Summary of "Chp 38 Transport Operations"

Summary of “Chp 38 Transport Operations”

This video lecture covers Chapter 38: Transport Operations, focusing on the safe and effective operation of ground ambulances, air medical transport, infection control, and related safety protocols. It provides detailed explanations of ambulance types, phases of ambulance calls, equipment organization, safe driving practices, air medical operations, and decontamination procedures. The content also integrates practical safety lessons, legal considerations, and operational guidelines.

Main Ideas and Concepts

1. Overview of Transport Operations

Transport operations include ground ambulance operation, air medical care, infection control, and decontamination.
Ambulances are stocked with both standard and advanced medical equipment capable of transmitting data to hospitals.
Rapid response is critical but increases risk to EMTs and the public.

2. Ambulance Design and Types

Ambulances must comply with National Fire Protection Association (NFPA) standards.
Three main types:
- Type I: Truck cab with ambulance box.
- Type II: Standard van ambulance.
- Type III: Van front with modular box (most common).
Ambulances have a driver’s compartment and patient compartment designed for safety, efficiency, and comfort.
Ambulance markings (Star of Life) and color standards vary by state.

3. Phases of an Ambulance Call

Preparation: Includes education, physical readiness, and ambulance/equipment checks.
Dispatch: Receiving detailed call information (nature, location, number of patients).
En Route: Planning and reviewing roles with partner.
On Scene: Scene safety assessment, PPE usage, and patient care.
Transport: Securing patient and equipment, monitoring patient, communicating with dispatch.
At Hospital: Patient handoff, verbal report, ambulance restocking and cleaning.
Post-Run: Reporting, vehicle maintenance, refueling, and deep cleaning.

4. Ambulance Equipment and Organization

Equipment must be approved by the medical director.
Supplies stored based on frequency and urgency of use (e.g., airway supplies near the patient’s head).
Standard equipment includes suction, CPR board, splints, OB kit, AED, and power cots.
Jump kits (or jump bags) contain essential supplies for first five minutes of patient contact.
External compartments hold PPE, extrication tools, navigation devices, and other operational gear.

5. Safety Precautions

Daily inspections of ambulance and equipment are mandatory.
Ensure all safety devices (lights, sirens, oxygen tanks) are functional and secured.
Seat belts must be worn by all occupants at all times.
Drivers must know traffic laws and drive defensively, assuming other drivers may not yield or notice the ambulance.
Avoid distractions (radios, GPS, phones, music).
Use mirrors extensively; never look over the shoulder while driving.
Use spotters when backing up the ambulance.
Excessive speed and siren syndrome (driving faster due to excitement) increase crash risk.
Intersections are the most common crash sites; approach with extreme caution.
Follow state-specific laws for emergency vehicle operation, including when and how to use lights and sirens.
Escorts by police can be helpful but also pose risks due to driver behavior.

6. Air Medical Transport

Air medical crews typically include paramedics, nurses, and sometimes physicians (no EMTs).
Helicopters are used for time-sensitive cases (major trauma, stroke, cardiac arrest, remote locations).
Fixed-wing aircraft handle longer transports.
Fire departments usually establish helicopter landing zones (LZ).
Recommended LZ size: approximately 100x100 feet, clear of debris and hazards.
Mark LZ with cones or vehicles; never use caution tape or flares.
Approach helicopters only from the front, crouching to avoid rotor blades.
Night landings require special precautions (no flashlights aimed at pilots, use lanterns).
Weather can limit helicopter use; some helicopters have altitude and speed limits.
Air medical transport is expensive but provides faster and smoother patient transport.

7. Infection Control and Decontamination

Remove and discard linens at the hospital.
Discard medical waste properly.
Clean contaminated areas with soap and water.
Disinfect non-disposable equipment and ambulance surfaces with germicidal or diluted bleach solutions.
Decontaminate patients before air transport.
Follow cleaning, disinfection, high-level disinfection, and sterilization protocols.

Detailed Instructions and Guidelines

Ambulance Call Phases and Procedures

Preparation:
- Attend classes and training.
- Ensure physical fitness.
- Stock and organize ambulance equipment.
- Perform daily ambulance inspections.
Dispatch:
- Receive patient info: nature of call, location, number of patients.
- Confirm callback number.
En Route:
- Review dispatch info with partner.
- Plan roles and actions.
- Use GPS or navigation aids.
On Scene:
- Park ambulance safely (100 feet before/after scene, uphill and upwind).
- Wear PPE and carry extra gloves.
- Assess hazards (fires, downed wires, unstable structures).
- Request additional resources if needed.
- Use TIMS (Traffic Incident Management System) principles for scene safety.
Transport:
- Secure patient with seatbelt on cot.
- Monitor patient condition continuously.
- Communicate with dispatch (patient count, destination, mileage).
At Hospital:
- Transfer patient physically to hospital staff.
- Provide verbal report.
- Complete run report in designated area.
- Restock and clean ambulance before leaving hospital.
Post-Run:
- Refuel and perform routine vehicle maintenance.
- Conduct deep cleaning and restock supplies.

Ambulance Driving Safety Tips

Always wear seat belts.
Drive defensively; assume other drivers may not yield.
Avoid excessive speed; speed does not improve patient outcome.
Use sirens and lights only when necessary per protocols.
Use mirrors extensively; never rely on shoulder checks.
Use a spotter when backing up.
Slow down for corners, weather conditions, and unpaved roads.
Follow local laws for emergency vehicle operation.
Avoid distractions (radio, phone, music).
Avoid confrontations with other drivers.

Air Medical Landing Zone Setup

Size: 60x60 to 100x100 feet clear area.
Clear debris, overhead hazards, and loose objects.
Mark with cones or vehicles, not caution tape or flares.
Keep non-essential personnel away.
Communicate wind direction to flight crew.
Approach helicopter only from front and crouch.
Avoid tail rotor area.
Use special precautions for night landings.

Infection Control Protocols

Remove and discard linens at hospital.
Dispose of medical waste properly.
Clean contaminated surfaces with soap and water.
Disinfect equipment and ambulance surfaces with germicidal or bleach solution.
Decontaminate patients before air transport.

Key Safety Lessons and Warnings

Proper rest and alertness are critical for ambulance drivers.

Seat belts save lives; failure to wear them can be fatal.

Siren syndrome leads to dangerous driving behaviors.

Intersections are the most dangerous locations for ambulance crashes.

Hydroplaning can occur at speeds of 30 mph or greater on wet roads.

Do not confront other drivers; avoid road rage.

Air medical transport is costly and should be reserved for appropriate cases.

Always prepare for hazardous material situations by parking uphill and upwind.

Speakers / Sources Featured

Primary Speaker: An EMS instructor or paramedic educator (unnamed).
References to National Fire Protection Association (NFPA) standards.
Mention of National Traffic Incident Management System (TIMS) training.
Anecdotes from paramedics and EMS personnel (including a paramedic student fatality).
Information aligned with National Registry EMT testing standards.

This summary encapsulates the core teachings and operational guidelines from the video on transport operations in EMS, emphasizing safety, preparedness, and professionalism in both ground and air medical transport contexts.