Chapter 47
Principles of
Emergency
Response and
Transportation
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47-1
Objectives
47-2
Principles of Emergency Response
47-3
Preparation Phase
• Personnel and basic supplies
– Minimum staffing requirements
– Medical equipment
• Nonmedical supplies
– Personal safety equipment
– Preplanned routes / street maps
– Communications equipment
47-4
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
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
Vehicle Inspection
[Insert figure 47-1]
47-7
Vehicle Inspection
[Insert figure 47-2]
47-8
Vehicle Inspection
[Insert figure 47-3]
47-9
Vehicle Inspection
Patient Area
[Insert figure 47-4]
47-10
Vehicle Inspection
Operator Area
[Insert figure 47-5]
47-11
Dispatch Phase
[Insert figure 47-6]
47-12
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
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
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
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
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
Emergency Response
• Due regard for the safety of others
• Speed and speed limits
• Warning lights and sirens
• Right of way
47-18
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
Contributing Factors to
Unsafe Driving Conditions
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Escorts
Road surface
Excessive speed
Reckless driving
Weather conditions
Multiple-vehicle response
47-20
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
Possible Driver Distractions
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Mobile computer
Global positioning systems
Using mobile radio
Operating visual and audible devices
Vehicle stereo
Wireless devices
Eating/drinking
47-22
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
Emergency Response
• Intersection crashes
[Insert figure 47-7]
47-24
Arrival Phase
• Consider potential dangers
– Hazardous materials
– Fires
– Heavy traffic flow
– Large crowds
– Violent situation / terrorist act
47-25
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
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
Vehicle Placement
• Traffic volume and flow
– Position the transport vehicle so that it
does not block traffic
47-28
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
Vehicle Placement
• Distance from the patient(s) or scene
– Use common sense and extreme caution
47-30
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
Transferring the Patient to the Ambulance
• Prepare the patient for transport
[Insert figure 47-8]
47-32
Transport Phase
[Insert figure 47-9]
47-33
Transport Phase
[Insert figure 47-10]
47-34
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
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
Post Run
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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
Post Run
• Complete cleaning and disinfection
procedures
– Low-level disinfection
– Intermediate-level disinfection
– High-level disinfection
– Sterilization
47-38
Infection Control Procedures
• Remove any contaminated clothing
• Discarded contaminated sharps in an
acceptable sharps container
• Decontaminate the vehicle and large
equipment
47-39
Questions?
47-40