Montgomery County Fire Montgomery County Fire RescueRescue

Medical Ambulance BusMedical Ambulance Bus20 Patient Capacity20 Patient Capacity

Medical Ambulance Bus Medical Ambulance Bus (MAB726)(MAB726)

Medical Ambulance Bus Medical Ambulance Bus (MAB726)(MAB726)

Medical Ambulance Bus Medical Ambulance Bus (MAB726)(MAB726)

Removable articulating ramp is Removable articulating ramp is stored under the bus bumperstored under the bus bumper

Eight removable “K” Oxygen cylinders located on the right Eight removable “K” Oxygen cylinders located on the right side. All 20 patient positions will flow oxygen at 15 LPM for 3 side. All 20 patient positions will flow oxygen at 15 LPM for 3 hours. Additionally a high pressure hose is provided to allow hours. Additionally a high pressure hose is provided to allow

for an outside source of O2. When connected to the bus it will for an outside source of O2. When connected to the bus it will provide oxygen for an undetermined length of time.provide oxygen for an undetermined length of time.

50 Amp Shoreline Receptacle to power inside lights and AC/Heat. For use when remote power is available

Emergency Door Opening Valve

Battery Charger Receptacle

Receptacle to power remote lighting.One at each corner.

Patient CompartmentPatient Compartment20 removable stretchers with a weightCapacity of 350 lbs. each. All stretchersHave adjustable heads.

Four large storage drawers

All stretcher are on a slide out track thatallows the stretcher to be easily removed.This will reduce the potential for injury whileattempting to remove or load the stretcher. It locks in place with a “T” type pin.

•Five attendant seats•Three on Drivers side•One on Officers side•One at rear door that stores out of the way

Electric oxygen monitoring systemlocated at desk behind driver

Adjustable liter flow valves are located atEach stretcher position.

The attendants desk #1 is located behind the driver.Below are the drawers in the desk.

There are multiple supply drawers, numbered from the front.

Drawer # 2 Drawer # 3

These drawers are located under the attendant seats.

Drawer # 5 Drawer # 4

Cabinet #6 is the tall skinny cabinet located next to the 3 attendant seats. Additional supplies are located here also.

There are 5 attendants bags that have basic supplies,airways, bag valves and blood pressure cuffs.

12,500 KW Generator

Battery Switch above driver

Remote Generator start switch

12,500 KW generatorLocated on drivers side

Shock Trauma – Baltimore MIEMSSJohns Hopkins – BaltimoreInova Fairfax Hosp – FairfaxMedSTAR – Washington DCHoward University Hosp – DCGeorge Washington (GW) - DC

o Treatment Outcome

o Allows Most Critical Patients to be Loaded Last and Unloaded First at the Receiving Facility. (Load in Middle Position if Possible)

o Mechanical Readinesso Operational Readiness

Washington Metropolitan Council of GovernmentsMedical Ambulance Bus Field Operations Guide (FOG)

Medical Ambulance Bus (MAB) Mission

MAB’s are designed to assist in transporting patients as a result of an Multiple Causality Incident (MCI). Each bus is designed to transport up to 20 patients on stretchers from the incident. Crew configuration will be dependent on each incident profile and resources available. These MAB’s are strategically located around the Washington Metropolitan Area for rapid deployment to incidents that may require this particular resource.

Crew Configuration Bus Operation with PatientsCrew Actions

Crew Position Responsibilities

Responsible for daily mechanical readiness. Primary operator of the vehicle and assures a safe response to the incident scene. Secures an area for crew assembly and operations. Designates an area for patient assembly and transfer to MAB.Assures patient safety and security during transport.

Assists the driver of the MAB in navigating to the scene of the incident in an “Escort” fashion. Helps establish radio communication and coordination with the Incident Commander. Provides direct medical care to patients being transported to the receiving facility. Provides documentation of patient injuries, treatment and identification if possible

Driver

Medical Crew

Vehicle Responsibility

Pre - Incident

On-Scene

Loaded From Rear DoorLoad Least Critical First – Bottom & Top Positions

(Consider Weight of Patient – Heaviest on Bottom)

Patient Loading: Key Points

Patient’s That May Require Invasive Care, i.e.: Airway Management, Should be Loaded in the Middle Positions for ease of careBus is Loaded FRONT to REARKeep in Mind that Patient Weight and Triage Level Should Be Considered When Loading Patients. If Possible, Heaviest/Least Critical Patients should be Loaded in Bottom Positions

Patient Documentation

Patient Name, Triage Tag Barcode or Identification NumberAge – If PossibleHPI – History of Present Illness or InjuryPatient Pertinent Medical HistoryPrescribed MedicationsMedication AllergiesTreatment Rendered

Vital SignsFinal Disposition

Tertiary Care CentersLevel 1 Trauma Centers Level 2 Trauma Centers Pediatric Trauma Centers Spinal Trauma Center Burn Centers

Suburban Hosp – BethesdaPG Hospital Center - Cheverly

Childrens – Washington DCJohns Hopkins – BaltimoreInova Fairfax Hosp - Fairfax

Shock Trauma – Baltimore MIEMSSJohns Hopkins – BaltimoreInova Fairfax Hosp – FairfaxMedSTAR – Washington DC

MedSTAR – Washington DCJohns Hopkins - Baltimore(Adult – Bayview)(Pediatric – Main Campus)

Monthly Inventory

o Navigation to Incidento Radio Coordination with Incident Command

o Secures Law Enforcement to Assure Vehicle, Patient & Crew Safety

o Crew Protection & Assembly Area

o Near Rear of Buso MAB Cots to Equipment Assembly near

Transfer Area

Designates patient Transfer Area

Patient Loading & Security

Directs Assembling Shelter (if available)

Security of Patient’s Personal PropertyCoordination of Patient Exchange

Assistant Driver or Medical CrewAssists Primary Driver Enroute to Incident

Operational ReadinessSlowly turns oxygen bottles on and charges O2 systemOverall Patient CareTransfer of Patient Information to Receiving Facility

DepartM E D I C A L A M B U L

A N C E B U S

MAB

Crew Assembly for Patient Loading

Patient Transfer Area

Patients ready for transfer and loading should be assembled near

the REAR of the MAB

Least critical loaded first – Front to Rear with Heaviest patients on

bottom if possible

If tent available, stage patients under tent until moved onto bus

MAB Equipment Assembly

Bus Orientation Stretcher Labeling

Side “A” Driver’s Side(Street Side)

Driver’s Side or Street Side – Stretchers are numbered A - #Top stretcher is # 1, middle is #2 and bottom is #3 – continues top to bottom and front of bus to rear of busTotal of 9 stretchers on Side “A”

Side “B” Officer’s Side(Curb Side)

Officer’s side or Curb Side – stretchers are numbered B - #Top stretcher is # 1 and middle is #2 - continues top to bottom and front of bus to rear of busTotal of 11 stretchers on Side “B”

Washington Metropolitan Council of GovernmentsMedical Ambulance Bus Field Operations Guide (FOG)