Chapter 38: Transport Operations

Objectives

• Describe and apply effective preparation for transport.
• Safe emergency vehicle operations and appropriate transport decisions.
• Safe patient transfer techniques.
• Responsible approach to patient care during transport.
• Identify nine phases of a call and EMT's role in each phase.
• Discuss differences between ground and air transport.
• Understand steps necessary to clean and disinfect emergency vehicle and equipment.

Modern Ambulance Features

• Stocked with standard medical supplies; may have state-of-the-art technology.
• Designed based on NFPA 1917 with input from the ambulance industry and EMS personnel.
• Components include:
  • Driver's compartment.
  • Patient's compartment for two EMTs and one supine patient.
  • Equipment for emergency medical care and safety.
  • Two-way radio for communication.

Phases of an Ambulance Call

1. Preparation

   • Ensure equipment and supplies are ready and durable.
   • Store equipment based on urgency and usage.
   • Daily inspections of ambulance and equipment.

2. Dispatch

   • Must be accessible 24/7.
   • Gather critical information about the call.

3. En Route to Scene

   • Fasten seat belts and shoulder harnesses.
   • Review dispatcher information.

4. Arrival at Scene

   • Perform scene size-up.
   • Evaluate need for additional units.
   • Park safely and control traffic.

5. Transfer of Patient

   • Secure the patient properly.
   • Use appropriate safety straps.

6. En Route to Receiving Facility (Transport)

   • Monitor the patient continuously.
   • Contact receiving facility.

7. Arrival at Receiving Facility

   • Inform dispatch.
   • Transfer patient and complete reports.

8. En Route to Station

   • Clean and disinfect ambulance.
   • Restock supplies.

9. Post-Run

   • Complete reports.
   • Conduct routine inspections and refuel.

Cleaning and Disinfecting

• Cleaning: Remove visible contaminants.
• Disinfecting: Kill pathogens using chemicals.
• Sterilization: Use heat to remove microbial contamination.

Defensive Ambulance Driving

• Attend certified defensive driving programs.
• Maintain physical fitness and emotional stability.
• Wear seat belts at all times.
• Avoid excessive speed and be mindful of siren effects.
• Understand laws, regulations, and right-of-way.

Air Medical Operations

• Types of Air Ambulances:
  • Fixed-wing for long-distance transfers.
  • Rotary-wing (helicopters) for shorter distances.
• MedVac
  • Used for critical patients or inaccessible locations.
  • Establish a safe landing zone (100x100 feet recommended).

Special Considerations for Helicopters

• Always approach from the front.
• Night landings require careful use of lights.
• Be aware of uneven ground risks with rotor blades.

Review Questions

• Knowledge of standard patient transfer equipment.
• Importance of obtaining location information first.
• Safety precautions like seat belt usage.
• Guidelines for safe ambulance driving.
• Hydroplaning occurs at speeds > 30 mph.
• Intersection is a critical point for accidents.
• Helicopter landing zone dimensions and safety protocols.

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Conclusion: Understanding transport operations is crucial for ensuring effective emergency care and safe patient transport. Continuous training and adherence to safety protocols are key to minimizing risks and improving outcomes.