Based on my friends who marked themselves as “safe” the feature appears to have been active as early as 11:30am EDT, but may have been activated earlier. You can see the page and check on the status of your own friends by clicking here.
Ambulance accidents have been the leading cause of death for EMS personnel for quite a few years now. There are a number of variables that need to be adjusted to in order to make riding in an ambulance safer. Some of these variables are response protocols, driving behavior and seatbelt usage. Another variable that is often overlooked but imperative is ambulance construction.
Braun Ambulances, an ambulance manufacturer, has posted the video from a rollover test they performed using a Type III. It is being billed as the industry’s first rollover test:
As someone who has actually rolled an ambulance (it was a 1996 Demers Mirage that I rolled AND was able to drive back to the garage after the accident) I would have to say that the video is a very good representation of what happens.
With the outdated KKK-A-1822 standards (“Triple K“) from 1974 being retired, ambulance manufacturers have had to look to both the NFPA 1917 and the CAAS Ground Vehicle Standard for guidance on ambulance construction. While the acute lack of testing these construction standards is a bit alarming, it is important to remember that the standard sets the minimums. It does not limit what you can do when you are ordering your ambulances.
Have you ever been in an ambulance rollover? If so, please share your experience in the comments…
Yesterday a Fire Department of New York (FDNY) ambulance spontaneously ignited while traveling on the Grand Central Parkway in Queens. It has been reported that the ambulance crew escaped the vehicle without injury, and there was no patient on the vehicle when the incident occurred.
This comes on the heels of winter storm Jonas that dumped between 30-34 inches of snow on the borough of Queens. The city has come under fire for inadequate snow management and removal, specifically in Queens itself. Additional criticisms were leveled at FDNY for not having ambulances with proper snow chains the way other city vehicles ( including fire apparatus ) are equipped.
The spontaneous combustion of ambulances during or after snow storms is not an uncommon occurrence. There was a similar incident in 2010, also in Queens, from which we learned the invaluable lesson of what happens when oxygen tanks explode. While that incident occurred at night time and failed to reach the mainstream media, it does make you wonder why do ambulances explode during/after snowstorms?
Feel free to offer your thoughts on that in the comments…
One of the hardest aspects of planning Event Medical Services is deciding on the resources to have onsite. Scheduling too little will result in you being overrun with patients and delivering a poor level of service. Schedule too many and you will find providers appearing to be doing nothing but trip over one another while earning you a reputation for excess in an environment where financial success is paramount. There needs to be a balance found between the two, and finding it begins with the initial Resource Recommendation.
In order to develop an initial Resource Recommendation, I came up with the following charts to establish base levels from the overall score on the Event Risk Assessment. The Resource Recommendations are derived from experience while also keeping in mind the New York State Part 18 Requirements. Because New York is my home state in my planning I have to maintain compliance with the minimums required. I also have to remember that, while well intentioned, Part 18 was developed in the 1970s in response to the original Woodstock. Since that time we have seen an increase in the utilization of the Emergency Medical Services and, subsequently, the need for Event Medical Services has also increased. The Part 18 requirements only takes one(1) variable of attendance into consideration for an event, but that has become wholly inadequate in today’s environment.
While these Resource Recommendation Charts take into account the Event Risk Assessment and it’s fourteen (14) variables, it is important to understand that this is a guideline that I use to create a base staffing plan. Resources can increase and decrease as other more specific risks are identified, event timelines are taken into account, and other factors come into focus.
Very Low Risk
For the Very Low Risk Events, such as corporate functions and church picnics, a single EMT with response equipment will often suffice. As attendance grows, so do onsite resources with the tipping point being the 10,000 attendee threshold. Once attendance goes beyond that point, deployment ups itself substantially but not to excess. The majority of the issues will be able to be handled at the Basic Life Support level, which is why there is no indication for Advanced Life Support until you reach the 35,000 attendee threshold.
Low Risk Events, your typical street fair or large calm gathering, are another example of taking a minimalist approach until the 10,000 attendee threshold. Although the risk is still Low comparatively, Advanced Life Support is brought in once the attendee tipping point is reached. Because the event is still a Low Risk, the event can generally be maintained with only two ambulances up to the 35,000 attendee mark.
The Medium Risk Events will (hopefully) be where you find most of your events categorized under. Professional sporting events in stadiums and arenas will most often fall under this category. An important side note to this is that the recommended levels encompass the venue and the attendees, not the actual participants of the sport being played. There are differing requirements for medical coverage amongst the professional organizations of Major League Baseball (MLB), National Basketball Association (NBA), National Hockey League (NHL), National Football League (NFL), Major League Soccer (MLS), and the United States Tennis Association (USTA). It is important to understand what each organization requires and, although those resources will still operate under your oversight, not include them when staffing for the rest of the event.
High Risk Events is often where you will find your music concerts and festivals falling under and occasionally a sporting event when there is a known and historic rivalry with the opposing team or some sort of playoff/championship event. Transports are more than likely for these types of events, which is why regardless of attendee population the recommendation starts with an ambulance onsite. This rated event is also where I begin including the EMS Information Officer in the recommendation. Although I will have more on this role later, it is important to understand that this is NOT a traditional Public Information Officer. In essence, this is the person pulling together the numbers from throughout the venue to provide the supervisory staff the “big picture” of how things are progressing. The information they collect is NOT for the public.
Very High Risk
Events categorized as Very High Risk have been rated that way for a few reasons. The most common events I have categorized under this rating are music festivals with numerous acts, poor infrastructure, and a culture that partakes heavily in uncontrolled and illegal substances. In other words, most outdoor concerts and every Electronic Dance Music (EDM) genre show fall under here. There will be medical calls, there will be transports, there will be surges of patients that will undoubtedly put your personnel and your planning to the test. Once again, please remember that this is just base numbers of what would be in the Initial Recommendation. For that matter, I’ll usually double the base numbers for an EDM show and may even triple it depending on the intelligence gathered on the lineup.
It’s A Start
Having an initial Resource Recommendation is a good start, but there are other things that will affect what becomes our Final Resource Recommendation. We’ll talk about some of those Special Considerations next, and how it changes what we are going to put into the Event Medical Plan.
When planning to provide Event Medical Services for any type of function the true first step is to complete a Risk Assessment. In doing so there are two things that need to be assessed, the event itself and the venue where the event is being held.
Event Risk Assessment
There are nine (9) variables that I assess when preparing for an event. They are:
- Event Type
- Event Length
- Event Planner/Producer
- Event History
- Anticipated Attendance
- Attendee Ages
- Attendee Culture
- Alcohol Availability
- Time and Day
In order to assess the risks associated with an event I utilize an Event Medical Services Event Risk Assessment Worksheet. This allows me to provide a Risk Rating for the nine variables associated with an actual event.
Venue Risk Assessment
There are five (5) variables that I assess a venue for when preparing for an event. They are:
- Local EMS Average Response Time
- # Of Levels
In order to assess the risks associated at a venue I utilize an Event Medical Services Venue Risk Assessment Worksheet. This allows me to provide a Risk Rating for the five variables associated with a venue where an event is scheduled to take place.
Overall Risk Assessment
In order to have an overall idea what the risk level at an event will be the first thing I do is tally all the numbers together and then I divide that number by fourteen for the average. Based on that number, I know what the likelihood is for an event to need Event Medical Services.
Of course, determining need is just the first step in the planning process. I use this same information in my next step which is developing my Event Medical Resource Recommendations.