Ch.38 Transport Operations Flashcards
(17 cards)
An___ is a vehicle that is used for treating and transporting patients who need emergency medical care. The first use of motor-powered___ occurred in the late 1800s. For many decades after that, a hearse was the vehicle typically used as an ambulance. While a hearse had enough room for someone to lie down, it left little room for supplies or medical attendants.
ambulance
Currently, ambulance designs are based on__, and, in large part, on suggestions from the ambulance industry and from EMS personnel (FIGURE 38-2).
NFPA 1917, Standard for Automotive Ambulances
One of the most significant developments in ambulance design has been the emphasis on creating the safest environment possible in the driver’s compartment and the patient compartment. Another development is the use of____ (FIGURE 38-3), which respond initially to the scene with personnel and equipment to treat the sick and injured
first-responder vehicles
Specialized vehicles used to transport EMS equipment and personnel to the scenes of medical emergencies
first-responder vehicles
Conventional, truck cab-chassis with a modular ambulance body that can be transferred to a newer chassis as needed
Type I
Standard van, forward-control integral cab-body ambulance
Type II
Specialty van cab with a modular ambulance body that is mounted on a cut-away van chassis
Type III
The six-pointed ___emblem (FIGURE 38-5) identifies vehicles as ambulances. It is often affixed to the sides, rear, and roof of the ambulance. Local or state regulatory authorities determine what emblems may be displayed on the side of a prehospital care ambulance. FIGURE 38-6 illustrates some of the required features of a licensed or certified ambulance.
Star of Life
An ambulance call has nine phases:____, as shown in TABLE 38-2.
These nine phases address the vehicle and its crew and their roles when responding to a medical emergency. The details of patient care are not included in these nine phases.
preparation, dispatch, en route, arrival at scene, transfer of patient to ambulance, en route to receiving facility (transport), at receiving facility (delivery), en route to station, and postrun
During the____, you will check to make sure all of your equipment is functional and the appropriate supplies are in their proper place on the vehicle. Getting into the habit of performing a thorough vehicle checkoff will ensure you have the necessary supplies to respond to any call and will familiarize you with where items are kept so that you may quickly provide appropriate care without having to search for equipment. New equipment should be placed on an ambulance only after proper instruction is given on its use and care, and, additionally, after approval by the medical director.
preparation phase
The___ includes EMT administration of beta agonists and anticholinergic agents for patients who are wheezing. This administration requires use of a nebulizer mask. The use of CPAP is also included and can be administered using a variety of devices.
National EMS Scope of Practice Model 2019
A____ provides a firm surface under the patient’s torso so you can give effective chest compressions (FIGURE 38-11A).
It also assists in establishing an appropriate degree of head tilt (FIGURE 38-11B). Only a few ambulances across the country carry this item. Use a tightly rolled sheet or towel to raise the patient’s shoulders 3 to 4 inches (8 to 10 cm); this will also keep the patient’s head in a position of maximum backward tilt and keep the shoulders and chest in a straight position. Caution:
Do not use this roll to hyperextend the neck if you suspect a spinal injury.
CPR board
Dispatch must be easy to access and in service 24 hours a day (FIGURE 38-19). It may be operated by the local EMS or by a shared service that also covers law enforcement and the fire department. The dispatch center might serve only one jurisdiction, such as a single city or town, or it might be an area or regional center serving several communities or an entire county. In either case, it should be staffed by trained personnel who are familiar with the agencies they are dispatching and the geography of the service area.
The dispatch phase
In many ways, the___ phase of the call is the most dangerous for responders. Crashes between motor vehicles and emergency vehicles cause many serious injuries among EMS personnel. As you and your partner prepare to respond to the scene, make sure you fasten your seat belts and shoulder harnesses before you move the ambulance.
En route to the scene phase
On arrival at the incident, you will perform a scene size-up. This scene size-up begins from inside the ambulance. You begin by evaluating the safety and stability of the scene. Do you see any hazards, or is the scene safe? Is this a medical call with only one patient, who is sitting in clear view on the front porch? Is this a traffic accident with people entrapped in a vehicle?
Is there a fight erupting on scene? As you gather more information, provide a brief report to your dispatch center with an update of the incident to which you have responded. This update will help to ensure that the appropriate resources are responding to the incident or possibly cancel additional resources that are not needed.
Arrival at the scene phase
The first emergency vehicle should create a barrier between the scene and traffic traveling in the same direction as the lane of traffic you are occupying. If arriving after other emergency vehicles, the ambulance should be positioned about ___beyond the scene, thereby preventing your vehicle from being blocked in when transporting a patient. If the street has not been completely closed and there is a driveway or parking lot adjacent to the scene, consider parking the ambulance there.
100 ft (30 m)
If you are the first vehicle to arrive on scene, you should park about 100 ft (30 m) before the scene on the same side of the road in the___ (FIGURE 38-22). In the fend-off position, the ambulance is parked at a diagonal angle with the front wheels turned away from the scene. This position helps to block the scene and create a safety barrier within which you can operate. If a vehicle strikes the rear of an ambulance parked in the fend-off position, it is more likely to be deflected outward than directly into the area of the crash, where emergency personnel are working. Distracted drivers or poor weather conditions may create dangerous scenarios in which a vehicle may inadvertently drive into the scene at full speed. Assume someone may collide with your vehicle and strike personnel on the scene. Having a large emergency vehicle as a safety barrier may provide you with a cushion of space that could save your life.
fend-off position
