1. Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 47-1 Chapter 47 Principles of Emergency Response and Transportation

2. 47-2 Objectives

3. Principles of Emergency Response 47-3

4. Preparation Phase Personnel and basic supplies –Minimum staffing requirements –Medical equipment Nonmedical supplies –Personal safety equipment –Preplanned routes / street maps –Communications equipment 47-4

5. Preparation Phase Patient transfer equipment –Wheeled stretcher –Collapsible stretcher –Long backboard or “Stokes” basket –Bariatric stretcher available for use by some EMS agencies 47-5

6. Preparation Phase Daily inspections –Inspection of vehicle systems –Equipment Checked and maintained Restocked and repaired Batteries for defibrillator, suction, oxygen, and other equipment and devices 47-6

7. Vehicle Inspection 47-7 [Insert figure 47-1]

8. Vehicle Inspection 47-8 [Insert figure 47-2]

9. Vehicle Inspection 47-9 [Insert figure 47-3]

10. Vehicle Inspection Patient Area 47-10 [Insert figure 47-4]

11. Vehicle Inspection Operator Area 47-11 [Insert figure 47-5]

12. Dispatch Phase 47-12 [Insert figure 47-6]

13. When to Notify Dispatch Receiving the call Responding to the call Arriving at the scene Leaving the scene for the receiving facility Arriving at the receiving facility Leaving the hospital for the station Arriving at the station 47-13

14. En Route or Response Phase Based on dispatch information, anticipate the knowledge, equipment, and skills you may need to provide appropriate patient care Notify dispatch that you are responding Write down essential information –Nature of the call –Location of the call Determine responsibilities of crewmembers before arriving on the scene 47-14

15. En Route or Response Phase Characteristics of good emergency vehicle operators: –Physically and mentally fit –Able to perform under stress –Positive attitude about their skills –Tolerant of other drivers 47-15

16. En Route or Response Phase Verify location and type of call Select most appropriate route Observe weather and road conditions –Modify response if needed Apply safety restraint devices Notify dispatch agency of your response Understand appropriate use of lights and siren Drive with due regard for the safety of others Maintain a safe following distance Approach the scene from uphill and upwind as needed 47-16

17. Emergency Response Emergency response –Operation of an emergency transport vehicle while responding to a medical emergency Laws pertaining to emergency response vary from state to state 47-17

18. Emergency Response Due regard for the safety of others Speed and speed limits Warning lights and sirens Right of way 47-18

19. Emergency Response General considerations –Parking or standing –Red lights, stop signs, intersections –Speed limit –Directions of flow and specified turns –Emergency or disaster routes –School buses 47-19

20. Contributing Factors to Unsafe Driving Conditions Escorts Road surface Excessive speed Reckless driving Weather conditions Multiple-vehicle response 47-20

21. Contributing Factors to Unsafe Driving Conditions Inadequate dispatch information and unfamiliarity with the location Failing to heed traffic warning signals Disregarding traffic rules and regulations Failing to anticipate the actions of other motorists Failing to obey traffic signals or posted speed limits 47-21

22. Possible Driver Distractions Mobile computer Global positioning systems Using mobile radio Operating visual and audible devices Vehicle stereo Wireless devices Eating/drinking 47-22

23. Emergency Response Escorts and multiple-vehicle responses –Extremely dangerous –Provide a safe following distance –Know agency policy regarding use of lights / siren in these situations 47-23

24. Emergency Response Intersection crashes 47-24 [Insert figure 47-7]

25. Arrival Phase Consider potential dangers –Hazardous materials –Fires –Heavy traffic flow –Large crowds –Violent situation / terrorist act 47-25

26. Arrival Phase Vehicle placement –Four things to consider: 1.Scene safety 2.Traffic volume and flow 3.Egress from the scene 4.Distance from the patient(s) or scene 47-26

27. Vehicle Placement Scene safety –Ensure access to equipment compartments is out of traffic flow –Vehicle positioning for scene protection –Park away from hazards –Do not block emergency personnel or vehicle access 47-27

28. Vehicle Placement Traffic volume and flow –Position the transport vehicle so that it does not block traffic 47-28

29. Vehicle Placement Egress from the scene –Position the vehicle in preparation for an easy and rapid departure –In general, position the transport vehicle pointed in the direction of the appropriate medical facility 47-29

30. Vehicle Placement Distance from the patient(s) or scene –Use common sense and extreme caution 47-30

31. Arrival Phase On-scene care –Notify the EMD of your arrival –Put on appropriate PPE Determine: –Mechanism of injury/nature of illness –Total number of patients –Need for additional help or assistance 47-31

32. Transferring the Patient to the Ambulance Prepare the patient for transport 47-32 [Insert figure 47-8]

33. Transport Phase 47-33 [Insert figure 47-9]

34. Transport Phase 47-34 [Insert figure 47-10]

35. Transfer to Definitive Care Notify dispatch of arrival at the receiving facility Give a verbal report to an appropriate staff person at the receiving facility Obtain a signature on your PCR when transferring patient care Leave a copy of your completed PCR with the hospital staff person 47-35

36. En route to the Station Notify dispatch when you are en route to your station and again when you arrive Prepare for the next call –Clean and disinfect the ambulance as needed –Clean and disinfect ambulance equipment –Restock disposable supplies 47-36

37. Post Run Refuel the unit File reports Notify dispatch Prepare yourself for the next call Inspect the vehicle Replace empty oxygen cylinders Replace discharged batteries or reconnect them to vehicle chargers Replace disposable supplies Change soiled uniforms 47-37

38. Post Run Complete cleaning and disinfection procedures –Low-level disinfection –Intermediate-level disinfection –High-level disinfection –Sterilization 47-38

39. Infection Control Procedures Remove any contaminated clothing Discarded contaminated sharps in an acceptable sharps container Decontaminate the vehicle and large equipment 47-39

40. Questions? 47-40