Category Archives: Emergency Vehicle Operation

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Missing the Grind of the Lightbar

I was doing some math and realized my career in EMS has reached past middle aged.  I have 18 years in and 17 to go.

It made me think of how I am still perceived as a new guy by some and an out of touch almost dinosaur by others.

Thinking back to the early days of when I realized this was what I wanted to do brought back some memories many in this field will never experience.

 

For example:

Manual transmission water tender.  My first paid unit was a 1970s 10 speed double clutch 1000 gallon water Tender.  I learned to drive code 3, work the siren and shift, all while reaching a top speed somewhere in the high 40s.

But as memories went through my head of that beast of a unit a certain sound crept into my head and has stuck for a few days:

 

The grinding of the rotators in the lightbar.

While some of you might still have an “old” rotating lightbar, most of you are likely used to all manner of flashing light bulbs and diodes.

Back in the olden days we had lights that turned on and spun around in circles.  Our old rescue truck on the Reservation had 3 bright white lights mounted on a 12″ diameter spinning disk covered with a sun bleached almost still reddish pink cover.  When you turned it on and pulled out of the station is spun slowly.  When you pressed the button for the old Federal Q siren mounted on the front bumper it would slow and almost stop.  It was not uncommon to reach the scene and go to work only to see the beacon slowly begin to dim as the alternator on the ford pickup could no longer keep it shining and turning.  It was later upgraded to a strobe light and we thought that was the neatest thing ever.

On the ambulance was the Code3 standard lightbar of the time, 2 rotating lights and a series of reflectors as well as intersection lights that swept back and forth on each side, apparently designed to get the attention of drivers coming from the sides.  Those rotators were noisy!

That grinding was constant, loud and almost annoying.  And they were especially annoying if one of the reflectors got dislodged and stuck while on a run at night.  Or in the snow.  Or in the rain.  Or at all.  A single beam of bright red or white light trying desperately to distract you from looking at the road.  And Gods help you if it was an intersection light that got stuck!  That was worse than driving code 3 with your alley lights on.

 

Nowadays the kids have these LEDs that blink in ever impressive patterns.  For those noobs unsure of exactly what I’m talking about when I mention the grinding of the old rotators, imagine how much nicer your drive would be without the high beam flasher motor clicking away under the dash.  You’ll be glad when it’s gone, then 15 years later remember when things were bigger, clunkier and less efficient and miss it ever so slightly.

 

Ambulance Facility Must Haves

Many an article looks at ambulance design, Paramedic training, policies and protocols but I’ve been wrestling with a different kind of barrier to quality: The Fleet Yard.

 

More specifically, I was wondering what your must have list is for an ambulance deployment center.

 

Is it indoors, well lit, vending machines, training on site, locker rooms, showers, supply techs, drive through ambulance wash…

Here’s my must haves if I could build a brand new facility:

  • Drive through restocking and shift change
  • Onsite mechanical repair
  • Onsite scheduling, CQI and training
  • Indoor secured fleet and employee parking
  • Vehicle Service Techs for restocking
  • In-unit mobile data gateway repair (after I get them installed that is)
  • Crew lounge
  • Locker rooms with full showers
  • Gym

Let me know what your must haves are, maybe you’re thinking of something I’m not.

 

Special Call Mobile Surgery 1, Mobile Surgery 2, EMS Surgeon 1…

A nice resource to have if your system is innundated by, oh I don’t know, the shaking of the earth until everything falls down.  Especially in a City with water on 3 sides and only 4 trauma bays…total.

 

 

Interventions Issue 4 – Supervisors

Please enjoy!

Child’s toys beat researchers to ambulance solution

TOTW has a great article responding to a reported breakthrough in ambulance design by our friends on the other side of the pond. Clicky for ready.

As I was reading that article, and the original he linked to I was taken back to my days in Newcastle upon Tyne with (then) UK Paramedic Mark Glencorse.  I didn’t like the ambulance layout at all, but the full access around the patient and forward facing seat in the back were great.  But it works for the patients they treat, which is one of the hallmarks of EMS 2.0.  That each community has unique challenges and needs unique solutions.  We treat heart attacks the same all over this nation, unless you take into account the training, equipment, vehicles, staffing, location, hospital capabilities, transport times…you get the idea.  With this in mind each community will look slightly different, much like they do now, only we hope to strengthen what is working and eliminate what is not.

Finishing TOTW’s review of the “advances” the littlest of the HM JRs, Miss Eliza, was playing in the room with the ambulance bin.  We call it that because these girls have a lot of ambulance toys.  Go figure.

 

I peeked over my shoulder to see her little ambulance company lined up for her inspection.

 

Asking why she did that, her reasoning was to make sure everyone knew what to do today.  But then I began to look at some of the “non-ambulance” toys that had made the lineup.

Then she blew my mind.  Her description of why each vehicle was in the lineup sounded like a research project from my college days.

 

I give you Miss Eliza’s Ambulance Company LLC.

Miss Eliza staffs 8 distinct apparatus in her fleet

1.  Emergency Ambulance – “I like the noises”  A standard 2 person reclined van ambulance.  This rig likely carries most of her clients, is painted in distinctive colors for safety and has an impressive warning lights and sirens package.
2. Heavy Rescue (for tiny things) – “It does lots of sounds. It has Happy on it.”  Indeed this truck does have the markings “Happy Medic” and a license plate of “Free Ride” (all thanks to the Angry Captain).  But with decreasing budgets at the municipal level, Miss Eliza may be unable to call another agency for extrication or rescue.  It also allows her to train her people with her own equipment instead of having to rely on other agencies.  She’s thinking ahead.
3. Light Duty Transport – “The back opens for the bed in the back.”  This unit is short and narrow, clearly for use at special events.  It fits one provider, who can then drive while the patient reclines in the back.  A great use for tough to access patients.
4.  Advanced Care Clinic -  “I like it colorful” She likes the colors on this rig and the irregular shapes, but I like what’s inside.  Cabinets, sinks, an x-ray machine, hospital type lighting, it really is a clinic on wheels.  Even better, the entire side folds down to reveal a treatment area.  Park this rig at a special event and all those treatment dollars the hospital is getting are now to Miss Eliza.  Added benefit, no need to staff multiple ambulances at the event.  Just call one if you need it.
5.  Rapid Response Car – “Because the car can go fast.”  Jimmy Johnson will be surprised to know he’s been flexed into active EMS duties, but Miss Eliza sees the benefits of getting ALS eyes on scene first to guide the remainder of the system depending on the patient’s presentation.  Perhaps there is a better vehicle available, but she opted for #48, so who am I to judge.
6.  Ladder Truck – “I like the fire truck and the ladder” I see where she’s going on this one, but really, the ladders should be fitted to your heavy rescue squad.  I don’t think we’ll need that 100′ stick nearly as much as she thinks.
7.  Tactical Response Vehicle – “It does new tricks. Goes fast and has guns.”  The SWAT has a giant armored vehicle, we need something too.  Maybe the Green Hornet car is a little much, but pull up in this baby on the scene of a violent assault and the crowd will not only part, but disperse…and fast.  Added bonus?  Competing companies won’t want to meet you at the intersection trying to grab the same call!
8.  Ambulance (Non-Emergency) – “I like that its white.”  At first I thought she was just looking at the colors of the toys, but then I realized…that’s exactly what she’s doing.  The white rigs are passenger vans for non-emergent patients and clinic appointments.  If the little blue van can get me to the airport with 2 hours notice, surely we can apply the same design to scheduled transports to appointments.  Put a modified ramp on the back for wheelchairs and I think she’ll corner the market.

 

So there you have it.  She didn’t design the inside of an ambulance, that will take a complete redesign from the patient out, not the walls in, but she does bring up some interesting concepts in response models that I think should be considered moving forward, especially if municipalities keep cutting back.

Sunday Fun – Close your doors

flickr - didbygraham

On a recent family trip we drove past a sub-urban/rural firehouse quite a few times. Each time we passed by, all three rigs were in quarters, sometimes bay doors open, sometimes closed, but I made an important observation I’d like you to confirm for me:

How busy your rig is is inversely noted by how many rig doors are open and how many boots sit outside said doors.

Each time we drove by all 4 doors of the ladder truck were open with boots on the ground and on some passes, even a coat could be seen hanging from the door. This tells me you aren’t running many calls.

When running a large number of calls it is important to keep all your gear safely inside the rig so as not to forget it or have it placed aside when the driver does something without you.

My system has 2 of the Nation’s busiest engine companies and one of the busiest truck companies and they don’t sit with their doors open, gear on the floor because they have become efficient in donning due to their call volume.

I thought back to my early rural days and we almost always put our gear out with the doors open in hopes of a call. Even the other night at the five-one I spotted a door open and we had had a slow day to that point.

Close your doors and put your gear back in the rig. All that “preparation” only telegraphs that you don’t get dressed all that often. Unless of course that’s the only time you get to touch your fire gear aside from the locker.

Ambulance Safety – A discussion with Greg Friese

At last year's EMS Expo I was invited to interview a number of folks for EMS1.com.  Among them was Greg Friese, noted blogger and educator, but did you know he has a background in passenger vehicle safety?  Have a look.

 

Oh, and wear your gorram seat belt.

 

Thank you.

 

 

Police car driver recovering after accident

An accident between an ambulance and a police car left the police car driver in the hospital and the ambulance crew recovering from minor injuries.

The initial investigation shows they were responding to separate incidents and that the ambulance had the green light.  All those things aside, I’m glad everyone is OK, considering the police car driver had to be extricated.

Police car drivers are given training to respond with lights and sirens, as are EMS personnel, and if the investigation holds, I wonder if the police car driver will be cited with failure to yield to an emergency vehicle, as EMTs and Paramedics are from time to time when they are the ones at fault.

Likely not, but I hope all police car drivers take this story and also a deep breath when responding, as we all should, and come to a complete stop to break an intersection with red light and siren.

What?

Wat’s that you say?

He’s not a police car driver?  How’s it feel to be referred to by only a portion of what you do? MC, I smell a crossover!

We have a tall hill to climb and perhaps we should start with some PSAs for the press.

“The ambulance drivers also were being treated at the hospital, Ramos said.”

Oh, and this lovely nugget:
“Sorrick said the ambulance company is prevented by privacy regulations from providing the names of the injured medical personnel.”

So here’s a HIPAA quiz (Adding information, creating a new scenario) – Does HIPAA prevent the ambulance company from releasing the names of the injured employees if they were not patients?
-Justin Schorr
Fire engine driver / Ambulance driver

Epiosde 10 of the Crossover – Quit being stupid!

Happy and Motor are at it again, finally, and this time calling out some stupid things done by stupid people while representing EMS, fire and police. From the ambulance company who lost $1 million to the 27 year old DUI while driving a fire truck and a special comment from Motorcop about a narcotics officer in Happy’s area caught stealing and selling narcotics. Quit being stupid!

EPISODE 10

Ambulance Specs

A facebook follower recently posted the following on the Happy Medic Page:

“I recently got involved in specifications for 2 new ambulances…any suggestions out there?”

Well, are there?

This is what social media is about folks, being able to spread an idea, issue or question far and wide quickly to get a wide variety of responses.

If I was on the committee to spec new rigs I’d have a few requests for sure.

  1. Larger area behind the front seats so night crews could recline a bit and have room to store their coolers and jackets, and packpacks etc.
  2. Plugs in said larger area for crew to run laptops and plug in other peripherals
  3. A compartmentalization layout designed by actual practitioners so that I don’t have to stand up from the airway chair to reach my airway supplies for example.
  4. Suspensions that last more than 6 months.
  5. Warning lights that can be seen when the back doors are open.
  6. GPS
  7. Because my system is limited by height since 2 of our ER entrances are underground, I can’t get a taller rig, but it’d be nice.
  8. If you’re a rural FD EMS, what about extra room for turnouts and airpacks, perhaps even a CAFS?

What are you looking for in a new ambulance?