To a large extent, early EMS equipment began as hospital equipment
that was extrapolated to the field; it was assumed that if something
worked in the hospital, then it would work in the field. It soon
became apparent that hospital equipment did not always perform under
the more rigorous conditions of prehospital care. Over the last
30 years, equipment has evolved specifically for EMS that is better
adapted to field use in terms of size, weight, and durability. This
equipment is directed at resuscitating and packaging the patient
for transport to the hospital and for maintenance of stability during
emergency or interfacility transport. As the science of EMS continues
to mature, more equipment will be scrutinized for effectiveness.1 The
four basic questions regarding efficacy of EMS equipment are:
Does it do the job?
Is it safe?
Does it do the job, and is it safe in the field environment?
Does it do the job, and is it safe in the field environment in
the hands of field personnel?
The nature of EMS equipment is changing due to the expanded scope
of practice by paramedics and the blurring of care levels between
BLS and ALS personnel. Equipment once considered only for ALS care
is now being carried on some BLS ambulances (e.g., defibrillators
and airway adjuncts). This chapter discusses EMS vehicles, communications,
the electronic patient record, personal protective equipment, and
specific equipment for stabilization, resuscitation, and treatment.
The vehicles may be ground ambulances, helicopters, fixed-wing
aircraft, or a variety of first-response vehicles (fire engines,
police cruisers, or sport utility vehicles). The most common vehicle
used is the ground ambulance, categorized into three common varieties:
- Type I, a standard truck (e.g., pick-up) chassis with
a separate modular box to carry personnel, patient, and equipment
- Type II, an enlarged van-type vehicle
- Type III, a van chassis with an integrated modular box on
the back for medical care and equipment
In types II and III, there is physical access between the driver’s
and patient care compartments, as opposed to type I, in which these
spaces are separate.
Ground vehicles typically have warning devices (lights and siren)
as part of their equipment. Unwarranted use of red lights and sirens
is dangerous for the EMS crew, the patient onboard (if present),
and the general public on the streets.2 Protocols
or guidelines to limit the use of these devices only to times when
they are medically indicated are important.
The two-way radio is an important piece of equipment carried
by prehospital providers. As the arena of wireless communication
changes, EMS systems will need to adapt their communications system
to best fit their needs. The spectrum of frequencies available for
emergency services is limited and is shared with other industries
that require wireless communications. In the U.S., EMS services
may use specific frequencies (channels) in the
very high frequency [around ...