Ambulance Design Questions...

Airwaygoddess said:
A design for the gurney to be inside of the ambulance but be able to get access to both side of the gurney. That would make it easier on the back! :)
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We can get to both sides of the pt. in ours. Mind you, it takes a little squeezing in and "excuse me's" when moving around

I like that though ^ , being able to get to the pt. from 360degrees.

-Another thing would be better built in scene lighting, at night it can often be hard to find things and work in the dark, with the aid of flashlights.

-A fixed and a portable monitor/AED.

-Communications: I think we should be issued more handhelds for when on scene. Like have sitting in chargers in the back waiting for us to grab as we egress.

-Navigation (GPS w/ mappign software that shows the area and information (hydrants (more for firetrucks), landmarks, bridges (capacity), allies, 'short cuts', TRAFFIC)

-This may sound weird, but I thought this would be cool: surfaces that could be written on (and easily erased). Like near the jump seat, the 'desk' area could be made from the same surface as a white-board. Scribbling vitals/Hx can be hard, and this would just make things more accessible.

...just a few ideas.

Edited: MORE SAFETY! Not just restraints, but roll protection, airbags (?), warning devices, etc
 
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My first suggestion was to remember that our patients and EMS providers are getting larger...why not design for the 250 lb patient, and the 250 lb provider.

And I'm not saying that everyone is overweight, but it is becoming a growing (pun intended) problem.
 
Our medics here have gone to LED warning lights on the rigs . They're very bright without the flash and dazzle of strobes . Side scene lights and a pole mounted light on the back that can elevate also work pretty good .
 
mikie333 said:
We can get to both sides of the pt. in ours. Mind you, it takes a little squeezing in and "excuse me's" when moving around

I like that though ^ , being able to get to the pt. from 360degrees.

-Another thing would be better built in scene lighting, at night it can often be hard to find things and work in the dark, with the aid of flashlights.

-A fixed and a portable monitor/AED.

-Communications: I think we should be issued more handhelds for when on scene. Like have sitting in chargers in the back waiting for us to grab as we egress.

-Navigation (GPS w/ mappign software that shows the area and information (hydrants (more for firetrucks), landmarks, bridges (capacity), allies, 'short cuts', TRAFFIC)

-This may sound weird, but I thought this would be cool: surfaces that could be written on (and easily erased). Like near the jump seat, the 'desk' area could be made from the same surface as a white-board. Scribbling vitals/Hx can be hard, and this would just make things more accessible.

...just a few ideas.

Edited: MORE SAFETY! Not just restraints, but roll protection, airbags (?), warning devices, etc
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Interesting suggestions. That writing board makes sense. So your issue is that when in a hurry, or gathering vitals, its hard to write on the small patient sheet, especially when moving?

Maybe even a screen that you can write on that transfers it for electronic use? So, maybe the screen is an enlarged (or zoomed in) portion of the info sheet for the patients. You can right down those vitals on the screen, etc.

Can you elaborate a little more on what your issue is when writing the vitals down?
 
certguy said:
Our medics here have gone to LED warning lights on the rigs . They're very bright without the flash and dazzle of strobes . Side scene lights and a pole mounted light on the back that can elevate also work pretty good .
Click to expand...

Let's not get started on the debate about LED's vs. other types of emergency lighting. They have their place, but they have some issues also. They're not the end all, be all that some people believe.
 
ffemt8978 said:
My first suggestion was to remember that our patients and EMS providers are getting larger...why not design for the 250 lb patient, and the 250 lb provider.

And I'm not saying that everyone is overweight, but it is becoming a growing (pun intended) problem.
Click to expand...

I had forgotten about weight considerations. While I've never used a ramp and winch system for our morbidly obese patients, I've certainly dreamed about it!

Anything that could make it easier to load and unload our patients would be great.
 
simonID said:
Interesting suggestions. That writing board makes sense. So your issue is that when in a hurry, or gathering vitals, its hard to write on the small patient sheet, especially when moving?

Maybe even a screen that you can write on that transfers it for electronic use? So, maybe the screen is an enlarged (or zoomed in) portion of the info sheet for the patients. You can right down those vitals on the screen, etc.

Can you elaborate a little more on what your issue is when writing the vitals down?
Click to expand...

A lot of EMT/Medics I know use their gloves to write down vitals and such. I've tried and either I can't read my own handwriting or I tear the glove with the pen. Also, there is always a pen shortage! We usually have a clipboard that we record vitals and other info (history, allergies, etc) on, but it can be hard to get too depending on how much work we're doing in the back.

I've even see someone use the 'bag' of a large trauma dressing to write on (which had to be pitched afterwards because it punctured the sterile seal).

I was just thinking that perhaps on some surfaces of the ambulance, there could be room to record things, like a whiteboard surface or something (erasable), and perhaps the markers or w/e could be magnetically mounted to the board so they don't get lost/fly away.

Also, when someone is calling the receiving hospital with our report, if they don't have all of the numbers in front of them, it can be hard to give a fluid report. So perhaps these larger surfaces that we could write on would allow for more visibility.

As for technology, since we do all of our reports on the computer, it would be 'neat' if once we record a vital, it automatically goes into the proper section of the report. Just in case after the call we lose the glove or sheet of paper that we recorded everything on.

just some thoughts
 
We use dry erase markers on the cabinet surface in our rigs...cleans up pretty easy too.
 
^Ahh, ok. I see what you mean. I'll take that into account.
 
Side Loading Ambulance

I saw information on a prototype that loads on the side leaving the back third for storage.....the main safety idea was to have the EMS people would facie either the front or back to reduce injury during a head on or rear end impact

The patient in a 4 point harness was safer and tested to 7Gs impact. This is of course a bigger mod and it had a lift gate

Further safety since all passengers are in the center of the rig even on side impact

I liked the design enough to call and they are going to bring the unit by when it comes to the west coast
 
^
Major design flaws in the concept:

Increased foot print for loading/unloading (most ambulance bays I've seen stack ambulances in like sardines. This is fine since you leave the back clear for loading/unloading).

Loading/unloading has the potential to put providers into active lanes of traffic.

Not enough room for airway management.
 
rmellish said:
A few ideas immediately come to mind.

1. Safe mobility in the back - patients are belted in but many of us still are not. A harness system which allowed for simple movement around the compartment would be nice.

Would be nice

2. A monitor shelf - using the cpr seat gets old

The bench seat works pretty good too. Ours is split so you can have the monitor resting on one sit and still access underneath if needed

3. Safe mounting for portable oxygen cylinders - under the bench seat doesnt cut it for me

Both our rigs have o2 bottle racks that you strap the spare bottles in so they dont go flying. They are also in their own cabinet behind the captains chair

4. Air ride suspension or something to cut down on the bouncing for the patient

the air ride suspension isnt that great with bouncing and bumps. I doubt there will ever be a day you have a completely smooth ride

5. A decent platform to write the PCR on. (I'm dreaming now)

The new Horton boxes have a pull out sheft just for that in front of the captains chair at lap height. Its perfect for writing the PCR on as youre enroute

6. Privacy in the rear windows. I'm sick of the lady behind me in rush hour traffic looking in on me and my patient at a stoplight.

Again, the new Horton boxes have a switch which instantly turns all back windows solid and can't be seen through

I'm sure I can think of more. I'll get back to you after my next shift.
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:) i bolded all my replies
 
Many of the medics that get killed in the backs of these trucks when in a wreck are killed from flying objects. I know people are supposed to STRAP everything down, but it does not happen. We carry our E cylinders in an outside compartment on the driver's side. That takes care of the O2 bottles. Now, if you had a quick clip type of system that was attached to all of your loose items. Something that when you put a monitor on a bench seat, you could easily and quickly clip it it, that would help a bunch with safety.

Now, jump 20 years. I have always thought it would be very cool if you had a fighter pilot type helmet to wear in the back. The only draw back (but could be worked around I am sure) is using your scope for pressures and lung sounds. What it will do it give you a HUD (heads up display) on your clear shield. You could get any amount of data on there from the time to what your monitor is showing to how much oxygen is in the main tank. It would also have a on board communications system so that you could talk with your partner in the front of the truck without yelling. If would provide protection for your head as well as a good face shield to protect your eyes. All of these components are already out there, they just need to be put together and made to were they work and are not $20k a set. OK, that is my million dollar idea. Next.:wacko:
 
simonID said:
Hi, everyone. I am a Senior Industrial Design (product design) student at Ohio State University. At our school, our last quarter is dedicated to a thesis project which gives each student the opportunity to research and develop their own project. Ive been working on re-designing the interior of an Ambulance. Specifically interactive aspects, storage space, and other related items.

Ive interviewed a guy at our local fire department who uses Horton rigs. Some things he pointed out were lighting, and communication issues. Cleaning (lots of crevices to worry about). And some other detail related items.

As I have been doing some other research, Ive discovered how broadly different Ambulances can be. So I joined here to see if I could get a more broad spectrum on current issues EMTs might have. I've been skimming through existing threads, and have gathered some ideas from that, but would like to get a more open collection of ideas from the community here.

What issues do you guys/gals currently have with the Ambulance you work in?

Are there specific ideas that have come across your mind? Is so, please explain.

Are there things you have worked with in one Ambulance, and wished they were available in another, etc?



If you can, please provide which model Ambulance you are working with and/or have issues with.

Thanks for your time. I will post up the final product when I have completed it for you all to see. And may post up concept ideas for feedback. For anyone local to the Ohio State University, our Senior show will be June 3rd - 14th with the main reception on June 4th.


Simon
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Are you close to the final product yet?? It's far past June 14th....Just curious.
 
Yeah, late assignment!

"NASA-OSIS" and the "universal ambulance".
I was lucky enough to work in an urban/rural area ("greater" Lincoln Nebraska) during the period when modulars were just getting going strong, but five other types were still lingering: "semi-mods" (modified small to medium motor homes), Caddy's, vans, station wagons, and Surburbans. (I'm leaving out military "crackerboxes", they deserve seperate consideration but not necessarily here).

STATION WAGONS: basically laydown transport, but in areas where they cannot afford a true ambulance, a possibility. No longer legal, I believe.

SUBURBANS: with a cap and a "slide in" ambulancve interior, a little crowded but good for long-distance transport with a good ride and fast as blazes. Trouble is that the interiors tended to seperate from the rest of the vehicle and eject everyone/ everything in a rollover, and rollovers were not uncommon at speed due to wheelbase versus CG issues. I don't think these are legal either, but, again, could be very useful where money and distance are a factor.

CADDY'S: the F-104's of the ambulance world, derived from hearses, good ride, fast, low, hard to move around in but not impossible. Little ground clearance. Little capabilites for electric outlets, scene lighting, etc due to engine compartment being FULL, and little storage. I do not think they are legal, are they?

VAN's: a stretch (add eighteen inches) Ford Econoline (has new name) with a cap and walkthrough to the front seat area could be a very nice ride, an excellent compromise between a modular and a Caddy, big enogh to carry some serious stuff yet narrow and light enough to go places a modular can't.

"SEMI-MODS" (as we called them): BIG Dodge van cab, cutaway behind and a motor home rear compartment grafted on and faired onto the cab. Cheaper than modulars but tended to have the independent substructures start coming apart with time and twisting (whereas a modular has everything fastened within the module, then to the frame, more or less). The front seat pedestals were vulnerable to shearing (they were stamped sheet metal), and cabinetry would start falling apart. New ones were great. Under-suspended, needed to be replaced and beefed up, and power train could be undersized too.

Why not devise a fairly simple bare-bones rapid deployment ambulance module you can drop into a pickup truck and SECURELY fasten down in the event of a disaster?

Why go for more and more complexity and built-ins, often to meet very rare or semi-mythical possibilities, when what you really need is GOOD storage and loadouts or kits to help keep the load to a manageable minimum, REAL climate control and commo, etc.?;)


 
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