In order to manage life-threatening conditions and minimize further injury, there is a mandated list of what equipment must be on board every single ambulance. There are two types of ambulances: Basic Life Support (BLS), and Advanced Life Support (ALS). Both have a standard set of medical equipment, but the ALS ambulance must have a more robust set of equipment for pre-hospital care. The required list was most recently revised in 2005 to adapt to the needs of a broader range of patients, such as infants and children. Each ambulance must be equipped with the tools necessary for multiple types of emergencies, from respiratory assistance machines and defibrillators to items as simple as bandages and disinfectant solution. This article will list and discuss several of the larger pieces of medical equipment required for both a BLS and ALS ambulance.

   1.

      Portable and fixed suction apparatus with a regulator: An important life saving device is the suction apparatus that is used to remove mucus and similar fluids from the airways. It is not a pretty process, but if something other than oxygen is entering your airways, a device such as the Schuco 130 Aspirator will save your life. This is a standard piece of equipment for both BLS and ALS ambulances.
   2.

      Portable and fixed oxygen supply equipment capable of metered flow with adequate tubing. Breathing is obviously one of the vital aspects of life support and having metered oxygen equipment on board can save many lives. An oxygen supply device is required for BLS and ALS ambulances.
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      Pulse oximeter with pediatric and adult probes: A pulse oximeter is a useful medical device for measuring the oxygen saturation of a patient’s blood and changes in blood volume in the skin. A pulse oximeter such as the Nonin Avant 4000 wireless oximeter is important for pulse signal quality assessment, high and low SpO₂ and heart rate alarms. One of these devices must be in both types of ambulances.
   4.

      Automated external defibrillator (AED) with pediatric and adult sized pads: Everyone has heard of an AED for a good reason, it can save lives by giving your heart a jump start. Defibrillation is the application of electrical therapy which should put a patient’s heart back into a healthy rhythm. AEDs are common in public places and are easy for laymen to use. CPR training courses often review the use of AEDs. Both BLS and ALS ambulances will have an AED on board. A good example of an AED is the Zoll M-Series Monophasic Defibrillator.
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      Portable, battery operated defibrillator: Portable defibrillators were invented around the 1960s and have been very important in assisting emergency personnel during pre-hospital care. When a defibrillator is needed, it is often a matter of minutes before the patient’s heart will not bounce back. A portable unit allows the medical team to bring help directly to the patient. A portable defibrillator is used in almost all ambulances around the world.
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      Sphygmomanometer: Also known simply as a “blood pressure meter,” this is a smaller piece of equipment needed on ambulances but still very important. Quickly being able to measure blood pressure will tell the medical personnel how well your heart is pumping blood the rest of your body. Every doctor on the planet should have a blood pressure meter, including all ambulances.
   7.

      Transcutaneous cardiac pacemaker: Yet another tool to measure the effectiveness of your heart, a transcutaneous cardiac pacing device is a temporary means of pacing a patient’s heart during a medical emergency. Pulses of an electric current are delivered through the patient’s chest, which will help stimulate their heart. This is usually on all ALS ambulances and is sometimes optional.
   8.

      Nebulizer: When it is important to administer medication as quickly as possible to a patient, a nebulizer is used to administer it in the form of a mist inhaled into the lungs. It is similar to how inhalers work for asthma patients and is very effective for immediate relief. A nebulizer is a required tool for ALS ambulances.

Immobilization equipment: This is more of a category than one specific device, but several types of immobilization is needed on all ambulances that often have patients who need to be secure to prevent further injuries. Cervical collars, a head stabilization device, upper and lower extremity immobilization devices, and impervious backboards are a few of the tools required to have on board BLS and ALS ambulances.

 What is your medical history?



Your medical history tells the story of your health!

Your medical history includes:

    * The health conditions that you have or had in the past
    * The medicines that you take now or, used to take
    * Any allergies that you have
    * Names and phone numbers of your doctors
    * Any other important information about your health

For many medical emergencies, time is very important.  Some people experience the symptoms of an emergency, such as a stroke or a heart attack, but do not get help right away.  A delay in treatment could lead to a more serious illness.
Emergency Checklist

The following suggestions can help you respond when you are with an individual that is experiencing a medical emergency.  This list describes your priorities in an emergency situation.  Follow these steps:

   1. Evaluate the situation to protect yourself and others from injury.
   2. Be calm and reassuring.  Talking to yourself may help keep you calm.  It may reassure the individual needing help to hear that you are calm.
   3. Do not move the individual unless the individual is in immediate danger or unless you cannot provide assistance without moving the individual.
   4. Get help.  Call out for someone to call 9-1-1 or, if the individual does not need immediate assistance, make the call yourself.
   5. Calmly explain the exact nature of the illness or injury.
   6. State the exact location of the emergency.
   7.  STAY ON THE LINE! The dispatcher will need to ask additional questions.
   8. Look, listen, and feel for breathing.
   9. Feel for a pulse to determine if the heart is beating.
  10. Control bleeding with direct pressure by putting a bandage, cloth, or gloved hand over the spot that is bleeding.
  11. Treat for shock.  Lay the individual flat.
  12. If the individual is unconscious, move him or her into the recovery position. 
  13.

      If the situation is a choking emergency, perform the abdominal thrust (Heimlich) maneuver.

 When you Call 9-1-1 for Help, Remember:

    * Speak calmly and clearly.
    * Give the name, address, phone number, and location of the person needing help (i.e., in the bedroom).
    * Describe the nature of the problem.
    * Don’t hang up until the dispatcher tells you to.  The dispatcher may need more information.
    * If you are using a cell phone, it is important to tell the emergency operator the location of the emergency.
    * If you are calling from a highway, look for the nearest highway marker or call box, and give the number to the dispatcher. 

After you have called 9-1-1, there are several things you can do until the Emergency Responders arrive.  These simple procedures will aid the Emergency Responders and the person in need of treatment.

    * Provide first aid to the best of your ability.
    * Use precautions to prevent exposure to bodily fluids.
    * If you determine that the individual has no pulse and/or is not breathing, and you have been trained in cardiopulmonary resuscitation (CPR), begin CPR.
    * Stay calm, do not get excited.  Being calm will reassure the individual that help is on the way.
    * Do not move the individual unless it is absolutely necessary for safety reasons.
    * Make the individual as comfortable as possible.
    * Gather the individual’s medication and medication information.  This will help the paramedics  determine the individual’s medical history.
    * It is important to remember the time and sequence of events.  For example, try to remember when you last spoke with the individual, how long he or she has been unconscious, and for how long this medical condition has existed.  Write this information down if possible. 

Emergency Tips:

Follow the tips below for responding to certain emergency situations:

    * Uncontrolled or Severe bleeding:  Elevate the injured area, support it, then use a sterile pad to apply pressure to the wound.  If blood seeps through the pad, place additional clean pads on top of each other.  Wear rubber gloves or place plastic bags over your hands to prevent the spread of hepatitis or HIV infection.  Call for emergency medical assistance.
    * Possible serious bone fractures:  Do not move a person with a broken bone unless you are in a life-threatening situation involving further potential harm to the injured person (such as a car accident that results in a car fire).  This is especially important for someone with a head, neck or back injury or a hip or pelvis fracture.  If it becomes necessary to move someone with a broken bone, immobilize the injured area first with a splint.  If you don't have a splint, make one using a folded newspaper, board, or rolled up piece of clothing.
    * Major burns:  First degree burns are red and painful but don’t have blisters.  For a first degree burn, put the injured area under cool water.  Second degree burns are deeper, painful and have blisters.  They should be washed with soap and water and treated with an antibiotic ointment. Seek medical attention if the blisters are severe and the skin looks white or charred.  Cover the burn with a non-stick sterile gauze bandage, if you have one.
          o Seek immediate emergency treatment if the burn is on the face, hands, feet or genitals; covers more than one square inch of skin; or causes respiratory problems because of smoke inhalation, indicated by coughing, wheezing, soot-tinged spit, or red sores in the mouth.
    * Choking adult:  Stand up and hold the person from behind.  Wrap your arms around his or her waist and put one fist against the abdomen.  Make sure your fist is slightly above the navel but below the rib cage.  Holding your other hand over your fist, quickly thrust in and up with both hands 4 to 10 times.  Call for emergency medical help if the person continues to choke.
    * Heart attack symptoms, e.g., chest pressure/pain:  If you suspect someone is having a heart attack:
          o Call 9-1-1 for emergency medical service.  Tell the dispatcher where you are.  Don't hang up until you're told to do so.
          o Give the person CPR only if you've been properly trained to do so.
          o While waiting for emergency help to arrive, give the person an aspirin if he or she is conscious and able to swallow.
          o If possible, get the person into a relaxed sitting position, with the legs up and bent at the knees, to ease strain on the heart.  Loosen tight clothing around the neck and waist.
          o Stay calm and reassuring.
          o If using an Automated External Defibrillator (AED) in the case of a heart attack or cardiac arrest, follow the instructions.  The AED will provide audible prompts at the appropriate intervals.
    * Poisoning:  If someone has swallowed an unknown substance or been poisoned, call the Poison Control Center (1-800-222-1222) or 9-1-1.
          o Try to determine what the person has swallowed by finding the product container.
          o Don't induce vomiting unless instructed to do so by medical personnel.  The Poison Control Center can help you find a local poison control center that is open 24 hours a day, 7 days a week.
    * Shock symptoms:  Signs of shock include:  pale, cool, clammy skin; restlessness, anxiety or agitation; drowsiness or fatigue; dizziness, light-headedness or faintness; profuse sweating, moist skin; irritability; thirst; rapid pulse; rapid, weak breathing; enlarged pupils; nausea or vomiting; blue tinge to lips or fingernails (or gray in the case of dark-complexions).  Call 9-1-1 and then lay the person down, with his or her feet elevated about 12 inches (unless there is a head, neck or back injury or if you suspect broken bones in the hips or legs); do not elevate the head.
    * Stroke:  Signs of stroke include: sudden numbness, weakness or paralysis and drooping of the face, arm or leg, especially on one side of the body; sudden blurred or decreased vision in one or both eyes; slurred speech, difficulty speaking or inability to understand or be understood; loss of balance or coordination.  Call 9-1-1 or seek emergency medical help right away.