MMSR Manual 2021-Standard 6 (Ambulance Service).pdf

Standard 6 AMBULANCE SERVICE Attachments: FIGURE 6-1 Ambulance - Vehicle Specs FIGURE 6-2 Ambulance Daily checklist (Van Type) FIGURE 6-3 Vehicle (Ambulance) Condition Report – Daily Checks FIGURE 6-4 Ambulance Movement Log FIGURE 6-5 Monthly Ambulance Statistics...

Standard 6 AMBULANCE SERVICE Attachments: FIGURE 6-1 Ambulance - Vehicle Specs FIGURE 6-2 Ambulance Daily checklist (Van Type) FIGURE 6-3 Vehicle (Ambulance) Condition Report – Daily Checks FIGURE 6-4 Ambulance Movement Log FIGURE 6-5 Monthly Ambulance Statistics 117 118  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code No NA Yes 6.0 Ambulance Service The CC/ HCP shall ensure that their medical facilities provide, or make arrangements to 6.1 provide, a dedicated emergency AMBULANCE vehicle to transport the sick and injured to a CC/HCP hospital facility for further management. The CC/ HCP shall ensure that their AMBULANCE is a two-wheel or four-wheel 6.2 (2WD/4WD) drive vehicle depending on location and terrain condition (e.g., tracks, CC/HCP dirt roads, etc.). 4x4WD is recommended for all off road areas. The CC/ HCP shall ensure that every AMBULANCE vehicle specifications is provided at a 6.3 minimum with the followings: CC/ HCP 1. Proper warning flashlights. 2. Purpose markings as follows: a. Red Crescent Insignia. b. AMBULANCE signs painted on the outside. 1. Air conditioning unit in the patient compartment. 2. Fire extinguisher ABC, small type. 3. Appropriate communication device (radio, cellular and/or satellite phone) with available network and appropriate frequency. AMBULANCE essential medical emergency and resuscitation supplies at a minimum include, but are not limited to: 6.4 Some additional items have been included in order to back up the emergency response bag HCP supplies. The items marked with an *asterisk, are loaded-up at the time of dispatch. 1. *Emergency Response Bag. 2. *Automated External Defibrillator (AED). 3. *Suction machine (portable) with the following accessories: a. Suction catheters. b. Tubing. 4. *Portable oxygen resuscitation unit (e.g., Robert Shaw unit or other). 5. *Entonox/ Nitronox unit 11  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code Yes No NA 6.0 Ambulance Service 6. Stretcher collapsible (Ferno or other). 7. Backboard short with straps. 8. Long board with straps. 9. Hare traction. HCP 10.Kendrick Extrication Device (KED). HCP 11.Oxygen cylinder, large size (modular and van type only). HCP 12.At a minimum, the following oxygen supplies accessories are available: HCP a. Rebreathing mask. b. Nasal cannulas. c. Tubing. 13.Oxygen cylinder key. HCP 14.Rigid cervical collar, sizes as follow or flexible size: HCP a. Small. b. Medium. c. Large. 15.Infection/Environmental control items and Personal Protective Equipment (PPE) HCP include, but not limited to: a. Goggles. b. Surgical mask. c. Plastic apron. d. Examination gloves (sterile). e. Examination gloves (unsterile). f. Small sharps container. g. Infectious waste plastic bag. h. Plastic trash bag. i. Heavy duty gloves. j. Safety hard hat. k. Safety shoes. 122  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code No NA Yes 6.0 Ambulance Service 16.First aid kit - unit size 36 & FA supplies as follows: Refer to Figure 1-4 HCP a. Ace bandages b. Kerlix bandages c. Cold packs. d. Scissors 17.Miscellaneous items include, but are not limited to: HCP a. Notepad. b. Pen. c. Flash light, 9 volt. d. Tire gauge. e. Kleenex tissue. f. Safety triangle. The HCP shall ensure that the AMBULANCE equipment and supplies are checked daily, or 6.5 after each patient trip. Inspections are recorded and available upon request. Refer to HCP Figure 6-2 The HCP shall ensure that the AMBULANCE is taken for a test run on a daily basis. The 6.6 vehicle condition is checked and recorded and available upon request. Refer to HCP Figure 6-3 The HCP shall ensure that their AMBULANCE is thoroughly cleaned inside and washed 6.7 outside on a weekly basis or after a patient run, if necessary and the Ambulance HCP Movement Log is completed. Refer to Figure 6-4 12  SURVEY AND COMPLIANCE REVIEW REPORT Instructions: Tick ()) Yes or NO or write “NA” where not Applicable Item Standards Responsible Date: Comments Code No NA Yes 6.0 Ambulance Service The HCP shall ensure that their AMBULANCE (s) have valid (quarterly) periodic 6.8 maintenance and the required Government Periodic Inspection with Documentation HCP evidence is available upon request. The CC and HCP shall ensure that each AMBULANCE is covered with valid 6.9 CC/HCP Comprehensive Insurance and valid registration. The VEHICLE REGISTRATION card (Isthimara) indicates that the used vehicle is registered 6.10 CC/HCP as an AMBULANCE. Complete Ambulance Statistics forms at the end of each month. Refer to 6.11 Figure 6-5 122 Figure 6-1 AMBULANCE – MINIMAL VEHICLE SPECIFICATIONS SN REQUIRED ITEMS MINIMUM SPECIFICATIONS REMARKS (√) 1. Engine 6 cylinder minimum 2. Transmission Automatic/Manual 3. Steering Power steering with tilt column 4. Brakes Power Assisted Safety (a) Air bags Driver and front passenger (b) Fire Fire extinguisher – type ABC small. (c) Triangles Holders/Brackets for portable equipment 5. (oxygen/suction) (d) Equipment Overhead IV holder/hook (e) Warning i. Lights - Beacon & dome light * With available network and the ii. Siren system, amplifier & microphone. appropriate frequency. iii. Communication device (Radio/cell phone/ satellite)* Factory installed. Driver & patient’s cabin. Roof 6. Air Conditioning type ventilation fan. Front bench seats. Patient’s cabin. Attendant’s seat with storage 7. Seating compartment underneath. Final height must not be higher than 36 cms. Tires Radial sand tires with speed rating of 120 KPH 8. minimum. 9. Spare tire Full size spare tire. Floor High grade embossed vinyl flooring. Partition Half or full wall partition behind driver. If full with sliding window. Storage Cabinet with sliding door on the left side of the ambulance. 10. Tow hooks Front, attached to chassis. Glass Tinted. 70% transparent heat film (V-cool or 3M). 11. Color White, single color. a. Complete light system in driver’s and patient’s 14. Lights cabin b. Scene/spot light mounted at rear top of vehicle. Oxygen system Individual cylinder** secured with brackets or centralized ** size ”E” or 680L (volume) 15. system. 16. Suction system Portable machine or centralized system. External. Reflective with “AMBULANCE” *** in *** Inverted 17. Signage English & Arabic & Red Crescent insignia. **** E.g. Suburban, GMC Yukon, Ford Expedition, In case of a carryall vehicle****, the roof must be Move upToyota, etc. Conversion shall 18. Roof conversion raised 10 inches (minimum) above regular height. The be by manufacturer or the vehicle is raised area shall be reinforced fiberglass. imported and registered as an ambulance. 123  Figure 6-2 Daily Ambulance Checklist (Van Type) Month & Year: Ambulance # Clinic: Equipment Qty 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LEFT REAR SIDE Oxygen Tank 1 Short backboard with 3 straps 1 Hare Traction 1 LEFT TOP 1st COMPARTMENT Ambu-bag 1 Non-rebreather mask & nasal cannula 2 ea O2 Tubing 2 Minilator with connector & Tube (2 1 meters) O2 Nipples 10 Liters 5 Oxygen Flow meter D&E 1 ea LEFT TOP 2 COMPARTMENT nd Ambu-bag 1 Non-rebreather mask & nasal cannula 2 ea Suction Catheters size 10 & 14 2 ea Suction connecting tubing 1 Yankeur Sucker 1 LEFT MIDDLE SHELF-TOP Arm Sling & Swath 1 Arm-boards (Adult & Pediatric) 2 ea Cold Pack 2 Kerlix Bandages 4 Non Sterile Gauze (100 / pack) 2 Sterile Abdominal Pads 4 Sterile saline (1000ml) 1 Multi-Trauma Pack 4 Burn Pack 2 124  Daily Ambulance Checklist (Van Type) Month & Year: Ambulance # Clinic: Equipment Qty 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LEFT MIDDLE SHELF-BOTTOM C-Collar (Hard)Fits all size 2 Tissues(Box) 1 Gloves (large, medium & small) 1 ea Face shield (Goggles) 3 Plastic Gown 3 Yellow Infectious Waste Bags(Roll) 1 UNDER BENCH SEAT Scoop Stretcher 1 Urinal / Bedpan 1 ea ON BENCH SEAT Long Backboard with 4 Straps 1 DRIVER CABINET Helmet 3 Reflective Vest (Nurse x 2, Driver x 1) 3 BACK SIDED NURSE SEAT Igloo Water Cooler 1 Ferno Collapsible Stretcher 1 Portable Air Compressor 1 Missing Item Replaced: Yes or No Y/N Any missing items should be replaced immediately or explain below and report. Problems/ Action Date Initials of Checker 125 Figure 6-3 Vehicle (Ambulance) Condition Report – Daily Checks Medical Facility: Vehicle No.: Day Checked and Initials Remarks if Deficient Item Code Items Checked 1 2 3 4 5 6 7 A.1 General cleaning inside and outside. A.2 Air conditioning. A.3 Directional lights. A.4 Fuel gauge. A.5 Horn. A.6 Siren. A.7 Mirrors. A.8 Steering wheel. A.9 Seat belts. A.10 Hand brake. A.11 Foot brake. A.12 Radio communication. A.13 Engine oil/Transmission oil. A.14 Fan belts. A.15 Radiator. A.16 Wiper water reservoir level. A.17 Battery. A.18 Flashers. A.19 Head lights, low and high beam. A.20 Tail lights. A.21 Stop lights and parking lights. A.22 Muffler. A.23 Tire condition and pressure. A.24 Spare tire and tire changing tools. A.25 Triangle. A.26 Fire extinguisher. Daily Test Run Mileage Record (km) 1 2 3 4 5 6 7 Mileage - Out Mileage - In Vehicle (Ambulance) Condition Report – Daily Checks 126 Figure 6-4 AMBULANCE MOVEMENT LOG Location: Ambulance 110 or Patient’s Name & Signature & Date Time Nature of Incident Incident Location Mileage Outcome Regular call Badge # Time out Time in Mileage in Badge # out Note: 1. Enter all calls, to include False Alarms, Ambulance runs, and MEDEVACs; 2. Enter patient’s condition at the time of turnover under OUTCOME, i.e., Stable, Unstable, or Expired; 3. Enter N/A for items that are not applicable. 127 Figure 6-5 Monthly Ambulance Statistics Month & Year Clinic Vehicle # Next PM Aramco ∆ Curent Month Last month Mileage done # of Runs Service Due Sticker Mileage reading Mileage reading this month (A- this month Date Exp. Date (A) Kms (B) Kms B) Kms # of Garage visits REMARKS Date B PM RP Lost PT O hours B-Breakdown, P.M - Preventive Maintenace, RP - Repair, PT - Patient related trips (Real emergencies, Fire Alarms, Fire & Disaster drills) O - Other trips (Orientation, Garage visits & Gasoline refill, Standby) Prepared by & Badge # Tel # Date 128