Policy for Ambulance Services

Quality Operating Document No : Process RML/AS/01 Dr. Ram Manohar Lohia Combined Manual of Operations Date of Issue : Hospital , Lucknow Ambulance Services 15/1/2008

Service Name : Ambulance Services Operational Policy Date Created : 15-01-2008

Chief Medical Superintendent

Approved By : Name :

Signature :

Emergency Medical Officer

Reviewed By : Name :

Signature :

Director

Issued By : Name :

Signature : Emergency Medical Officer

Responsibility of Updating : Name :

Signature :

Page of Contents

1 Manual of Operation Quality Operating Document No : Process RML/AS/01 Dr. Ram Manohar Lohia Combined Manual of Operations Date of Issue : Hospital , Lucknow Ambulance Services 15/1/2008

Sl.Order Particulars

A Purpose

B Scope

C Responsibility

D Policy

i. Abbreviations

ii. Key Standards for Ambulance service

iii. Protocols

iv. Responsibility for maintenance of the Ambulance

v. Emergency Calls

A. Purpose:

1. To ensure proper and timely transportation of patient to the hospital for appropriate medical attention.

2. To ensure proper transfer of patient from the hospital.

B. Scope:

Hospital wide

C. Responsibility:

Emergency Medical Officer

D. Policy:

The ambulance service provides the first point of access to health care for a wide variety of patient conditions, ranging from life-threatening emergencies to chronic illness and social care.

i. Abbreviation:

EMO – Emergency Medical Officer. ED - Emergency Department.

ii. Key standards for ambulance services include:

1. Responding to life-threatening calls. 2. Responding to non-life threatening calls. 3. Getting Emergency drugs and blood for hospital emergency 4. To provide any such service that the hospital may find deem. 5. Ambulance will not be used for carrying dead bodies except incase where the patient expires during transportation. 6. Ambulance services will be available within city limits and will be restricted to carrying patients to the hospital or transferring patient to the referred medical center.

iii. Protocol

1. All Ambulance drivers will be BLS trained. 2. Drivers must be in uniform and ID tag when driving the ambulance. 3. All ambulance drivers must have the CUG phone in possession while on duty.

iv. Responsibility for Maintenance of the ambulances:

1. The ambulance driver shall maintain the ambulance in clean and good condition.

2. The ambulance driver is responsible to maintain 90% of the medical gas (oxygen) to the total storage capacity of Oxygen. If the level of the Oxygen storage goes less than 50% the ambulance driver requests the ED staff to replace a 100% full refilled Oxygen cylinder.

3. The ambulance driver has to ensure the pneumatic pressures of the wheels are within stipulated pressure. If found less it is to be notified and refilled with informing the EMO and a movement entry has to be made in the designated register.

4. The ambulance driver has to upkeep all the non clinical equipments inside the ambulance if in case of any malfunction it is to be reported to the ED which has to be entered in the designated register.

5. The ambulance driver shall check the brake-oil level, Engine oil level, Wheel pneumatic pressure. Engine coolant, oxygen level, fuel level, siren, lights ups charge and the equipments in the ambulance twice everyday .

6. The ED Pharmacist will be responsible to maintain the required medicines in the Ambulance. The availability of medicines in the ambulance will be checked by the ED pharmacist at 8:00 am in the morning, the entry of the same would be made in the designated register. Prior to the dispatch of the Ambulance the ED rechecks the medicines in the Ambulance to ensure the availability of all the essential drugs. Once the Ambulance returns, the on duty ED Pharmacist checks the medicines to replenish any medicine which has been used.

6. The ambulance Driver shall upkeep and maintain all the documentation relating to the ambulance

7. The ambulance driver shall always maintain the Adequate fuel in ambulance and procures diesel as and when it reaches the safe minimum level of stock.

8. The ambulance driver requests for the diesel indents from the designate clerk in the administrative office as and when ambulance diesel stock level goes below the safe stock level. The diesel is got filled from the authorized vendor decided by the Administration.

9. The movement of ambulance for the refill of the fuel is to be notified to the EMO and an entry of the same is made in the designated register.

v. Emergency calls:

1. The Emergency ambulance call is received in the ED, then the time and Number of the caller is noted down by the ED staff responding to the call and transfer the call immediately to the EMO.

2. The EMO collects the exact address location and landmark etc, from the caller and advices for the precautions to be taken to patient. .

3. The Ambulance driver reports to the Emergency Medical Officer.

4. All the movements of the Ambulance are controlled only by the emergency medical officer. Apart from the Emergency room medical officer the Director, Chief Medical Superintendent and Medical Superintendents can control the movement in conjunction with the Emergency Medical Officer.

5. All the patient calls that are entertained by the hospital are considered load and go situation so the patient is picked up and moved to the hospital as soon as possible. The ambulance driver may assist on all the load-and –go situation in scene of emergency.

6. The ambulance will not move out of the hospital without the EMO concern when patients are being transferred.

7. The EMO summons the Ambulance driver and briefs the Ambulance driver of the location and landmarks etc.On being briefed by the EMO the ambulance driver does all the pre-departure check and brings the ambulance to the front patio of the emergency department.

8. Picks up the Waiting nurse (Refer Transfer of patient policy) in patio and drives to the destination to pick up the patient safely and as fast as possible.

9. The Emergency drugs and the Clinical therapeutic, diagnostic equipment will be kept in the Emergency Department and will be moved into the ambulance only during calls as per the advice of the EMO.

10. The ED staff pharmacist will be responsible for the same.

11. The ambulance driver will have to assist in-shifting of the patient as directed by the EMO.

12. All communications are done from the ambulance to the ground station through the CUG phone in possession with the Ambulance driver.

13.The patient when being brought is wheeled in and loaded in the ED trolley and the Ambulance driver sets back all the system in the ambulance and cleans the ambulance with the assistance of the house keeping personnel inside the hospital. This cleaning operation shall not exceed 20 min.

14. In case of any planned shifting and transfer of the patient all the modalities are worked out by the emergency medical officer in conjunction with the respective departments . The ambulance driver will be informed by the Emergency medical officer and an entry is made in outgoing ambulance register the ambulance driver brings the ambulance to the patio and takes the trolley to the pick up point of the patient inside the hospital and moves the patient accompanied by the nurse/doctor to the ambulance and proceeds.

15. In this operation the Ambulance driver will not be liable to satisfy any clinical documents or requirements.

16.In case of any purchase of pharmacy drugs and Blood done by the ambulance team, the medical officer shall handover the requisite prescription and cash and briefs the ambulance drive as to where and when and how to get it.

17.In case of non emergency planned pick up of the patient the Ambulance driver may be informed in prior and handed over the trip sheet by the medical officer not exceeding 48 hours in advance.

19. In the Transfer and shifting of the patients ,depending upon the condition of the patient a nurse/doctor may accompany the patient.

20. For referral –the referral hospital must be informed before sending the patient. Staff accompanying the patient must be seated at the back with patient .Only one person will be allowed to accompany the patient in the ambulance. Relatives \ accompanying the patients to do so at their own risk.

21. Sirens – Silent –if the road is empty .Only lights on-cold case will be used. Siren only on-if carrying ill case and/or to clear traffic.

6 Manual of Operation