Emergency Ambulance Response Driver's Handbook PDF

Emergency Ambulance Response Driver's Handbook emergency vehicle will have an initial reaction of a belligerent attitude towards the drivers of those vehicles. This is further compounded by the driver realising why vehicles were slowing or stopping and their subsequent realisat...

Emergency Ambulance Response Driver's Handbook emergency vehicle will have an initial reaction of a belligerent attitude towards the drivers of those vehicles. This is further compounded by the driver realising why vehicles were slowing or stopping and their subsequent realisation 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 confrontational, with reactions such as verbal abuse or hand gestures. You can diffuse the situation by proceeding safely through without any further reactions to the situation. '.nr- Mi Figure 3.1 Confrontational behaviour can cause severe consequences. KNOWLEDGERre '4' 1 Describe three specialist skills that emergency response drivers should possess. 2 How frequently should drivers perform dynamic risk assessments? 3 Describe two types of operational stress that drivers may encounter while carrying out their day-to-day duties. 4 Describe two methods that can be used by drivers to deal with the effects of stress. 5 Why must the comfort of patients be taken into consideration when formulating driving plans? 6 How can different seating positions within an ambulance affect passenger comfort? 7 Describe the stress coping strategies that relate to a safer driving performance. 34  Driver Characteristics and Responsibilities Braking smoothly 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 patients into the vehicle When loading patients, consider the seating position that will afford them the most comfort. A seat directly above a wheel arch will generally be more susceptible to vibrations. Likewise, a seat on the offside of the vehicle is likely 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 patient can reach the floor with their feet, enabling them to gain better stability when the vehicle is cornering, and point out any handrails that may be available to them. Patients 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 condition permits, that they are sitting up on the stretcher. Confrontational behaviour For every action there is a reaction. If you react to a given driving situation unfavourably it could have disastrous consequences for yourself and others. An example of when confrontational behaviour can arise is when you are engaged in an emergency response drive and progressing through a stream of heavy traffic. Situations can arise when vehicles slow or become stationary, 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 stationary vehicles because they failed to hear or see the approaching 33  Emergency Ambulance Response Driver's Handbook I Driver and attendant's responsibility to ensure passenger safety and comfort Regardless of the type of driving being undertaken - whether standard or emergency response driving (ERD) - you have a responsibility to ensure that patients' and passengers' journeys are smooth and comfortable as well as safe. Remember! The clinician in charge of the patient's care should communicate with the driver about the nature of the drive that is required during transport to a place of definitive care. It is important to remember that the drive should be regarded as part of the treatment process and should be tailored to the particular patient's needs and condition. As an example, a patient who has sustained a fracture, or is suffering from rheumatoid arthritis will be particularly susceptible to discomfort from uneven road surfaces or potholes. There are other traumatic injuries whereby erratic acceleration, harsh braking or hasty cornering can significantly influence the patient'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 patient care en route. It can be a daunting 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 anticipation of vehicle 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 positioned. It is therefore important that the drive is smooth and the system of car control is applied effectively, with emphasis given to good acceleration sense, early braking for hazards and the application of tapered braking. 32  Driver Characteristics and Responsibiliti< s ► Avoidance coping: ignoring the stressor, often through self-distraction and diverting attention away from driving, which can impair performance ► Reappraisal coping: deaiing with driver stress by re-appraising one's emotionai and cognitive reactions, which tends to have a more positive infiuence on driving behaviour. Risk taking in driving performance correlates with emotion-focused, confrontive, 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 y Using strategies that have been learned in advance ► Maintaining a high level of general health y Learning to relax ► Approaching driving in a calm, confident manner y Using the skills that have been learned y Trying to share difficult decision making as a team y Keeping problems separate from operational driving y Not allowing previous incidents to impair judgement y Putting minor errors to one side ► Learning to recognise stresses and adjust. Professional support There are many ways to deal with these stresses. Some people may be able to employ their own coping strategies - however, anyone experiencing difficulties should obtain professional help from the various agencies that are available. 31  Emergency Ambulance Response Driver’s Handbook develop situational awareness, anticipation planning and preparation (see Chapter 4). Training and equipment The diverse range of vehicles in the statutory ambulance operational fleet will sometimes determine the necessity for additional 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 satisfied that the vehicle is legally roadworthy by performing a vehicle daily inspection (see Chapter 5). There has been some interesting research on how different types of emergency drivers are affected by different sources of stress (Sharp et al, 1997; Dorn, 2013), Three types were identified: ► Those for whom personal reward is the most important factor, such as a salary, fringe benefits, job security and working conditions ► 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 prestige, independence and use of professional skills required by the job. Operational driving stress Poor stress-coping strategies would not only mean that you fall to manage the experience of driver stress but also may intensify it. Coping strategies for drivers are based on cognitive appraisals of the driving task, these include: ► Emotion-focused coping: self-criticism from the driver, which may impair driving performance through distraction and self-focus ► Confrontive coping: mastery of the driving challenge through self- assertion or conflict, which is a dangerous driver-coping strategy ► Task-focused coping: active attempts to change the external environment via a behavioural response, for example, reducing speed when driving conditions are dangerous, which is an effective coping strategy in the face of driver stress 30  Driver Characteristics and Responsibilities! Recognising risk is something that underpins driver education. It is important that you are aware of how physical influences of road conditions affect a vehicle and its handling and that you are cognisant of a vehicle’s controls and handling characteristics, Poor driver attitudes and behaviours may undermine the reputation of the ambulance service. The following factors may be influential to poor driving standards: ► Medical conditions Stressful situations Operational pressures Fatigue Traffic situations Driving at nighttime Driving in difficult weather situations. Ambulance drivers should notify team leaders, supervisors or managers if any of these factors affect them. It is important that you are able to dynamically self-assess your actions and performance, This will help you to meet the changing circumstances and pressures you will face in your decisions and actions, especially when driving to incidents, when working extended hours or during challenging situations. Ambulance drivers may fall short of standards because of human failings and can require a measured or bespoke intervention 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 situation that develops, drivers must continually perform a dynamic risk assessment on the changing environment and conditions. You must be fully aware that attitudes related to driving under emergency response conditions may be influenced considerably by reduced concentration and intrusive thoughts, however insignificant they may seem. Examples may include, but are not limited to, focusing on the potential incident that is being responded to, personal influences relating to work or private life and instances of physical or mental fatigue, 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 prosecution if your driving falls below a safe standard. Driving commentary is an effective tool to help 29  Emergency Ambulance Response Driver's Handbook It is well known that human factors are a significant contributing 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 conditions. This chapter considers some of the skills and behaviours essential for an emergency response driver as well as the stress factors that can impact on how drivers carry out their duties. It also covers drivers' responsibilities for ensuring the comfort of their passengers. I Recognise the principles of the Goals for Driver Education 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 attention during a complex drive to be able to deal with conditions in a systematic way ► Build up awareness of the whole environment ► Plan accurately and quickly ► Anticipate problems based on observations and experience ► Make sound judgements in all circumstances Remain alert and vigilant to ensure no hazard is overlooked. Goals for Driver Education In respect of standard and emergency response driving, the Goals for Driver Education represent an essential appreciation 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 situations at different levels, within a range of driving situations. 1 28  3 Driver Characteristics and Responsibilities Learning outcomes By the end of this chapter you should: Know the specialist skills required by emergency response drivers. Understand how driver attitudes and behaviour can contribute to increased risk. Recognise how intrusive thoughts can influence the decision making process. ( Recognise the different operational driving stress factors that may impact on emergency response drivers and how their i effects can be combated. Recognise how passenger comfort can be compromised and the driver's responsibility to prevent this. \ r I I.