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>> As a companion to the work done to improve worker
and patient safety through crashworthiness, the team recognized
that to fully implement these changes,
the layout of the patient compartment had to change.
For example, for a new seating and restraint system
to be effective, the practitioner actually needs
to be seated and restrained while treating patients.
To accomplish this goal, the US government partnered
with representatives from the EMS community
to better understand the job duties and tools involved
at each level of service -- BLS, ALS, and transport.
By understanding these things, engineers
and scientists were armed with the information they needed
to develop a design guidebook that could be used
by any level of service.
The guidebook will help EMS organizations design a safe
and efficient patient compartment
so that practitioners can stay seated
and restrained while treating a patient.
This module will help you understand how an efficient
patient compartment can improve your overall safety.
The first step in the process is to really know your service.
And once you understand the needs of your service,
you will have the tools you need
to design the right ambulance for you.
>> One of the things that we're talking
about in this video series is the development
of new patient compartments to improve worker safety
but also improve patient care.
>> Interiors of ambulances are going to change.
And instead of taking an outside-in approach to design
where we would look at equipment and where the equipment needs
to go and then build in and somewhere fit in a medic
and a patient, you're now seeing an inward-out approach.
You start with keeping a patient safe,
you start with keeping a medic safe, and then you build
that environment around them.
And so with that there comes a whole host of new opportunities
and new ways to approach vehicle design and vehicle safety.
>> Identify what you want to achieve.
And I think that was our starting point as what we wanted
to achieve is a configuration that ensured
that the paramedic was seat-belted during the transport
phase and could still touch their equipment.
>> By having things within reach doesn't necessarily compromise
how we take care of the patient, but it's smarter.
It's a second thought.
We need it to be a primary thought in the sense
that primary seating position -- what can we do without moving?
And the positive end is it becomes safer.
>> The first step in trying to design a safer
and more efficient patient compartment is
to understand the primary duties of your service.
Do you run advanced life support calls?
Or are you a basic life support
or interfacility transport service?
>> Before you start designing, you really have
to know what your service does.
What type of patient do you treat most often,
how far do you travel to the hospital,
how often do you transport more than one patient?
>> Where do you most often sit?
Where are your equipment and supplies located?
Can you reach the controls for the lighting,
HVAC, and communication?
Do you have to get out of your seat to reach the patient?
What works and does not work in your ambulance today?
>> Often you already have this data within your system.
The first task is to mine this existing data.
>> When you're reviewing your call volume and call type,
think about where you prefer to sit, where you are best able
to monitor an IV or take your patient's blood.
Do you prefer the ability to see your patient's face
to ensure they're comfortable and relaxed?
If your preference is to sit next to your patient's chest
to accomplish these tasks, then this might be the best location
to be identified as your primary care position.
>> That primary seating position should have
within arm's reach the controls, the operations that you need
to have in the back of the ambulance, whether it be
as simple as turning on the oxygen or turning
on a specific light or suction,
or any of those critical components you need
to have within arm's reach.
>> Pooling your data actually allows you
to right size your ambulance versus buying an ambulance
that is overbuilt and with items and infrastructure
that you don't necessarily need.
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>> One of the tools the government is providing you
to help you design the ambulance that is right
for you is the new Ambulance Patient Compartment Human
Factors Design Guidebook.
This guide book provides you a step-by-step process
to design an ambulance with safety and efficiency in mind.
>> The design guidebook is a tool for that EMS service
to design their next ambulance based on their needs,
not the needs of everyone else.
>> Today with the book actually asks the questions of the people
that are buying the ambulance and says, "Okay,
what's going to work for you?
Do you need to be able to carry two patients?
Is the equipment that you use most often, is it reachable?"
>> So when using the guidebook, we really didn't intend for it
to be a very complicated way of designing an ambulance.
We really do envision provider organizations to sit
down with either a pen and paper and draw
out the design they're considering.
Or we've seen, and we've actually done, sat down
and mocked up a compartment in just an office using chairs
and tables and cardboard boxes.
>> If you think of the layout using a single patient model,
where are you going to locate that patient?
Where are you going to work most of the time
when you have that patient?
You have just identified your primary patient care position.
>> Now that you have identified the primary patient care
position, what tools do you use most often?
How much space do they take up?
Where will you locate them?
>> And don't forget about the lighting and HVAC controls
and your communication tools.
These all need to be within reach to ensure that you're able
to treat your patient while seated and restrained.
>> If you traditionally run two people in the back,
some of these can be duplicated in two locations
so that you can work as a team.
>> Take your time, look at every possible layout,
even if you don't think it will work.
Look at demos, get everybody's input, talk to people from all
over the place, and then look at your call volume
and your demographics.
>> Where are you spending the majority of your time
in the back of the unit,
in the back of the ambulance treating the patient?
And then let's design around that area first and foremost,
then tell me where your second area and third options are going
to be, if there is a third option, and then move controls
over there if need be.
And it's no different than if I move
into a new office and I get new desk.
I'm going to put my computer where I'm going to be sitting
and facing that screen, I'm going to put my phone next it.
I'm going to lay out my desk area so that it makes sense
and fits me to the way I'm working.
And we want to ask the same questions of the end users
and the paramedics and EMT's -- where they're going to be,
where they're go to spend most of their time and put the tools
around them so that they don't have to get out of the seat
and they can stay belted in and be safer where they're at
and still be able to perform the functions of their jobs.
>> The takeaway message from this module is
that your next ambulance has to work for you.
The good news is that you already have the tools
to make this happen.
You know your run history, you know what works and doesn't work
in your ambulance, and it's up to you
to put the pieces together.
We encourage you to utilize the Ambulance Patient Compartment
Human Factors Design Guidebook to design your next ambulance.
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