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x635

Maximum Patients In The Back Of An Ambulance

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Is there any sort of rule on how many patients can be transported in the back of an ambulance?

I've seen different views all over the place, basically it depends on how many patients can fit. That theory should correlate to how many patients can be safely secured?

But shouldn't there be a ratio regarding how many people the EMT can actually treat at once?

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My record is 3 in one transport. 2 AEMTs in the back of the ambulance with 2 teenaged minors females and one 19 year old female whom had been involved in a 3 car MVA. None were on c-spine precautions and all were seat belted during transport.

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You come up with some odd questions, Seth. What I mean is the slant in this one about a RULE. Why would there need to be one? Is this something that needs to be legislated? That aside, lemme get to the meat of your question.

Here's how we do it at my agency. We used to say one backboarded patient only. Seeing as we don't backboard anyone anymore, it's pretty much one patient per ambulance.

We will take one extra ambulatory patient, and sometimes two based on circumstance. One thing that helped with this was the removal of the full bench seat from our ambulances. Take away the place to put a second backboarded patient, and pow, you call a second bus. Generally, if we do put extra patients in a bus, we add a provider, too. But, when all the seats are taken up by patients...where's the provider gonna sit?

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This is simply a question that really can't have a finite answer. First, the ability to transport more than one patient is heavily dependent on the situation at hand and the design of your ambulance at the incident. With the current trend in ambulance design to move away from the traditional bench seat style, the ability to transport more than one pt on a backboard is not going to be possible in those designs. If backboards aren't needed, then you're going to be limited in part by the number of seating positions available.

Beyond that, the condition of the patients and number of providers that will be in the unit are going to be a big factor. If you have the seating for it, taking 3 people complaining of headaches with a single provider at a CO call may not be much of an issue, but in my opinion and experience, if one patient requires ALS treatment, you shouldn't transport a second patient regardless of condition unless you have a second provider in the back. If the second patient also requires ALS treatment, then they should be in a separate transport unit. To do otherwise, unless we're talking extraordinary circumstances necessitating it, you simply can't provide each patient the care and attention they deserve.

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Can anyone recollect (and some may have to go back some 40 to 50 years in Westchester County) if a patient had to be transported to an Emergency Room in Westchester County either inside of a Rescue Rig or on a backboard on top of the hose bed on a Pumper Truck, because a BLS or ALS Ambulance Rig (and going back to the 'Old Days" just a plain old Ambulance) was not available for transport? (Back in 1963, I had to be transported inside of the Old Yonkers Rescue 1 Mack Rig due to an Bycycle/Auto Accident, to Lawrence Hospital, because all of the Yonkers City/Hospital Ambulances and the Old Lawrence Hospital Ambulances were all unavailable, due to being tied up on other runs

Does anyone have any recollection of other incidents that required transportation to an ER on a Fire Rig?

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Ive done 4 guys at once, all had lacerations on their hands from trying to grab a knife from a drunk guy at a party, they were all ambulatory and they all got their hands cleaned and wrapped and 3 sat in seat belts and 1 on the stretcher, was it a good idea? I thought so at the time. We can play the what if game all day, my commercial service company was out of units and we weren't waiting 20 mins for another truck so we did the 3 min transport to the ER.

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Can anyone recollect (and some may have to go back some 40 to 50 years in Westchester County) if a patient had to be transported to an Emergency Room in Westchester County either inside of a Rescue Rig or on a backboard on top of the hose bed on a Pumper Truck, because a BLS or ALS Ambulance Rig (and going back to the 'Old Days" just a plain old Ambulance) was not available for transport? (Back in 1963, I had to be transported inside of the Old Yonkers Rescue 1 Mack Rig due to an Bycycle/Auto Accident, to Lawrence Hospital, because all of the Yonkers City/Hospital Ambulances and the Old Lawrence Hospital Ambulances were all unavailable, due to being tied up on other runs

Does anyone have any recollection of other incidents that required transportation to an ER on a Fire Rig?

Its happened on a number of occasions. And in police cars even more often

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Prior to the formation of the Peekskill Volunteer Ambulance Corps in 1964, Emergency Medical Transportation in Peekskill was provided by the Peekskill Fire Patrol which at that time operated with a walk-in rescue truck. Patients were loaded into the back of the rescue truck and transported on the squad bench. Even after the PCVAC was formed, and the Fire Patrol received a new apparatus, a pumper, Fire Patrol continued to be dispatched to accidents. It wasn't until a car pedestrian accident involving a relative of a Peekskill police officer that a new policy was implemented designating PCVAC as the Medical Response agency for Peekskill. In that accident, the victim was transported on a stretcher atop the hose bed of a pumper.

Back in the 60's and 70's, transporting more than one patient in a single rig was common. Anyone who worked on an ambulance back in those days will remember that most, if not all Cadillac ambulances came equipped to transport four patients on stretchers. One on the standard wheeled stretcher, one on a folding stretcher placed on the squad bench and two on folding stretchers hanging from the ceiling. The ambulances generally carried the three folding stretchers and the hooks that suspended the stretchers from brackets built into the ceiling of the ambulance. I can not ever recall using the hanging stretchers. I can only imagine what a struggle it would have been to lift a patient onto those hanging hooks! But many times we transported two patients on stretchers.

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