0071643192.pdf

EMS AND DISASTER MEDICINE

Transportation

GROUNDTRANSPORTATION

■ Ground transportation is used for the majority of acutely ill or injured
patients.
■ Manned by two persons of varying training levels

There are three types of ambulances:

■ Type I (see Figure 20.1): Pick-up chassis with a separate modular compart-
ment to carry equipment, personnel, and patient but no passageway
between driver and patient
■ Type II (see Figure 20.2): Van chassis with raised roof and other modifications
■ Type III (see Figure 20.3): Pickup chassis with an integrated modular
patient care compartment

ROTARY-WINGAIRTRANSPORTATION

■ Range of 50–150 miles
■ Use when travel time >30 minutes to hospital and rapid transport is essential.
■ Limited by poor weather

FIXED-WINGAIRTRANSPORTATION

■ For distances >100 miles, when rapid transport is essential
■ Limited by weather, lack of runways, refueling
■ Possible altitude problems for the patient, eg, pneumothorax, ET cuff, bal-
loon catheters
■ There are noabsolute contraindications to air transport.

TABLE 20.3. EMS Training Levels

PROVIDER HOURS OFTRAINING SKILLS

First responders 40 CPR and BLS

Basic trauma care

Emergency medical 110 FR training, plus:

technician basic Basic assessment skills

Automated external defibrillation

May assist in medication administration

Emergency medical 300—400 Addition of IV access

technician Endotracheal intubation

intermediate Manual defibrillation

Emergency medical 1000—12,000 EMT-I, plus:

technician paramedic Surgical airway

Needle decompression of chest

Advanced drug therapy including ACLS

ECG interpretation

External cardiac pacing

FIGURE 20.1. Type I

ambulance.

FIGURE 20.2. Type II

ambulance.

FIGURE 20.3. Type

III ambulance.