Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
Service Name :
Ambulance Services
Operational Policy
Date Created :
15-01-2008
Chief Medical Superintendent
Approved By :
Name
:
Signature :
Emergency Medical Officer
Reviewed By :
Name :
Signature :
Director
Issued By :
Name :
Signature :
Emergency Medical Officer
Responsibility of Updating :
Name :
Signature :
1
Manual of Operation
Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
Page of Contents
Sl.Order Particulars
A
Purpose
B
Scope
C
Responsibility
D
Policy
i.
Abbreviations
ii.
Key Standards for Ambulance service
iii.
Protocols
iv.
Responsibility for maintenance of the Ambulance
v.
Emergency Calls
2
Manual of Operation
Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
A. Purpose:
1. To ensure proper and timely transportation of patient to the hospital for appropriate
medical attention.
2. To ensure proper transfer of patient from the hospital.
B. Scope:
Hospital wide
C. Responsibility:
Emergency Medical Officer
D. Policy:
The ambulance service provides the first point of access to health care for a wide variety of
patient conditions, ranging from life-threatening emergencies to chronic illness and social
care.
i. Abbreviation:
EMO – Emergency Medical Officer.
ED - Emergency Department.
ii. Key standards for ambulance services include:
1. Responding to life-threatening calls.
2. Responding to non-life threatening calls.
3. Getting Emergency drugs and blood for hospital emergency
4. To provide any such service that the hospital may find deem.
5. Ambulance will not be used for carrying dead bodies except incase where the patient
expires during transportation.
6. Ambulance services will be available within city limits and will be restricted to carrying
patients to the hospital or transferring patient to the referred medical center.
3
Manual of Operation
Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
iii. Protocol
1. All Ambulance drivers will be BLS trained.
2. Drivers must be in uniform and ID tag when driving the ambulance.
3. All ambulance drivers must have the CUG phone in possession while on duty.
iv. Responsibility for Maintenance of the ambulances:
1. The ambulance driver shall maintain the ambulance in clean and good condition.
2. The ambulance driver is responsible to maintain 90% of the medical gas (oxygen) to
the total storage capacity of Oxygen. If the level of the Oxygen storage goes less than
50% the ambulance driver requests the ED staff to replace a 100% full refilled
Oxygen cylinder.
3. The ambulance driver has to ensure the pneumatic pressures of the wheels are within
stipulated pressure. If found less it is to be notified and refilled with informing the EMO
and a movement entry has to be made in the designated register.
4. The ambulance driver has to upkeep all the non clinical equipments inside the
ambulance if in case of any malfunction it is to be reported to the ED which has to be
entered in the designated register.
5. The ambulance driver shall check the brake-oil level, Engine oil level, Wheel pneumatic
pressure. Engine coolant, oxygen level, fuel level, siren, lights ups charge and the
equipments in the ambulance twice everyday .
6. The ED Pharmacist will be responsible to maintain the required medicines in the
Ambulance. The availability of medicines in the ambulance will be checked by the ED
pharmacist at 8:00 am in the morning, the entry of the same would be made in the
designated register. Prior to the dispatch of the Ambulance the ED rechecks the medicines
in the Ambulance to ensure the availability of all the essential drugs. Once the Ambulance
returns, the on duty ED Pharmacist checks the medicines to replenish any medicine which
has been used.
6. The ambulance Driver shall upkeep and maintain all the documentation relating to the
ambulance
7. The ambulance driver shall always maintain the Adequate fuel in ambulance and
procures diesel as and when it reaches the safe minimum level of stock.
8. The ambulance driver requests for the diesel indents from the designate clerk in the
administrative office as and when ambulance diesel stock level goes below the safe
4
Manual of Operation
Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
stock level. The diesel is got filled from the authorized vendor decided by the
Administration.
9. The movement of ambulance for the refill of the fuel is to be notified to the
EMO and an entry of the same is made in the designated register.
v. Emergency calls:
1. The Emergency ambulance call is received in the ED, then the time and Number
of the caller is noted down by the ED staff responding to the call and transfer the call
immediately to the EMO.
2. The EMO collects the exact address location and landmark etc, from the caller and
advices for the precautions to be taken to patient. .
3. The Ambulance driver reports to the Emergency Medical Officer.
4. All the movements of the Ambulance are controlled only by the emergency medical
officer. Apart from the Emergency room medical officer the Director, Chief Medical
Superintendent and Medical Superintendents can control the movement in conjunction
with the Emergency Medical Officer.
5. All the patient calls that are entertained by the hospital are considered load and go
situation so the patient is picked up and moved to the hospital as soon as possible.
The ambulance driver may assist on all the load-and –go situation in scene of
emergency.
6. The ambulance will not move out of the hospital without the EMO concern when
patients are being transferred.
7. The EMO summons the Ambulance driver and briefs the Ambulance driver of the
location and landmarks etc.On being briefed by the EMO the ambulance driver does all
the pre-departure check and brings the ambulance to the front patio of the emergency
department.
8. Picks up the Waiting nurse (Refer Transfer of patient policy) in patio and drives to the
destination to pick up the patient safely and as fast as possible.
9. The Emergency drugs and the Clinical therapeutic, diagnostic equipment will be kept
in the Emergency Department and will be moved into the ambulance only during
calls as per the advice of the EMO.
5
Manual of Operation
Dr. Ram Manohar Lohia Combined
Hospital , Lucknow
Quality Operating
Process
Document No :
RML/AS/01
Manual of Operations
Ambulance Services
Date of Issue :
15/1/2008
10. The ED staff pharmacist will be responsible for the same.
11. The ambulance driver will have to assist in-shifting of the patient as directed by the
EMO.
12. All communications are done from the ambulance to the ground station through the
CUG phone in possession with the Ambulance driver.
13.The patient when being brought is wheeled in and loaded in the ED trolley and the
Ambulance driver sets back all the system in the ambulance and cleans the ambulance
with the assistance of the house keeping personnel inside the hospital. This cleaning
operation shall not exceed 20 min.
14. In case of any planned shifting and transfer of the patient all the modalities are worked
out by the emergency medical officer in conjunction with the respective departments .
The ambulance driver will be informed by the Emergency medical officer and an entry
is made in outgoing ambulance register the ambulance driver brings the ambulance to
the patio and takes the trolley to the pick up point of the patient inside the hospital and
moves the patient accompanied by the nurse/doctor to the ambulance and proceeds.
15. In this operation the Ambulance driver will not be liable to satisfy any clinical
documents or requirements.
16.In case of any purchase of pharmacy drugs and Blood done by the ambulance team,
the medical officer shall handover the requisite prescription and cash and briefs the
ambulance drive as to where and when and how to get it.
17.In case of non emergency planned pick up of the patient the Ambulance driver may be
informed in prior and handed over the trip sheet by the medical officer not exceeding 48
hours in advance.
19. In the Transfer and shifting of the patients ,depending upon the condition of the patient
a nurse/doctor may accompany the patient.
20. For referral –the referral hospital must be informed before sending the patient.
Staff accompanying the patient must be seated at the back with patient .Only one
person will be allowed to accompany the patient in the ambulance. Relatives \
accompanying the patients to do so at their own risk.
21. Sirens – Silent –if the road is empty .Only lights on-cold case will be used. Siren only
on-if carrying ill case and/or to clear traffic.
6
Manual of Operation