AMBULANCE

SERVICES

Dr. SOETOMO GENERAL

HOSPITAL
SURABAYA
 ORDER
ORAL EMERGENCY

1404x 1402x 50060x

10’-15’
(COOK FIRST)

OUR EMERGENCY AMBULANCE ???

 DRY RUN
EMERGENCY vs INTERHOSPITAL TRANSPORT
EMERGENCY vs INTERHOSPITAL TRANSPORT
OPERASIONAL AMBULANCE
THE SIXED-BARS AMBULANCE CALL

1
1. PREDISPATCH
2. DISPATCH
6 2 3. TRAVEL TO THE
SCENE
4. ACTIONS AT THE
SCENE
5. TRAVEL TO THE
5 3 HOSPITAL
6. ACTIONS AT
HOSPITAL
4
OPERASIONAL AMBULANCE
THE SIXED-BARS AMBULANCE CALL
1
TELPON
A 2AMB.
B 4AMB.
TIBA DI
C AMB. D
MENINGGAL-
AMB.
6
TIBA DI RS
E
MASUK BRGKAT TKP KAN TKP TUJUAN

F WAKTU
AKTIVASI 3
G WAKTU
MENUJU TKP

H DITINDAKAN
TKP 5
PERJALANAN
I KE RS
WAKTU TANGGAP WAKTU TINDAKAN
OPERASIONAL AMBULANCE

THE SIXED-BARS AMBULANCE CALL

1. PREDISPATCH (PERSIAPAN PEMBERANGKATAN)
2. DISPATCH (PEMBERANGKATAN)
3. TRAVEL TO THE SCENE (MENUJU LOKASI EMERGENSI)
4. ACTIONS AT THE SCENE (DI LOKASI EMERGENSI)
5. TRAVEL TO THE HOSPITAL (MENUJU RUMAH SAKIT
RUJUKAN)
6. ACTIONS AT HOSPITAL (DI RUMAH SAKIT RUJUKAN)
CHARACTERISTICS OF EMERGENCY AMBULANCE
SERVICE 118
IN Dr.SOETOMO GENERAL HOSPITAL

• Hospital based
• A sub-system of the pre hospital care service, intra
hospital and inter hospital services.
• A component of an integrated emergency medical
service system (SPGDT)
• A medical-equiped ambulance car A-B-C-D-E
• Well skilled team member
ORGANIZATION CHART OF EMERGENCY DEPT.
OF DR. SOETOMO GENERAL HOSPITAL
 COVERAGE

YEAR
NO ITEM OF SERVICES AMOUNT
1998 1999 2000 2001 2002 2003 2004

1 NUMBER OF TRAVELLING 18 269 396 630 1056 955 520 3844

2 DRY RUN 1 19 18 24 19 10 7 98
3 EMERGENCY CALL 18 172 270 321 283 166 61 1291
4 LIFE SUPPORT TRANSPORT 0 97 126 309 773 787 459 2551

5 TRAUMA PATIENTS 8 114 115 181 412 284 165 1279

6 NON TRAUMA PATIENTS 10 155 281 449 644 669 356 2564
7 DEATH AT SCENE/HOME 1 8 15 11 12 1 4 52
8 BROUGHT IN DEAD 0 0 0 0 0 0 0 0
9 H. RESPONSE TIME *) 7.1 4.5 6.2 6.2 5.1 4.35 6 4.85
10 TRAVELLING TIME *) 22.4 18.7 14.9 13.8 11.9 14.69 19 16.48
11 RANGE (km) 137 4090 8204 30138 102741 142581 31621 287891
 PROFILES

• Well trained human Resources

• 11 Ambulance cars
• On-board medical communication
• Fully equiped with medical devices
• Patient’s medical sheet records
 Human Resources

Team member who is basic/advanced well trained

They are:
• Nurses taken from emergency unit
• Radiocomunication operator
• Basic Life Support Trained - Drivers
• General physicians (Disaster Brigades)
 AMBULANCE CREW MEMBER
EACH WORKING SHIFT

• 6 NURSES (MALE)
• 2 DRIVERS (SENIOR HIGH SCHOOL
GRADUATED)
• 2 RADIOCOMUNICATION OPERATORS
(SENIOR HIGH SCHOOL GRADUATED)
• SPECIAL AMBULANCE CREW UNIFORM
 THE VEHICLES

• 8 AMBULANCE CAR
• 2 TRANSPORT AMBULANCE
CAR
• 1 MOTOR CYCLE AMBULANCE
 COMMUNICATION

• AMBULANCE CAR EQUIPED WITH ON-BOARD

RADIOCOMUNICATION.
• CALL ACCES TO COMMAND CONTROL
MEDICAL CENTER FOR REQUESTING
AMBULANCE AND MEDICAL ADVICES 5501233-
5501244, 08113440118
• EACH TEAM MEMBER USING THEIR CELLULAR
PHONE FOR EXTENDED COMUNICATION.
• NURSE IN CHARGE CALL NUMBER:
08113440118
 DUE TO THE AVAILABILITY OF COMMAND CONTROL CENTER,
THE NETWORK ARE WELL IMPROVED WITH NEARBY HOSPITAL
 MEDICAL EQUIPMENTS

• SUPPORTING BASIC AND ADVANCED LIFE SUPPORT

CARE.
• MED EQUIPMENT ARE SUPOSSED TO BE MINISTRY
OF HEALTH STANDARD.

MED EQUIPMENT:
AIRWAY SUPPORT
BREATHING SUPP.
CIRCULATION SUPP.
DISABILITY SUPP.
EXPOSURE SUPP.
 PATIENT’S MEDICAL
REPORT SHEET

• COMPLETE
PATIENT’S DATA
• PATIENT’S
CONDITION
MONITORING
• AMBULANCE
EVALUATION DATA
• MEDICOLEGAL
• CREW MEMBER ETHICS
• PROCEDURE AT SCENE OF ACCIDENT
• PROCEDURE OF EMERGENCY CALL
• PROCEDURE OF TRANSPORT
• PROCEDURE OF AMBULANCE STAND BY

STANDARDS of SERVICE
 EVALUATION GUIDELINES

• NUMBER OF PATIENT’S, MONTHLY

• ABLE TO DO RESUSCITATION PRIOR TO
TRAVELLING.
• ABLE TO PERFORM RESUSCITATION
DURING ENROUTE.
• PATIENT’S MEDICAL REPORT
• HOSPITAL RESPONSE TIME
• TRAVELLING TIME
COMMAND CONTROL CENTER
MEDICAL RADIOCOMUNICATION

RADIOCOMUNICATION
BY HANDY TALKIE RADIO
 24 HOURS
EMERGENCY PRE HOSPITAL CARE
SERVICE

24
HRS
THERE’S NO SUPERMAN
BUT SUPERTEAM
 EMERGENCY CALL CALL IS RECEIVED BY
FROM PUBLIC. DIAL 118 RADIOMEDIC OPERATOR

RADIOMEDIC OPERATOR ON-BOARD MEDICAL

DISPATCH THE AMBULANCE RADICOMMUNICATION
 TEAM DISPATCH
TRAVEL TO THE SCENE OF ACCIDENT
COMMUNICATION DURING ACTION WITH RADIO COMM.
STERILE AREA
HIGH TECH vs HIGH TOUCH
POTENTIALLY MIS-HUBS
AMBULANCE CREW PERFORMANCE AT THE SCENE
RESUSCITATION AND STABILIZATION A PATIENT INSIDE
AMBULANCE DURING TRAVELLING
THE COMPLETE MEDICAL EQUIPMENT AND WELL TRAINED CREW
SUPPORT THE PATIENT’S LIFE
PATIENT AT THE HOSPITAL, HANDING OVER AND REFERED TO THE
PROPER WARD, ICU, OR OTHER UNIT AT HOSPITAL
MAINTENANCE OF AMBULANCE CAR TO MAKE THE BODY AND THE
CABIN NEAT AND CLEAN
 PROBLEMS AND DIFICULTIES
• AIR CONDITIONING SYSTEM
• HYDRAULIC & SUSPENSION SYSTEM IS NOT
WORKING
• SOME OXYGEN RESUSCITATOR ARE NOT
WORKING.
• SINK & WATER TANK ARE NOT WORKING
• BATTERY OF DEFIBRILATOR DEVICE
• OXYGEN SEAL, LEAKING
• OIL & FUEL
• HUMAN RESOURCES
OTHER MEDICAL DEVICES
TO BE EQUIPED ON-BOARD AMBULANCE CAR

(ELECTRIC)
AMBULANCE CAR SPARE PART(S) REPLACEMENT
SUPPLIED BY MEDISON Co.,Ltd.
SUPPLIED REPLACE TO :

NO PARTS QUANTITY L-202-AX L-203-AX L-204-AX L-205-AX L-206-AX L-207-AX

1 BRAKE PADS 2 - a a - a -

2 OIL FILTER 2 - - - a - a
3 FUEL FILTER 2 - - - - a -

4 AIR FILTER 1 - - - a - -

5 STROBE LAMP 2 - - - - - -

6 SIDE FLICK LAMP 2 - - - - - -

7 AUTOMATIVE LAMP 1 - - - - - a
8 SEARCH LAMP 2 a - - a - -

9 PLATE LAMP 4 - - - - - -

10 FUSE 10 a - a a a a
IMPLEMENTATION ?
 ACUTE RESPONSE TEAM

1. RAPID MEDICAL ASSESMENT TEAM (RMA TEAM)

 Dokter, perawat , ambulance crew

2. RAPID HEALTH ASSESMENT TEAM (RHA TEAM)

 Sanitarian, Petugas Farmasi, Petugas Laboratorium.

3. RAPID LOGISTIC SUPPORT TEAM (RLS TEAM)

 Petugas transportasi
 Petugas komunikasi,
 Pertugas tenda
 Petugas pendukung fasilitas (pembuatan jamban, air
bersih, sumber listrik dll)
SPGDT-IEMSS DAY TO DAY
EMERGENCY

1. Early access & first aids - MFR

2. HRD, healthcare facilities, communication, and

transportation.

3. Pre-intra-inter hospital
 ORGANIZATIONAL
COORDINATION
Diperlukan ;
• Establish Public safery center (PSC),
SECURITY, HEALTH, RESCUE.

• Communicaton among stake-holders

 INTRODUCTION

• Critical care and emergency

medical care, must be
implemented in the field, where
crises occur.

TWMS2011
 DEFINITION

SPGDT adalah suatu sistem berupa koordinasi dari

sektor kesehatan yang didukung oleh sektor lain
dan kegiatan kelompok profesional pada keadaan
kedaruratan medis sehari hari (SPGDT-S)dan
pelayanan kedaruratan medis pada saat kejadian
bencana (SPGDT-B).

IEMSS
• A System of coordination in health sector
supported by other sector and profesional
groups activity on daily medical emergency
and emergency medical services on disaster
events.
45
 LINGKUP SPGDT

• Pelayanan kesehaan ( Health services)

dalam SPGDT (IEMSS) meliputi :
1. Sistem Pelayanan pra Rumah sakit
(Prehospital medical services system)
2. Sistem Pelayanan di Rumah sakit
(Hospital service system)
3. Sistem Pelayanan antar Rumah sakit
( Interhospital service system)
 INTEGRATED EMERGENCY MEDICAL
SERVICE SYSTEM (IEMSS)
Environmental
Demographic
Inter
HOSPITAL
Daily Emg Prehospital
Hospital EMS
Communication Emergency Dep
Population Transportation HCU, ICU, OR
outcome

Disaster +
mass casualties
Resources :
Prevention Personnel, Facilities, Equipment
Programs Organization
30/04/2014 Procedures 47
THE PROUDNESS TO BE AN
AMBULANCE ATTENDANT

THANK YOU