Chapter 37 Transport Ops

Chapt 37 Transport Ops ***Ambulance design based on NFPA 1918 Standard for Automotive Ambulances Phases of an Ambulance Call -An ambulance call has nine phases: 1. Preparation 2. Dispatch 3. En route 4. Arrival at scene 5. Transfer of patient to ambulance 6. En route to receiving facility (transport) 7. At receiving facility (delivery) 8. En route to station 9. Postrun Air Medical Operations Helicopter medical evacuation operations 1. Medical evacuation (medivac) is performed exclusively by helicopters. 2. Medivac capabilities, protocols, and procedures vary between EMS systems. 3. Calling for a medivac a. Why call for a medivac? i. Transport time to the hospital by ground is too long considering the patient’s condition. ii. Road, traffic, or environmental conditions prohibit the use of a ground ambulance. iii. The patient requires advanced care beyond EMT capabilities (eg, pain medication administration, airway insertion). b. Who receives a medivac? i. Patients with time-dependent injuries or illnesses ii. Patients suspected of having a stroke, heart attack, or serious spinal cord injury iii. Patients who are found in remote areas and have experienced SCUBA diving accidents, near-drownings, or skiing and wilderness accidents iv. Trauma patients v. Limb replantation, burn center, hyperbaric chamber, or venomous bite center Establishing a landing zone 1. The safest, most effective way to land & take off is similar to that used by fixed-wing aircraft a. Landing at a slight angle allows for safer operations. 2. Establishing a landing zone is the responsibility of the ground EMS crew. 3. An appropriate site for a landing zone should be: a. Hard or grassy level surface 100 × 100 feet and no less than 60 × 60 feet b. Cleared of loose debris c. Clear of overhead or tall hazards (eg, power lines, telephone cables, antennas, trees) 4. Mark the landing site using weighted cones or emergency vehicles positioned at the corners of the landing zone with headlights facing inward to form an X. a. Never use caution tape or ask people to mark the site. b. Do not use flares. 5. Move nonessential persons and vehicles to a safe distance outside the landing zone. Landing zone safety and patient transfer 1. You should stay away from the helicopter and go only where the pilot or crew member directs you. 2. If you are asked to enter the landing zone, stay away from the tail rotor; the tips of its blades move so rapidly that they are invisible. 5. Always approach the helicopter from the front, even if it is not running. Special considerations 1. Night landings a. Don’t shine lights in the air to help the pilot; they may temporarily blind the pilot. b. Direct low-intensity headlights or lanterns toward the ground at the landing site. c. Illuminate overhead hazards or obstructions if possible. 2. Landing on uneven ground a. If a helicopter must land on uneven ground, use extra caution. b. The main rotor blade will be closer to the ground on the uphill side. c. Approach the aircraft from the downhill side only or as directed by the flight crew. 3. Medivacs at HazMat incidents a. Immediately notify the flight crew of the presence of HazMat at the scene. b. Consult the flight crew and incident commander about the best approach and distance from the scene for a medivac. c. The landing zone should be uphill and upwind from the HazMat scene. d. Properly decontaminate patients before loading them into the helicopter. Medivac issues 1. Factors that influence the decision to request a medivac: a. Assess the severity of the weather or environment/terrain. b. Most helicopter services are limited to flying at 10,000 feet above sea level. c. Medivac helicopters fly between 130 and 150 mph. d. Because of the cabin’s confined space, assess the number and size of the patients who can be