Ambulance Safety & Design PDF

AMBULANCE SAFETY & DESIGN AMBULANCE SAFETY  Safety is always a priority when working as a paramedic:  Paramedic Safety Culture & Patient Safety Culture  Safety priorities – Paramedic, Partner, Patient, Public. are te...

AMBULANCE SAFETY & DESIGN AMBULANCE SAFETY  Safety is always a priority when working as a paramedic:  Paramedic Safety Culture & Patient Safety Culture  Safety priorities – Paramedic, Partner, Patient, Public. are terms that are frequently heard in EMS and majorly influence policy, protocol and decision making.  Ambulance design is a key factor in keeping everyone  “ “Culture” in its simplest form, consists of the attitudes, beliefs, safe. Many factors of the design come from: and perceptions of a collective group of people. It shapes their behaviors, decisions, and choices and is therefore a complicated  Safety Culture but highly influential component of the safety equation.” –  Research Studies & Test Trials Lee Varner - EMS World  Incident Reporting & Investigation AMBULANCE DESIGN  AMBULANCE DESIGN  Crash tested materials.  When designing an ambulance, there are many, many factors that need to be considered.  Appropriate mechanical specs for the job.  Brakes, suspension, power, noise, etc.  A major priority is safety, however functionality and comfort are also very important.  Interior & exterior layouts to maximize efficiency.  Ambulances are at increased risk of crash due to the  Cabinet placement & equipment storage. use of emergency features, day & night operation, and use in adverse conditions, such as storms.  Seating placement & occupant restraint systems.  The ambulance needs to be able to stand up to the  Airbag systems. job, as well as provide a paramedic & patient centric  Emergency entrance & egress. design, ensuring the best care is always provided.  Paramedic & patient comfort. WOULD YOU WANT TO SIT THERE? IT COULD HAPPEN TO YOU “UNRESTRAINED AMBULANCE OCCUPANTS, OCCUPANTS RIDING IN THE PATIENT COMPARTMENT AND ESPECIALLY UNRESTRAINED OCCUPANTS RIDING IN THE PATIENT COMPARTMENT WERE AT SUBSTANTIALLY INCREASED RISK OF INJURY AND DEATH WHEN INVOLVED IN A CRASH.” RELATIVE RISK OF INJURY AND DEATH IN AMBULANCES AND OTHER EMERGENCY VEHICLES – TY - JOUR, AU - BECKER, LES R, AU - ZALOSHNJA, E, AU - LEVICK, NADINE, AU - LI, GUOHUA, AU - MILLER, TED, PY - 2003/12/01, SP - 941, EP - 8 JO - ACCIDENT; ANALYSIS AND PREVENTION PATIENT TRANSPORT & RESTRAINTS  Patients restraint systems must be used anytime a patient is being transported. This includes securing straps, seatbelts, and stretcher mounting systems.  Extrication, Lifting & Moving.  Inside the patient compartment while the ambulance is moving.  Patient restraints must be used appropriately and secured snugly in order to be effective.  Equipment modifications should never be used unless approved by the manufacturer.  Defective equipment should never be used – safety is the main priority. PATIENT TRANSPORT & RESTRAINTS  Appropriate tools for the job.  Extrication & Transfer  Correct style stretcher.  Appropriate loading dock.  Stretcher securing straps with shoulder harness.  Crash resistant stretcher mounting system.  Stretcher securing strap adaptions.  Length extensions.  Infant & Child Adaption.  Car seat connections for stretcher and/or patient compartment seats. NEONATE & INFANT CHILDREN PARAMEDIC RESTRAINTS  Paramedics often feel wearing a seatbelt is not necessary or interferes with providing patient care. This has resulted in death & injuries during crashes.  Older ambulance design did not always consider how the paramedic would provide care while still remaining safely restrained during transport.  The use of bench seats with lap belts was still an acceptable practice as recently as 10 years ago.  Newer designs have carefully examined the needs of the paramedic, their ability to continue care during transport, and the safety of doing so. RESTRAINT STYLES CLICK ME! https://local21news.com/news/local/new-technology-aims-to-keep-first- responders-safe-while-on-the-road-to-calls PARAMEDIC RESTRAINTS  Paramedics should be restrained whenever possible during the transport of a patient.  Harness style seatbelts are the new safety standard, allowing for movement to provide patient care, as well as crash protection.  Paramedics should sit in a forward facing seat, vs. a side or rear facing seat, whenever possible.  Using devices such as a Lucas or Mechanical Ventilator can assist with paramedic safety during transport of critical patients, allowing for them to remain safely seated and secured. SECURING THE PARAMEDIC, PATIENT & EQUIPMENT SECURING AND STORING EQUIPMENT  Design and Manufacturing of the ambulance needs to consider things such as:  Cabinet location, design and strength.  Location of equipment in the patient compartment.  Ease of use and access by the paramedic.  Trip hazards (wires, cords, equipment placement).  Crash resistant equipment mountings.  (stretcher, monitor, suction, equipment kits, stair chair, backboards, sharps, tablet, etc.).  Any potential projectiles during a crash.  Unsecured equipment becomes projectiles during a crash, majorly increasing risk of injury or death.  Your cardiac monitor is basically a 30lb projectile if it’s not properly secured! EQUIPMENT STORAGE LOCATIONS  Interior Access Compartments  Exterior Access Compartments  Interior Cabinets  Combination or exterior access only or Interior/Exterior  Labelled and/or numbered access compartments.  Equipment Specific Areas  Kit bags and cardiac monitor should be accessible from an  Airway Cabinet, IV Cabinet, Medication Cabinet, etc. exterior compartment. It is usually interior/exterior mix.  Wall mounted pouches/bags  Extrication equipment is commonly found in exterior  Easy access and often used frequently used equipment, such as oxygen compartments. masks or IV kits.  Oxygen M tank compartment is usually found in an exterior  Equipment towers/actions areas. compartment.  Ideally have working space for equipment set up.  Interior access to pressure gauge is common.  Often have equipment mounting stations on top, ie; monitor.  Mass Casualty Kits.  Bench seat storage  Road Safety Equipment  Hinged seat that allows storage underneath.  High visibility gear, traffic cones, safety tape, etc.  Equipment Kits  This may also be located in the driver/passenger areas.  These are usually accessible from the inside & outside of the  Spare tires and tools. ambulance. SECURING & STORING EQUIPMENT EQUIPMENT STORAGE LOCATIONS ENTRANCE & EXIT  Ambulances usually sit higher off the ground than normal vehicles, making entry and exit a safety hazard.  They come equipped with rear and side steps, slip resistant finishes, and assist handles to provide safe entry and exit of the ambulance.  The top of the doorway may also be padded to prevent head strikes. LIGHTS & SIRENS – EMERGENCY RESPONSE  Extreme caution must be used when operating an ambulance with lights & sirens:  Lights & Sirens should be used together, even at night.  Always stop at intersections – never assume you have the right of way.  “Clear Right – Clear Left”  Do not follow close behind other emergency responder's.  Drivers often pull over for the first vehicle and then return to traffic without looking for additional emergency vehicles.  Follow speed limits – consult your company policy.  Always slow down in school zones and residential areas.  Children are often curious and may run into the roadway. LIGHTS & SIRENS – EMERGENCY RESPONSE  2019 Study - Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? A Contemporary Analysis Using National EMS Information System (NEMSIS) Data  the response phase crash rate was 4.6 of 100,000 without lights and sirens and 5.4 of 100,000 with lights and sirens  For the transport phase, the crash rate was 7.0 of 100,000 without lights and sirens and 17.1 of 100,000 with lights and sirens  Conclusion: Ambulance use of lights and sirens is associated with increased risk of ambulance crashes. The association is greatest during the transport phase. EMS providers should weigh these risks against any potential time savings associated with lights and sirens use. https://pubmed.ncbi.nlm.nih.gov/30648537/#:~:text=Conclusion%3A%20Ambulance%20use%20of%20lights,with%20lights%20and%20sirens%20use. LIGHTS & SIRENS  Lights:  Standard colours for the service provider.  Highly visible in bright and no light.  Flashing, oscillating and/or rotating.  Visible from all angles of the vehicle.  Siren:  Hands free control.  Loud enough to be heard as approaching vehicles.  Multiple sounds & frequencies.  Wail,Yelp, Piercer, Phaser, Hi-Lo, Air Horn, Rumbler, loud speaker.  Changing siren tones can help alert drivers of your presence. STANDARD FEATURES  High visibility exterior and open door interior.  Padded & Rounded corners/edges.  GPS tracking and speed monitoring.  Multiple grab bars for standing and moving.  In vehicle safety coaching.  Slip resistant flooring.  Driver & Passenger Air Bags.  Non-permeable interior.  Adaptive braking systems.  Infection control design in mind.  Adaptive Stability Control.  Secure closing of sharps containers.  Battery back-up system.  Oxygen securing area.  Reversing alarm.  Fire extinguishers.  Noise Control.  Heating, cooling, & ventilation.  Central and external door lock system.  Communication system. WHAT’S WRONG WITH THIS PICTURE?