Ambulance Operations
Ambulance Standards
State administrative rules
 Minimum standard vs. Gold standard
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Ambulance Standards
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Vehicle Design
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GSA KKK 1822D specs
• Type I: truck-cab chassis/modular body
• Type II: standard van, integral cab/body
• Type III: specialty van, integral cab/body
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Medium duty ambulance/rescue
Ambulance Standards
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Medical Equipment Standards
OSHA
 NFPA
 Local medical direction
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Ambulance Standards
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Additional Guidelines
Commission on Accreditation of
Ambulance Services (CAA)
 American College of Surgeons
“Essential Equipment”
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Checking Ambulances
Vehicle/Equipment Checklist
 Stretcher Days
 Medication Expiration Dates
 Vehicle Cleaning/Disinfecting
 Medical Equipment Tests/Calibration
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Ambulance Deployment
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Deployment = Strategy used to:
Position ambulances, personnel
 Reduce response times
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Factors influencing
Location of EMS stations
 Location of hospitals
 Anticipated call volume
 Geographic, traffic considerations
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Ambulance Deployment
Peak load staffing
 Fluid deployment (Primary areas of
responsibility, Posting)
 System Status Management
 Computer Assisted Dispatch
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Ambulance Deployment
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Tiered Responses
Fire/Police First Response
 BLS Units
 ALS Units
 Paramedic Quick Response Units
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System Reserve Capacity
Emergency Vehicle Laws
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The driver of an authorized emergency
vehicle may:
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Park or stand irrespective of the provisions of
this chapter;
Proceed past a red light or stop signal, but
only after slowing down as may be necessary
for safe operation;
Exceed the maximum speed limits so long as
he does not endanger life or property
Disregard regulations governing direction of
movement or turning in specified directions.
Emergency Vehicle Laws
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The exemptions herein granted to
an authorized emergency vehicle
shall apply only when such vehicle is
making use of audible and visual
signals meeting the requirements of
this Act.
Emergency Vehicle Laws
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The foregoing provisions shall not
relieve the driver of an authorized
emergency vehicle from the duty to
drive with due regard for the safety
of all persons.
Driving Excellence
Good Driving Basics
Wear seat belts
 Practice; Become familiar with:
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Acceleration
 Deceleration
 Braking
 Cornering
 Fender and bumper clearance
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Good Driving Basics
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Hand position
9-3 o’clock positions
 One hand pulls; the other slides
 Neither hand should pass 6 o’clock
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Keep to the left (other traffic should
be to the right)
 Never rely on what another motorist
will do
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Maintaining Control
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Braking
Pump brakes slowly, smoothly
 NEVER brake on curve
 Brake going into curves; accelerate
moving out of them
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Maintaining Control
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Railroads
Plan alternate routes for grade
crossings
 Wait out long trains if there is no over
or underpass in a reasonable distance
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Maintaining Control
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School buses
There is NO emergency vehicle
exemption from laws pertaining to
school buses
 If red lights are flashing, stop and wait
until driver motions you on.
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Maintaining Control
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Bridges and Tunnels
Ability to pass may be limited
 Consider alternative routes if traffic is
heavy
 Be sure height of roadway will
accommodate ambulance
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Maintaining Control
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Traffic Patterns
Learn traffic flow patterns in your area
based on time of day, day of week,
locations
 Plan for alternative routes through or
past specific problem areas
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Maintaining Control
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Road Surface
Pay attention to irregularities in road
surface (bumps, potholes)
 Inner lanes of multi-lane highways
usually are smoothest
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Maintaining Control
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Hydroplaning
Occurs on wet roads at speeds >35mph
 Water causes loss of contact between
tire and road surface
 If you can’t see tread marks of car
ahead of you in water on highway,
there is risk of hydroplaning
 Slow down; lightly tap brakes to ensure
dryness
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Maintaining Control
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Backing Up
ALWAYS have someone spot for driver
while ambulance is backing
 Move slowly, carefully
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Maintaining Control
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Escorts
Extremely dangerous
 Use only when unfamiliar with location
of patient or hospital
 Allow safe distance between escort
vehicle and ambulance
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Intersection Collisions
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Most common form of ambulance collision
Causes:
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Other drivers “timing” lights
Emergency vehicles following each other
Multiple emergency vehicles converging on
same location
Motorists going around stopped traffic
Vision of pedestrians in crosswalk obstructed
by other vehicles
Intersection Collisions
Slow down at
intersections.
Ensure other drivers
have seen you and
stopped before you
proceed.
Parking and Loading
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At least 50 feet from wrecked vehicles if
no fire, other hazards
100 feet uphill, upwind if fire, other
hazards present
Park 100 feet in front of wreck if first unit
on scene
Park 100 feet beyond wreck if police
already have control of scene
Shut off headlights unless needed to
illuminate scene
Standard Operating Procedures
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Operator qualification
Handling, reporting
collisions
Investigating,
reviewing collisions
QA in collision
aftermath
Backing vehicles,
spotters
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Seat belt use; child
transport
Emergency response
procedures
Prudent speed, use of
oncoming lanes,
intersection
negotiation
Use of police escort
Drug, alcohol policy
Warning Devices
Warning Lights
Use at all times when responding to
emergency calls
 Also, turn on headlights during
daylight hours
 Use minimal lighting in heavy fog or
when parked
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Siren
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Usually not audible until 50 to 100 ft from
vehicles
Motorists less inclined to yield when
sirens sound continuously
Motorists feel units with sirens are
abusing right-of-way privileges
Drivers increase speed 10 to 15 mph
Sirens increase patient anxiety
Drivers develop anxiety, hearing problems
Give other drivers time to
notice, react to warning
devices.