van ambulances

[katgrl2003]

Could be worse man, you could have to teabag the pt. for the whole transport like we do in some of the smaller rotors. lol

In the AS350 as well as some of the smaller Bell products, you have minimal access to the whole lower body, the left side, and you get up close and personal with them. Hope you had a breath mint and clean underwear!

Dang Flight! I was drinking a coke when I read this, and now my sinuses have been powerwashed. The carbonation tingles a bit when its shooting out your nose. :wacko:

 

[the_negro_puppy]

We use these

and for our larger pts

 

[HotelCo]

At my service ALS (including CCT), and BLS work primarily in vans. I've never had an issue with it. When I first started at the company, I had my doubts, but it's not really an issue.

 

[HotelCo]

The bigger concern for me is the fact that we don't secure much of our gear. Our Pelican Box full of drugs, pedi kit, monitor and asorted other flotsam and jetsam that accumulate in the back of the rig will all turn into projectiles that will KILL ME if we ever get in an accident.

Why isn't your gear secured? I've never seen a Type II that wasn't able to be configured to safely store all of the ALS gear properly.

 

[gicts]

Just for the peanut gallery, Careflite showed off their new configuration (with Crestline, I believe) for a CCT-level Sprinter chassis.
Take a look at Kelley Grayson (Ambulance Driver)'s description

http://ambulancedriverfiles.com/2010/10/a-fresh-outlook-on-ambulance-design/

(photos taken from AD's blog)

can't transport a second on the bench seats can ya?
....or nearly anywhere for that matter. Otherwise it is a pretty cool setup. For CCT and other transports it is pretty much perfect.

 

[rook901]

I can honestly say Linuss is the first person I have ever heard thats worked in a van, complain about a van. Most of the people I hear complaining about them, have never worked in one.

Then you can add me as your second . I've spent more than my fair share of time in a type II, and it sucks immensely. Maybe the people who AREN'T complaining about vans have never worked in a box unit.

The space is cramped as hell. You have almost no room to move around. Accessing equipment on scene is awkward with no outside doors. I've even worked in one vanbulance where you couldn't turn on the under-bench main O2 without opening the rear doors (we usually leave them off because most of our units have O2 line leaks). So, if you run into a situation where you start out on portables and need to switch to main, you get to play musical doors.

Fortunately, the company that I work for typically only uses the vans for BLS units, so it's not that big of a deal with accessing the equipment. But problems do happen occasionally. And occasionally ALS units have to use vans when the boxes are in the shop. Working a big MVC and having to fight against your unit trying to get spinal immob gear out is a PITA.

The only thing I hate as much as Type II's are Medium Duty units, but that's for a whole different set of reasons. Give me a Type III any day.

 

[NomadicMedic]

Why isn't your gear secured? I've never seen a Type II that wasn't able to be configured to safely store all of the ALS gear properly.

Well, we have a bracket for the monitor that is useless because the cables don't reach the patient when it's secured. Our pelican doesn't have a mount point. It sits on the floor next to the side door. Our other kits and bags are on open shelves. There is a tray of "stuff", including an EZIO driver kit, blood tubes, iv set ups and other stuff in the action area. There are also portable radios, metal clipboards, portable o2 and other stuff that is "secured" in the back of the rig. It will become a maelstrom of churning debris if the rig ever rolls. I've mentioned that we need to secure the gear in the rigs and I'm subsequently told to "deal with it".
It is what it is. And it's been like that in EVERY type II I've ever been in.

And please, don't say "you should find another job". Landing a full time non fire based medic position is like finding a needle in a haystack in Washington state.

 

[TransportJockey]

Then you can add me as your second . I've spent more than my fair share of time in a type II, and it sucks immensely. Maybe the people who AREN'T complaining about vans have never worked in a box unit.

The space is cramped as hell. You have almost no room to move around. Accessing equipment on scene is awkward with no outside doors. I've even worked in one vanbulance where you couldn't turn on the under-bench main O2 without opening the rear doors (we usually leave them off because most of our units have O2 line leaks). So, if you run into a situation where you start out on portables and need to switch to main, you get to play musical doors.

Fortunately, the company that I work for typically only uses the vans for BLS units, so it's not that big of a deal with accessing the equipment. But problems do happen occasionally. And occasionally ALS units have to use vans when the boxes are in the shop. Working a big MVC and having to fight against your unit trying to get spinal immob gear out is a PITA.

The only thing I hate as much as Type II's are Medium Duty units, but that's for a whole different set of reasons. Give me a Type III any day.

I've worked in Type I, II, and III rigs, and now work in Medium duty rigs (I absolutely hate them. Too big, sucks to drive). Out of all of them I love the Type IIs I've worked in the most So soem of us that like vans have worked in boxes too

 

[rook901]

So soem of us that like vans have worked in boxes too

I only made that statement because of the silly "only people complaining are the ones who haven't worked in vans" statement.

 

[TransportJockey]

I only made that statement because of the silly "only people complaining are the ones who haven't worked in vans" statement.

Makes sense Just making sure you knew that some of us like them and haven't just worked in them

 

[RanchoEMT]

I'm going to assume the original post was pertaining to actual "mini-Van" Vans... not type II ambulances. (ex: http://southerncaliforniamedicaltransportation.com/) I've worked for a company that used them. And their horrible. ....Its a MiniVan! Not an ambulance. We would do IFT type transfers with them and it was so cramped in these things that both EMT's would be forced to sit up front and turn around every 15 minutes(5 min. for an unstable patient... ;o) and ask "How you doing Sir." There's NO room for storage. Our extra O2 was shimy'ed under the spare tire, which needed to be unscrewed to access. Our Sheet/pillow and BLS bag was a cardboard box on the rear passenger seat that would fall on top the patient when making hard turns... JUST HORRIBLE.

 

[EMSLaw]

I'm going to assume the original post was pertaining to actual "mini-Van" Vans... not type II ambulances. (ex: http://southerncaliforniamedicaltransportation.com/) I've worked for a company that used them. And their horrible. ....Its a MiniVan! Not an ambulance. We would do IFT type transfers with them and it was so cramped in these things that both EMT's would be forced to sit up front and turn around every 15 minutes(5 min. for an unstable patient... ;o) and ask "How you doing Sir." There's NO room for storage. Our extra O2 was shimy'ed under the spare tire, which needed to be unscrewed to access. Our Sheet/pillow and BLS bag was a cardboard box on the rear passenger seat that would fall on top the patient when making hard turns... JUST HORRIBLE.

I'm flabbergasted. While I recognize that they only do non-emergent transports, I'm sure we can all come up with a few dozen stories of dispatchers and nursing homes getting it wrong.

So, this company can't even have an EMT in the back with the patient. It's worse than a Cadillac ambulance. What happens if the supposedly stable patient starts to go south? You pull over and call a real ambulance on your cell phone?

Ambulance regulations are a wonderful thing. As long as you can squeeze a cot and the necessary equipment in there, you're good to go. (Though CA must be different from NJ. I don't see any backboards or other necessary equipment in that 'ambulance'.)

 

[JJR512]

I'm flabbergasted. While I recognize that they only do non-emergent transports, I'm sure we can all come up with a few dozen stories of dispatchers and nursing homes getting it wrong.

So, this company can't even have an EMT in the back with the patient. It's worse than a Cadillac ambulance. What happens if the supposedly stable patient starts to go south? You pull over and call a real ambulance on your cell phone?

Ambulance regulations are a wonderful thing. As long as you can squeeze a cot and the necessary equipment in there, you're good to go. (Though CA must be different from NJ. I don't see any backboards or other necessary equipment in that 'ambulance'.)

In my experience doing IFT, my feeling is that a lot of the patients transported by BLS ambulance didn't need an ambulance at all. The only reason they got one is because their doctor felt (sometimes legitimately) that they couldn't sit in a chair, otherwise they could have been transported by a wheelchair van with only one worker (the driver) that doesn't even need to be an EMT.

I always felt that there needed to be an option between wheelchair vans and BLS ambulances, an option that is essentially equal to wheelchair van service in terms of the care available, except the patient lays down on a stretcher. The minivan shown there would be perfect for this, especially if they stop trying to pretend it's an ambulance. There would still need to be two crew members, since it takes two to handle a loaded stretcher, but just like the solo wheelchair van driver, neither would need to be an EMT.

On another note, I've never liked Sprinter ambulances. I've never worked in one, or even been in one, so I don't know first-hand what they're like to work in or drive. My main dislike is that they seem disproportionately tall for their width, which makes them look top-heavy, which makes it seem like they'd tip over easily. In other words, they scare me.

 

[medicdan]

It looks like those vans are "bed coaches"-- they have electric (1 man) stretchers, so likely are horizontal chair cars. With some good body mechanics training (bed to stretcher, stretcher to dialysis chair, etc), I'm sure this works well... although is absolutely not an ambulance...

 

[RanchoEMT]

I'm not sure how EMS is ran outside of CA, but in San Bernardino County we have code3's (ALS) and code2's (BLS). These code2's are pretty much the ALS bull:censored::censored::censored::censored: calls that paramedics really don't need to be tied up with. So they run x2 EMT's and its kinda of a B.S. taxi service to the ER... The MiniVan company that i worked for pretty much would steal these code2 calls from the qualified ambulance companies and would charge maybe 1/10 of the price. Providing about 1/20 the service. And OMFG..... working for this one company in particular was horrid! Our Ops Manager would send us to calls without 02. Cus they forgot to order it..... Only myself and another guy were actual EMT's putn in time to get hired somewhere else... Our equipment was ALWAYS broke.... ALWAYS. Our check engine light was on for a month, until the owner popped open the hood of the van and cut a couple wires.. FIXED. One homie they hired would smoke while transporting. Just an amazing experience. You'd think you were in a movie.
Anyways... I Just Had To Vent That All Out...

Ha! and YES they're trying to look like AMR.

 

[medicdan]

Wait, i'm sorry, I just want to understand this correctly. Southern CA medical transport is operating AMBULANCES in those vans, and billing for ambulance-level care? Do they carry medical equipment or supplies- it seems not even oxygen.
I can understand those vans being used for transport (dialysis, etc), as long as it's kosher with the government, but transporting patients to the ER in those??? What?

 

[Minnick27]

I always felt that there needed to be an option between wheelchair vans and BLS ambulances, an option that is essentially equal to wheelchair van service in terms of the care available, except the patient lays down on a stretcher. The minivan shown there would be perfect for this, especially if they stop trying to pretend it's an ambulance. There would still need to be two crew members, since it takes two to handle a loaded stretcher, but just like the solo wheelchair van driver, neither would need to be an EMT.
me.

My company used to run a couple trucks like this. We had a modified paratransit van that could hold a stretcher and we had two paratransit drivers in the truck to take Pts who didn't have a medical necessity but couldn't comfortably sit for the ride. Both people rode up front. We called it an ambulette. I'm still not sure how legal it was but we don't do it anymore

 

[EMSLaw]

In my experience doing IFT, my feeling is that a lot of the patients transported by BLS ambulance didn't need an ambulance at all. The only reason they got one is because their doctor felt (sometimes legitimately) that they couldn't sit in a chair, otherwise they could have been transported by a wheelchair van with only one worker (the driver) that doesn't even need to be an EMT.

I'm in complete agreement that many - perhaps even a majority of - people transported by ambulance don't need to be. That goes for 9-1-1 as well as IFT. However, if that minivan is being advertised as, and billing as, a BLS ambulance, it most assuredly is not one.

 

[RanchoEMT]

Southern California Medical Transport(SCMT) predominantly runs hospital transports. They have a contract with a Kaiser down here in San Bernardino County. They provide some renal roundup, and do take some calls like the code2’s mentioned previously and transport to the hospital. They wait in the waiting room like regular people and provide oxygen. All employees are “required” to have a CPR card in hand when working, though no one has ever given CPR, practiced(Cert. is from Online)nor know what to do if they needed to do compressions. When I asked one of them about it, they said “Isn’t it 30 and something?” Myself, “30 what?” SCMT Employee “iunno haha...”

 

[njff/emt]

the IFT companies i worked for had the type II's., one had a sprinter which was not fun to work in., the vans aren't too bad but it is a major pain tryin to work on the pt's right side., plus depending how tall you are you had pretty good odds of whacking your head afew times on the bars reaching for stuff., added bonus with vans was squeezing places you can't with a box