A Doctor’s Reflection on Ambulance Design
J Brent Myers, MD MPH
Director | Medical Director
Wake County Dept of EMS
Source of Response Time Measure
De Maio: Ann Emerg Med, Volume 42(2).August 2003.242-250
Proportion of Patient’s Surviving Vs. Response Time of Defibrillator
Ultra-Time Critical = BLS
Clinical Condition Ultra-time critical treatment
BLS or ALS
Cardiac arrest Compressions and defibrillation
BLS
Severe trauma Hemorrhage control, reduction of fracture, rapid transport, chest decompression
BLS (save for chest decompression today)
Anaphylaxis IM Epinephrine BLS
Asthma Inhaled beta agonist, IM Epinephrine
BLS
ALS Response Times that Matter?
Severe respiratory distressCPAP (can’t this be BLS?)
IV medications for treatment
Advanced airway management
Chest pain/STEMIDysrhythmia treatment
EKG interpretation
Cardiac arrest management
Summary
Lighting/conspicuity that is evidence-based
Climate control that is appropriate for pharmaceuticals (and pharmaceuticals that are appropriate for the climate)
Speed that is measureable and can be monitored as well as attained
Safe use of interior spaces
We succeed only as we identify in life, or in war, or
in anything elsea single overriding objective
and make all other considerations bend to that
one objective.- Eisenhower