AMBULANCE

OPERATIONS
Learning Objectives:

• Overview of SIEHS ambulance operations with different phases

• Learning of ambulance operations from pre run phase to post run phase
• Learning of what should be done in every phase of ambulance operation
• Learn where each item is, what it is for, and when it should be used
SIEHS Ambulance
Operations
SIEHS Ambulance Operations

• Pre-run Phase
• Dispatch Phase
• En-route to the Scene
• At the Scene
• En-route to the Receiving Facility
• At the Receiving Facility
• En-route to Key Point/Station
• Post-run Phase
 1 - Pre-run Phase :

When the crew reports for work and is assigned to an ambulance, this phase begins.
The primary tasks in this stage include.
Providing the ambulance with all of the required supplies, washing and disinfecting the
vehicle, and thoroughly inspecting the equipment make sure the ambulance is
prepared to handle any situation.
Ambulance Supplies and Equipment :

. Find out where each thing is, what it's for, and how and when to use it.
Ensuring Ambulance Readiness for Service :

. Ensure that the vehicle and equipment are prepared for usage at the start of each
shift.
Inspection of Patient Compartment Supplies and Equipment :

Verify the operation, condition, and completeness of every item.

Verify the medical supplies, interior, and outdoor equipment.
Check the oxygen cylinders' pressure.
Check the functioning of the oxygen and ventilation equipment.
Use battery-operated equipment to test the batteries' state of charge.
Make a thorough inspection and inventory of the tools and materials using your
checklist.
AEDs are one piece of equipment that can need additional testing.
Make sure that every item transported by the ambulance is inspected piece by piece,
with the results being noted on the inspection report.
 Inspection of Patient Compartment Supplies and Equipment :

Finish writing the inspection report.

Any shortcomings must be fixed. Complete any missing parts.
Inform your supervisor of any shortcomings that cannot be fixed right away.
Finally, sanitize the space to prevent infection and improve attractiveness.
Utilize only vetted cleaning and disinfection supplies.
2 - Dispatch Phase :

The Command and Control(C&C) Dispatcher informs the ambulance crew about the
assigned call during this phase.
The crew will often get a code from the dispatcher along with the first assessment of
the patient.
This detailed code might include details about the nature, seriousness, and present
condition of the patient/victim.
2 - Dispatch Phase

The minimum information for the crew to proceed should include:

The time of call.
Number of patients.
Name of the caller/attendant or patient.
Location of the caller/attendant or patient.
Command and Control Centre
 Role of the Emergency Medical Dispatcher

Query the caller and give the call priority.

Give callers pre-arrival medical advice and information to crews.
Coordinate and dispatch EMS resources.
Coordinate with other public safety organizations.

Questions :

•Where exactly is the patient located?

•What number can I reach you at?
•What is the issue?
•What is the patient's age?
•What gender is the patient?
•Is the patient awake?
•Does the patient have a pulse?
3 - En Route to the Scene

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3 - En Route to the Scene

This stage offers instructions on how to get to the scene (incident site) safely without
endangering the personnel or the flow of traffic.
To get the crew ready to efficiently handle the given call.
A “ hot “ response means using lights and siren. Hot response involve high risk.
A “ cold “ response means no lights and no siren. Cold response decrease risk.
Crew members should check that seat belts are tightened and all doors are locked
before departure.
Verify dispatch information, including victim count, emergency type, and
patient/incident location.
In the emergency first aid bag, collect the necessary supplies that will be needed at the
scene of the accident.
Establish each crew member's duties and make sure they are understood.
Listen for status updates.
4 – At the Scene

This phase includes evaluating the patient, lifting or transporting the patient into the
ambulance, and stabilizing the patient.
Inform the Command and Control room that the ambulance has arrived at the scene of
the event or other significant location and that the crew has located the patient or
attendant.
When responding to a roadside collision, crews should do a thorough 360-degree
scene inspection and determine whether the location is safe before exiting the
ambulance.
When approaching a scene or a patient, the team must don personal protection
equipment.
4 – At the Scene

Using the required manual handling skills and the necessary tools (collapsible
stretchers, folding stretcher spine boards, etc.), the patient should be stabilized before
being transferred from the roadside, hospital, or home, whether it is a single or multi-
story building.
Before being transferred from the roadside, hospital, or home, whether it is a single or
multi-story building, the patient should be stabilized.
Using the requisite manual handling abilities and the necessary tools (collapsible
stretchers, folding stretcher spine boards, etc.).
At the Scene

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Transferring the Patient to the Ambulance

1. Choose the best patient-carrying equipment.

2. .Patient packaging for transport.
3. Transport patient to ambulance.
4. Patient loaded into ambulance.

= Packaging the patient :

•preparing the patient for transfer and merging the patient and the patient-carrying
device as unit ready for transfer
•Patient who is ill or injured must be wrapped carefully to prevent aggravation of
condition.
Before putting the patient on a carrying device.
All required medical attention for wounds and other issues.
Make impaled items more stable.
Verify splints and dressings.
Protect the patient, then fasten the patient-carrying device.
Transferring the Patient to the Ambulance

Protecting the patient

• Must be secured to patient-carrying device
• Minimum of three straps to secure
• Chest level
• Waist level
• Lower extremities
• Use shoulder harness if available.
Transferring the Patient to the Ambulance

•Protecting the EMT :

•Higher risk for EMT in patient compartment.
•Ensure that all equipment is locked down.
•Keep your seat.
•If at all possible, use a harness and seatbelt.
• Avoid unnecessary movement during response and transport.
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5 - En Route to the Facility

Stabilizing the patient, monitoring and providing care during transport are all part of
this phase.

Successful transfer depends on the steps taken during this phase as many of the
interventions maybe provided during the transport
5 - En Route to the Facility

Make sure all of the equipment brought to the location has been removed before
departing.
The ambulance should only be able to carry a maximum of two attendants. They need
to sit in the back cabin.
5 - En Route to the Facility

The crew should note any on route interventions and vital signs.
Before providing any treatment during transport, caution should be exercised.
To deliver any intravenous or intramuscular medication or to maintain an intravenous
line, the ambulance should briefly halt.
 5 - En Route to the Facility

Before the ambulance moves in the event of a hospital to hospital transfer, the crew
should ensure that all infusion pumps, their infusion lines, NG tubes, chest tubes, or
catheters are fixed correctly.
Preparing the Patient for Transport

Continue the assessment.

Place the stretcher securely in the ambulance.
Patient positioning and safety.
Adjust the safety straps.
Be ready for heart and respiratory issues.
Taking off restrictive clothes.
People who must accompany the sufferer should be loaded.
Pack personal belongings.
Discuss with your patient.
Don't allow patients to sit on a bench or an airway seat.
Caring for the Patient en Route

Let the hospital know.

As necessary, keep giving emergency treatment.
During transportation, exercise caution.
Assemble more data about the patient.
Maintain assessment and keep an eye on vital signs.
Make the receiving facility aware.
Pediatric Note

The entire scene may create a terrifying experience for a child .

• A toy such as a teddy bear can do much to calm a frightened child.

• The presence of a female EMT or police officer may be helpful.

Small children do not, as a rule, carry identification.

 6 – At the Receiving Facility

The continuation of care can only be ensured if proper handing over practice is
followed during patient’s transfer to any facility.
This involves relaying basic bio data, brief history of illness and treatment steps taken
before the patient was brought to the facility. The patient should be handed over to
the appropriate personnel of the appropriate department of the facility.
6 – At the Receiving Facility

The patient's name, primary complaint, vital signs, a brief history, any treatments
received prior to transfer or administered by the ambulance crew, as well as any
changes in the patient's condition, should all be included in an oral report & written
report that is given to the healthcare provider at the patient's bedside.
 6 – At the Receiving Facility

The patient should not be left unattended or transferred to a non-qualified individual.

If requested, the crew should assist the receiving facility’s staff in lifting and moving
the patient.
 6 – At the Receiving Facility

All valuables and possessions must be given to the MLO in the event of an RTA or a
medico legal proceeding, and a receipt must be obtained.
Transferring the Patient to the Emergency Department Staff

Prepare the prehospital care report as soon as you are through with patient care.
Move the patient's personal belongings.
Obtain your hospital discharge.
At the Hospital

Clean the patient compartment as soon as possible while using the proper Standard
Precautions.
Get the breathing equipment ready for use.
Replacing throw a way items
In according with your policy, exchange equipment.
Set up the emergency room cot.
 7 - En-route to the Station/Key Point

The status of the ambulance should be reported to the command and control room.
If a medical waste facility is available, all trash should be appropriately disposed of
there, otherwise, it will be disposed of at the station during shift changes.
Wireless the ETC.
If required, air the ambulance.
The ambulance needs fuel.
Place badly contaminated linens in a biohazard container and non contaminated linens
in a regular hamper.
As necessary, clean any equipment that touched the patient.
Clean and disinfect used non disposable respiratory-assist and inhalation therapy
equipment.
Execute any necessary post operation vehicle maintenance procedures.
Clean the vehicle.
Finish off paperwork
 7 - En-route to the Station/Key Point

The ambulance and the reusable equipment need to be cleaned and disinfected as the
main tasks during this period.
The Ambulance Report would also be finished at this phase.
During this time, it may also be necessary to replace the oxygen cylinder or restock on
medical supplies.
The personnel must ensure that all of the equipment, including the pulse oximeter, bag
valve mask, and other items brought into the hospital with the patient, has been
found.
The crew should thoroughly clean and sanitize the back compartment and reusable
equipment before departing for the key point or station.
8 – Post run Phase

1- The ambulance is now turned over to the crew of the following shift.
2- In order for the new crew to identify and replace on the used items.
3- It is the duty of the crew passing over the ambulance to ensure that it is clean and
disinfected.
4- And that the handing over - taking over documents are properly filled out.
5- Inventory of equipment and supplies should be checked and marked handing over
And taking over form end of the shift.
6- If disinfection has not been done before ,it should be done before getting out of the
ambulance.
Questions
Q.1 Which phase of ambulance operation is determine the responsibilities of each crew
member?

A. En route to the scene.

B. At the scene.
C. Dispatch phase.
Q.1 Which phase of ambulance operation is determine the responsibilities of each crew
member?

A. En route to the scene.

B. At the scene.
C. Dispatch phase.
Q 2. A "hot" response means using?

A. No lights and siren.

B. Lights and siren.
C. None of above
Q 2. A "hot" response means using?

A. No lights and siren.

B. Lights and siren.
C. None of above
Q3. Which question is the role of the Emergency Medical Dispatcher?

A. The call time.

B. Number of patient.
C. Is the patient conscious.
Q3. Which question is the role of the Emergency Medical Dispatcher?

A. The call time.

B. Number of patient.
C. Is the patient conscious.
Q4. Which phase is the ambulance operation before leaving the scene, ensure all
equipment taken to the scene has been retrieved?

A. At the Scene.
B. En route to the scene.
C. En route to the receiving facility.
D. Post run Phase.
Q4. Which phase is the ambulance operation before leaving the scene, ensure all
equipment taken to the scene has been retrieved?

A. At the Scene.
B. En route to the scene.
C. En route to the receiving facility.
D. Post run Phase.
Q5. Which phase is ambulance operation command and Control room should be
notified about the status of the ambulance?

A. Post run phase.

B. Dispatch phase.
C. En route to the key point/station.
Q5. Which phase is ambulance operation command and Control room should be
notified about the status of the ambulance?

A. Post run phase.

B. Dispatch phase.
C. En route to the key point/station.
Q6. What should be protecting the patient transferring to the Ambulance?

A. Minimum of three straps to secure.

B. Check dressings and splints.
C. Position and secure patient.
Q6. What should be protecting the patient transferring to the Ambulance?

A. Minimum of three straps to secure.

B. Check dressings and splints.
C. Position and secure patient.
THANK YOU