Need ambulance driving help!!! [Archive] - Glock Talk

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MissAmericanPie
05-29-2008, 21:25
Hi All,

I haven't been here in a while since I have been working a lot and do not feel much like internet chat by the time I am home. I have the day off, however!! :)

Well, here is my question: I love my job, however, the training is really slow and not really organized as training at all. It has been almost three months and I still do not know some ambulance-specific, basic things such as setting up IVs for the medics and my radio reports and radio skills in general, well, they suck.:faint:

And I just find out that some people have an issue with my driving - I am not very smooth. I have never driven a diesel (with the exception of occasionally picking up the rescue for our volunteer calls in my town) and my acceleration and deceleration is jerky. I do not drive my vehicle this way.

What I really want is to work out these bugs. I haven't even begun to focus on patient care (although I get to tech some small, inconsequential calls) since everything is all over the place. There is no program in place and I'm partnered with so many different people that I never get training.

When this nightmare is over and I have been there for a long time, I am determined to set up a training program with objectives and completion dates for new hires!! But in the mean time, any suggestions? I especially need help with my driving. I seem to have difficulty multitasking when operating the vehicle. When I started, I was just handed the keys (basically) and was driving right off the bat. I need to figure out how to drive this beast without throwing the tech and the patient around when driving code.:shocked:

:)

Glkster19
05-29-2008, 21:48
One thing I always heard when I was new was "Easy on-Easy off". Meaning to accelerate slowly and brake in an assured distance to not throw people around. Remember, everything you feel in the drivers seat is magnified x10 in the back. Go slowly around corners, takes very little to toss people/things around when cornering. The fact that it is a diesel should have no bearing on anything really. Practice when you don't have a pt in the back. Pretend you're doing pt care and have your partner drive around so you can realize what it's like in the back at certain speeds around corners, what it feels like when someone accelerates hard or brakes hard. It will give you a new perspective on driving. You'll get the hang of it, it just takes time. You'll never get yelled at for going to slow around a corner but you will hear complaining every time about going to fast.

Glkster19
05-29-2008, 21:50
Forgot to mention.........




always give yourself plenty of space going around corners so you don't hit curbs. Guarantee you'll hear about that.

Hunca Munca
05-29-2008, 22:07
I can help with the radio reports. I have heard many horrible ones.

First let me know if you want orders or if it is just a notification.

Then state what is wrong with pt. Just give pertinent meds (like aspirin for chest pain) I don't need or want the whole 5 page list.

Then give vital signs BP , pulse, Pulse ox, RR, Blood sugar if pertinent

Then state treatment given or request orders.
That's it!

Example:
"This is NH medic 007 requesting orders
65 year old patient complaining of chest pain began 1 hour ago. Pt has CAD history.
Pt took his own aspirin.
BP 156/90 hr 98 sinus, rr 20 sat 98% on 4 liters 02.
We have given three nitro sprays pain now 7/10. BP now 134/70
Requesting orders for additional nitro and 2mg morphine as long as BP stays above 100 systolic.
ETA 30 minutes "

If I have any questions I'll ask after this report.
:wavey:

Glkster19
05-30-2008, 07:26
Requesting orders for additional nitro and 2mg morphine as long as BP stays above 100 systolic.


You have to ask for this??

RyanNREMTP
05-30-2008, 08:50
Get to know the ambulance. Learn the way it handles when taking off, slowing down, going around curves and making turns. This comes with practice. It's not something you learn overnight. It will take time depending on call volume and how much you train driving.

As for radio reports, get a pad that has the info already to be filled in. Those EMS field guides usually have one on page one. Go over your med report in your head and then say it. After awhile it will be second nature.

Lastly Don't Give Up. Stick with it.

Hunca Munca
05-30-2008, 09:41
You have to ask for this??

I don't have to ask for anything. I am the askee...:supergrin:

The protocols usually allow for 3 ntg then if still having pain a consult.
My EMS region is very consult dependent "mother may I..."

MissAmericanPie
05-30-2008, 10:40
Get to know the ambulance. Learn the way it handles when taking off, slowing down, going around curves and making turns. This comes with practice. It's not something you learn overnight. It will take time depending on call volume and how much you train driving.

As for radio reports, get a pad that has the info already to be filled in. Those EMS field guides usually have one on page one. Go over your med report in your head and then say it. After awhile it will be second nature.

Lastly Don't Give Up. Stick with it.

Thanks so much. Our call volume has been really low - spring is quite slow. However, the other day we had 11 911s and that is a lot for us - it kept our two crews busy most of the day and our third (our operations manager and our extra guy) went out a few times as well. So that day sucked for me since my partner was *****ing most of the day (not in an inappropriate way) about those aspects of my driving. The funny thing is - he has been my partner more than anyone else on the roster and has never suggested we go out for driver training since it has been so slow. Everyone just sits in quarters watching television and playing on their laptops complaining about being bored!!

I have always asked for feedback and have gotten none until recently. It is really irritating and I feel that I have had too much time to develop bad habits - I don't even realize I'm doing it when it happens.:dunno:

I'm going out with one of the experienced crew members Sunday and I have requested to work with him every Sunday in June so he can get me up to speed. He is going to take me driving, etc.

Also, with the radio reports, I do realize that it will come with time. I have a template I made up the other day with the info. our particular hospital is interested in. I guess I am less comfortable with remembering to sign on/off scene, radio the hospital informing them of our call, informing the county dispatch center (different from ours) when we do mutual aid, etc. when I am driving code 3. I think I would have learned by now if everyone I was with didn't grab the mic and insist on doing it. It also pisses me off when people take the siren and work it for me. I need to learn this stuff.

Anyway, thanks everyone for the advice. I'll be using it - and I've become quite assertive about it as well.

mrdann
05-30-2008, 14:36
When driving the big rigs, imagine a glass of nitroglycerin, filled to the brim, with no cover, sitting in the back and if you spill one drop.."boom".

Seriously, in a big truck you have to do everything about 1/4 of the speed you think.

huskerbuttons
05-30-2008, 18:10
Have your partner drive you around while you are on laying on the cot. You will get a first hand look at what your patient and your partner feels. Easy on / easy off is good thing to remember too. Drive, drive, drive, and then drive somemore. It all comes with time.

DTLarson
05-30-2008, 18:38
When your in the drivers seat, sit with your back off the seat by about 2 inches. If you feel any sort of motion from your torso, your accelerating or decelerating too fast or taking a turn too fast. This has been the best indicator that I have found. Also, you need to start braking about 3x as far back as a normal vehicle so its nice and smooth in the back.

MissAmericanPie
05-30-2008, 19:01
When your in the drivers seat, sit with your back off the seat by about 2 inches. If you feel any sort of motion from your torso, your accelerating or decelerating too fast or taking a turn too fast. This has been the best indicator that I have found. Also, you need to start braking about 3x as far back as a normal vehicle so its nice and smooth in the back.

All good advice. Thank you and I'll try that.

I thought that driving code 3 would be what scared the crap out of me, having to weave through congested areas and figuring out how to get through clustered intersections, but nooooo - it has turned out that I'm just terrified of pissing my partner off by being to gung ho with the accelerator and brakes!! :)

DTLarson
05-30-2008, 21:19
Code 3 doesn't need to be more than 10mph over the speed limit. Any more than that and you are most likely throwing people around with any bump you hit. Remember to slow down for every green and stop at every red. Its a reality that if you get into an accident in an ambulance at 30+ mph with a partner in the back they have a good chance of being killed in the accident.

Also in the beginning when driving code 3 remember to look at your speedometer. A lot of new drivers will get "adrenalin" foot and without realizing it start to drive faster and faster.

gruntmedik
05-30-2008, 21:43
Just remember, you are driving an ambulance, not a sports car. Quick on the pedal is uncomfortable to the pt, and potentially dangerous to your partner. Remeber to scan ahead and anticipate problem areas, never pass on the right, and do not blow through intersections. I drove, and taught those I was precepting, as if the ambulance were invisible, because it sure as heck seems to be once you turn on the lights and siren.

Photographer
06-01-2008, 00:17
Here's a practice tip from 25 years ago: Find a large empty parking lot. Lay a radio microphone on a flat portion of the dash. If it moves, you're doing whatever you're doing too hard. Focus on moving the ambulance -- accelerating, decelerating, turning -- so smoothly that the microphone doesn't shift. You'll probably never drive this way in traffic, but attempting to get to that point will teach you the feel that you are striving for.....

FiremanMike
06-01-2008, 18:38
Please don't take this the wrong way, but I don't think you should be driving yet. I would tell this to any new person to this field, even though I know it happens every day. When I first came on I wanted to drive a lot because it was fun, looking back it was a big mistake.

First, you need to focus on your patient assessment and care skills at this point. You are fresh out of school and need to start developing on all the things you just learned. You could be the best driver in the world, but if you suck as an EMT, you are useless on my truck.

Second, you are probably still very excited on runs. Not necessarily in a bad way, just in a new way. That being said, this will be amplified when you are driving and you will be much more apt to make critical driving errors. You need to get to a point where you are comfortable on most runs, such that the majority of the time when the tones drop it doesn't increase your heart rate or put you into an excited state. This will allow you to focus on driving and not be worried about what's to come on the run.

Please don't take these words as harsh, I don't know you and I'm not judging you. The only thing I know is from your posts which revealed you just recently got into this business, and I'm comparing you against every new person I've ever seen in this business (including myself). I know its fun to drive really fast on the wrong side of the road, but my personal soap box recommendation is that you not worry about it just yet.

edit: by the way, I agree with the above poster about the mic on the dash, very good practice.

MissAmericanPie
06-02-2008, 09:48
Please don't take this the wrong way, but I don't think you should be driving yet. I would tell this to any new person to this field, even though I know it happens every day. When I first came on I wanted to drive a lot because it was fun, looking back it was a big mistake.

First, you need to focus on your patient assessment and care skills at this point. You are fresh out of school and need to start developing on all the things you just learned. You could be the best driver in the world, but if you suck as an EMT, you are useless on my truck.

Second, you are probably still very excited on runs. Not necessarily in a bad way, just in a new way. That being said, this will be amplified when you are driving and you will be much more apt to make critical driving errors. You need to get to a point where you are comfortable on most runs, such that the majority of the time when the tones drop it doesn't increase your heart rate or put you into an excited state. This will allow you to focus on driving and not be worried about what's to come on the run.

Please don't take these words as harsh, I don't know you and I'm not judging you. The only thing I know is from your posts which revealed you just recently got into this business, and I'm comparing you against every new person I've ever seen in this business (including myself). I know its fun to drive really fast on the wrong side of the road, but my personal soap box recommendation is that you not worry about it just yet.

edit: by the way, I agree with the above poster about the mic on the dash, very good practice.

Thanks for the advice - but I do need to drive or I am of no use to this company yet. Half of our crew are paramedics. That means I am paired often with a paramedic and I have to be able to drive that person when we get a call that requires his/her skills. So, unfortuntately, that is not an option at this particular operation. It is small - about 15 full time employees and another 10 part time employees (some one shift per month).

I have been working on my town's rescue since October when I took my exam and this winter I got a decent amount of patient assessment experience from my job at base first aid (at a local ski area). I understand that I am still learning all of that and I still haven't seen a lot since it has been slow season at the ambulance since I started at the beginning of March. But I do have the opportunity to tech calls on occasion. I tech a lot of our transfers (taking vitals is now second nature) and I have teched some 911s. The feedback I have gotten from those I have worked with was positive - that my patient care skills are good and will improve and become smoother as we get busier.

I went out driving yesterday with one of our more experienced EMTs. He noted one issue - that I need to be smoother in maintaining my speed. I tend to let off of the gas and accelerate too often. He said my stopping and accelerating from a stop was good and I took turns smoothly. I was confused since I was driving no differently than normal. He said that everyone has different opinions about how the rig should be driven. He told me that he personally has never noticed a problem with my driving.:dunno:

So what I want to do is see if I can have our operations manager ride with me for a few hours and give me some feedback. Since the two people "in charge" of making sure I'm up to speed have differing opinions, I guess I need a third - and I should get it from the boss.

As far as getting excited - I do. I love it, however and have never noticed it to be an issue. I love what I do and although a fire alarm activation does not get me amped, an MVA with personal injury does. I will be sad if I lose that feeling - it is how I work best and being amped lets me focus. I work best under stress and I do better on calls where a person has a more serious injury than I do on a general "back pain" call, etc. I step back and go into a mode where things start falling into place. There is an EMT where I work that has been doing this since 1974 and he still gets amped when the tone goes off! I can't see how that can't happen when you have been sitting in quarters for a couple of hours bored off of your ass!! :)

But I see where you are coming from where it could be a hinderance when driving. I do try not to let myself get too excited when driving. That doesn't help me like it does with other things. It seems like critical mistakes can be made.

I understand your concerns about having me drive so soon. I think I would agree if it had been another larger company. I think a driving test should be instituted here, however. First, a week of driver training, then a test. I like objective benchmarks. That is how I know that I am where I am expected to be.

Thanks to everyone for all of your suggestions - I did try some of them yesterday!! Now I need to learn to multitask........driving, radio, lights & sirens!! :)

obxemt
06-02-2008, 22:09
Thanks for the advice - but I do need to drive or I am of no use to this company yet. Half of our crew are paramedics.

That's the first thing I thought when I read that post. When I was 18 years old, I was in the same situation in a larger system (seven stations and 11 trucks plus a helicopter). As a new full-time EMT I was always paired with a paramedic partner, so driving was my primary gig. I was an excellent tech, but had to prove it since the presumption was always working against me because of my age.

For whatever it is worth, it seems that you're over-thinking driving way too much. Driving isn't that complicated. The "mic on the dash" sounds exceedingly silly to me and proves nothing.

Just use common sense and take it easy. There's no way you can become competent without practice, and that means driving as much as possible and getting over the hump.

obxemt
06-02-2008, 22:12
Code 3 doesn't need to be more than 10mph over the speed limit.

That depends completely on your response area, roads, conditions and ability of the driver.

MissAmericanPie
06-03-2008, 19:07
That's the first thing I thought when I read that post. When I was 18 years old, I was in the same situation in a larger system (seven stations and 11 trucks plus a helicopter). As a new full-time EMT I was always paired with a paramedic partner, so driving was my primary gig. I was an excellent tech, but had to prove it since the presumption was always working against me because of my age.

For whatever it is worth, it seems that you're over-thinking driving way too much. Driving isn't that complicated. The "mic on the dash" sounds exceedingly silly to me and proves nothing.

Just use common sense and take it easy. There's no way you can become competent without practice, and that means driving as much as possible and getting over the hump.

Well, everyone else seems to think my driving is fine for how long I've been at it. I am probably overthinking it because it was brought to my attention and my manager's (and everyone else's too) by two particular individuals at work (who happen to reside together). It isn't that I don't need improvement - it just seems like I need less than I initially thought.

We just went to a suicide a few hours ago and I drove and my partner (one I rarely work with) said I did just fine. He told me that he witnessed a problem about a month ago where I was driving (rerouted back to the hospital we were transferring patient from since pt. was circling the drain) and he was behind me. He said I seemed to head for a certain route and changed my mind at the last minute. He told our manager, he said since he was concerned that I needed to understand that I cannot change directions when running code once I commit. Makes sense, but I've certainly come a long way since then.

Thanks for the reply - it really puts things into perspective.

Denthead
06-25-2008, 21:11
When i was driving ambulances they told to act as if there was an egg between your foot and the pedals......hope it helps

FlaFF
06-26-2008, 19:33
If the truck is equipped with a Jake Brake keep your foot on the accelerator a bit even as you decelerate, it will keep the jake brake from engaging and creating that sudden jerk that occurs when you let off the accelerator.

FLaFF

DoogieHowser
06-28-2008, 17:26
As far as radio reports go really listen to what is the norm in your area to learn how 'they' do it. Listening to a scanner could be helpful to you.

Glkster19
06-28-2008, 17:58
That depends completely on your response area, roads, conditions and ability of the driver.


...and how fast your pt is circling the drain.

larry_minn
06-28-2008, 22:43
...and how fast your pt is circling the drain.

Well my info may be dated.... We soon found that speed was NOT the answer. The rigs we used (Ford 7.3 dsl before powerstroke) one ton rigs were boxy and rode rough. I could get to most scenes faster with my POV driving normal then the rig code III.
The fast acceleration/braking did NOT get you there that much faster then smoother driving. Plus if you are involved in a accident with a ambulance. :( Add in that you are doing ANYTHING you would not be legal in a POV. :( :( You don't do anyone any good getting in a wreck. (does not help pt either)
I also was one who was handed the keys and told to drive. I took the rig out at night in the fog (with another EMT) and played with lights till I found a combo that I could see to drive with. And I learned to take my time and pick priorities. When I was driving I would handle dispatch traffic. (When leaving garage, on scene, enroute to hospital, back on call) To Hospital I only gave ETA and general info. "Female aprox 28 involved in car rollover, backboard,spine precautions, Pt is alert to place,date,time. eta 10 minutes" If they want more info they can talk to person treating pt.

MattHappyTrails
06-29-2008, 11:58
Back when I was a school principal, our Driver Ed Instructor used to put a full paper cup of water on the dash. He then taught proper stopping and acceleration but having his students learn to do it without spilling a drop. Might give that a try.

Glocker
07-05-2008, 22:19
That depends completely on your response area, roads, conditions and ability of the driver.

Our EMS director followed a unit in one afternoon. The unit ran what we called 10-33/10-18 traffic the entire route. The EMS Director drove five miles over the speed limit. The unit only beat him by a few minutes and was at a larger risk of an accident, turn over etc by driving like idiots.

These units are big, heavy and top heavy. Quick take off's and stop's do nothing but toss the PT around. Many times causing more pain and possible further injury. I drove for over ten years and I drive tractor trailers etc for a living. These things are not sports cars. Listen to the advice of the others here. Be easy on the pedal, it will actually pick up speed better if you are not standing on it. Allow more room to stop. Break early and slow down for all turns. Do not weave in and out of traffic. Lights and Sirens are only asking permission to disobey traffic rules, it is not a right. You blow through a red light and get t-boned, it is still your fault, I don't care how many lights you have on and how many sirens you are blowing, people do not see them. Besides, you can drive too fast and over drive your warning devices, meaning that by the time the people you are warning hear them, they do not have time to react.

Yes, a call comes in you get pumped, thats what keeps you doing the job, just take a sec to focus on the job, don't let the trama rush blind you to safety. Also, don't let the routine blind you to something that could be a serious injury. An MVA with injuries could be a minor fender bender that someone got excited and called in as much worse, but that back pain call could be a serious injury. Treat all calls as if the PT's life depends on you, it does. I know we had our monthly prescription ran out sick call's you take in on a Friday night. But one night that person could really need your help, so you have to have your mind set that every time they call, its that night.

Stick with it, be easy on the driving and I wish you luck on advancing to paramedic....

obxemt
07-05-2008, 23:00
The EMS Director drove five miles over the speed limit.

Then he should save the expense of lights and sirens.


Quick take off's and stop's do nothing but toss the PT around.

I was referring to responding, not chauffeuring. For instance, in rural areas where seconds count and more than 5 mph over the limit is both safe and prudent, I hope (heck, I know) that kind of driving is still done regularly.

I was an EMT for 8 years in an area that had no hospital. The closest hospital was 45 minutes away, the nearest Level I trauma center close to 90 minutes. We safely and gently traveled at high speeds all the time (multiple transports per shift) so the generalizations don't apply to all situations or locales.

Glocker
07-05-2008, 23:49
I served a long narrow county (Chowan), north end where my unit was to the hospital was 30 minutes. We could make the run in an ambulance in about 15 minutes, less with the older gas models, if we had to.

We had a problem with a few people trying to turn it into a competition. I made it in 16 minutes, oh yeah, I can do it in 14. They didn't really restrict our speed just suggested we not go over 75, but they did warn about the I can beat your time crap.

The day the Director followed the unit in it was an afternoon call, at a time when traffic was at its worst on the main highway. Not tourist season beach traffic, but enough that the unit had to constantly speed up and slow down and get caught behind traffic for a few seconds before it could pass. He was just trying to prove that driving like a mad man and risking an accident is not worth the gains in time that a steadier safer response could be. I think he claimed to of averaged 60-65mph and below. The unit, a type three diesel the driver ran what he could get out of it in what he felt was a safe manner and topped out around 75 to 80 on straight aways. They beat the director by 5 minutes maybe. Yes it could be a important five minutes, again, just showing that you do not save the time you think you are by driving like Speed Racer.

I was in an all Volunteer unit, some of these people drove all the time, others, you might have someone behind the wheel that is usally in the back. Depends if an ER/AA was on duty or if the most Jr. EMT drove.

Yes seconds count. Our best run was less than ten minutes, but it was a little girl that lost both legs to a bushhog, LE had the entire route blocked, and there was no traffic, so when they freed her from the equipment she was in the ER in 10 minutes or less. She still died in the helicopter enroute to Norfolk General.

Didn't mean to step on any toes OBXEmt, just trying to show that he doesn't have to be so rough with the pedal and brake and still get the job done with out giving the guys in the back an E ticket ride. I have been back there trying to brace against a fixed object with a knee holding onto the overhead bar with on hand and trying to get work on a PT with the other and helping to hold my parter up with the other hand while the driver took a turn way to fast. I have also been back there when my partner coded and we did CPR while enroute and I thougth the unit would never get there. It almost seemed like we were not moving at times.

So, you still on the OBX? Any good shooting places down there?

Brian

obxemt
07-06-2008, 07:43
I served a long narrow county (Chowan)...

So, you still on the OBX? Any good shooting places down there?

10 or 11 years ago we did a L&D transport to Chowan. She kept telling the medic (also a supervisor) that she had to push. He said, "No you don't! Close your legs!" And then leaned up to the front seat and said "Drive faster!" I'll never forget that. :rofl: I already had her in the wind.

Oh, and another Chowan story. Well, actually, it was either Chowan or Gates...I can't remember which now. We were at Albemarle Hospital and heard them call in a patient report on a 30-something-year-old with abdominal pain. The report ended with, "And we currently have an AED in place with no shock advised." I laughed for days. :)

No, I'm not on the Outer Banks anymore but I sure wish I was! :supergrin:
I went back to college a little later in life and now I'm in graduate school in Tennessee.

The county range out in Stumpy Point is the only place to shoot. I spent a lot of time there! There was talk of an indoor range in KDH/Nags Head that I don't think ever went anywhere. But the outdoor range ("Outer Banks Gun Club") used to be $5 per visit or $25 for the year, it has probably gone up a little by now.