Transport Operations - Chapter 38

Medical equipment: jump kit for the preparation phase

"5-minute kit": anything needed in the first 5 minutes with the patient, except for the AED

where to park when you arrive on scene

-100 feet before or past the crash scene -Park uphill/upwind -Leave warning lights or devices on

An appropriate site for a landing zone should be

-A hard or grassy level surface 100 × 100 feet and no less than 60 × 60 feet -Cleared of loose debris -Clear of overhead or tall hazards

Medical equipment: CPR equipment for the preparation phase

-CPR board -Mechanical devices that deliver chest compressions and ventilations

when you return to the station

-Clean and disinfect ambulance and equipment -Restock supplies

postrun phase

-Complete and file any additional reports -inform dispatch of your status, location, and availability -debrief on the call -inspect and refuel vehicle

night landings

-Direct low-intensity headlights or lanterns toward the ground at the landing site. -Illuminate overhead hazards or obstructions if possible

En route to the station

-Inform dispatch whether you are in service and where you are going

The decision to activate the emergency lights and siren will depend on

-Local protocols -Patient condition -Anticipated clinical outcome of the patient

The preparation phase

-Make sure equipment and supplies are in their proper places and ready for use -Store equipment and supplies according to how urgently and how often they are used -Cabinets and drawer fronts should be transparent or labeled

Safety precautions during the preparation phase

-Make sure safety devices (eg, seat belts) are in proper working order. -Oxygen tanks must be secured by fixed clasps or housings. -Make sure all equipment in the cab, rear, and compartments is secured appropriately.

When you are ready to leave with the patient, inform dispatch of:

-Number of patients -Name of receiving hospital -Beginning mileage of the ambulance (in some jurisdictions)

Medical equipment: Airway and ventilation equipment for the preparation phase

-Oropharyngeal airways -Nasopharyngeal airways -CPAP equipment--Equipment for advanced airway procedures -Two portable artificial ventilation devices that operate independently of an oxygen supply -Bag-mask devices capable of oxygen enrichment -Nebulizer masks -Portable and mounted suctioning unit -At least two oxygen supply units: one portable and one installed on board.

If you are on an emergency call and are using your warning lights and siren, you may be allowed to do the following

-Park or stand in an illegal location -Proceed through a red light or stop sign -Drive faster than the speed limit -Drive against the flow of traffic -Travel left of center to make an illegal pass

Who receives a medevac?

-Patients with time-dependent injuries or illnesses -Patients suspected of having a stroke, heart attack, or serious spinal cord injury -Patients who are found in remote areas and have experienced SCUBA diving accidents, near-drownings, or skiing and wilderness accidents -Trauma patients -Candidates for limb replantation, a burn center, a hyperbaric chamber, or a venomous bite center

Medical equipment: Basic supplies for the preparation phase

-Personal protective equipment (PPE) and sharps containers -Airway and ventilation equipment -Basic wound care and bleeding control supplies -Splinting supplies -Childbirth supplies vi. Automated external defibrillator -Patient transfer equipment -Medications -Communication equipment -Other regionally appropriate supplies

Safety and operations equipment for the preparation phase

-Personal safety equipment -Equipment for work areas -Preplanning/navigation guides -Extrication equipment

Medical equipment: patient transfer equipment for the preparation phase

-Primary wheeled ambulance stretcher -Wheeled stair chair -Long backboard -Short backboard or short immobilization device

Three blind spots around the ambulance

-Rearview mirror creates a blind spot in front of driver. -Rear of vehicle cannot be seen fully through the mirror. -Side of the vehicle

After each call, perform the following regimen:

-Strip used linens from the stretcher and place them in a plastic bag or designated receptacle. -Discard medical waste -Wash contaminated areas with soap and water -Disinfect all nondisposable equipment used for patient care -Clean the stretcher with an EPA-registered germicidal/virucidal solution or bleach and water at 1:100 dilution.

landing on uneven ground

-The main rotor blade will be closer to the ground on the uphill side. -Approach the aircraft from the downhill side only or as directed by the flight crew

during the dispatch phase the dispatcher should gather and record

-The nature of the call -The caller's name, present location, and call-back number -The exact location of the patient(s) (most important) -The number of patients and the severity of their conditions -Any other special problems or pertinent information about hazards or weather conditions.

transfer pahse

-The patient must be packaged for transport -Properly lift the patient into the patient compartment. -Secure the patient with all manufacturer-approved straps.

Use of warning lights and siren is governed by three basic principles

-The unit must be on a true emergency call to the best of your knowledge. -Audible and visual warning devices must be used simultaneously. -The unit must be operated with due regard for the safety of all others.

Daily inspections during the preparation phase

-ambulance inspection -Inspect the cleanliness, quantity, and function of medical equipment and supplies.

Medical equipment for the preparation phase

-basic supplies -airway and ventilation equipment -CPR equipment -Basic wound care supplies -Splinting supplies -Childbirth supplies -Automated external defibrillator (AED) -Patient transfer equipment -medications -jump kit

transport phase

-inform dispatch -monitor patients condition -contact the receiving hospital -Do not abandon the patient emotionally.

delivery phase

-inform dispatch you arrived at hospital -give report to hospital staff -transfer patient to hospital bed -complete patient report -restock items

Arrival at the scene

-perform a scene size-up and give a brief report of your findings to dispatch -park a safe distance away -control traffic if needed

who do you call for medevac

-the dispatcher should be notified first. -In some regions, EMS may be able to communicate with the flight crew after initiating the medevac request.

En route to the scene

-the most dangerous phase for EMTs -Review dispatch information. -Prepare to assess and care for the patient.

Why call for a medevac?

-transport time by ground is too long -Road, traffic, or environmental conditions prohibit the use of a ground ambulance. -The patient requires advanced care -There are multiple patients who will overwhelm resources at the hospital reachable by ground transport.

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

1. Preparation 2. Dispatch 3. En route 4. Arrival at scene 5. Transfer of patient to ambulance 6. En route to receiving facility (transport) 7. At receiving facility (delivery) 8. En route to station 9. Postrun

Most helicopter services are limited to flying at

10,000 feet above sea level

Medevac helicopters fly between

130 and 150 mph

Fixed-wing units are used for interhospital patient transfers over distances greater than

200 to 250 miles

the most common and usually the most serious type of collision in which ambulances are involved

Intersection crashes

School zones

It is unlawful for an emergency vehicle to exceed the speed limit in school zones

Medevacs at hazmat incidents

The landing zone should be uphill and upwind from the hazmat scene

sterilization

a process, such as the use of heat, that removes all microbial contamination

To keep the ambulance in the proper lane when turning

enter high in the lane, and exit low

The safest and most effective way to land and take off is similar to that used by

fixed-wing aircraft

An emergency vehicle is never allowed to pass a

school bus that has stopped to load or unload children

Rotary-wing units (helicopters) are efficient for

shorter distances

Always approach the helicopter from

the front between 10 o'clock and 2 o'clock positions

disinfection

the killing of pathogenic agents by directly 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

cleaning

the process of removing dirt, dust, blood, or other visible contaminants from a surface or equipment

Mark the landing site using

weighted cones or emergency vehicles positioned at the corners of the landing zone with headlights facing inward to form an X

Use police escorts as a guide only when

you are in unfamiliar territory

on a highway shut down emergency lights and siren until

you have reached the far-left lane