Chapter 38: Transport Operations

Learning Objectives

• Describe and apply effective preparation for transport.
• Ensure safe emergency vehicle operations and appropriate transport decisions.
• Understand safe patient transfer techniques and responsible patient care during transport.
• Identify the nine phases of a call and the EMT's role in each phase.
• Discuss differences between ground and air transport.
• Understand cleaning and disinfection procedures for emergency vehicles and equipment.

Ambulance Design and Standards

• NFPA 1917 standard for automotive ambulances.
• Designed for maximum safety, efficiency, and comfort.
• Components include:
  • Driver's compartment
  • Patient's compartment (space for two EMTs and at least one supine patient).
  • Equipment and supplies for emergency medical care and safeguarding personnel.
  • Two-way radio for communication.

Types of Ambulances

• Type I, Type II, Type III
• Star of Life identifies vehicles as ambulances.

Phases of an Ambulance Call

1. Preparation
   • Ensure all equipment and supplies are ready and in place.
   • Equipment stored based on urgency and frequency of use.
   • Daily inspections of vehicle and equipment.
2. Dispatch
   • Accessible and in service 24/7.
   • Gather information on the nature of the call and patient details.
3. Enroute to the Scene
   • Most dangerous phase due to risk of crashes.
   • Seat belts and shoulder harnesses mandatory.
4. Arrival at Scene
   • Perform scene size-up, report findings to dispatch.
   • Look for safety hazards, evaluate need for additional units.
5. Transfer of Patient
   • Secure patient for transport using appropriate equipment.
6. Transport
   • Monitor patient, provide updates to dispatch and receiving facility.
7. Arrival at Receiving Facility
   • Transfer patient, complete verbal and written reports.
8. Enroute to Station
   • Notify dispatch, clean and disinfect ambulance if not done at hospital.
9. Post-Run
   • File reports, debrief, conduct routine inspections.

Cleaning and Disinfecting Procedures

• Cleaning: Removing visible contaminants.
• Disinfecting: Killing pathogenic agents with chemicals.
• High-Level Disinfecting: Using potent means of disinfection.
• Sterilization: Removing microbial contamination.

Defensive Ambulance Driving Techniques

• Participate in certified defensive driving programs.
• Safe driving practices include wearing seat belts and maintaining proper speed.
• Siren Risk-Benefit Analysis: Weighing the necessity of using lights and sirens.
• Driver Anticipation: Assume other drivers are unaware of your presence.
• Cushion of Safety: Maintain safe following distances.
• Weather and Road Conditions: Adjust driving based on changing conditions.

Air Medical Operations

• Fixed Wing Units: For distances >200-250 miles.
• Rotary Wing Units: Helicopters for shorter distances.
• MedVac: Performed by helicopters for time-dependent injuries or remote areas.
• Landing Zone Safety: Establish clear zones and follow safety protocols.

Regulations and Safety

• State laws and regulations must be followed even when disregarding normal vehicle operations.
• Right-of-way privileges and use of escorts defined by local protocols.
• Intersection Hazards: Most serious collisions occur here.
• Use of Warning Devices: Governed by emergency call status and local protocols.

Special Considerations

• Night Landings: Manage light exposure to prevent blinding pilots.
• Hazmat Incidents: Coordinate with flight crew for safe patient transfer.

---

Conclusion: This chapter covered essential aspects of transport operations, including vehicle operations, patient transfer, and air medical operations. It emphasized safety, regulations, and the importance of preparedness and defensive driving in emergency medical services.