Preparation for the Call. Phases of the Ambulance Call. Preparation for the Call 12/21/2008. Ambulance Operations. Check Equipment

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1 CHAPTER 33 Operations Phases of the Call Phases of the Call Preparation for the call Dispatch & Responding Evaluation / Treating Transferring patient to the ambulance Transporting the patient Handing off to the Hospital Restocking / Documention Terminating the call Is it there? Does it work? Will it fail? Mechanical/Fluids Walk-Around Communication Treatment Supplies Safety Other Supplies Mechanical/Fluids Mechanical Inspection Follow your agency s checklist through a careful mechanical inspection. Be as sure as you can about your safety and the public s. (Follow Agency list) Under-hood check Startst Steers Stops Stays running 1

2 Walk-Around Walk-Around Inspection Start the engine. Turn on the lighting equipment. Literally walk around the vehicle, looking and listening. What is your equipment telling you? New body damage Fluid leaks Tire wear Warning equipment Communications Communications s Your radio equipment and your warning equipment are vital to your patients and your safety. They need to work perfectly. Dispatch Mobile Radio Hand-held Medical Control Treatment Supplies Safety (Follow agency or state checklist) Suction Oxygen/Resuscitation Carrying devices Defibrillation BSI gear Binoculars Scene wear Flares 2

3 Other Supplies Carry-in kits Maps Personal gear Ensure Cleanliness Disease Prevention Public Perception Personal Pride Carry-in gear interior exterior Your equipment talks about you all the time. Make sure it refers to you as a professional. Vehicle Out Dispatch & Responding Dispatch & Responding Central Access (9-1-1) Private Dispatch 24-hour availability Trained personnel (EMDs) Information Nature of call Name, location, callback number Location of patient Number of patients and severity Special problems 3

4 Dispatch & Responding Procedures Notify dispatch when responding. Driving the Emergency vehicle operations course recommended Personnel Available for Response At least one EMT B in patient compartment (minimum staffing) Two EMT Bs preferred Course mandated in some areas Continued Driving the Good Operators Mentally/physically fit Emotions under control Able to perform under stress Driving the Wear safety belts. Driver and passengers. Become familiar with vehicle. Tolerate other drivers Continued Continued Driving the Be alert to road and weather conditions. Do not operate under the influence or when fatigued. Driving the Use caution when using emergency lights/siren. Select appropriate route. Maintain safe following distance. Continued Have regard for safety of others. 4

5 Must Use Due Regard for the Safety of Others Failure to stop at controlled intersections is NOT using due regard Educating providers is the first part of any proactive education program ensuring safe ambulance operations. The days of blowing through intersections with lights and sirens blaring have come and gone! Motorists are less likely to yield when sirens are continually sounded. Many motorists feel the right-of-way privileges of ambulances are abused when sirens are used. Inexperienced drivers speed up when they hear sirens. Sirens can worsen sick or injured patients. operators may also develop anxiety from sirens and long-term hearing problems. Use the siren sparingly. Never assume motorists will hear your siren. Assume that some motorists will hear your siren, but choose to ignore it. Be prepared for panic and erratic maneuvers. And never use the siren to scare someone!!! Other drivers may not be able to see you Larger vehicles obstructing view Inattentive drivers Sun glare Blind corners Bad weather 5

6 Other Drivers may not be able to hear you Inattentive drivers Dense shrubbery Buildings Loud radios Air tight cars Windows up with A/C on NYS VEHICLE AND TRAFFIC LAW Section Authorized emergency vehicle. (a) The operator of an authorized emergency vehicle, when involved in an emergency operation, may exercise the privileges set forth in this section, but subject to the conditions herein stated. NYS VEHICLE AND TRAFFIC LAW (Continued) (b) The driver of an authorized emergency vehicle may: Stop, stand or park irrespective of the provisions of this title; Proceed past a steady red signal, a flashing red signal or a stop sign, but only after slowing down as may be necessary for safe operation; Exceed the maximum speed limit as long as he does not endanger life or property; Disregard regulations governing direction of movement or turning in specific directions. NYS VEHICLE AND TRAFFIC LAW (Continued) The exemptions granted by this section shall only apply if the ambulance is sounding an audible signal and it is equipped with at least one red lighted lamp, which, under normal atmospheric conditions, can be seen from any direction at a distance of 500 feet. NYS VEHICLE AND TRAFFIC LAW (Continued) The foregoing provisions shall not relieve the di driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of all persons, nor shall such provisions protect the driver from the consequences of his reckless disregard for the safety of others. Driving Hazards Intersection most common accident type. Use caution with escorts and multiple-vehicle l l responses (motorists don t expect second emergency vehicle). 6

7 Other Procedures Obtain additional info from dispatch. Assign personnel specific duties. Assess equipment needs. Arrival at Scene Arrival at Scene Parking the Park uphill from leaking hazards. Park 100 feet from wreckage. Set parking brake. Parking the Utilize warning lights. Avoid parking where exit will be hampered. Arrival at Scene Arrival at Scene Procedures Notify dispatch. Size up the scene: Safety Body substance isolation Number of patients 7

8 Protecting the Scene Protecting the Scene On Scene Transferring Patient to the Actions Evaluate and Treat Stay organized. Move rapidly & efficiently towards goal of transportation. Procedures Prepare patient for transport. Complete critical interventions. dressings and splints. Select proper moving device & secure patient. Package patient and secure to device. Loading the patient 8

9 Transporting Patient Seat belts for all patients and riders Notify dispatch. Continue ongoing assessment. Notify receiving facility (if needed) Reassure patient. Prepare for any changes. At Receiving Facility Notify dispatch. Off Load the patient Shut off engine or move out of the bay Use caution backing into facility. At Receiving Facility Patient Transfer at Facility Provide verbal and written reports to staff. Ensure transfer of care to hospital personnel. Receive Signature for the patient Terminating the Call Notify dispatch. Prepare for the next call. Restock equipment. Continued Terminating the Call Refuel unit. Complete and file reports. Complete cleaning and disinfection. i i Notify dispatch When available for next call 9

10 Utilizing Air Medical Service Air Medical Operations Medical reasons. Distance from hospital Operational/rescue reasons. Know local protocols. Helicopter Landing Zone Requires 100 x 100 area. Less than 8 slope. Free of wires, trees, people, and loose objects. Never shine light at pilot. Helicopter Landing Zone Helicopter Landing Zone Helicopter Danger Area Main Rotor Approach Area Approach Areas DANGER AREA DANGER AREA Tail Rotor 10

11 Approach to Helicopter Approach to Helicopter on Hillside Main Rotor DANGER AREA: Do not approach. Approach from downhill side. Approach Crouched. Ground Approach to Helicopter Follow directions of crew. Crew will direct patient loading. Stay clear of tail rotor. No smoking, traffic, vehicles within 100 of helicopter. Review Questions 1. What are the phases of an ambulance call? 2. What are the procedures for requesting air medical assistance? STREET SCENES When operating an ambulance using the red lights and siren, what precautions do you need to take? How can speed affect the safety of ambulance operation? STREET SCENES What driving techniques might be used to make driving to this scene safer? 11

12 Sample Documentation 12

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