Emergency Ambulance Response Driver's Handbook PDF

Emergency Ambulance Response Driver's Handbook It is well known that human factors are a significant contribu ng factor to most road traffic collisions. Emergency response drivers need to demonstrate the highest standards and must be appropriately trained to deal with these factors when driving und...

Emergency Ambulance Response Driver's Handbook It is well known that human factors are a significant contribu ng factor to most road traffic collisions. Emergency response drivers need to demonstrate the highest standards and must be appropriately trained to deal with these factors when driving under emergency condi ons. This chapter considers some of the skills and behaviours essen al for an emergency response driver as well as the stress factors that can impact on how drivers carry out their du es. It also covers drivers' responsibili es for ensuring the comfort of their passengers. Recognise the principles of the Goals for Driver Educa on Driving standards required by law Driving skills There are a number of important specialist elements in emergency response driving. You should possess the ability to: Deal with several complicated tasks simultaneously and to a high standard Spread your a en on during a complex drive to be able to deal with condi ons in a systema c way Build up awareness of the whole environment Plan accurately and quickly An cipate problems based on observa ons and experience Make sound judgements in all circumstances Remain alert and vigilant to ensure no hazard is overlooked. Goals for Driver Educa on In respect of standard and emergency response driving, the Goals for Driver Educa on represent an essen al apprecia on of how to structure and understand more clearly what competencies a safe driver needs and how well they will perform. Driving tasks can be described within a hierarchical framework of behaviour, conduct, competencies and decisions in a varying number of situa on +difforent levels, within a range of driving situa ons.  Driver Characteris cs and Responsibili es Recognising risk is something that underpins driver educa on.lt is important that you are aware of how physical influences of road condi ons affect a vehicle and its handling and that you are cognisant of a vehicle's controls and handling characteris cs. Poor driver a tudes and behaviours may undermine the reputa on of the ambulance service. The following factors may be influen al to poor driving standards: Medical condi ons Stressful situa ons Opera onal pressures Fa gue Traffic situa ons Driving at night me Driving in difficult weather situa ons. Ambulance drivers should no fy team leaders, supervisors or managers if any of these factors affect them. It is important that you are able to dynamically self-assess your ac ons and performance.This will help you to meet the changing circumstances and pressures you will face in your decisions and ac ons, especially when driving to incidents, when working extended hours or during challenging situa ons. Ambulance drivers may fall short of standards because of human failings and can require a measured or bespoke interven on within the structure of ambulance driver training in order to address areas of development. As there is no predetermined procedure for every conceivable type of situa on that develops, drivers must con nually perform a dynamic risk assessment on the changing environment and condi ons. You must be fully aware that a tudes related to driving under emergency response condi ons may be influenced considerably by reduced concentra on and intrusive thoughts, however insignificant they may seem. Examples may include, but are not limited to, focusing on the poten al incident that is being responded to, personal influences rela ng to work or private life and instances of physical or mental fa gue, all of which can compromise the decision-making process. A robust driving response system needs to be employed to help equip the driver with the ability to perform safely regardless of outside influences. You must bear in mind that you may be liable to prosecu on if your driving falls below a safe standard. Driving commentary is an effec ve tool to help Emergency Ambulance Response Driver's Handbook develop situa onal awareness, an cipa on planning and prepara on(see Chapter 4). The diverse range of vehicles in the statutory ambulance opera onal fleet will some mes determnine the necessity for addi onal training or even the requirement to hold certain driving licence categories. Regardless of the vehicle type, any driver responsible for a vehicle must ensure that they are appropriately trained and equipped to operate it,that they are fully conversant with the vehicle controls - by performing a pre-driving check- and that they are sa sfied that the vehicle is legally roadworthy by performing a vehicle daily inspec on (see Chapter 5). There has been some interes ng research on how different types of emergency drivers are affected by different sources of stress (Sharp et al, 1997;Dorn, 2013). Three types were iden fied: Those for whom personal reward is the most important factor, such as a salary,fringe benefits, job security and working condi ons Those who are people orientated, where helping the public, providing a service and working with people is most important Those for whom a professional career is most important, valuing the high pres ge, independence and use of professional skills required by the job. Opera onal driving stress Poor stress-coping strategies would not only mean that you fail to manage the experience of driver stress but also may intensify it. Coping strategies for drivers are based on cogni ve appraisals of the driving task, these include: Emo on-focused coping: self-cri cism from the driver, which may impair driving performance through distrac on and self-focus 30  Confron ve coping: mastery of the driving challenge through self- asser on or conflict, which is a dangerous driver-coping strategy Task-focused coping:ac ve a empts to change the external environment via a behavioural response, for example, reducing speed when driving condi ons are dangerous, which is an effec ve coping strategy in the face of driver stress 30  Driver Characteris cs and Responsibili es Avoidance coping:ignoring the stressor,o en through self-distrac on and diver ng a en on away from driving, which can impair performance Reappraisal coping: dealing with driver stress by re-appraising one's emo onal and cogni ve reac ons, which tends to have a more posi ve influence on driving behaviour. Risk taking in driving performance correlates with emo on-focused,confron ve, and avoidance coping strategies, whereas task-focused and reappraisal coping strategies usually lead to safer driving performance. The first line of defence is to recognise the factors that cause stress;the second is to rely on training. Stress can be alleviated using the following measures (Sharp et al, 1997): Using all mental capacity available Using strategies that have been learned in advance Maintaining a high level of general health Learning to relax Approaching driving in a calm, confident manner Using the skills that have been learned Trying to share difficult decision making as a team Keeping problems separate from opera onal driving Not allowing previous incidents to impair judgement Pu ng minor errors to one side Learning to recognise stresses and adjust. There are many ways to deal with these stresses. Some people may be able to employ their own coping strategies-however,anyone experiencing difficul es should obtain professional help from the various agencies that are available. 31 Emergency Ambulance Response Driver's Handbook Regardless of the type of driving being undertaken-whether standard or emergency response driving (ERD) - you have a responsibility to ensure that pa ents' and passengers' journeys are smooth and comfortable as well as safe The clinician in charge of the pa ent's care should communicate with the driver about the nature of the drive that is required during transport to a place of defini ve care. It is important to remember that the drive should be regarded as part of the treatment process and should be tailored to the par cular pa ent's needs and condi on. As an example, a pa ent who has sustained a fracture, or is suffering from rheumatoid arthri s will be par cularly suscep ble to discomfort from uneven road surfaces or potholes. There are other trauma c injuries whereby erra c accelera on, harsh braking or hasty cornering can significantly influence the pa ent's prognosis. It should be emphasised that even in the cases listed above, speed should not be so great that it interferes with the ongoing treatment of the pa ent care en route. It can be a daun ng experience for anyone travelling in the saloon of an ambulance; this is exacerbated by the lack of vision afforded,which does not allow for the an cipa on of vehice movements, which is usually experienced when travelling in a car. While engaged on emergency response driving it is useful to inform the banksman of approaching hazards that may affect vehicle movements so that they can ensure that they are safely restrained or suitably posi oned. It is therefore important that the drive is smooth and the system of car control is applied effec vely, with emphasis given to good accelera on sense,early braking for hazards and the applica on of tapered braking.  Driver Characteris cs and Responsibili es Vary the brake pedal pressure when bringing the vehicle to a stop,this will give maximum braking control and ensure smoother stopping. 1 Gently take up the free play in the brake pedal. 2 Increase the brake pedal pressure progressively,as required,to bring the vehicle to stop. 3 Relax the brake pedal pressure as unwanted road speed is lost. 4 Release the brake pedal pressure just before stopping to ensure the vehicle stops smoothly. Loading pa ents into the vehicle When loading pa ents, consider the sea ng posi on that will afford them the most comfort. A seat directly above a wheel arch will generally be more suscep ble to vibra ons. Likewise, a seat on the offside of the vehicle is liely to be more comfortable due to most uneven surfaces, drain covers for example,being nearest to the kerb. If seats in the vehicle are of different heights, try to ensure that the pa ent can reach the floor with their feet, enabling them to gain be er stability when the vehicle is cornering, and point out any handrails that may be available to them. Pa ents on a stretcher can feel vulnerable and insecure, especially as they are normally rear-facing. Ensure that they are securely fastened in with the securing belts and harnesses provided, and if their condi on permits, that they are si ng up on the stretcher. | Confronta onal behaviour For every ac on there is a reac on. If you react to a given driving situa on unfavourably it could have disastrous consequences for yourself and others. An example of when confronta onal behaviour can arise is when you are engaged in an emergency response drive and progressing through a stream of heavy traffic. Situa ons can arise when vehicles slow or become sta onary,because they have seen or heard an approaching emergency vehicle and reacted accordingly. A driver of a nearby vehicle that pulls out suddenly to overtake the slowing or sta onary vehicles because they failed to hear or see the approaching 30 Emergency Ambulance Response Driver's Handbook emergency vehicle will have an ini al reac on of a belligerent a tude towards the drivers of those vehicles. This is further compounded by the driver realising why vehicles were slowing or stopping and their subsequent realisa on that the emergency vehicle is now impeded from making safe progress. This loss of credibility in their driving capability can lead to the driver becoming confronta onal, with reac ons such as verbal abuse or hand gestures. You can diffuse the situa on by proceeding safely through without any further reac ons to the situa on. Figure 3.1 Confronta onal behaviour can cause severe consequences. 1 Describe three specialist skills that emergency response drivers should possess. 2 How frequentlyshould drivers perform dynamic risk assessments? 3 Describe two types of opera onal stress that drivers may encounter while carrying out their day-to-day du es. 4Describe two methods that can be used by drivers to deal with the effects of stress. 30 5Why must the comfort of pa ents be taken into considera on when formula ng driving plans? 6 How can different sea ng posi ons within an ambulance affect passenger comfort? 7 Describe the stress coping strategies that relate to a safer driving performance. Driving Commonr Learning outcomes By the end of this chapter you Be able to iden fy the purpose of aidrving sumientary and the key skills in delivering an effec ve commentary Understand how to give mely,relevant informa on when delivering a driving commentary.