EMS providers are frequently out of quarters posting and responding to calls for eight to 12 hours at a time. An ambulance, at an all-day assignment such as a sporting event, concert or festival, may use lots of small supplies like bandages or ice packs, or they might be busy maneuvering through traffic to transport patients.
On the road or at a post, the following are five features that will make long shifts in an ambulance a little bit easier on EMS providers:
1. Auxiliary heating and air conditioning
Air conditioning is as vital in Arizona in July as heating is in Illinois in January. Each state mandates the heating and cooling requirements of ground ambulances, so there are some variations in standards. In addition to the basics, auxiliary heating, ventilation and air conditioning (HVAC) units can save fuel, reduce emissions and maintain an ambient temperature in the ambulance cab and compartment. The type of chassis and compartment will determine the most appropriate system. It is also important to consider the regulatory environment, as some locations may not require all of the auxiliary features available.
2. Climate controlled storage
Studies have shown that storing medications outside recommended temperature ranges can impact their potency and stability.[1,2] Maintaining drugs in a stable environment can prolong their shelf life and effectiveness.
The Commission on Accreditation of Ambulance Services (CAAS) Standard 203.03.04 mandates that providers establish storage policies and procedures to protect medication from extreme temperature changes. The American Ambulance Association advocated this standard in a white paper in 2005.
Parking in climate-controlled locations, rotating stock, portable pharmaceutical cases, and coolers are options; however, electronic, climate-controlled storage maintains an appropriate, stable temperature with minimal user interface. In addition, some storage units are not only climate-controlled, but also have locked access, even individualized access, which increases the accountability for and security of controlled substances.
3. Internet connectivity
Establishing wireless communication at an all-day posting is the most efficient way to communicate with the department’s intranet, dispatch information, and complete electronic patient care reports (PCRs). Deploying a unit to a location without a way to connect to the internet means more work at the end of a shift to submit PCRs and review emails sent during the day.
Take advantage of the increasing capabilities of devices to connect and synchronize through the internet. Bluetooth and internet connectivity, integrated into patient care equipment like cardiac monitors, can efficiently transfer information to other health care providers and synch to patient records.
4. Portable power
Radios, cell phones, tablets, cardiac monitors and more require batteries. You may be connected, but you are not very useful with low battery power. An option for the mobile devices is storing a portable AC power supply in each unit. Battery chargers are now available that allow a user to connect multiple devices from different manufacturers to one source.
Just like medication, electronics are susceptible to extreme temperatures. There may need to be some discussion on where to store chargers when ambulances are not in service.
5. Space where you want it most
EMTs and paramedics are clear in this final need; more room in the cab, please. They want more legroom and a place to store a cooler with water and snacks and a bag with extra hand warmers, gloves, and other cold weather gear. Remember your crews might spend the equivalent of a transcontinental flight in the ambulance every day. Give them more space than they get in a coach airplane seat.
There are other challenging factors to evaluate in ambulance design. Certain specifications increase cost. Incorporating additional equipment affects gross vehicle weight, which affects fuel consumption. And all the safety standards must be met or exceeded.
Add your must-have ambulance features in the comments.
References
1. De Winter S, Vanbrabant P, Gillet J, et al. Emergency medical services/original research: Impact of temperature exposure on stability of drugs in a real-world out-of-hospital setting. Ann Emerg Med. 2013; 62:380-387.
2. McMullan J, Jones E, Silbergleit R, et al. Degradation of benzodiazepines after 120 days of EMS deployment. Prehosp Emerg Care. 2014; 18(3):368.
