Vehicle Orientation
Every team member, especially those who infrequently participate in transports, should be oriented or reoriented to the transport vehicle(s) used by the team. For aircraft, the content of the orientation is mandated by the FAA.
US Department of Transportation rules govern the operations of ambulances. In addition, CAMTS offers transport programs the opportunity to be evaluated voluntarily against standards of quality and safety. The CAMTS standards include criteria for training in the safe use of transport equipment and vehicles. These issues are particularly important for neonatal- pediatric transport teams that occasionally fly with one or more unrelated aeromedical services. In such cases, the neonatal-pediatric team is expected to function as an integral part of the aeromedical team and is subject to the same rules and guidelines.The transport team should be fully oriented to all aircraft used and should understand how to safely approach the aircraft to board and to load and unload patients. Likewise, team members should be well versed in all emergency procedures. Although specific guidelines vary with the type of aircraft used, team members should be aware of the potential dangers associated with each type of aircraft, how to minimize these dangers, and how to respond if necessary. Helicopters pose the greatest hazards. Contact with the tail rotor blade or main rotor blades, which can dip several feet if turning slowly in high winds, is likely to be lethal. In addition, a landing helicopter can generate gale force winds that, like naturally occurring winds, will cause flying debris and can damage nearby objects and injure bystanders.
All team members should be familiar with and use restraint systems and ensure that the patient and all passengers are properly restrained. Equipment, such as stretchers and incubators, must be properly restrained within the vehicle. Emergency evacuation procedures and appropriate responses to a vehicular crash, fire on board the vehicle, and other emergency situations should be well rehearsed.
The more realistic the training, the more likely the crew is to survive an actual incident. With an estimated accident rate of approximately 1 in 1000 ground transports, it is likely that most transport teams will have experience with an adverse vehicular event.