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There are a variety of specially designed and equipped vehicles in service as part of the emergency response system in almost every community in North America. These vehicles all serve unique roles and provide benefits, as well as hazards. Some hazards of operation are generalized to the operation of an emergency vehicle and others are specific to different types. EMS physicians must be familiar with these vehicles, their roles, hazards, and capabilities to ensure the physician's maximum safety and effectiveness in the field. Operation of an emergency vehicle is both a privilege and a potentially dangerous activity if care in operation is not observed. This chapter will describe emergency vehicle types and discuss the basics of safe operation. The authors recommend formal training for anyone operating an emergency vehicle.
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Describe common types of emergency service vehicles.
Discuss the basic principles of safe emergency vehicle operation.
Describe usual traffic law exceptions and limitations.
Discuss vehicle placement at the scene and proper parking technique.
Detail types of emergency vehicle lighting and usual minimum standards for lights and audible warning equipment.
Discuss the proper use of audible warning equipment during emergency response, and describe the limitations and dangers of their use.
Discuss some of the common dangers to prehospital providers while operating, and providing care within, emergency vehicles.
Discuss the merits of nonemergency response for EMS physicians, and other secondary responders.
Discuss basic vehicle maintenance and out-of-service vehicles.
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Ambulances are emergency vehicles that are specially designed and equipped to provide for medical care and transport of patients typically in the recumbent position. In the United States, these are typically larger vehicles. Three main ambulance design types are prevalent and offer different advantages and disadvantages. Several ambulance standards exist, including those composed by the American Ambulance Association (AAA), the US General Services Administration (GSA): KKK-A-1822F, and the National Fire Protection Association (NFPA): 1917. EMS physicians must understand the differences in the basic ambulance types and should also take the time to review local, state, and federal standards. The ambulance types described below are based on industry common language and not representative of the “typed resources definitions” used by the Federal Emergency Management Agency (FEMA). These are briefly described later in this chapter.
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A type I ambulance is built on a truck chassis and the patient compartment typically is shaped like a large rectangular box with a double door on the back and a single side door at the front of the right-hand side of the box (Figure 31-1). Because the patient care area is mounted on the truck chassis, there is typically only a very limited pass-through into the driver's compartment. The increased load-bearing capacity of this ambulance type allows for larger patient care areas and makes this ...