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A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS

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Page 1: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

A Doctor’s Reflection on Ambulance Design

J Brent Myers, MD MPH

Director | Medical Director

Wake County Dept of EMS

Page 2: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 3: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 4: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 5: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 6: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

Source of Response Time Measure

Page 7: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

De Maio: Ann Emerg Med, Volume 42(2).August 2003.242-250

Proportion of Patient’s Surviving Vs. Response Time of Defibrillator

Page 8: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

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

Page 9: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

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

Page 10: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 11: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 12: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 13: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 14: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 15: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 16: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 17: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 18: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 19: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical
Page 20: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

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

Page 21: A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical

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


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