Transportation of patients - PowerPoint Presentation

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Transportation of patients

Lecture for 1

st

year ed. Students

Ass. Proff. Dr. M. Lebedeva

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Ambulance

An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury,

and in some instances will also provide out of hospital medical care to the patient. The word is often associated with road going emergency ambulances which form part of an emergency medical service, administering emergency care to those with acute medical problems.

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Patient in lying position

Example: Transport from accident site to hospital, transportation of patients

Patient in sitting position

Example: Rescue of road traffic accident victims

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UniqueResc+

 – the most effective form of mobile hypothermia prevention in the rescue field. Its unique microchip technology in combination with its light-weight heat conducting fabric is responsible for the revolutionary characteristics of this elegant electrical rescue warming system.

Benefits for the patient

Rapid stabilisation of the patient 

(patient calms down and is able to communicate much more quickly)

Prevents shivering due to cold 

(by active and even conduction of warmth)

Reduction of fear 

(patient feels much mire comfortable – even during transportation)

Benefits for the user

Small, light-weight and foldable 

(fits into emergency backpacks)

Plug and warm 

(by integrated control unit)

Versatile and mobile (by battery or on-board power supply)

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Rescue blankets

Small blanket – UniqueResc+ R150

Dimension: 48 x 49 cm

Ideal for short-distance transport

Integrated control unit with preset target temperature of 41 °C including universal plug for motor vehicles

Medium blanket - UniqueResc+ R130

Dimension: 50×96 cm

Ideal for long-distance transport

Integrated control unit with variable target temperature of 37 °C or 41 °C including Universal motor vehicle plug

UniqueResc+ – the latest polymer technology combined with a special surface coating create an ideal symbiosis between the very highest safety standards and maximum efficiency in our warming blankets.

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First Aid Flat Spine Board

Spine boards are used for the immobilisation and transportation of patients, specifically for when trauma to the spine is suspected.

Compatible with basket stretchers and multiple handholds allow for ease of lifting.

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Bio-Bag EBV - 40

determined

 for primary transport of individuals suspected of highly dangerous infection or individuals touched by microbiological agents from contaminated place to a stationary plant designated to treat such individuals.

The Bio-Bag EBV-40 can be even used for transportation of patients with hypo-immunity in order to protect them from an "impure" environment.

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The construction of Bio-Bag enables immediate usage safe transportation and protection of environment.

Basic characteristic:

1) manufacturing technology using high-frequency welding with hermetic zip

    prevents infection transmission to medical staff and into surrounding 

2) the Bio-Bag has its own construction with

    inner overpressure 

3) attached filtration-ventilation unit provides sufficient

    amount of filtered air (120 dm3/min) 

4) filtration-ventilation unit is equipped with visual and

    acoustic signal 

5) accumulator guarantees up to 8 hours of

    operating time 

6) quality of filtered air is ensured by appropriate filters,

     placed both on inlet and outlet of the Bio-Bag 

7) integrated gloves for basic medical treatment 

8) ports for infusion, monitors or breathing

    masks connection 

9) large through views for supervision of

    patient's condition 

10) combination of vacuum mattress and strap

      belts with adjustable length enables stabilization

      of patient during transportation

 

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Ambulance

The term ambulance does, however, extend to a wider range of vehicles other than those with flashing warning lights and sirens. The term also includes a large number of non-urgent ambulances which are for transport of patients without an urgent acute condition and a wide range of urgent and non-urgent vehicles including trucks, vans, bicycles, motorbikes, station wagons, buses, helicopters, fixed-wing aircraft, boats, and even hospital ships.

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Ambulance

The term ambulance comes from the Latin word ambulare, meaning to walk or move about

which is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements. During the American Civil War vehicles for conveying the wounded off the field of battle were called ambulance wagons. Field hospitals were still called ambulances during the Franco-Prussian War of 1870 and in the Serbo-Turkish war of 1876 even though the wagons were first referred to as ambulances about 1854 during the Crimean War.

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There are other types of ambulance, with the most common being the patient transport ambulance (sometimes called an ambulette). These vehicles are not usually (although there are exceptions) equipped with life-support equipment, and are usually crewed by staff with fewer qualifications than the crew of emergency ambulances. Their purpose is simply to transport patients to, from or between places of treatment. In most countries, these are not equipped with flashing lights or sirens. In some jurisdictions there is a modified form of the ambulance used, that only carries one member of ambulance crew to the scene to provide care, but is not used to transport the patient. Such vehicles are called fly-cars. In these cases a patient who requires transportation to hospital will require a patient-carrying ambulance to attend in addition to the fast responder.

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Functional types (1)

Ambulances can be grouped into types depending on whether or not they transport patients, and under what conditions. In some cases, ambulances may fulfill more than one function (such as combining emergency ambulance care with patient transport).

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Functional types (2)

Emergency ambulance – The most common type of ambulance, which provide care to patients with an acute illness or injury. These can be road-going vans, boats, helicopters, fixed-wing aircraft (known as air ambulances) or even converted vehicles such as golf carts.

Patient transport ambulance – A vehicle, which has the job of transporting patients to, from or between places of medical treatment, such as hospital or dialysis center, for non-urgent care. These can be vans, buses or other vehicles.

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Functional types (3)

Response unit – Also known as a fly-car, which is a vehicle which is used to reach an acutely ill patient quickly, and provide on scene care, but lacks the capacity to transport the patient from the scene. Response units may be backed up by an emergency ambulance which can transport the patient, or may deal with the problem on scene, with no requirement for a transport ambulance. These can be a wide variety of vehicles, from standard cars, to modified vans, motorcycles, pedal cycles, quad bikes or horses. These units can function as a vehicle for officers or supervisors (similar to a fire chief's vehicle, but for ambulance services).

Charity ambulance – A special type of patient transport ambulance is provided by a charity for the purpose of taking sick children or adults on trips or vacations away from hospitals, hospices or care homes where they are in long term care. Examples include the United Kingdom's 'Jubilance' project. These are usually based on a bus.

Bariatric ambulance – A special type of patient transport ambulance designed for extremely obese patients equipped with the appropriate tools to move and manage these patients.

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Vehicle types (1)

Van or pickup truck – A typical ambulance is based on either the chassis of a van or pickup truck. This chassis is then modified to the designs and specifications of the purchaser.

Car/SUV – Used either as a fly-car for rapid response or for patients who can sit, these are standard car models adapted to the requirements of the service using them. Some cars are capable of taking a stretcher with a recumbent patient, but this often requires the removal of the front passenger seat, or the use of a particularly long car. This was often the case with early ambulances, which were converted (or even serving) hearses, as these were some of the few vehicles able to accept a human body in a supine position).

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Vehicle types (2)

Motorcycle – In developed areas, these are used for rapid response in an emergency as they can travel through heavy traffic much faster than a car or van. Trailers or sidecars can make these patient transporting units. See also motorcycle ambulance.

Bicycle – Used for response, but usually in pedestrian-only areas where large vehicles find access difficult. Like the motorcycle ambulance, a bicycle may be connected to a trailer for patient transport, most often in the developing world. See also cycle responder.

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Vehicle types

All-terrain vehicle (ATV) – for example quad bikes; these are used for response off road, especially at events. ATVs can be modified to carry a stretcher, and are used for tasks such as mountain rescue in inaccessible areas.

Golf cart or Neighborhood Electric Vehicle – Used for rapid response at events or on campuses. These function similarly to ATVs, with less rough terrain capability, but with less noise.

Helicopter – Usually used for emergency care, either in places inaccessible by road, or in areas where speed is of the essence, as they are able to travel significantly faster than a road ambulance.[19] Helicopter and fixed-wing ambulances are discussed in greater detail at air ambulance.Fixed-wing aircraft – These can be used for either acute emergency care in remote areas (such as in Australia, with the 'Flying Doctors'), for patient transport over long distances (e.g. a re-patriation following an illness or injury in a foreign country), or transportation between distant hospitals. Helicopter and fixed-wing ambulances are discussed in greater detail at air ambulance.

Boat – Boats can be used to serve as ambulances, especially in island areas[ or in areas with a large number of canals, such as the Venetian water ambulances. Some lifeboats or lifeguard vessels may fit the description of an ambulance as they are used to transport a casualty.

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Vehicle types

Ship – Ships can be used as hospital ships, mostly operated by national military services, although some ships are operated by charities. They can meet the definition of ambulances as they provide transport to the sick and wounded (along with treatment). They are often sent to disaster or war zones to provide care for the casualties of these events.

Bus – In some cases, buses can be used for multiple casualty transport, either for the purposes of taking patients on journeys, in the context of major incidents, or to deal with specific problems such as drunken patients in town centers. Ambulance busses are discussed at greater length in their own article.

Trailer – In some instances a trailer, which can be towed behind a self-propelled vehicle can be used. This permits flexibility in areas with minimal access to vehicles, such as on small islands.

Horse and cart – Especially in developing world areas, more traditional methods of transport include transport such as horse and cart, used in much the same way as motorcycle or bicycle stretcher units to transport to a local clinic.

Hospital train – Early hospital trains functioned to carry large numbers of wounded soldiers. Similar to other ambulance types, as Western medicine developed, hospital trains gained the ability to provide treatment. In some rural locations, hospital trains now function as mobile hospitals, traveling by rail from one location to the next, then parking on a siding to provide hospital services to the local population. Hospital trains also find use in disaster response

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Air ambulances are usually only used in the most extreme situations.

Patients who are too ill to travel on board a commercial airline often require the services of an air ambulance, or an aircraft dedicated to patient transportation. These aircraft are essentially airborne intensive care units, equipped with medical supplies and staffed by medical personnel trained to care for patients while in flight. For some, transportation in an air ambulance is the only way to access lifesaving medical treatments or to be closer to loved ones in a time of need.

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London Air Ambulance - England

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Typical helicopter interior

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Typical helicopter interior

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t

he helicopter-based emergency transport could pick up patients within a 200 mile radius of the 

hospital

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Every year, flight medics perform over 550,000 emergency medical missions across the U.S.. Flight medics provide advanced emergency care to critically injured or sick patients as well as rapid transportation to medical centers. Flying out from over 800 medical bases, most flight medics work in teams with registered nurses, respiratory therapists or other specially-trained medics.

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Vehicle types

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Design and construction

Ambulance design must take into account local conditions and infrastructure. Maintained roads are necessary for road going ambulances to arrive on scene and then transport the patient to a hospital, though in rugged areas four-wheel drive or all-terrain vehicles can be used. Fuel must be available and service facilities are necessary to maintain the vehicle.

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Design and construction

Methods of summoning (e.g. telephone) and dispatching ambulances usually rely on electronic equipment, which itself often relies on an intact power grid.

Similarly, modern ambulances are equipped with two-way radios

or cellular telephones to enable them to contact hospitals, either to notify the appropriate hospital of the ambulance's pending arrival, or, in cases where physicians do not form part of the ambulance's crew, to confer with a physician for medical oversight.

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Design and construction

Ambulances often have two manufacturers. The first is frequently a manufacturer of light trucks or full-size vans (or previously, cars) such as Mercedes-Benz, Nissan, Toyota, or Ford. The second manufacturer (known as second stage manufacturer) purchases the vehicle (which is sometimes purchased incomplete, having no body or interior behind the driver's seat) and turns it into an ambulance by adding bodywork, emergency vehicle equipment, and interior fittings. This is done by one of two methods – either

coachbuilding

, where the modifications are started from scratch and built on to the vehicle, or using a modular system, where a pre-built 'box' is put on to the empty chassis of the ambulance, and then finished off.

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Equipment

In addition to the equipment directly used for the treatment of patients, ambulances may be fitted with a range of additional equipment which is used in order to facilitate patient care. This could include:

Two-way radio – One of the most important pieces of equipment in modern emergency medical services as it allows for the issuing of jobs to the ambulance, and can allow the crew to pass information back to control or to the hospital (for example a priority ASHICE message to alert the hospital of the impending arrival of a critical patient.) More recently many services world wide have moved from traditional analog UHF/VHF sets, which can be monitored externally, to more secure digital systems, such as those working on a GSM system, such as TETRA.

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Equipment

Mobile data terminal – Some

ambulances are fitted with Mobile data terminals (or MDTs), which are connected wirelessly to a central computer, usually at the control center. These terminals can function instead of or alongside the two-way radio and can be used to pass details of jobs to the crew, and can log the time the crew was mobile to a patient, arrived, and left scene, or fulfill any other computer based function

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Equipment

Trauma lighting – In addition to normal working lighting, ambulances can be fitted with special lighting (often blue or red) which is used when the patient becomes photosensitive.

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Equipment

Air conditioning – Ambulances are often fitted with a separate air conditioning system to serve the working area from that which serves the cab. This helps to maintain an appropriate temperature for any patients being treated, but may also feature additional features such as filtering against airborne pathogens.

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Intermediate technology

In parts of the world which lack a high level of infrastructure, ambulances are designed to meet local conditions, being built using intermediate technology. Ambulances can also be trailers, which are pulled by bicycles, motorcycles, tractors, or animals. Animal-powered ambulances can be particularly useful in regions that are subject to flooding. Motorcycles fitted with sidecars (or motorcycle ambulances) are also used, though they are subject to some of the same limitations as more traditional over-the-road ambulances. The level of care provided by these ambulances varies between merely providing transport to a medical clinic to providing on-scene and continuing care during transport.

The design of intermediate technology ambulances must take into account not only the operation and maintenance of the ambulance, but its construction as well. The robustness of the design becomes more important, as does the nature of the skills required to properly operate the vehicle. Cost-effectiveness can be

a high priority.

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NIST GCR 05-879

 —

Photonics Technologies:Applications in Petroleum Refining, Building Controls, Emergency Medicine, and Industrial Materials Analysis

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Ambulance for transportation of critically ill patient.

We use for the critically ill patients’ transportation a well equipped ambulance ( ECG, monitor, defibrillator, oxygen, intubation kit, advanced life support devices and medicines, etc.), where a large scale of medical intervention could be performed during the transportation. This kind of ambulances are equipped with

MICU-level 

medical devices

. Ambulance for long-distance transportation. 

One of the most frequent assistance tasks of SOS-Hungary is the medical evacuation by ground ambulance.  Our purpose-built ambulance can transport the patients even for long haul. The patient cabin has room enough for the doctor and also for one of family member, moreover some place for their luggage. If we prepare our ambulances for the long distance transportation, besides the 

necessary medical equipment

  for the long distance travel, some food and drink has been reserved in the portable refrigerator too. Even a portable DVD player and audio devices help to „enjoy” the long travel time!

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A water ambulance in Silly Isles, UK

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Star of Life Symbol

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Star of Life Symbol

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Star of Life Symbol

The Star of Life is a blue, six-pointed star, outlined with a white border which features the Rod of Asclepius in the center and has traditionally been used as a means of identification for medical personnel, equipment, and vehicles. Many ambulance services mark the symbol on their vehicles, and ambulance crews often wear the design as part of their uniform.

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EMERGENCY MEDICAL SERVICES WORKERS

Emergency medical services (EMS) workers are primary providers of pre-hospital emergency medical care and integral components of disaster response. The potentially hazardous job duties of EMS workers include lifting patients and equipment, treating patients with infectious illnesses, handling hazardous chemical and body substances, and participating in the emergency transport of patients in ground and air vehicles. These duties create an inherent risk for EMS worker occupational injuries and illnesses; and research has shown that they have high rates of fatal injuries and nonfatal injuries and illnesses.

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MEDEVAC Charter

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MEDEVAC Charter provided by  “Stronding Air” is:

o

rganizing of emergency medical flights

- organizing of MEDEVAC flights- transportation of patients to clinics and specialized medical centres

- transportation of patients home after treatmentDepending on the complicacy of the task, condition of the patient and his location the medical charter flight may be organized on an aircraft leased from our partners in any place of the world and equipped in accordance with the most modern medical achievements with a team of professional medical staff onboard.  Thus, a fast and reliable medical evacuation of the patient is ensured as well as the transportation and high quality medical treatment.

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Upon receipt of the request of the patient our managers prepare the transfer of all required medical documentation for the council of physicians who will establish an individual programme of medical check and treatment of the patient. 

Within several days the patient will receive a written reply with the detailed information on the programme of the medical check and treatment with indication of the estimated cost and period of stay in the clinic. 

Having coordinated the dates of arrival our managers will help obtain the invitations for medical visa, book air tickets, organize a charter flight and reserve a hotel taking into account the patient’s preferences.

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Services provided

Safe and comfortable transportation in a fully equipped turboprop or Learjet® pressurized aircraft with state-of-the-art medical equipment including:

cardiac monitoring

IV infusion therapy

ventilator capabilitiesA flight team of specially trained physicians, nurses and paramedics to assist patients in transport

Two FAA-trained pilots

Available 24 hours a day, seven days a week

Domestic and international air transport service to the closest sending or receiving airport facility

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Supersizing Air Ambulances

 

larger air ambulances

 that will allow transportation of patients weighing upto 260 Kg (up from the current 140 Kg). 

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like this aircraft is used for the

transportation

 of 

patients 

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Treatment Area Considerations for Mass Casualty Incidents

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Time Is Muscle: Translation Into Practice

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Options for transportation of STEMI patients and initial reperfusion treatment. Panel A, 

Patient transported by EMS after calling 9-1-1

: Reperfusion in patients with STEMI can be accomplished by the pharmacological (fibrinolysis) or catheter-based (primary PCI) approaches. Implementation of these strategies varies based on the mode of transportation of the patient and capabilities at the receiving hospital. Transport time to the hospital is variable from case to case, but the goal is to keep total ischemic time within 120 minutes. There are 3 possibilities: (1) If EMS has fibrinolytic capability and the patient qualifies for therapy, prehospital fibrinolysis should be started within 30 minutes of EMS arrival on scene. (2) If EMS is not capable of administering prehospital fibrinolysis and the patient is transported to a non–PCI-capable hospital, the hospital door-to-needle time should be within 30 minutes for patients in whom fibrinolysis is indicated.

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A Russian hospital train

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It is used in hospital for rapid transportation of patients in critical condition.

Material: 

Quality stainless steel and PP Plastics. 

Introduction: 

The back rest can rise 60°.The stretcher is removable. And it is flexible and convenient to steer the cart which is solid and practical and is equipped with infusion stand, side rails and ￠150 castorsSize: 

1900*630*800mm

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Hospital Lift

Hospital elevators are used for simple transportation of a patient on wheelchair to wheeling away a critical patient on stretcher without disturbing his life support system with doctors and nurses, smoothly, silently and swiftly, without jerks and shocks. Elevators for medical purpose are vertical transport equipment used in hospital and other relevant places to move patients and surgical instruments. PACE offers Hospital elevator in Auto Door and Manual door operation

 

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Carriages for transportation of patients

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The chairs are used to transport patients down stairs when other methods are unavailable.

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Carriages for transportation of patients

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Blood donors chairs