Overview
This lecture covers the key aspects of transport operations in EMS, focusing on safe ambulance operation, air medical care, equipment decontamination, and patient transfer protocols.
Ambulance Design & Equipment
- Ambulances are built to NFPA safety standards, featuring compartments for drivers, patients, and equipment.
- Three main ambulance types: Type 1 (truck cab), Type 2 (van), Type 3 (van front/modular box).
- Ambulances are stocked with both standard and advanced medical equipment, including devices for transmitting patient data.
- Equipment should be stored by urgency and frequency of use; cabinets should be labeled and/or transparent.
- Daily inspections are mandatory for cleanliness, quantity, and function of supplies.
Phases of an Ambulance Call
- Phases: preparation at station, dispatch, en route, arrival at scene, patient care/transport, hospital delivery, return to station, post-run.
- At least one EMT must be in the patient compartment during transport.
- Always wear seat belts in a moving ambulance; ensure all equipment and oxygen tanks are secured.
Dispatch & En Route Procedures
- Dispatch provides details: nature of call, location, number of patients, and any pertinent info.
- En route, review dispatch info and make a plan with your partner.
- Obey traffic safety laws; drive defensively and anticipate hazards.
Scene Safety & Operations
- On arrival, assess hazards, determine need for additional help, and always use PPE.
- For mass casualty incidents, identify an incident commander and additional resources.
- Ambulances should park 100 feet before/past scene, uphill/upwind for hazmat, and leave warning lights on.
- Traffic should be managed until relieved by police/fire.
Patient Transfer & Hospital Procedures
- Secure patient with seat belts on the cot for transport.
- Notify dispatch of patient count, hospital destination, and starting mileage.
- At hospital, give a verbal handoff, complete documentation, and restock/clean ambulance as needed.
Post-Run & Decontamination
- Remove linens, discard medical waste, and clean/disinfect equipment and ambulance with appropriate solutions.
- Routine checks include tires, fuel, and vehicle fluids.
Safe Ambulance Driving
- Drivers must be rested, alert, and familiar with ambulance handling.
- Speed does not improve outcomes; safe, smooth driving allows for better patient care.
- Always use seat belts; use mirrors to check blind spots and never confront other drivers.
- Never use unnecessary speed or excessive siren/lights; follow state/local laws for right-of-way and emergency driving.
- Use spotters when backing up and slow down in bad weather, intersections, and unpaved roads.
- Distractions (radio, GPS, phone) and fatigue are major accident risks.
Air Medical Operations
- Air ambulances include helicopters and fixed-wing aircraft, staffed by paramedics, nurses, or physicians.
- Use air transport for time-dependent injuries, poor ground access, or special care needs (e.g., burns, trauma).
- Landing zones must be 100x100 feet, clear of debris and hazards, and marked with cones/vehicles (not tape/flares).
- Approach helicopters from the front, only when directed by the pilot; crouch and use eye protection near rotors.
- Decontaminate patients before air transport; avoid approaching from downhill or uneven ground.
Q&A/Exam Review
- Stokes basket is not standard ambulance transfer equipment.
- Jump kits contain all equipment needed for first 5 minutes of patient care.
- Most important dispatch info: exact patient location.
- Most important safety precaution: always wear seat belt.
- Avoid one-way streets when possible; do not always use siren with lights.
- Hydroplaning can start at 30 mph.
- Most serious ambulance crashes occur at intersections.
- Recommended helicopter landing zone: 100x100 feet, clear of hazards.
- Always park ambulance uphill and upwind at hazmat scenes.
Key Terms & Definitions
- NFPA — National Fire Protection Association, sets ambulance design standards.
- Jump Kit — Portable bag with equipment for the first 5 minutes of care.
- Hot Helicopter — Helicopter with spinning rotors on the ground.
- Decontamination — Cleaning process to remove infectious material from equipment/ambulance.
Action Items / Next Steps
- Complete assigned readings on transport operations.
- Review local/state ambulance driving laws and protocols.
- Take the National Traffic Incident Management System (TIMS) online class if required.
- Practice daily ambulance inspections and equipment checks.