EMT - Chapter 37 - Transport Operations

Describe the capabilities, protocols, and methods for accessing air ambulances. (pp 1376-1380) Describe key scene safety considerations when preparing for a helicopter medivac, including establishing a landing zone, securing loose objects, reducing onsite hazards, and approaching the aircraft. (pp 1378-1381)

Air Ambulances - fixed wing airplane: inter hospital > 100 miles - rotary wing helicopter: more efficient > short distance Calling Medivac - why: ↓ xfer time, multi pt, certain interventions etc - who: time dependent pt. Landing Zone - dangerous, one person controls while NOT tx pt. - hard or grassy surface, 100x100' - level ground, clear of debris - watch lines, antennas, trees, etc - mark off, or vehicles with lights forming X - never use: caution tape, flares Transfer to Helicopter - "hot" = blades spinning - approach from front, only w/pilot signal (10 to 2 o'clock) - walk crouched, can dip below 4' - don't get in zone unless instructed Night Landing - don't "help" with lights - i.e. only shine at landing site "X" Uneven Ground - approach from downhill limited to 10,000' above sea lvl fly b/n 130-150mph very fat = ng

Discuss the guidelines for safely and defensively driving an ambulance. (pp 1368-1370) Identify key steps EMTs should take to improve safety while en route to the scene, the hospital, and the station. (pp 1368-1376) List the three factors that dictate the use of lights and siren to the scene and to the hospital; include the risk-versus-benefit factors regarding their use. (pp 1370-1371)

Defensive Ambulance Driving Techniques obey the law watch centrifugal force during turns 4 second rule Siren time saved is minimal cost benefit analysis PA System could cause distraction don't count on other folk Safety Cushion watch blind spots, 4 sec rule tailgater = slow down Type 1/3 EMS Trucks = wide Cornering: enter: high lane, to the outside exit: low, to the inside wet + >30mph = hydroplaning wet brakes = light tap tis dry, don't drive through water 4wd do not stop faster than 2wd

Describe the specific, limited privileges that are provided to emergency vehicle operators by most state laws and regulations. (pp 1374-1376) Explain the additional risks and special considerations posed by the use of police escorts, and the hazards and special considerations posed by crossing intersections. (pp 1375-1376)

I am the Law Lights + Siren Allows (check local statutes) - park in illegal location - run red lights or stop signs (still have to stop first) - speed - drive against traffic, one way streets - make illegal pass Not Allowed - pass stopped school bus Siren 1 use during emergency only 2 use siren + lights at same time 3 regard for safety - warn pt. of use, don't speed Right of Way - kinda, know local statutes Police Esport - dangerous, try not to use Highway - turn off lights until in far left lane (could confused folk) School Zone - don't speed, careful with lights

1. List the nine phases of an ambulance call; include examples of key tasks EMTs perform during each phase. (pp 1353- 1368) 2. Name the medical equipment carried on an ambulance; include examples of supplies that are included in each main category of the ambulance equipment checklist. (pp 1354-1360) Name the safety and operations equipment carried on an ambulance; include examples of how each item might be used by EMTs in an emergency. (pp 1360-1361) Discuss the importance of performing regular vehicle inspections; include the specific parts of an ambulance that should be inspected daily. (pp 1361-1362) List the minimum dispatch information required by EMS to respond to an emergency call. (p 1363) Describe some high-risk situations and hazards during both pretransport and transport that may affect the safety of the ambulance and its passengers. (pp 1363-1366, 1368-1376) Discuss the specific considerations required to ensure scene safety; include personal safety, patient safety, and traffic control. (pp 1363-1366) Describe the key elements that must be included in the written patient report upon patient delivery to the hospital. (pp 1366-1367) Summarize the tasks EMTs must complete in the postrun phase. (pp 1367-1368) Define the terms cleaning, disinfection, high-level disinfection, and sterilization. (p 1367)

▪ Preparation for the call basic supplies, airway & ventilation gear (2 of each), suctioning (300mmHg, mounted and portable), splinting, childbirth, AED charged, pt. xfer (stretcher 60* angle, stair chair etc) wound care, 2 o2 units (on board 3,000L, portable 500L), >1 hour run = humidifier, CPR board, jump kit, PPE etc etc etc ambulance has at least 1 EMT preferred: 2 in back + 1 driving (could have non EMT driver, cop or firefighter) never secure o2 to bench check defib battery e'ry day ▪ Dispatch gather: nature of call, name/location/#, location, # of pt + condition, special hazards ▪ En route gather: more info prep for pt, assign EMT duties ▪ Arrival at scene report size up to dispatch park 100' before scene, same side of road, block traffic (100' after scene if fire already there) park uphill, upwind, siren lights on, headlights off traffic: tx pt first, then control ▪ Transfer of the patient to the ambulance use necessary speed secure w/ at least 3 straps across body ▪ Transport, En route to the receiving facility dispatch: # of pt's, name of hostpial, etc inform med control work on written report ▪ Delivery, At the receiving facility report to nurse xfer pt from strecher verbal report signed detailed report, PCR ▪ En route to the station dispatch again get back and clean, restock ▪ Postrun file report, inform dispatch of availability clean, disinfect, sterilize bleach: 1:100 dilution'

review

▪ Today's ambulances are designed according to strict government regulations based on national standards. ▪ The six-pointed Star of Life emblem identifies vehicles that meet federal specifications as licensed or certified ambulances. An ambulance call has nine phases: ▪ Preparation for the call ▪ Dispatch ▪ En route ▪ Arrival at scene ▪ Transfer of the patient to the ambulance ▪ En route to the receiving facility (transport) ▪ At the receiving facility (delivery) ▪ En route to the station ▪ Postrun ▪ Certain items, like sterile gloves, must be available on the ambulance at all times, as dictated by state and jurisdictional requirements. ▪ Every ambulance must be staffed with at least one EMT in the patient compartment whenever a patient is being transported. However, two EMTs are strongly recommended. Some services may operate with a non-EMT driver and a single EMT in the patient compartment. ▪ Check all medical equipment and supplies daily, including all the oxygen supplies, the jump kit, splints, dressings and bandages, backboards and other immobilization equipment, and the emergency obstetric kit. ▪ During the postrun phase, you should complete and file any additional written reports and inform dispatch of your status, location, and availability. Perform a routine inspection to ensure the ambulance is ready to respond to the next call. ▪ Learning how to properly operate your vehicle is just as important as learning how to care for patients when you arrive on the scene. ▪ The first rule of safe driving in an emergency vehicle is that speed does not save lives; good care does. ▪ The second rule is that the operator and all passengers must wear seat belts and shoulder restraints at all times. ▪ Air ambulances are used to evacuate medical and trauma patients. ▪ There are two basic types of air medical units: fixed-wing and rotary-wing, otherwise known as helicopters. ▪ A medical evacuation is commonly known as a medivac and is generally performed exclusively by helicopters.