To a large extent, early EMS equipment began as hospital equipment that was extrapolated to the field; it was assumed that if something worked in the hospital, then it would work in the field. It soon became apparent that hospital equipment did not always perform under the more rigorous conditions of prehospital care. Over the last 30 years, equipment has evolved specifically for EMS that is better adapted to field use in terms of size, weight, and durability. This equipment is directed at resuscitating and packaging the patient for transport to the hospital and for maintenance of stability during emergency or interfacility transport. As the science of EMS continues to mature, more equipment will be scrutinized for effectiveness.1 The four basic questions regarding efficacy of EMS equipment are:
Does it do the job?
Is it safe?
Can it be applied to the field environment?
Can it be used effectively by prehospital personnel?
The nature of EMS equipment is changing due to the expanded scope of practice by paramedics and the blurring of care levels between basic life support (BLS) and advanced life support (ALS) personnel. Equipment once considered only for ALS care is now being carried on some BLS ambulances (e.g., defibrillators and airway adjuncts). This chapter discusses EMS vehicles; communications; the electronic patient record; personal protective equipment; and specific equipment for stabilization, resuscitation, and treatment.
The vehicles may be ground ambulances, helicopters, fixed-wing aircraft, or a variety of first-response vehicles (fire engines, police cruisers, or sport utility vehicles). The most common vehicle used is the ground ambulance, categorized into three common varieties:
- Type I: A standard truck (e.g., pick-up) chassis with a separate modular box to carry personnel, patient, and equipment
- Type II: An enlarged van-type vehicle
- Type III: A van chassis with an integrated modular box on the back for medical care and equipment
In types II and III, there is physical access between the driver's and patient care compartments, as opposed to type I, in which these spaces are separate.
Ground vehicles typically have warning devices (lights and siren) as part of their equipment. Unwarranted use of red lights and sirens is dangerous for the EMS crew, the patient onboard (if present), and the general public on the streets.2 Protocols or guidelines to limit the use of these devices only to times when they are medically indicated are important.
The two-way radio is an important piece of equipment carried by prehospital providers. As the arena of wireless communication changes, EMS systems will need to adapt their communications system to best fit their needs. The spectrum of frequencies available for emergency services is limited and shared with other industries that require wireless communications. In the United States, EMS services may use specific frequencies (channels) in the very high frequency (around 170 MHz), ultra-high frequency (around 460 MHz), and public safety ...