Guest guest Posted February 24, 2007 Report Share Posted February 24, 2007 Hi all A bit of background: My employer wants me to check out an ambulance that has been sourced from a village in the Middle East, probably a landcruiser with the seats removed with a few added bits and pieces. question: Does anyone have a pre-prepared checklist that i can use to give this ambulance a proper systematic checkover (either mechanically and from a medical point of view) and not miss anything. This will determine whether we will then buy the vehicle or not. Replies welcomed on my private email adress. Cherio Dan --------------------------------- No need to miss a message. Get email on-the-go with for Mobile. Get started. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2007 Report Share Posted February 25, 2007 I cannot promise this is what you are looking for, but apart from the vehicle being Mechanically sound, ensure you have space, ESPECIALLY, if you have a patient on a backboard with a Traction Splint on. I worked on a Toyota Landcruiser, and we couldn't close the doors...anyway, ensure you have decent Oxygen storage space. The list I have, consist of a daily checklist, including an equipment checklist. There might be a lot of unnecessary items, and some unknown ones. You can chop and change, depending on standard...BLS...ALS/ICU. Email me at rudyvdenten@... Ambulance Hi all A bit of background: My employer wants me to check out an ambulance that has been sourced from a village in the Middle East, probably a landcruiser with the seats removed with a few added bits and pieces. question: Does anyone have a pre-prepared checklist that i can use to give this ambulance a proper systematic checkover (either mechanically and from a medical point of view) and not miss anything. This will determine whether we will then buy the vehicle or not. Replies welcomed on my private email adress. Cherio Dan ------------ --------- --------- --- No need to miss a message. Get email on-the-go with for Mobile. Get started. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2007 Report Share Posted February 25, 2007 Hi " ie " Howzit? The only info I can give you is on a website,www.stoof- international.de. They are based in Germany and are very helpful. They build armoured and soft skin ambulances. They helped me with a quote and changes of a landcruiser in CRG. They will be able to assist you with specifications and mechanics for your ambulance. Hope that helps and stay well. Be safe out there!!! Rgds, Byron > > I cannot promise this is what you are looking for, but apart from the vehicle being Mechanically sound, ensure you have space, ESPECIALLY, if you have a patient on a backboard with a Traction Splint on. I worked on a Toyota Landcruiser, and we couldn't close the doors...anyway, ensure you have decent Oxygen storage space. > > The list I have, consist of a daily checklist, including an equipment checklist. There might be a lot of unnecessary items, and some unknown ones. You can chop and change, depending on standard...BLS...ALS/ICU. > > Email me at rudyvdenten@... > > > Ambulance > > Hi all > > A bit of background: > > My employer wants me to check out an ambulance that has been sourced from a village in the Middle East, probably a landcruiser with the seats removed with a few added bits and pieces. > > question: > > Does anyone have a pre-prepared checklist that i can use to give this ambulance a proper systematic checkover (either mechanically and from a medical point of view) and not miss anything. This will determine whether we will then buy the vehicle or not. > > Replies welcomed on my private email adress. > > Cherio > Dan > > ------------ --------- --------- --- > No need to miss a message. Get email on-the-go > with for Mobile. Get started. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2007 Report Share Posted February 25, 2007 I've sent this to your personal mail but it might be of interest to others in similar positons so here's my contribution: Hi , I've used the old box back style 4x4 Landcruiser `Troopcarrier' vehicle ( basically the old style pick up with an `ambulance' module on the back) and the more modern style Landcruiser ( rear seats removed and a stretcher fitted on the left hand side and an attendants seat on the right). You seem to be indicating you will be looking at the later type of vehicle. I am afraid both are extremely limited in their use for patient transport and management of the seriously ill or injured. In most formal ambulance services they seem to be used as a rapid response vehicle packed with kit and only used to transfer patients on rare occasions e.g. from off- road conditions to a `normal' ambulance when they reach proper roads. When examining the vehicle try lying on the stretcher and then see what it would be like for a patient and I think you'll find it extremely claustrophobic. Working on a patient in the back of one would be almost impossible; you can't access the patients head from behind or from one side and can't perform CPR, for example, as the restricted head height prevents you leaning over the patient. Likewise all of your patients will have to transported supine as there may not be enough head room for them to sit with the stretcher head raised, especially if there are internal roll bars fitted; not ideal for your breathless patient! In real incidents we have found it impossible to close the rear doors when we have a traction splint applied to a patient and it's a tight fit for anyone reasonably tall. If you've got the patient in a basket stretcher, on a vacuum mattress or they're close to 6ft tall then you'll probably need to secure the rear doors open with an improvised strap system…and eat the dust! Equipment wise I have predominantly seen these vehicles provided with a rudimentary first aid box and a 2 litre o2 bottle, BvM and o2 powered mechanical ventilator/suction unit in a hard carry case; they have always been of poor quality and we have had to add our own equipment When looking at the vehicle remember there is virtually no space to store reasonably sized oxygen bottles (a 2 litre will only last 15 minutes or so at 15L/minute!), stretchers, splints, response bags etc. Once you have the patient in the back there is nowhere to put the kit so you either have to cram it into the front passenger seat or have a roof box fitted. Once in the back of the vehicle with the patient you won't be able to reach anything. If you would only be transporting patients a very short distance it might be usable, otherwise I think you'll find it is not fit for purpose as a means of patient transport. But then there might not be much choice. Regards > > > > I also used a landcruiser for 10 weeks in Jordan with similiar problems with fiiting in a full size stretcher and had to cut down what we had but a spinal board went in ok. Pretty basic inside and was imposiible to sit in the back with the causualty off road. > Only advice I can give is that you give it a really good look over as it might well off been thrashed off road. > > > > > > --------------------------------- > The all-new goes wherever you go - free your email address from your Internet provider. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2007 Report Share Posted February 26, 2007 In this case, size does matter. Although I am not from the U.S, they do have minimum design specifications in a document called " KKK-A-1822B of the US Department of Transportation " , and this was to prevent people stuffing a a stretcher into any vehicle (station wagons, hearses and and a variety of vans) and called it an ambulance. Equipment: There is also a document (Essential Equipment for Ambulances) furnished by the American College of Surgeons. Sometimes we do think we can perform better if we have all the creature comforts we desire, but companies are trying to cut as much costs as possible, and unfortunately, it always involves the medical aspect of a contract. To some, unfortunately, we are deemed an expensive overhead. In relation to transport, we have to adjust to the situation, whether you are in a large top-of-the-range ambulance, or a crampy Jet Ranger helicopter, you might have to adjust your management of a patient to suit the transportation environment. The advantage to road transport, you can always stop and do what is necessary (except if you are travelling through a hostile environment). Your innitial assessment and stabilisation of the patient will dictate how your approach to " packaging " the patient for transportation. This is also going to have an impact on your skills. If you are unable to intubate with a laryngoscope due to patient position, are you familiar and well practised with using a LMA, Combitube, or even attempt blind digital intubation whilst en-route. On some projects, you might not have the luxury of having a similarly trained colleague doing the driving. Certain rough-terrain vehicles are quite hard on patients with multiple injuries, and more worry-some, spinal injuries. Normally, you are lumped with a local driver, because he has an in-country license (aquired his driving skills watching " Bringing out the dead " starring Nicolas Cage), thereby alleviating any insurance liability to yourself. Just food for thought... ___________________________________________________________ The all-new goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2007 Report Share Posted February 26, 2007 Thanx for all the input fellas, much appreciated. However in this terrain I reckon Land Cruiser is best. I note the traction splint argument and also the configuration issues, i.e. no room for intubation behind the pte's head and oxygen cylinder storage etc.. However we still have to get to definitive care, i.e. surgery. No use having a Mercedes Sprinter or whatever with lovely suspension and spotlights and room and we are stuck in mud or the oil sump is hit due to low ground clearance. I reckon this is the thing we need: http://www.stoof-international.de/en/armored_cars/armoured_ambulance/base.html Thanx PS Thanks for the link Byron. RUDY VAN-DENTEN <medicrudy@...> wrote: In this case, size does matter. Although I am not from the U.S, they do have minimum design specifications in a document called " KKK-A-1822B of the US Department of Transportation " , and this was to prevent people stuffing a a stretcher into any vehicle (station wagons, hearses and and a variety of vans) and called it an ambulance. Equipment: There is also a document (Essential Equipment for Ambulances) furnished by the American College of Surgeons. Sometimes we do think we can perform better if we have all the creature comforts we desire, but companies are trying to cut as much costs as possible, and unfortunately, it always involves the medical aspect of a contract. To some, unfortunately, we are deemed an expensive overhead. In relation to transport, we have to adjust to the situation, whether you are in a large top-of-the-range ambulance, or a crampy Jet Ranger helicopter, you might have to adjust your management of a patient to suit the transportation environment. The advantage to road transport, you can always stop and do what is necessary (except if you are travelling through a hostile environment). Your innitial assessment and stabilisation of the patient will dictate how your approach to " packaging " the patient for transportation. This is also going to have an impact on your skills. If you are unable to intubate with a laryngoscope due to patient position, are you familiar and well practised with using a LMA, Combitube, or even attempt blind digital intubation whilst en-route. On some projects, you might not have the luxury of having a similarly trained colleague doing the driving. Certain rough-terrain vehicles are quite hard on patients with multiple injuries, and more worry-some, spinal injuries. Normally, you are lumped with a local driver, because he has an in-country license (aquired his driving skills watching " Bringing out the dead " starring Nicolas Cage), thereby alleviating any insurance liability to yourself. Just food for thought... __________________________________________________________ The all-new goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2007 Report Share Posted February 26, 2007 Hey Rudy!. What an assessesment! For a paramedic from SA you sure know allot about other country's EMS. How's you're country doing lately? Re: Ambulance In this case, size does matter. Although I am not from the U.S, they do have minimum design specifications in a document called " KKK-A-1822B of the US Department of Transportation " , and this was to prevent people stuffing a a stretcher into any vehicle (station wagons, hearses and and a variety of vans) and called it an ambulance. Equipment: There is also a document (Essential Equipment for Ambulances) furnished by the American College of Surgeons. Sometimes we do think we can perform better if we have all the creature comforts we desire, but companies are trying to cut as much costs as possible, and unfortunately, it always involves the medical aspect of a contract. To some, unfortunately, we are deemed an expensive overhead. In relation to transport, we have to adjust to the situation, whether you are in a large top-of-the-range ambulance, or a crampy Jet Ranger helicopter, you might have to adjust your management of a patient to suit the transportation environment. The advantage to road transport, you can always stop and do what is necessary (except if you are travelling through a hostile environment). Your innitial assessment and stabilisation of the patient will dictate how your approach to " packaging " the patient for transportation. This is also going to have an impact on your skills. If you are unable to intubate with a laryngoscope due to patient position, are you familiar and well practised with using a LMA, Combitube, or even attempt blind digital intubation whilst en-route. On some projects, you might not have the luxury of having a similarly trained colleague doing the driving. Certain rough-terrain vehicles are quite hard on patients with multiple injuries, and more worry-some, spinal injuries. Normally, you are lumped with a local driver, because he has an in-country license (aquired his driving skills watching " Bringing out the dead " starring Nicolas Cage), thereby alleviating any insurance liability to yourself. Just food for thought... __________________________________________________________ The all-new goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2007 Report Share Posted February 26, 2007 It's always a pleasure buddy. Be safe and dont get stuck in the mud or oil. Stay safe!!! Byron > In this case, size does matter. Although I am not from the U.S, they do have minimum design specifications in a document called " KKK-A-1822B of the US Department of Transportation " , and this was to prevent people stuffing a a stretcher into any vehicle (station wagons, hearses and and a variety of vans) and called it an ambulance. > > Equipment: There is also a document (Essential Equipment for Ambulances) furnished by the American College of Surgeons. > > Sometimes we do think we can perform better if we have all the creature comforts we desire, but companies are trying to cut as much costs as possible, and unfortunately, it always involves the medical aspect of a contract. To some, unfortunately, we are deemed an expensive overhead. In relation to transport, we have to adjust to the situation, whether you are in a large top-of-the-range ambulance, or a crampy Jet Ranger helicopter, you might have to adjust your management of a patient to suit the transportation environment. > > The advantage to road transport, you can always stop and do what is necessary (except if you are travelling through a hostile environment). Your innitial assessment and stabilisation of the patient will dictate how your approach to " packaging " the patient for transportation. > > This is also going to have an impact on your skills. If you are unable to intubate with a laryngoscope due to patient position, are you familiar and well practised with using a LMA, Combitube, or even attempt blind digital intubation whilst en-route. > > On some projects, you might not have the luxury of having a similarly trained colleague doing the driving. Certain rough-terrain vehicles are quite hard on patients with multiple injuries, and more worry-some, spinal injuries. Normally, you are lumped with a local driver, because he has an in-country license (aquired his driving skills watching " Bringing out the dead " starring Nicolas Cage), thereby alleviating any insurance liability to yourself. > > Just food for thought... > > > > __________________________________________________________ > The all-new goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2007 Report Share Posted February 27, 2007 Just been looking at various 4WD ambos for my project. I still like the 110 and even better the 130 land-rovers. The military version is basic-4 stretcher points and loads of room. trouble is you use canvas stretchers. There is a version that uses 2 points to fix ferno washington or york 2 stretchers.O2 points fitted as well-and piped suction.You can fix a sink as well if needed. Used the earlier versions all over the world in the Army-a treat to use. Various coach-builders can customise as needed. I realise that it is rare we get to buy from scratch,and where the client places such a high premium on health and medical,that they underwrite the costs. I find that if its construction-you can sell the kit as an asset to be handed over when completed-applies to defibs,ambos and so on.. Mostly we have to adapt what we have(like I did fairly recently at a mine in Mongolia). Totally agree that space to work is vital,plus storage. Mostly I like storage to be in transportable bags-so you can work away from the ambo easily. Fraser --- Medic at BUhemba <medic@...> wrote: > Hey Rudy!. What an assessesment! For a paramedic > from SA you sure know allot about other country's > EMS. How's you're country doing lately? > Re: Ambulance > > > In this case, size does matter. Although I am not > from the U.S, they do have minimum design > specifications in a document called " KKK-A-1822B of > the US Department of Transportation " , and this was > to prevent people stuffing a a stretcher into any > vehicle (station wagons, hearses and and a variety > of vans) and called it an ambulance. > > Equipment: There is also a document (Essential > Equipment for Ambulances) furnished by the American > College of Surgeons. > > Sometimes we do think we can perform better if we > have all the creature comforts we desire, but > companies are trying to cut as much costs as > possible, and unfortunately, it always involves the > medical aspect of a contract. To some, > unfortunately, we are deemed an expensive overhead. > In relation to transport, we have to adjust to the > situation, whether you are in a large > top-of-the-range ambulance, or a crampy Jet Ranger > helicopter, you might have to adjust your management > of a patient to suit the transportation environment. > > > The advantage to road transport, you can always > stop and do what is necessary (except if you are > travelling through a hostile environment). Your > innitial assessment and stabilisation of the patient > will dictate how your approach to " packaging " the > patient for transportation. > > This is also going to have an impact on your > skills. If you are unable to intubate with a > laryngoscope due to patient position, are you > familiar and well practised with using a LMA, > Combitube, or even attempt blind digital intubation > whilst en-route. > > On some projects, you might not have the luxury of > having a similarly trained colleague doing the > driving. Certain rough-terrain vehicles are quite > hard on patients with multiple injuries, and more > worry-some, spinal injuries. Normally, you are > lumped with a local driver, because he has an > in-country license (aquired his driving skills > watching " Bringing out the dead " starring Nicolas > Cage), thereby alleviating any insurance liability > to yourself. > > Just food for thought... > > > > > __________________________________________________________ > > The all-new goes wherever you go - > free your email address from your Internet provider. > http://uk.docs./nowyoucan.html > > [Non-text portions of this message have been > removed] > > > > > > > [Non-text portions of this message have been > removed] > > ___________________________________________________________ New is the ultimate force in competitive emailing. Find out more at the Championships. Plus: play games and win prizes. http://uk.rd./evt=44106/*http://mail..net/uk Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2007 Report Share Posted February 27, 2007 Fraser, What type of ambulance did you use when you were in Mongolia? Just wanted to know as our client is recently interested in purchasing a new one here in Mongolia to replace the old Nissan Urvan weve been using. GG Re: [Remotemedics. co.uk] Ambulance > > > In this case, size does matter. Although I am not > from the U.S, they do have minimum design > specifications in a document called " KKK-A-1822B of > the US Department of Transportation " , and this was > to prevent people stuffing a a stretcher into any > vehicle (station wagons, hearses and and a variety > of vans) and called it an ambulance. > > Equipment: There is also a document (Essential > Equipment for Ambulances) furnished by the American > College of Surgeons. > > Sometimes we do think we can perform better if we > have all the creature comforts we desire, but > companies are trying to cut as much costs as > possible, and unfortunately, it always involves the > medical aspect of a contract. To some, > unfortunately, we are deemed an expensive overhead. > In relation to transport, we have to adjust to the > situation, whether you are in a large > top-of-the-range ambulance, or a crampy Jet Ranger > helicopter, you might have to adjust your management > of a patient to suit the transportation environment. > > > The advantage to road transport, you can always > stop and do what is necessary (except if you are > travelling through a hostile environment) . Your > innitial assessment and stabilisation of the patient > will dictate how your approach to " packaging " the > patient for transportation. > > This is also going to have an impact on your > skills. If you are unable to intubate with a > laryngoscope due to patient position, are you > familiar and well practised with using a LMA, > Combitube, or even attempt blind digital intubation > whilst en-route. > > On some projects, you might not have the luxury of > having a similarly trained colleague doing the > driving. Certain rough-terrain vehicles are quite > hard on patients with multiple injuries, and more > worry-some, spinal injuries. Normally, you are > lumped with a local driver, because he has an > in-country license (aquired his driving skills > watching " Bringing out the dead " starring Nicolas > Cage), thereby alleviating any insurance liability > to yourself. > > Just food for thought... > > > > > ____________ _________ _________ _________ _________ _________ _ > > The all-new goes wherever you go - > free your email address from your Internet provider. > http://uk.docs. / nowyoucan. html > > [Non-text portions of this message have been > removed] > > > > > > > [Non-text portions of this message have been > removed] > > ____________ _________ _________ _________ _________ _________ _ New is the ultimate force in competitive emailing. Find out more at the Championships. Plus: play games and win prizes. http://uk.rd. / evt=44106/ *http://mail. .net/ uk Send instant messages to your online friends http://uk.messenger. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2007 Report Share Posted February 27, 2007 we had a ford ute-which had stretcher bolts welded on the floor,along with the same for the O2. then we switched to a landcruiser-which had more room,but the same problems as mentioned in other posts re working space,and only one stretcher capacity. distances travelled ranged from a few miles to a mine, up to over an hours journey or more. Fraser --- De Los Santos Gener <gdls11@...> wrote: > Fraser, > What type of ambulance did you use when you were in > Mongolia? > Just wanted to know as our client is recently > interested in purchasing a new one here in Mongolia > to replace the old Nissan Urvan weve been using. > GG > > > Re: [Remotemedics. co.uk] Ambulance > > > > > > In this case, size does matter. Although I am not > > from the U.S, they do have minimum design > > specifications in a document called " KKK-A-1822B > of > > the US Department of Transportation " , and this > was > > to prevent people stuffing a a stretcher into any > > vehicle (station wagons, hearses and and a variety > > of vans) and called it an ambulance. > > > > Equipment: There is also a document (Essential > > Equipment for Ambulances) furnished by the > American > > College of Surgeons. > > > > Sometimes we do think we can perform better if we > > have all the creature comforts we desire, but > > companies are trying to cut as much costs as > > possible, and unfortunately, it always involves > the > > medical aspect of a contract. To some, > > unfortunately, we are deemed an expensive > overhead. > > In relation to transport, we have to adjust to the > > situation, whether you are in a large > > top-of-the-range ambulance, or a crampy Jet Ranger > > helicopter, you might have to adjust your > management > > of a patient to suit the transportation > environment. > > > > > > The advantage to road transport, you can always > > stop and do what is necessary (except if you are > > travelling through a hostile environment) . Your > > innitial assessment and stabilisation of the > patient > > will dictate how your approach to " packaging " the > > patient for transportation. > > > > This is also going to have an impact on your > > skills. If you are unable to intubate with a > > laryngoscope due to patient position, are you > > familiar and well practised with using a LMA, > > Combitube, or even attempt blind digital > intubation > > whilst en-route. > > > > On some projects, you might not have the luxury of > > having a similarly trained colleague doing the > > driving. Certain rough-terrain vehicles are quite > > hard on patients with multiple injuries, and more > > worry-some, spinal injuries. Normally, you are > > lumped with a local driver, because he has an > > in-country license (aquired his driving skills > > watching " Bringing out the dead " starring Nicolas > > Cage), thereby alleviating any insurance liability > > to yourself. > > > > Just food for thought... > > > > > > > > > > > ____________ _________ _________ _________ _________ > _________ _ > > > > The all-new goes wherever you go - > > free your email address from your Internet > provider. > > http://uk.docs. / nowyoucan. html > > > > [Non-text portions of this message have been > > removed] > > > > > > > > > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > > ____________ _________ _________ _________ _________ > _________ _ > New is the ultimate force in competitive > emailing. Find out more at the > Championships. Plus: play games and win prizes. > http://uk.rd. / evt=44106/ *http://mail. > .net/ uk > > > > Send instant messages to your online friends > http://uk.messenger. > > [Non-text portions of this message have been > removed] > > ___________________________________________________________ The all-new goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
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