SAFETY

[pyroknight]

One of the best inventions I have seen in years is Stryker's new power cot that works on the 24V DeWalt tool battery. Think of how many back and knee injuries could be avoided every year! I was extremely pessimistic when I saw the first version of power cot, but this new version is user-friendly, fast, and very well-built.

[dahlio]

One of the best inventions I have seen in years is Stryker's new power cot that works on the 24V DeWalt tool battery. Think of how many back and knee injuries could be avoided every year! I was extremely pessimistic when I saw the first version of power cot, but this new version is user-friendly, fast, and very well-built.

I've used the new stryker power cot, and think it can be quite helpful. Not just for knee and back injuries, but for pure convience. You don't have to worry about moving the ER bed up and down, instead, it's a push of a button right at your finger tips. No more trying to figure out how the ER bed works. Only down side is that it's a pain in the neck if your battery runs out...

[pyroknight]

There is a manual override so that you can use it just like a regular cot. I would hope that you keep a spare battery in the rig and switch them out on a schedule.

[dahlio]

There is a manual override so that you can use it just like a regular cot. I would hope that you keep a spare battery in the rig and switch them out on a schedule.

I know theres a manual override, but it's a pain in the neck to use it. Expecially if you have one call after the next. We're usually good about changing the battery, but we don't keep a spare in the ambulance.

[pyroknight]

Reminds me of being called one time to assist an ambulance crew who could not get their cot back in their rig. After we put their patient on my cot and loaded them for transport, I took a look at their cot. As the son of an engineer, I got their cot to fold, put it in my rig, and took it back to the shop. It's always good to know how your equipment works and know how all the parts fit together (unless it's the brains of the LP12 or something, probably ought to leave the case intact on that beast).

As far as restraints go, I don't think compliance is going to take a big hike until they develop a chair that not only slides fore and aft, but also moves toward and away from the patient and swivels. Give me THAT chair and I'll stay belted the entire time. Until then, I guess I'll keep putting my life on the line kneeling between the cot and the bench, straddling the stretcher, etc.

We have come a long way and we don't have a high incidence of crashes with attendant injuries/fatalities each year (that I'm aware of, if I'm letting my ignorance "hang out" as we say in the South, tell me). You just cannot reduce the dangers of every day life to zero. SOMETHING is going to kill you. It may be an ambulance crash or it could be choking on a Gobstopper, you just never know.

[Dale]

Ahh, there are high back seats that not only slide fore/aft (we use them all the time) to reach the patient but also rotate (swivel.) We install one on every unit we build as standard at the head of the primary cot. The problem with installing most swivel seats where the squad bench would normally be located is that some folks want storage under the bench or a large exterior curbside compartment that must be incorporated into the squad bench structure. We do have some hospitals that have locking-style pedestal high-back seats in this location. Most everyone else that wants this option will have the seats mounted on a low "riser" but the seats still individually adjust fore and aft along with an adjustable backrest. The only real problem is the size of each of these seats. The base section tends to stick out towards the cot (overhangs where the vertical squad bench base normally is located) so you either relocate your cot towards the streetside location (if you have dual-position cot mounts) or you deal with less legroom between the cot and the seats. However, you can remain buckled into the seat and treat most patients securely.

The only other problem I see with these high-back seats also has to do with bariatric cots. They are wider than normal so they should be located into a streetside mounting location with the cot brackets to provide you with any legroom at all. This can become a real problem if you have highback seats installed on both sides of the vehicle.

There are some new seats available from EVS and Wise that will allow individual curbside highback seats that even have a fold-down backrest, allowing for the transport of a second litter patient (on a backboard or similiar device) by rotating the seats and placing the litter on top of them. Some restraints are provided to secure the litter. This is pretty common in Europe on many ambulances where a second patient needs to be transported at the same time in the same vehicle.

[mrmeaner]

I had intentions of starting a new thread, but many of the points are already made in this thread.

First, Type I & III ambulances vs. Type II. The van type such as Sprinter is made in an automotive facility to automotive standards. The cabins that are added to frames in the Type I & III styles are built in manufacturing plants to the KKK specs which are less than restrictive. Type I & III ambulance cabins haven't really changed in what, the last 30 years. The Type II ambulances have been improved along with automotive standards such as crumple zones. To see an example of the testing that is being promoted by manufacturers, look here: http://www.aev.com/main.php A previous test was broken because instead of being able to hold a 18 ton trailer on top of it, the new cabins can hold 55,000 lbs. of water on it's side. Wonderful. The next time someone slowly and carefully sets a 22.5 tons of water on the side of your ambulance (assuming it isn't damaged in the transit from horizontal to vertical) you will be safe. :roll: Well, unless you want to open the doors. That may lessen the structural integrity.

Aside from using a body that withstands impact (not static pressure) better than what's available now, the inside of the ambulances needs to be improved. Both by design and practice. Storage bins need to be able to stay closed in an accident and be able to keep the items contained. Anything that is outside the bins needs to be secured with anchoring systems that have been crash tested. I haven't seen first hand what an oxygen tank and regulator can do to a human head, but I've seen pictures.

The safety devices that are in place need to be used. Seatbelts need to be worn. Probably not the "EMT on a leash" seatbelts. I haven't had a chance to verify this yet, but apparently these have caused capitation. The equipment bins need to be designed in a manner that make them assessable to the attendant without getting out of the seat. The seat belts need to be applied to the patient, including the shoulder straps.

Last Friday, I had the opportunity to meet Nadine Levick, MD who studies safety and injury. She was one of the speakers at the trauma conference. We talked a little about the difference between US EMS and EMS in other countries. I get the impression that we are about 10 years behind here in the states from a safety aspect. It seems that a lot of the unsafe practices come from tradition. Traditional ambulance styles, traditional clothing worn on scene and the tradition of running hot when we don't need to. These are things that can be change and should be. The funny thing is everyone knows it. I'm not saying that I haven't done things that were unsafe or just plain wrong. However, I plan to talk to my supervisor regarding these concerns so they get addressed. I know this is one of the cornier lines, but we have a lot of traditions and unfortunately one of them is dying in accidents.

[spenac]

Misdemeanor excellent post. We are way behind, even consider the back door lift that the UK uses that helps stop on job injuries. I do agree we need to slow down even on serious patients. At high rates of speed you cannot work in the back thus doing more harm than good to everyone. Lets run with this.

[WestSideBorderPatrol]

Until then, I guess I'll keep putting my life on the line kneeling between the cot and the bench, straddling the stretcher, etc.

When is that EVER a good idea? [-X I understand that there are instances were we have to contort our bodies and put ourselves in less-than-safe conditions, but straddling the stretcher? I can't see where that would ever be necessary.

As far as the electric stretcher, they're great! :thumbup: However, our power stretcher is about 50lbs heavier than a standard stretcher and some of the more petite providers have trouble with it.

[mrmeaner]

As far as the electric stretcher, they're great! :thumbup: However, our power stretcher is about 50lbs heavier than an standard stretcher and some of the more petite providers have trouble with it.

How do they lift the backboard? Maybe the have backboards that work like the skateboard in Back to the Future. That would be cool.