IS IT THE SAME… OR NOT?
There are nearly one-quarter of a million individual ambulance companies in the United States, many of these agencies own more than one emergency vehicle. In addition, there are FOUR diverse types of land ambulances. Add to this that there are multiple ambulance manufacturing companies each boasting better, newer, and more efficient designs. Now top this off with many of the smaller agencies needing to conserve meager funds by buying used vehicles and corps with fleets purchasing the same brand and design, but with slight modifications depending on the year.
For the E.M.T. or Paramedic working in one company with identical rigs in their fleet, switching between vehicles is usually easy – the cabinets and general layout in each rig is identical, or close enough. Now imagine the non-profit agency with three rigs, and volunteer or part-time EMTs to fill the shifts – and because rigs could only be bought as the budget allows, they are a few years apart at least and some were bought used. It is vital during a life-threatening emergency to be able to access and use the proper equipment as quickly as possible, taking time to look for something that takes time away from the patient.
EMTs and Paramedics need to be able to rely on the equipment at hand to give their patient(s) the best care possible enroute to the hospital – sometimes this care can make the difference between life and death. Supervisors should help all newcomers to their agency orient themselves with the insides of each rig, to have a basic understanding of where to locate oxygen masks and tanks, BP cuffs, collars, gauze, defibrillators and more. They also need to locate immediately their own PPE. If possible, having another provider, more experienced with the insides of the ambulance, ride the first few shifts with the newcomer, would help with the orientation. It would not hurt the agency to label many of the cabinets as well.
Providers who expect to jump on the rig should take responsibility for themselves to review the various cabinets, draws and outside compartments before each shift. This way they not only familiarize themselves with the location of the supplies needed, but they also help to ensure that the ambulance is fully and properly stocked. Obviously if they need to replace missing equipment and supplies, they should take care to fill the items in their proper places.
Providers should also practice removing and loading the patient stretcher so that, when needed, patient loading can go smoothly. They need to be able to align the stretchers so that they lock in safely for transportation. While most corps will use the same stretcher system for each rig, it is important to know that different brand stretchers will not fit in every rig; this is a big reason that during a response to an MCI, both the driver and the stretcher must remain WITH the individual rig. In addition to the assorted brands of stretchers, some are manual, and some are powered/self-loading. If rigs are designed for pediatric or obese patients, their stretchers may also be different from the others.
The more familiar each crew member is, including drivers who may help with loading patients or bringing in equipment, the smoother the call can go. It is in everyone’s best interest, especially the patient, that equipment, supplies, and providers work together.
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