in school zones

Describe key scene safety considerations when preparing for a helicopter medivac, including establishing a landing zone, securing loose objects, mitigating onsite hazards, and approaching the aircraft.

hard or grassy surface. 100 ft x 100 ft, but at least 60x60; Make an X with the headlights and mark landing site with cones Clear loose debris and make sure you're clear of overhead obstacles. move nonessential people/vehicles away Communicate wind direction to flight crew Always approach from downhill