Who is in ambulance

The next level of service is provided by advanced life support ALS ambulances, which are staffed by paramedics and nurses, who have advanced training, as well as EMTs. An ALS team can respond to more complicated health situations, and is able to provide a higher level of care, such as administering medications and initiating intravenous IV therapy to deliver the drugs directly into a patient's veins. In addition to full ambulances, EMS services also may use chase cars — basically, passenger vehicles that will transport an additional paramedic and his or her equipment to the scene of a medical emergency, until an ambulance can get there.

At that point, the paramedic will jump on the ambulance and accompany the patient back to the hospital. The type of vehicle sent to a call depends upon the nature of the emergency. A BLS ambulance might handle a patient with a broken leg, but if that person is in cardiac arrest, a dispatcher may send an ALS vehicle instead, according to Buchle.

Ambulances come in a variety of vehicle types and configurations, according to Dr. Ben Weston, M. There's the familiar minivan style, but other ambulances have a pickup-truck chassis with an attached patient compartment. Inside, ambulances carry an assortment of lifesaving equipment. BLS ambulances carry portable oxygen supplies and masks, cervical collars, slings, backboards to protect patients with spinal injuries, and kits with towels, dressings, scissors, clamps and sterile gloves to use in delivering babies.

Among other equipment, they're also equipped with disinfectant, shoe covers, coveralls and other gear for controlling exposure to infections [source Facs. At the ALS level, vehicles have more sophisticated devices, including intubation equipment and gear to treat patients with pneumothorax, or collapsed lung. They also often have the tools to take blood samples and perform simple lab tests, which can be transmitted directly to the hospital while in route.

One of the most important — and costly — pieces of equipment on an ALS ambulance is the heart monitor. The devices that Life Lion EMS uses are capable of doing an electrocardiogram EKG , and also transmitting the readings via wireless modem to a doctor at the hospital while they are in route.

Additionally, the device can check oxygen levels and blood pressure, and even act as a pacemaker for patients whose hearts need such assistance. Ambulances also carry supplies of medications, with state regulations determining what they're allowed to have. ALS ambulances can carry an extensive assortment of drugs, from various cardiac medications and drugs to treat patients who've suffered allergic reactions or asthma attacks.

There also are various pain medications, ranging from aspirin to fentanyl [source: Buchle]. Another useful piece of equipment on ambulances these days is a laptop computer, which crews can use to receive detailed information from the dispatcher. That enables them to be better prepared when they arrive on the scene. Ground ambulances generally are staffed by at least two EMS workers, both of whom are trained to drive the vehicle. Driving is a vital skill for ambulance crews, whose members usually take turns behind the wheel.

They receive special training to enable them to get to the scene of an emergency safely, as well as quickly. Defensive driving skills are crucial. So, who are the people onboard the ambulance? They are usually EMTs , but sometimes paramedics as well. Emergency medical technicians EMTs , spend six months in school to learn basic life support measures. Paramedics , in contrast, typically undergo two years of training, and have more advanced emergency care skills, says Buchle.

Critical care nurses are often a part of air ambulance crews. Their advanced skills can be important for keeping gravely injured trauma patients alive as they're being transported from smaller hospitals to big trauma centers for care and surgery. Some helicopter teams may include a physician as well. Contrary to what you've seen in TV shows, ambulance drivers can't go way over the speed limit, and they have to be careful with traffic lights. When there is a medical emergency and someone calls for help, they talk to a dispatcher.

As an added precaution, the paramedic may also use a lightweight head immobiliser an equipment that supports and protects your head and neck. If the paramedics suspect a neck or head injury, they may also use a device called a cervical collar. This features an inflexible frame that fits around your neck, held securely with Velcro straps. Perhaps it goes without saying that paramedics carry certain pain-relieving and life-saving medications on board! This lightweight, padded bag has several pouches and elastic straps to keep medications organised.

These usually include:. They can use this to look for abnormal patterns, known as arrhythmias, when the heart is beating too fast, too slow or with an irregular rhythm.

This advanced life support machine will be packed into the ambulance if the patient's condition requires it. The machine is attached to an oxygen cylinder to help you take in oxygen. The paramedic will also be able to adjust the rate and depth of your breathing, if it's necessary. The paramedic will be able to use this device to take a quick reading of your blood glucose level by placing a small drop of your blood on a disposable strip, which will be inserted into the device.

The number on the screen will indicate your blood glucose level. If the reading is too high or too low, the paramedic will try to stabilise your condition with medication.

If you're unable to walk, the paramedic will use this padded cot to move you from the scene. In addition to advanced medical equipment, you'll also find inside an ambulance basic but important items such as blood pressure gauges, stethoscopes, thermometers, medical tapes, flashlights and blankets, to ensure the paramedics are prepared for almost any situation! As a precaution, you should always have emergency numbers on speed-dial.

Bag-Valve-Mask Ventilation , March Optimal Use of Emergency Services n. Inside the ambulance, you can find a variety of medical equipment, including cardiac monitors, oxygen tanks and IV equipment. When a patient is in the ambulance, they may be able to request a specific hospital if it is nearby and can care for their specific condition. If you are ever driving and see an ambulance approaching with its lights on, there are several steps you need to take.

Occasionally an emergency vehicle driver might give you direction to move left or right so they can proceed to the call. While paramedics often receive calls for heart attacks and strokes , there is another type of injury that is quite common. Similarly, in a USA Today survey of 50 major cities, the lowest number of paramedics per capita had the highest cardiac arrest survival rates.

Additionally, worse outcomes are associated with trauma provided by ALS, which is most likely due to additional procedures performed by ALS and increased scene times. One study found that provider skills for intubation is based on frequency of the skill performed and its association with cardiac arrest survival. A study conducted with the Mississippi Department of Health evaluated the volume-outcome relationship of paramedics.

A greater volume of paramedic experience was significantly related to reduced total prehospital time and time on scene. The authors concluded that retention of skills is accomplished by increased volume.

A study of 10, out-of-hospital cardiac arrests evaluated whether more paramedics three or more vs. A similar paper evaluated two paramedic vs. They found that additional paramedics on the crews resulted in more errors than with single paramedic crews. An unpublished thesis paper in , a three-year retrospective review of the Wake County EMS System, compared a two paramedic crew vs.

During the years studies, half of Wake County had one paramedic per crew and half of their system had two ALS providers per crew. Inclusion criteria were cardiac arrests, respiratory emergencies, cardiac emergencies and traumas that required emergent transport utilizing lights and sirens.

No statistically significant difference was found regarding scene times, intubation success and first-pass success. Not surprisingly, the two paramedic crews had a high rate of statistically significant IV success 0.

An Australian study evaluated scene time difference in 1, prehospital cases with all-paramedic crews vs. All-paramedic crews had a statistically significant longer scene time than mixed crews There were no differences in procedure failure rates including intubation and intravenous insertion.

Researchers in Columbus, Ohio, retrospectively studied ambulance staffing models in a metropolitan, fire-based EMS system.

Paramedic-basic PB crews were compared with paramedic-paramedic PP crews. There were no differences between PB vs. In , Santa Cruz, Calif. A review of state statutes and regulations show the majority of states require only a single paramedic on the crew that will staff an ALS ambulance. Among the states requiring only a single paramedic ALS unit, regulations for non-paramedic crew members vary.