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HIGH-RISK SITUATIONS

On the scene of an accident, If PD and FD have NOT secured the scene, the ambulance should be parked between the flow of traffic and the accident in a "fend off" position.  In this position, the ambulance deflects and averts from the scene other vehicles that may strike the ambulance or the providers. 

On the scene where HAZMAT or other dangerous chemicals or toxins may be present, park the ambulance a safe distance away and try to be uphill and upwind of the danger. If you're working a train derailment and one of the train cars contains HAZMAT materials, you want to keep the ambulance far from the site, so that you're not evacuating people from toxic areas into an ambulance that is, itself, inside the toxic area! UPWIND means the DIRECTION THAT THE WIND IS BLOWING FROM. Uphill means HIGHER GROUND where heavier-than-air pollutants are less likely to cause problems. ANTICIPATE the potential hazards ahead of time and err on the side of caution.

That is,  

  • if a person or vehicle is pointed UPWIND then they are against the wind.

...assuming the hazard is farther downwind than you are: the wind is blowing against you from UPWIND and then onward to and past the hazard. In other words, the wind will go by you first before reaching the hazardous substance/material/situation!  

  • If a person is pointed downwind they are with the wind.

            You would not want to be standing DOWNWIND of a smelly odor. 

 

Learning how to correctly operate the ambulance is as important as learning how to care for your patient once you arrive on scene.

An ambulance crash delays patient care and may take the lives of the EMS personnel, other motorists, or pedestrians. Stay aware of some of the high-risk situations you may be faced with.

If you are on an emergency call and can not wait for the traffic lights to change, you should still stop at the light, make eye contact with the other motorists to ensure they see you and are yielding, and look around for pedestrians before proceeding.

Intersection accidents are the most common and most serious type of crashes that ambulances can be involved in.

Emergency medical personnel should work closely with law enforcement to help ensure a safe response.

Traffic flow on highways is a major hazard for first responders. Factors associated with these hazards include limited or unlimited access to highways and backup of traffic that impedes flow to and from the scene.

Never allow any type of call to affect how you respond to it.

Remember it is their emergency, not yours. When you hear a call come out for a child or other EMS personnel, you may have the urge to drive faster and with less caution, feeling that speed is more important than safety. Always drive with caution. Do not let the nature of the call affect your arriving safely at the scene. If you are involved in a collision trying to get to the call you are of no help to the person that called for help initially.

Your partner should be an active participant while en route. They are an extra set of eyes and ears. Use them!

Many things can distract the driver operating the emergency vehicle. While en route to a scene, it should not be the driver's responsibility to operate any of the audible devices. Let your partner operate all of the audible devices.

Be sure to study the area you are working in. GPS systems should be used supplementally.

Global Positioning Systems are a key piece of equipment available in most ambulances today, but these systems can distract the driver from focusing on the roadway. Never attempt to drive while setting up the GPS system. Make sure to set it up before you go en route or allow your partner to operate it.

Do not text or make phone calls while driving!

Also, do not operate the stereo or service radio. Allow your partner to perform all communications while you are driving. Your focus should always be on the roadway.

It is important to take breaks and recharge when you can.

As we all know, we do not always get meal breaks. Eating and drinking in the ambulance may be convenient when you do not have time to take breaks.

Ambulances have a high center of gravity.

This creates a tendency for them to roll over if curves or turns are taken at a high rate of speed. Ejection from a vehicle is a major cause of death (80% mortality), so proper restraints (seat belts) while in the patient compartment are your best protection. 

When you add rain on top of the ambulance's design, you are at a greater risk of a rollover accident. Remember to use extreme caution when driving in inclement weather. Drive slower and give plenty of room between you and other vehicles on the road.

Also, be aware that your line of sight may be limited, so make it a habit of using your side mirrors. If your visibility is hindered by fog, smog, snow, or heavy rain, slow down and use low light beams for maximum clarity without reflection.

You can not predict the actions of the other drivers. Be sure to always maintain a safe following distance.

Prepare for them to freak out and slam on their brakes, pull to the left, pull to the right, or just stop altogether. This is inevitable about driving an ambulance during emergency traffic. 

Don't assume that other drivers will pull to the right like they are supposed to.

Also, be on the lookout for aggressive drivers. Not all drivers on the road respect the passage of an emergency vehicle, and they may refuse to grant you the right of way. Do not respond to those drivers aggressively. Just wait until it is safe to pass.

In many areas, you may be required to drive the ambulance on unpaved roadways.

While driving on unpaved roadways, be sure to drive slowly with both hands on the steering wheel, so you have complete control over the unit. Unpaved roads generally have uneven surfaces, small ditches, or potholes; they may be unpassable in the rain.

Do not drive onto an unpaved, wet roadway unless you are sure you will not get stuck.

Do not operate your unit if you are feeling fatigued.

Make sure to alert your partner and your supervisor that you are feeling fatigued. Your supervisor should take you out of service for the rest of the shift or until the feeling of fatigue has passed. As always, the safety of you and your partner is your first priority.