Vol.5-Ch.9 " Ground Ambulance Operations" Flashcards
Who is in charge of broad oversight of EMS and Ambulance Standards?
Who is in charge of the more specific details?
State Government usually sets the MINIMUM STANDARDS and NOT the GOLD STANDARD, when it comes to EMS and Ambulance regulations, they set broad guidelines, such as just the essentials that are to be carried on every truck.
Local and/or regional EMS systems are in charge of specifics details such as all specific equipment to be carried on a truck. They often get much closer to reaching the Golden Standard.
Who is in charge of Ambulance design?
What is the name of the Specifications Design?
The U.S. General Services Administration’s Automotive Commodity Center issues the federal regulations that specify ambulance design and manufacturing requirements. These specifications are known as the DOT KKK 1822F Specs.
These are broad specs set by the federal level, but individual states are in charge of coming up with more specific details and standardization of design. However, a few states even come up with their own base regulations and do not follow the feds, or New York for example leaves it up to the EMS service to decide.
What are the 3 Types of basic ambulance design specified by the “KKK Specifications”?
Type I - Conventional Truck cab-chassis with a modular ambulance body
Type II - Standard van, forward control integral cab-body ambulance
Type III - Specialty can, forward control integral cob-body ambulance
Who is in charge of medical equipment standards?
OSHA is the national agency in charge of setting standards in equipment to help protect the worker. There are other agencies such as NIOSH and NFPA that help set additional standards. Local or State Medical Direction Boards also have some control over medications on board.
At the national level, who determines the Gold Standard?
The Commission on Accreditation of Ambulance Services (CAAS) sets the Gold Standard for EMS systems to follow. This includes requiring that onboard medical equipment and supplies comply with state and local guidelines. In the absence of their Gold Standard recommendations they require that at a minimum EMS follows the guidelines set by the American College of Surgeons (ACS).
What are some things that are helped by Ambulance Check Offs?
- Reminds personnel exactly where things are
- Ensures all equipment is available and operable
- Makes the work environment safer
- Helps mitigate risk
- Ensures drugs aren’t expired
- Ensures the truck is properly cleaned (cleaning should be documented after calls if needed)
What is “Deployment” referring to and what are the 4 major factors?
Deployment is the strategy used by an EMS agency to maneuver its ambulances and crews in order to reduce response times.
- Location of facilities to house ambulances
- Location of hospitals
- Anticipated call volume
- Local geographic and traffic considerations
Ideal deployment takes into account what two major factors?
- Past community responses and projected DEMOGRAPHIC changes
- Highest volume of calls, or PEAK LOAD, should be described both in terms of the day of the week and the time of day.
What is the Primary Area of Responsibility (PAR)?
It is used when communities do not have multiple strategic stations. It is the area that services deploy ambulances to stage and wait for calls at high volume areas. The PAR can move throughout the day as the population moves and can be just a few blocks or can be an entire sector of town.
What is the minimum response time that is associated with improved patient outcomes?
What is the Industry Standard of response time?
Response times of 4 minutes or less have been proven to end in better pt outcomes.
The industry standard of response time is 8 minutes, which is not showing that it improves pt outcomes.
What is System Status Management (SSM)?
What is a Tiered Response System (TRS)?
System Status Management (SSM) is a computerized personnel and ambulance deployment system designed to meet service demands with fewer resources and to ensure appropriate response times and vehicle locations. This has been growing in popularity.
A Tiered Response System is a system in which public safety agencies trained as first responders and carry and AED are sent first and can easily make the 4 minute window, then a second 2nd tier back up is sent that brings an ALS unit to the pt within the 8 minute window.
What does Reserve Capacity refer to in an EMS system?
Reserve Capacity is the ability to muster additional crews when all ambulances are on call or when as system’s resources are taxed by a multiple-causality incident. This is sometimes achieved by giving off-duty medics pagers.
Under what conditions did the most ambulance collisions occur?
Data shows that most collisions occur as “a LATERAL collision that takes place on a DRY road during DAYLIGHT hours on a CLEAR DAY in an INTERSECTION with a TRAFFIC LIGHT”
What are 7 guideline recommendations to implement that might help reduce ambulance collisions?
- Routine use of driver qualification checklists and driver’s license checks, either through the local police or the DMV
- Demonstrated driver understanding of preventative mechanical maintenance including vehicle operator checklist and reporting failures/malfunctions
- Provision of adequate hands-on driver training, using experienced and qualified field officers.
- Implementation of a slow-speed course to ensure that operators know how to use mirrors, back up, park, and handle ambulance-sized vehicles, including accurate demonstration of braking distance and turn radius.
- Training that ensures operators know how to react to emergency situations such as the loss of brakes, loss of power steering, a stuck accelerator, a blown-out tire, or a vehicle breakdown
- Demonstrate driver knowledge of both the primary and backup routes to all hospitals in your service response area
- Demonstrated driver understanding of the rules, regulations, and laws that your DMV has established for drivers in general and for ambulance operators in particular
What is the Due Regard Standard?
It is a legal concept that most state laws adopt where it exempts ambulance drivers from certain laws but at the same time holds them to a higher standard. However that are a few situations in which ambulance drivers are not exempt such as passing over a railroad when the guards are down or passing a stopped school bus with the stop sign out. In spite of these guidelines, it is still up to the driver when to take advantage of the exemptions and will be held responsible for accidents caused.
