AMBULANCE OPERATION

Learning Objectives

distinguish EMS to EMT;

identify the things that needs to be checked by an ambulance crew
before travel;
identify the phases of an ambulance call;
employ the inspection and safety precautions during ambulance
operations;
apply the traffic rules and regulations to include the sign, signals and
markings as a vital means of communication

2
EMS

This is a system consists of a

team of health care
professionals, who, in each
area of jurisdiction, are
responsible for and provide
emergency care and
transportation to the sick and
injured.

3
EMT

Is a member of the EMS team

who respond to emergency
calls, provides efficient
emergency care to ill or injured
patients and transports to a
medical facility.

4
 AMBULANCE

Is a vehicle for transportation

of sick or injured people to,
from or between places of
treatment for an illness or
injury, and in some instances
will also provide out of
hospital medical care to the
patient.

5
 HISTORY

The first use of an ambulance to transport only

was on year 1487

While the first use of ambulance / attendant to

care for injuries on site was on year 1800

6
AMBULANCE

7
8
 BFP Technical Specification

References:
a. NFPA 1917: Standard for Automotive Ambulance
b. European Norm (1789): Medical vehicles and their equipment -
Road Ambulance
c. DOH, Health Facilities and Services Regulatory Bureau ANNEX C
AO 2018-0001

9
Ambulance should be composed of standard
provisions
a) Engine
b) Cab
c) Chassis
d) Accesorries

10
 ENGINE

• Diesel Fed/Four Cylinder

• Turbo intercooler type
• Engine displacement : not more 3,000cc
• Power Output: at least 150PS
• water cooled
• Euro IV-Compliant
• Transmission: at least Speed Manual
11
 CHASSIS

Dimension:
a) Length: not more than 5,500mm
b) Width: not more than 2,000mm
c) Height: not more than 2,500mm
d) Weight: 2,600kgs

Under Chassis
a) Left Hand Drive
b) Power steering 12
Licensing and Registration

Ambulance licensing or
certification standards are
established by the Department
of Health
DOH Administrative Order 2018-0001
Revised Rules and Regulations
Governing Licensure of Land
Ambulances and Ambulance Service
Providers

13
 The Star of Life® emblem
is affixed to the sides,
rear, and roof of the
ambulance

14
Star of Life

15
Government Owned
Categorization of Ambulance
– Type I
– Type II

16
Type I Type II
BLS ACLS

17
 Personnel

Type I Type II
Health related 4 year RN
course With:
BLS SFA
Standard First Aid (SFA) BLS
EMT
ACLS

18
 “
Why BFP need to study Ambulance Operation?

19
“

20
 “
Responsibilities:
Team Leaders - assumes the command
responsibility in the overall decorum of the team.
Ambulance Drivers - responsible in keeping the
ambulances operationally ready during the tour of
duty.
Ambulance Crew - maintains the AOR and
ambulance equipment clean and in order.
21
 9 Phases of an Ambulance Call
1. Preparation for the call
2. Dispatch
3. En route
4. Arrival at the scene
5. Patient Transfer
6. En route to the receiving facility (Transport)
7. At the receiving facility (delivery)
8. En route to the station
9. Post run 22
1. Preparation for the call

Check equipment and supplies

Personal safety equipment
Equipment for work areas
Pre planning and navigation
Extrication equipment
Daily inspections

23
Medical equipment

Airway and ventilation devices

Suction unit
Oxygen delivery
CPR equipment AED
Basic wound care Patient transfer equipment
Splinting supplies Medications
Childbirth supplies Jump kit
 Personal Safety Equipment

Face shields
Gowns, shoe covers, caps
Turnout gear
Helmets with face shields or safety
goggles
Safety shoes or boots

25
 Equipment for work areas

Warning devices that flash intermittently or have

reflectors
2 high intensity halogen flashlights
Fire extinguisher
Hard hats or helmets with face shields
Portable flood lights

26
 Other Preparations

Pre planning and navigation

Carry detailed maps and directions
Be familiar with the local area
Extrication equipment
Equipment needed for simple, light extrication

27
 Personnel

Every ambulance must be

staffed with at least one EMT
in the patient compartment
during patient transport
Two EMTs are strongly
recommended
Some services may operate
with a non EMT driver
28
 Inspections and Safety Precautions

Being fully prepared means inspecting

the ambulance and equipment daily
Check medical equipment and supplies
at least daily
Review standard traffic safety rules and
regulations
Make sure seat belts work and that
oxygen tanks are secured
29
 Dispatch Phase

The dispatcher should gather these

minimum information:
Nature of call
Name of person, location,
and call back number
Location of the patient(s)
Number of patients and idea
of the severity of their conditions
30
 En Route to the Scene

Fasten seat belt

Confirm response and location
Prepare for arrival
Decide what equipment to take
initially
Special problems or other
pertinent information
31
 Arrival at Scene

Scene safety
Safe parking
Traffic control
Park away from hazards and out of flow of traffic
Do not block other responding EMS vehicles
Place appropriate warning devices on both sides of
the accident
32
33
 Transfer Phase

Provide life saving treatment

Package patient for transport
Be sure to secure the patient with
at least three straps across the
body

34
 Transport Phase

Inform dispatch when you are

ready to leave the scene.
Report the number of patients and
the name of receiving hospital.
Conduct ongoing assessments.
Contact medical control.
Report number of patients
Nature of problems
35
 Delivery Phase

Report arrival to dispatch.

Give report to staff.
Physically transfer the patient.
Complete written report.
Leave a copy with an appropriate staff member.

36
 En Route to the Station

Inform dispatch whether or not you are in service

and where you are going.
Clean and disinfect the ambulance and any
equipment used.
Restock supplies.
Cleaning
Disinfection
High – level disinfection
37
Sterilization
Cleaning. The process of removing dirt, dust, blood, or
other visible contaminants from a surface or equipment
Disinfection. The killing of pathogenic agents by directly
applying a chemical made for that purpose to a surface or
equipment
High-level disinfection. The killing of pathogenic agents
by using potent means of disinfection and use of thorough
application processes
Sterilization. A process, such as the use of heat, which
removes all microbial contamination
38
 Post-run Phase

Complete and file any additional

written reports.
Inform dispatch of your status,
location, and availability.
Clean and restock the ambulance.

39
 DEFENSIVE DRIVING
Defensive driving means assessing the risk when you drive and
doing all you can to reduce or control it.
5 Ways of Defensive Driving
Keep your car in top condition.
Anticipate the actions of others: search for clues
Take steps to protect yourself and others: seatbelts and
headlights on
Drive only when in sound physical and mental condition.
Make a conscious effort to develop your skill
40
 SIPDE PROCESS

SEARCH – gather as much information as possible

about what is happening near the roadway.
IDENTIFY – things that could interfere with your
planned path of travel
PREDICT – about what might happen and prepare for it
DECIDE – weigh the possibilities
EXECUTE – a kind of emergency action
41
 TRAFFIC LAWS, RULES AND REGULATIONS

“Keep your eyes moving and make sure others see

you”
Importance:
Provide rules for behavior of drivers
Help drivers predict what others on the road will do
Promote the orderly flow of traffic and help prevent
collisions

42
 SIGNS, SIGNALS AND MARKINGS

WARNING SIGNS – alert you in the condition or use of the

road ahead.
REGULATORY SIGNS – regulates the flow or control the
movement of traffic.
INFORMATION SIGNS – provide information about where
you’re going, how far, etc...
SIGNALS SIGNS – keep traffic moving in an orderly manner
and to indicate right of way.
43
 RULES OF THE ROAD

The right of way

Speed limit law
Don’t drink and drive
Always wear seatbelts
Always signal your intentions
Know and follow safe following and stopping
distances

44
 Driver Characteristics

Physical fitness
Effects of medication
Fatigue
Emotional fitness
Maturity and stability
Proper attitude
Your actions will be scrutinized.
45
 Safe Driving Practices

Speed does not save lives; good

care does.
Seat belts must be worn.
Learn how your vehicle accelerates,
corners, sways, and stops.

46
 Cushion of Safety

Keep safe following distance.

Watch for tailgaters.
Be aware of blind spots.
Use a spotter when backing up.

47
 Excessive Speed

Speeding is unnecessary
if patient is properly
assessed and stabilized.
Decreases reaction time
Increases stopping time
and distance

48
 Vehicle Size and Cornering

Vehicle length and width are critical factors in

maneuvering.
Vehicle size and weight greatly influence braking and
stopping distances.
Always be aware of your position on the roadway.
Take corners at the speed that will put you in the
proper road position as you exit the curve.
49
 Weather and Road Conditions

Be alert to changing conditions.

Decrease speed and increase distance in poor
conditions.
Hydroplaning
Water on roadway
Decreased visibility
Ice and slippery surfaces

50
 Laws and Regulations

Vary from state to state

EMS drivers have certain limited privileges.
These privileges do not lessen driver’s liability

51
 Warning Lights and Sirens

Must be responding to an emergency

Use both audible and visual devices.
Operate with due regard.

52
 Right-of-Way Privileges

You must not endanger people or property under

any circumstances.
Know your local right-of-way privileges.
Exercise them only when necessary for the patient’s
well-being.

53
 Escorts and Intersection Hazards

Use of escorts
A dangerous practice
Follow escorts at a safe distance.
Intersection hazards
Most common place for collisions
Even on urgent calls, come to a momentary
stop at the light.
54
 Air Ambulances

Fixed wing - Inter-hospital transfers

Rotary-wing - Used for shorter distances

55
 AMBULANCE OPERATION

AIR
MEDICAL
OPERATIONS
 AMBULANCE OPERATION

AIRGURUS
(MEDEVAC)
PHILIPPINE AIRFORCE
AMBULANCE
 AMBULANCE OPERATION

PHILIPPINE
AIRFORCE
AMBULANCE
 AMBULANCE OPERATION

Reasons for Utilizing Air Medical Services

1. Medical

2. Operation

3. Rescue
 Medivac Operations

Be familiar with local capabilities.

Calling for a medivac
Ground transport would take too long.
Spinal cord injuries, amputations, burns, diving
emergencies, venomous bites
Notify your dispatcher first.

61
 Establishing a Landing Zone

Area should be hard or grassy level surface that

measures 100’ x 100’ (recommended)
Clear area of loose debris and survey for overhead or
tall hazards.
Mark landing site with weighted cones or headlights.

62
 AMBULANCE OPERATION

HELICOPTER LANDING ZONE

 Safety Precautions

Do nothing near the helicopter and only go to where

the crew or pilot directs you
Keep a safe distance away from the aircraft.
Stay away from the tail rotor.
Never approach the helicopter from the rear.

64
 AMBULANCE OPERATION

Main Rotor
HELICOPTER Approach
Approach Areas
DANGER Area

AREA

DANGER DANGER
AREA AREA

Tail Rotor
66
 AMBULANCE OPERATION

APPROACHING
HELICOPTER
ON
GROUND
 AMBULANCE OPERATION

APPROACHING Main Rotor

DANGER
HELICOPTER AREA:
Do not
ON approach.
Approach from
downhill side.
HILL SIDE
 AMBULANCE OPERATION
REMEMBER!!!
Follow directions of crew.
Crew will direct patient loading.
Stay clear of tail rotor.
No smoking, traffic, vehicles within 100’ of helicopter
70
 Special Considerations

Night time operations

Considerably more dangerous than daytime
operations
Landing on uneven ground
Main rotor blade will be closer to the ground on
uphill side.
Hazardous materials incidents
Land zone should be upwind and uphill.
71
 AMBULANCE OPERATION

DOH
PHILIPPINE
1ST SEA
AMBULANCE
 AMBULANCE OPERATION

DOH
PHILIPPINE
2ND SEA
AMBULANCE
 AMBULANCE OPERATION

LGU
SEA
AMBULANCE
Thank you!
Any questions?

75