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Title: Emergency Vehicle Operator Refresher Course Ambulance National Standard Curriculum


1
Emergency Vehicle Operator Refresher Course
(Ambulance)National Standard Curriculum
  • 1995 Revision

2
Before you Begin
  • If you have questions contact Todd Oyen
  • E-mailoyen_at_nwscc.edu
  • Call 256-331-5437
  • You may wish to download the NHTSA EVOC
    Participant Manual (this is a large file) NHTSA
    EVOC manuals

3
Before you Begin
  • You may wish to download the free Adobe Acrobat
    Reader if you currently do not have it. Some of
    the links in this program are to PDF files and
    you need the Acrobat Reader to open them.
  • Adobe Acrobat Reader

4
Course Overview
  • Legal aspects of ambulance operation
  • Communications
  • Ambulance types
  • Navigation and route planning
  • Normal and High risk driving situations and the
    appropriate driving skills
  • Safety considerations

5
National Standard Training Curriculum
  • Comprised of three modules
  • Module A Classroom/Cognitive
  • Module B Field exercises
  • Module C On the job training

6
Module A-Classroom/Cognitive
  • This refresher provides a review of what you were
    taught in your original EVOC course

7
Module B-Field Exercises
  • This was performed in you original EVOC course

8
Module C-OTJ
  • Performed by your service/employer when you began
    driving an ambulance
  • Checklists
  • Ambulance Familiarization
  • Ambulance Inspection, Maintenance, and Repair
  • Normal and High Risk Operating Situations
  • Operational Driving

9
  • This course will NOT cover pursuit driving or
    high-speed operation of an ambulance. The U.S.
    Department of Transportation recommends operating
    at or below the posted speed limits and getting
    to the scene safely.

10
Legal Aspects of Ambulance Operation
11
State of Alabama Ambulance Operator
Qualifications
  • Must be 18 years of age or older.
  • Eyesight 20/20 in one eye/ 180 degrees peripheral
    vision
  • Pass physical requirements
  • Successful completion of EVOC
  • Pass background check
  • Acceptable MVR
  • Alabama drivers license
  • Familiar with EV operation under the laws of
    state/ county/ city
  • CPR certification

State of Alabama EMS Rules
12
Qualifications for Alabama Ambulance Driver
  • A license will not be issued to an individual
  • Convicted of vehicular homicide
  • Convicted in the last five years of a DUI
  • Convicted in the last five years of possession of
    drugs or drug paraphernalia

13
Qualifications for Alabama Ambulance Driver
  • A license will not be issued to an individual
  • Required to surrender his or her motor vehicle
    license within the last five years
  • Convicted with the past five years of operating a
    vehicle while his/her license is revoked

14
Qualifications for Alabama Ambulance Driver
  • A license will not be issued to an individual
  • Convicted of being under the influence of alcohol
    or a controlled substance while operating an
    emergency vehicle

15
To Maintain your Ambulance Driver status
  • Keep licenses up to date
  • Report all driving violations ASAP
  • Remain physically and mentally fit
  • Maintain a good driving record
  • Participate in refresher training every other year

16
Physical and Mental Fitness
  • Are you physically fit?
  • Well rested?
  • Injuries that may hamper driving?
  • Over the counter medication use?
  • Ill?

17
Physical and Mental Fitness
  • Are you mentally fit?
  • Worries or distractions?
  • Ill family members
  • Money problems
  • Fights with significant others
  • Alcohol or other drug use?
  • Prescription
  • Nonprescription

18
Personal Appearance and Hygiene
  • Professional appearance
  • Prevention of the spread of disease
  • Clean unit
  • Clean, properly stored equipment

19
Types of Regulations
  • Constitutional Law
  • Statutory Law
  • Ordinances
  • Rules and Regulations

20
Understanding the Law
Ask Yourself This!
  • What is there about emergency vehicle operation
    laws that I need to know?
  • How the law works
  • When I am exempt from the law

21
How the Law Works
All organizational policies, S.O.Ps, rules, and
regulations should incorporate the principles of
constitutional law, statutory law and local
ordinances.
Municipal Law S.O.Ps
22
When Am I Exempt From the Law?
  • Ambulance operators are subject to all traffic
    regulations unless a specific exemption is made
    in the state or local statute.
  • Any exemption is legal only in emergency mode.
  • Even with an exemption, operators can be held
    criminally or civilly liable if involved in a
    crash.

23
Interpreting the Law
  • Law of Due Regard
  • True Emergency Situation
  • Negligence

24
Specific Exemption
  • A specific exemption is a statement which appears
    in the statues and specifies an exception to the
    rule.

25
Example
  • During a run, you are following behind another
    emergency vehicle responding to an emergency
    call. You are approaching the intersection when
    you notice a red light. The other emergency
    vehicle stops, checks to see the intersection is
    clear, and then proceeds through the
    intersection. You then follow right behind the
    other vehicle through the light. Was your action
    within the law? Why?

26
Example
  • Yes
  • There is an exemption for emergency vehicles that
    allows emergency vehicles while operating in
    emergency mode to proceed through a red light.
  • HOWEVER, when using Due Regard, each vehicle
    should stop and clear an intersection before
    proceeding against a red light.
  • You MUST use Due Regard

27
Due Regard for Safety
A reasonably careful person, performing similar
duties and under similar circumstances would act
in the same manner.
28
Due Regard
  • Ask Yourself These Questions!!!
  • Am I responding like my peers would in the same
    situation?
  • Am I giving enough notice of my vehicles
    approach to allow other motorists and pedestrians
    to clear a path and protect themselves?
  • Am I using my lights and siren appropriately?
  • Am I using extreme caution?

29
True Emergency Situations
A situation that involves a high probability of
death or serious injury to an individual and
action by the ambulance operator may reduce the
seriousness of the situation
Who decides when a situation is a True
Emergency?
30
Deciding True Emergencies
  • Code system calls
  • Information from a dispatcher
  • Emergency services on the scene
  • Medical facility physician

31
Deciding True Emergencies
  • En route to calls the dispatcher will determine
    what is a True Emergency
  • En route to the hospital the patient care
    provider usually determines that a call is a True
    Emergency after the patient has been assessed.

32
Negligence
Any action that violates a standard of care.
  • There is a Duty to Act
  • There is Breech of that Duty
  • There is Patient Injury
  • There is Proximal Cause

33
Case Study
  • An ambulance was transporting a young girl with
    an injured arm to the hospital when it crashed
    with another vehicle. The operator of the
    ambulance was at fault. The crash caused an
    additional injury to the child. The operation
    could be found negligent.

34
Abandonment
  • Act of refusing to transfer or terminating
    transportation prior to being relieved by other
    qualified healthcare provider

35
Good Samaritan Provision
  • Protects person who gives aid at the scene of an
    emergency from liability for additional damage or
    injury

36
Patients Rights(Constitutional Law)
  • Consent
  • Actual-conscious and mentally competent
  • Implied-unconscious or for other reasons unable
    to give actual consent
  • Refusals
  • Respect patients right
  • Witness
  • Document

37
Confidentiality
  • Do not speak to
  • Press
  • Your family/friends
  • Coworkers
  • Do not relate specifics
  • Consider what you say on the radio

38
Other Legal Liability Issues
  • Responsibility for passenger possessions
  • Failure to report crashes or using improper
    reporting procedures
  • Exceeding load capacity or the vehicle
  • Failure to conduct/record vehicle inspections
  • Failure to provide training
  • Failure to maintain training records
  • Failure to maintain written records or safety
    meetings

39
Scenario
  • You are returning from a run when a car pulls up
    beside you while you are stopped at a traffic
    light. The individual informs you that a
    three-vehicle crash has just occurred on the
    nearby interstate. No other emergency vehicles
    are at the scene. The individual informs you
    that several of the victims are trapped in the
    cars. The severity of the injuries is unknown.
    Is this a true emergency? Why?

40
Scenario
  • This is a true emergency. The extent of the
    injuries is unknown. The time you save by
    running in emergency mode may reduce injuries and
    save lives.
  • This is a situation that involves a high
    probability of death or serious injury to an
    individual and action by the ambulance operator
    may reduce the seriousness of the situation
  • You should contact dispatch prior to responding.
    Dispatch may already be aware of the accident and
    has contacted a closer unit

41
Scenario
  • Your ambulance is traveling the wrong way down a
    one-way street while en route to a fire at a
    large apartment complex where people are reported
    injured. You are using the signaling equipment.
    Are you observing due regard? Why?

42
Scenario
  • Maybe.
  • Due Regard A reasonably careful person,
    performing similar duties and under similar
    circumstances would act in the same manner.
  • Ask these questions
  • Am I responding like my peers would in the same
    situation?
  • Am I giving enough notice of my vehicles
    approach to allow other motorists and pedestrians
    to clear a path and protect themselves?
  • Am I using my lights and siren appropriately?
  • Am I using extreme caution?

43
Scenario
  • A dispatcher reports that a man phoned requesting
    help. The man is hysterical and the dispatcher
    can not determine the extent of the injuries.
    You respond in an emergency mode. En route, you
    receive a call from the dispatcher. He reports
    the man has calmed down and the man thinks his
    son may have broken his ankle there is some pain
    and swelling. Is this a true emergency
    situation? Why?

44
Scenario
  • Is this a situation that involves a high
    probability of death or serious injury to an
    individual and action by the ambulance operator
    may reduce the seriousness of the situation?
  • Most people would feel that a possibly fractured
    ankle is not a True Emergency. However, dispatch
    may have information that you are not aware of,
    and you should follow the directions of the
    dispatcher.

45
Legal issues surrounding ambulance operation is
a serious subject. You can be sued. Knowing the
laws makes a difference and helps you to act
legally smart .
46
Communication and Reporting Roles and
Responsibilities
47
Communication Responsibilities
  • EMT
  • Communicate and help navigate
  • Dispatcher
  • Coordinates all activities for the call
  • Ambulance Operator
  • Safely and efficiently drive the ambulance
    communicate only during non-driving points
  • Before leaving the scene
  • After arriving at the hospital

48
Dispatch Information
  • Two critical points must be known by the driver
  • Address of the emergency
  • Description of the emergency
  • Nature of the emergency
  • Number of patients
  • Other pertinent information

49
Routine Reporting Points
  • Prerun
  • When dispatched on a call
  • Upon arrival at the scene
  • Scene update
  • Before scene departure
  • En route to medical facility
  • After arriving at the medical facility
  • When headed back to the station

50
Communication Equipment
  • Most common types of equipment
  • Radios-most common
  • Cell phones
  • Telemetry
  • Satellite

51
Phonetic Alphabet
  • Use of words to symbolize letters
  • A-alpha
  • W-whiskey
  • Use has become minimized in favor of plain English

52
Composing Messages
  • Seven things to remember when sending radio
    messages
  • Plan
  • Identify person called, then the calling unit
  • Be brief
  • Use plain English
  • Pronounce words clearly
  • Spell phonetically
  • Repeat Directions

53
EMT Communication Responsibility
  • The EMT in the passenger seat is responsible for
    communication when the operator is driving

54
Dispatcher Responsibility
  • Coordinate calls for an agency
  • Provide pre-arrival instructions
  • Coordinate with other agencies

55
Operator Reporting Requirements
  • Only during non-driving points
  • Before leaving the scene
  • Transport mode
  • What facility
  • When arriving at medical facility
  • When leaving the vehicle

56
Ambulance Types and Operation
57
The KKK-A-1822 federal specifications standards
published by General Services Administration
(GSA) recognizes three types of ambulances.
58
Star of Life
  • Can only be displayed when an ambulance meets KKK
    specifications

59
Ambulance Types
  • Type I
  • conventional truck, cab-chassis with modular body

60
Ambulance Types
  • Type II
  • standard van, integral cab-body ambulance

61
Ambulance Types
  • Type III
  • cutaway van, cab-chassis with integral or
    containerized modular body ambulance

62
Weight Restrictions
  • No matter what type of ambulance you drive, you
    must know the weight restrictions to operate it
    safely.
  • Payload capacity is the term used to describe
    crew members and patients

63
Ambulance Operation
  • Size - affects maneuverability, wider and longer
    than your car
  • Weight - affects acceleration and braking
  • Visibility - blind spots use a ground guide when
    backing

64
Vehicle Inspection, Maintenance, and Repair
65
Vehicle Inspection, Maintenance and Repair
  • Inspect the vehicle according to established
    procedures
  • Make sure all scheduled maintenance has been
    performed
  • You may be held legally responsible for
    preventable accidents
  • Make sure all needed repairs have been made

66
Inspections
  • Quick Check
  • Each sift
  • Full Inspections
  • When designated by your organization

67
Systematic Vehicle Inspections
  • Find and report problems
  • Track preventive maintenance
  • Document vehicle conditions
  • if its not in writing, it did not happen

68
Recommended Inspection Schedule
69
Vehicle Inspections
  • Quick check for systems to check most often
  • Full check for all systems checked without
    special equipment or facilities

70
Sample Checklist
71
Checklist FormatAmbulance Identification/Instruct
ions
72
Checklist FormatInspection Sequence
73
Checklist Format Items
74
Checklist Format Check Column
75
Checklist FormatProblem/OK/Work Columns
76
Example
  • Suppose a vehicle you have inspected has one
    cracked turn signal lens and a slow oil leak. Do
    you place it in service?
  • Probably yes, but the items must be documented
    and the information given to your supervisor

77
Example
  • It is a clear day and you have a broken
    windshield wiper. What do you do?
  • You are probably authorized to fix the windshield
    wiper. Regardless of weather, there are times
    you may need your windshield wipers. The unit
    should be taken out of service.

78
Inspection Sequence
  • 1. Overall appearance
  • 2. Operator compartment
  • 3. Exterior operators side
  • 4. Exterior front
  • 5. Engine compartment
  • 6. Exterior passengers side
  • 7. Patient compartment
  • 8. Exterior rear

79
Refusing to Drive an Unsafe Vehicle
  • You should never operate a vehicle that is not in
    safe operating condition
  • The Federal Injury/Illness Prevention Program
    supports an operators right to refuse to drive
    an unsafe vehicle

80
Injury/Illness Prevention Program
  • Federally mandated program
  • Specifies who is to do safety checks on the
    vehicle
  • Specifies who is to do the maintenance on the
    vehicle
  • Identifies who is at fault if maintenance is not
    performed

81
Navigation and Route Planning
82
Operator Negligence
  • Failing to inspect a vehicle thoroughly in
    accordance with the organizations requirements.
  • Knowingly operating an unsafe vehicle
  • You will be held responsible for any PREVENTABLE
    accident that leads to an accident or loss of
    life.

83
Operator Responsibility
  • Making repairs you are authorized to make
  • Documenting any needed repairs found during an
    inspection
  • Making sure repairs have been completed

84
Advantages of Preventive Maintenance
  • Ensures safe, reliable vehicle operation
  • Reduces total cost of repairs
  • Minimizes major equipment failure

85
Malfunction During a Run
  • Ensure patient care
  • Use your communication equipment

86
Route Planning
  • Route planning is a key decision for both urban
    and rural area driving. Each time you leave on a
    run, you must decide on a route that is quick and
    avoids potential hazards or delays

87
SAFETY is the most important factor when driving
to the scene
88
Choose routes that...
  • Minimize stops and turns
  • Avoid intersections
  • Avoid residential streets - posted speed limits
    are lower, children, pets, etc.

89
After the patient has been loaded, the EMT will
be caring for the patient and not able to help
navigate
90
Route Planning
  • Minimize travel time
  • Minimize crash exposure
  • Allow operator to focus attention on driving
  • Avoid environmental and construction hazards
  • Arrive at the scene, and transport to the
    hospital in the most efficient way
  • Avoid residential areas is possible

91
On the way to a scene, you and the crew should
communicate and navigate the route together
92
Operator Familiarization
  • Primary and alternate routes
  • New construction
  • Local landmarks and reference points
  • Traffic flow changes
  • Height restrictions
  • How to read a map book

93
Basic Maneuvers and Normal Operating Situations
94
One of the most dangerous areas of a road
surface is that area where the surface changes
from one type to another, such as from asphalt to
gravel
95
Alternate Routes
  • When a primary route is blocked
  • Construction
  • Hazards
  • Time of day
  • Location
  • Plan secondary routes

96
Adjust Driving for Road Conditions
  • Bridges/Ramps/Overpasses
  • Consider the height of the ambulance
  • Curves
  • Banking with inside lower
  • Crown
  • Water drainage
  • Roadside engineering

97
Adjust Driving to Road Surfaces
  • Asphalt
  • Concrete
  • Dirt/Gravel

98
Adjust Driving for Road Conditions
  • Bumps
  • Mud
  • Potholes
  • Animals / Tree limbs

99
Adverse Effects on a Patient When Riding in an
Ambulance
  • Pain
  • Fright
  • Nausea
  • Further complications

100
Good driving skills can positively influence the
quality of a patients ride
101
Four Main Driving Skills
  • Cornering
  • Braking
  • Accelerating
  • Maintaining appropriate speed

102
Adverse Effects on a Medical Team When Riding an
Ambulance
  • Cant properly treat patient
  • Moving equipment
  • Problems handling a terrified patient

103
Ambulance Suspension System
  • Designed to do two things
  • Keep all four wheels firmly on the ground so that
    you can steer, brake, and accelerate
  • To isolate the body and its occupants from the
    bouncing of the wheels

104
Begin Braking Early
  • Total Stopping Distance
  • Reaction Time Braking Time

105
To Maximize the time and distance available for
braking, you need to place your ambulance in the
safest position by following a simple rule.
106
2 - 4 - 12 Rule
  • 2 second interval below 55 mph
  • 4 second interval above 55 mph
  • 12 second visual lead time

107
Always try to accelerate smoothly and steadily---
Go no faster than necessary
108
There is a delicate balance between the operator,
the machine, and the environment
109
The ambulance is responsible for only 1 of
crashes,the environment for only 10.That
leaves you, the operator.
110
Most collisions are PREVENTABLE
111
Preventing Collisions
  • Drive defensively
  • Maintain a safety cushion
  • Be aware of your surroundings

112
Defensive Driving
  • Good driving habits
  • Be prepared to act
  • Expect the unexpected
  • Have plan of action at all times
  • Exercise good judgment
  • Be aware that other drivers cannot be relied upon
    to drive properly and safely

113
Passing-Two Lane Roads
  • Visually clear oncoming lane
  • Change lanes
  • Accelerate past vehicle
  • Smoothly pull back into lane

114
Backing
  • Backing accidents account for 85 of single
    vehicle accidents with ambulances
  • Use ground guide at left rear
  • Keep guide in view at all times
  • Use side mirrors
  • Accelerate slowly

115
Communication with Other Drivers
  • Lights
  • Horn
  • Eye contact
  • Hand signals
  • Siren

116
Pre-Crash Planning
  • Keep doors locked
  • Wear your seat belt
  • Have good housekeeping habits

117
Preparing for the Crash
  • Reduce
  • Speed
  • Angle of impact
  • Size and hardness of object

118
Operations in Emergency Mode and Unusual
Situations
119
Emergency Driving
  • Using clearly defined procedures in the operation
    of an ambulance when responding to a medical
    emergency, including the use of emergency
    signaling devices, such as lights and siren.

120
Emergency Signaling Devices (Lights Siren)
  • Notify other drivers that an emergency vehicle is
    approaching
  • Request that other drivers yield the right of way
    to the ambulance

121
Other Drivers Responses
  • Most will yield the right-of-way if
  • They realize you are there
  • Have sufficient time to respond
  • Have time and space to carry out their decision

122
Controlled Intersections
  • What is a controlled intersection?
  • What are ambulances in emergency mode allowed to
    do?

123
Dangers
  • 60 of ambulance crashes occur at intersections
    with stop signs and traffic lights

124
Law of Due Regard
  • A reasonable careful person, performing similar
    duties and under similar circumstances, would act
    in the same manner

125
National Voluntary Consensus Standards
  • Siren to wail mode 300 feet prior to intersection
  • Siren to yelp mode 150 feet prior to intersection
  • Brake to stop at crosswalk line
  • Two blasts of air horn

126
National Voluntary Consensus Standards
  • Stop, look, make eye contact, proceed
  • Continue yelp mode, proceed with highest degree
    of care
  • Clear each lane prior to crossing
  • Anticipate vehicles entering from right and left

127
National Voluntary Consensus Standards
  • Anticipate multiple responding units
  • Avoid passing stopped vehicles on the right
  • Turn right after drivers on the right are aware
    of ambulance
  • Anticipate left turns in front of ambulance by
    oncoming traffic
  • Beware of other intersection hazards

128
Driving Against Traffic
  • Do not enter opposing traffic lane until all
    oncoming vehicles are aware of ambulances
    presence
  • Do not enter one-way street against traffic until
    all opposing traffic has yielded right of way

129
Multiple Responding Units
  • Be aware at intersections
  • Maintain 300-400 feet distance between units

130
Adverse Conditions
  • Traction
  • Vision

131
Conditions Affecting Traction
  • Rain
  • Snow and ice
  • High winds
  • Leaves
  • Temperature

132
To Improve Traction
  • Reduce speed
  • Steer, brake, accelerate smoothly

133
Traction Devices
  • Snow tires
  • Chains

134
Skidding
  • Causes
  • Over acceleration
  • Turning too sharply
  • Not enough weight on the front axle
  • Correction
  • Release the accelerator
  • Turn into the skid

135
Hot-Weather
  • Inspect the tires more frequently since they are
    more likely to fail

136
Conditions Affecting Vision
  • Night driving
  • Rain and fog
  • The vehicle
  • The driver

137
Night Driving
  • Conceals hazards
  • More difficult to judge other vehicles speed and
    position
  • Peripheral vision is reduced if you smoke
  • Adequate lighting is limited
  • Glare can impair your vision

138
Night Driving Techniques
  • Dim dash and panel lights
  • Reduce speed
  • Keep headlights and windshield clean
  • Watch area beyond headlights
  • Keep eyes moving

139
Maintaining Night Vision
  • Dont move from a bright room to darkness
  • Avoid looking into headlights
  • Dont smoke
  • Dont wear sunglasses

140
Rain and Fog
  • Reduce visibility
  • Reduce warning capability
  • Create glare

141
Speed Management
  • Wet roads-reduce your speed by about 1/3
  • Packed snow-reduce speed by about 1/2
  • Stopping takes longer
  • Easier to skid

142
Compensating for Poor Visibility
  • Prepare yourself
  • Use low beams and wipers
  • Watch for slow or stopped vehicles
  • Check rear view mirrors often
  • Be alert for fog
  • Drive slowly, but keep moving

143
Compensating for Poor Visibility
  • Increase safety cushion
  • Pull over and park

144
Other Factors Affecting Vision
  • Vehicle
  • Windshield/wipers
  • Visors
  • Bug screens
  • Headlights
  • Side view mirrors

145
Crash Avoidance
  • Drive to keep the ambulance out of a situation
    where a crash is unavoidable

146
Crash Avoidance
  • Plan ahead
  • Secure equipment
  • Wear seatbelts
  • Mentally prepare yourself
  • Maintain space cushion
  • Use a ground guide

147
To Avoid a Crash
  • Brake smoothly, firmly
  • Accelerate smoothly
  • Turn to avoid

148
Off Road Recovery
  • Remove foot from accelerator
  • Continue to drive
  • Slow and regain control
  • Signal intentions
  • Pull back onto the road

149
Be Prepared for Vehicle Malfunctions
  • Tire blowout
  • Brake failure
  • Steering failure
  • Stuck accelerator
  • Released hood

150
Pulling Off the Road
  • Plan exit
  • Signal intentions
  • Brake smoothly, firmly
  • Park out of traffic path

151
Ambulance Fires
  • First action is to stop the vehicle and get
    everyone out!

152
Brakes
  • The heavier a vehicle and the faster it is
    moving, the more heat the brakes have to absorb
    to stop the vehicle and the longer it takes to
    stop

153
Special Considerations
154
Ambulance Operators
  • Are responsible for safety of
  • Passengers
  • Crew
  • Vehicle

155
Passenger Safety
  • Restraints
  • All passengers should be restrained unless it
    interferes with patient care. This included the
    EMT in the back of the ambulance!
  • Secure Equipment
  • Unsafe behavior

156
Responsibility for Families of Patients
  • May include
  • Transporting
  • Ensuring safety
  • Communicating information

157
When to Transport
  • Psychological crisis if family is comforting
  • Parents of children
  • If family is too upset to drive
  • If there is a translator
  • If the patient is a parent and there is no one to
    care for a child
  • Family has no other means of transportation

158
Safety as Passengers
  • Wear seatbelts
  • Consider extra load
  • Use car seats for children

159
Following the Ambulance
  • Talk to family before leaving the scene
  • Where you are going
  • Transport mode
  • If emergency family must still
  • Obey traffic laws
  • Obey speed limits
  • Not tailgate
  • Give directions

160
Safety on ScenePotential Dangers
  • HAZMAT
  • Fires
  • Crowds
  • Violent acts
  • Traffic
  • Downed power lines

161
HAZMAT
162
Common Hazmat Scenes
  • Trains
  • Tractor-trailer truck
  • Trucks hauling compressed gases
  • Factories
  • Look for
  • Placards
  • Hazard classes
  • Hazmat labels on containers

163
Fire
164
Fire
  • Follow the directions of the incident commander
  • Provide support for fire department personnel

165
Crowds
166
Crowds
  • Drive slowly to avoid a crash
  • Call for help for crowd control
  • Have the EMT clear a path

167
Violent Acts
168
Violent Acts
  • Types of situations
  • Domestics
  • Assaults
  • Suicides
  • Unknown emergencies
  • EMS personnel do not carry weapons
  • Allow law-enforcement personnel to handle the
    situation

169
Downed Power Lines
170
Downed Power Lines
  • Dont touch
  • Notify dispatch to contact power company
  • Set up a safety zone around the wires

171
Vehicle Placement
  • Safety
  • Access
  • Scene protection
  • Traffic flow
  • Ease of departure
  • Distance from patient

172
Diagram 1
  • Provides good protection of the scene, traffic
    flow, and proximity to patient.
  • Ambulance may be struck

173
Diagram 2
  • Some protection for the scene
  • Easy accessibility to scene and departure from
    scene
  • Poor traffic flow

174
Diagram 3
  • The police car provides protection for the scene
  • You may or may not have good accessibility
  • Departure will be easy
  • Poor traffic flow

175
Diagram 4
  • This is very poor. The scene is not safe.
  • Traffic flow is between the ambulance and the
    scene-prevents access and places the EMTs at
    greater risk
  • Traffic flow is reduced in both directions
  • Departure would be easy

176
Diagram 5
  • The ambulance is too close to down power lines!!

177
The Run
178
Operations Phases of a Call
  • Leaving for the scene
  • Driving to the scene
  • Transporting the patient

179
Post run
  • Paperwork
  • Clean and decontaminate the ambulance
  • Restock the ambulance

180
Scenario
  • You and several others are arriving at the
    station to begin your shift. While you are
    settling in, you find out one of the crew only
    had an hour of sleep because of a sick child.
  • What should you do?
  • Drive for your partner
  • Notify your supervisor

181
Scenario
  • There is construction on Main street with one
    lane blocked a baseball game at the stadium and
    probably thunderstorms in the afternoon.
  • How will such conditions affect operations?
  • A new route will have to be planned around the
    construction
  • The area around the baseball game will be
    congested and other routes should be determined
  • The thunderstorms will make conditions slippery.
    You should also check your wipers and rain gear.

182
Scenario
  • The previous crew left the ambulance a mess.
  • What should you do to prepare the ambulance for
    another run?
  • Take your unit out of service. Notify your
    supervisor
  • Clean and restock. Use body substance isolation
    procedures, such as gloves
  • Place your unit back in service.

183
Inspecting Ambulance
  • While inspecting the
  • ambulance you notice
  • the brake lights are
  • not working.
  • What do you do?
  • If authorized, replace the bulb and document the
    repair.
  • If not authorized to do the repair you should
    notify your supervisor

184
Congratulations!
  • You have completed the EVOC Refresher program.
  • You must now schedule a time to take the written
    exam.
  • Contact Northwest-Shoals Community College
    Testing Lab at 256-331-5262
  • If you have any further questions contact Todd
    Oyen
  • oyen_at_nwscc.edu
  • 256-331-5437
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