Category Archives: Vehicle Operations & Apparatus

EMS Flashmob

Eli Beer formed an all volunteer First Aid/EMS group when he was 17.  In the process of developing the program he volunteered on an ambulance and was always upset when they would get stuck in traffic.

Eli attributed his dying patients’ demise on the extended response time and wanted to do more for them in the time between when they needed help and when help arrived.

This video goes directly to the core of the Response Time argument and it is important to make a clear distinction between first response and ambulance response times.

We can all agree that getting someone in the door quickly can help guide the rest of the system’s response.  This can be a fire department engine, an EMT Police Officer or perhaps a third service handling first response.  What we don’t need is to send a reclined cot van on every call, nor does it need to get there in 4 minutes most of the time to make a difference.

In this TEDMED talk, Eli talks about how he came to found United Hatzalah and send motorcycles he calls “Ambucycles” to the scene of an emergency to help until an ambulance can arrive.  He touts a 3 minute response time to over 207,000 incidents last year and is using mobile technology to achieve it.

The phone app broadcasts the medical incident to the 5 closest volunteers in the same way CPR needed apps do so in the states.  When he mentioned it was kind of like an EMS flash mob he had my attention.  We’re locked into some old ideas and this one breaks the mold.

 

Why aren’t we as communities encouraging this kind of organization?  Sure there are volunteer First Aid Squads all over, but this is far far simpler than that.  And don’t wave the liability flag here, those folks would have to be trained to get access to the app and with the right kind of basic QA program built in you’re golden.

What do you think of the various things mentioned in this video?

  • Motorcycle first response
  • Volunteers
  • Phone App dispatching

 

Big Brother or Caught in the Act? SF Buses to Issue Parking Tickets

Flick user Forty PhotographsParking in San Francisco is not a nightmare, but more of a craps shoot.  When Mrs HM and I lived in the City we only had one car and it was a small car at that.  When trying to find parking there was a rule:

3 blocks 6 times or 6 blocks 3 times.

This meant that if you went around the 3 nearest blocks in all directions 6 times you were not going to find a spot and should just find a shady spot maybe no one would see you.  But you had to be careful.  Handicap spots and the little ramps in the sidewalks were big tickets and I would never block a plug (hydrant).  Parking in a driveway or blocking a garage not your own was a guaranteed tow, so sneaking into a half spot was generally attempted, sometimes with success, other times that little white envelope would be waiting for you in the morning.

Unless of course you forgot which day of the week street cleaning was.  Then you’ve got another ticket for that too.

The Department of Parking and Traffic wanders the City in little 3 wheeled bikes and are almost like locusts swarming through the neighborhoods looking for places to earn revenue.  It’s a thankless job and when I see their little trucks parked on a plug and they’re no where in sight I call them in as illegally parked.

But I’ve gotten a bit off topic.

Point is, when you would be sitting at a sidewalk cafe and see a DPT bike go by, you suddenly sprang up and sprinted to the clearly expired meter and gave it another 25 cents for another 4 minutes without a $65 ticket.

But since 2008 the DPT officers aren’t looking around as often.

Listen to KRON 4′s Gabe Slate and Stanley Roberts Team up to look at how transit buses are issuing parking tickets just by driving down the street.

[yframe url='http://www.youtube.com/watch?feature=player_embedded&v=u3S2MVQW_qs']

Installed on select Municipal Transportation Buses (MUNI) are cameras that capture images of cars along the bus’s route.  Those videos are then screened by a DPT officer and offending vehicles are sent tickets in the mail.

Unlike static red light cameras, they are able to see if a vehicle is moving, blocking traffic, occupied etc.  However, Happy is not a fan.

Reason being that buses are buses and parking enforcement is parking enforcement.  In addition, I seriously doubt the MUNI drivers are being cited for all their traffic violations, including blocking multiple lanes, stopping blocking intersections, illegal turns etc.  Or perhaps the drivers are safer now that the cameras are installed?

Either way, the City sees some value to the service since over the next 15 months cameras will be installed on all 819 buses.  At a cost of $800,000 in a City facing cuts in Fire, Police, EMS, library, even MUNI is hard to justify.  But in 2010 they recovered almost 1/4 of that cost on only 30 buses.

You do the math.

Some will scream “Big Brother!” and I see that argument and raise you a “it’s breaking posted laws.”

I only hope that the trucks that double park 2 and 3 wide directly next to a clearly identified loading zone get fined as much as the drivers who don’t notice the 3 feet tall letters on the street “TAXI ONLY.”

Perhaps MC could speak to the validity of mounting a camera on the ambulances to capture traffic violations?  I think we could up that 2102 citations in a year in just a few months the way folks seem to go insane around an ambulance.

Do you think this program is a good idea?  Think it goes too far?

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?

Calculated Risk and Letters in the Files

Before you get too excited to hear what I think about the politician and the ambulance company at the shooting scene, close the door and take a seat.
Before you go ripping into scene safety and how this guy has no idea what it is we do, take a deep breath.

Because half of you are hypocrites.

How many of you race lights and sirens without wearing your seat belts? According to NIOSH studies and reviews of fatal and non fatal ambulance accidents…HALF. Yes, half.
Half of you are not wearing your seat belts in your ambulance.

So when you complain that some politician thinks you are invincible and should go racing into an unsafe scene, I almost gag knowing full well HALF of you already do that on a daily basis. And for even more minor incidents than the one in the press.

Yes, this is a letter in YOUR file. Those of you not wearing your seat belts in the cab of the ambulance. Patient care in the back does not even enter into this or the data I’m finding, this is only about in the cab.

So many were so fast to jump on the politician, yet how many of you really pay attention to yourselves on a daily basis?
Worried about a wrinkled shirt? Can’t reach the radio? Go ahead, try to give an excuse for not wearing your seat belt, the same thing you preach about to unrestrained drivers at wreck scenes. You can’t. There is no excuse for not wearing your seat belt in the cab of the ambulance. None.

Then why is not wearing one killing so many EMS responders?

We’re not a stupid group, stubborn perhaps, but we seem to understand kinematics and mechanism of injury, at least to the point it guides our treatment, but to not apply those standards to our own flesh and blood is insane.

Stop shaking your head and muttering that you already do wear it. Half of you are lying. Lying to yourselves.

I’ve had enough. You have made me unHappy.

Buckle up. I’m getting annoyed reading these studies about line of duty deaths and the lack of a simple click that could have made a difference. And if you are a LODD from not wearing a seat belt, should it really be a Line of Duty Death or should it be renamed Lack of Due Diligence?

The Crossover LIVE

My brother from another mother Motorcop and I continue our back and forth between the boys in blue and the heroes in a segment he dubbed The Crossover.

In this most recent installment we knew the back and forth would be great, so I fired up the ambulance, hit the lights and ran a red light on the way for a coffee so we’d run into him.

Topics covered include continuing education for motors and medics, why he can let law breakers go with a warning and how I’m bound to take every Tom, Dick and Harry to the ER no matter what and the burning question: Why don’t motor officers wear chaps?

Episode 1

Thank for listening, more to come!