1. PURPOSE 2. POLICY STATEMENT. Reference Number: PPR/HCP/P0006/07. Division/ Department/Section: PPR/HCP. Issue Date: May 2007

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Health Authority - Abu Dhabi ﻲﺒﻇﻮﺑأ -ﺔﺤﺼﻟا ﺔـــــﺌﻴــه

Division/ Department/Section: PPR/HCP Subject: Policy on Ambulance Service

Reference Number: PPR/HCP/P0006/07 Issue Date: May 2007

Revision Date: May 2009 Version: I

1. PURPOSE

To guide and facilitate the health care providers on the standards of safe, efficient and timely transportation of a patient from one health care facility to another designated health care facility by the ambulance service.

2. POLICY STATEMENT

Health authority Abu Dhabi (HAAD) mandates that while transporting the patient who requires ambulance service the following steps must be adopted by each and every Health Care Facility (HCF):

2.1. All HCFs/ providers must identify the appropriate ambulance service available in the locality with their complete address and contact numbers available, and ensure that an ambulance (vehicle) is designed and is appropriately equipped as per ambulance standards to respond to medical emergencies.

2.2. Each health care facility should have a designated person from the facility who will coordinate this service effectively and ensure the timely transportation of the patients by ambulance in case of emergency.

2.3. The ambulance service contact numbers should be displayed in front of the reception counter as well as other appropriate locations in the facility and is visible.

2.4. The ambulance service should be available or reach the HCF within the time frame as per international standard (The most critical emergency calls, referred to as "Category A" calls, have a response time requirement of eight minutes and zero seconds, with a 75% compliance requirement, and the additional stipulation that 95% of these calls must be reached within 14 minutes in urban areas and 19 minutes in rural areas Non-life-threatening calls have an established target of 14 [urban] and 19 [rural] minutes without response time compliance percentage requirements).

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2.5. The physician/consultant of the referring/transporting HCF would be responsible to assess/establish the need for the patient to be transferred through an ambulance.

2.6. The referring HCFs must identify the appropriate health care facility before the patient is transported by an ambulance service (all steps have to be met for referring patient as per the HAAD Referral Policy Ref 001/07).

2.7. Complete documentation (through file) which includes the treatment that was given to the patient from the referring/transporting HCF including demographic data of patient, diagnosis, reason for referral, medications administered, diagnostic test results, and all available procedural and therapeutic interventions must accompany with patient/guardian/relative/paramedic staff while transporting the patient through an ambulance.

2.8. Qualified clinical / paramedical staff from referring HCF must accompany the patient in an ambulance while transportation to the receiving facility.

2.9. It is the responsibility of management and staff of the referring/transporting HCF to check that the ambulance is well equipped and all equipments are functional to respond to medical emergencies during the patient transportation.

2.10. The referring HCF management will be responsible for any delay (if happened) in transporting the patient to the referred health care facility.

2.11. After each patient transfer by ambulance, it is the responsibility of ambulance service provider to dispose of all used disposable and contaminated items and replace them with new. All other items including emergency medicines should also be refurbished.

2.12. If the HCFs do not have their own ambulance or ambulance service contract with the third party then they may call police ambulance service- universal access no: 999, for transporting of patients in Emirates of Abu Dhabi. The complete address regarding the location of referring HCF, demographic data of patient, his/her illness and the complete

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address of referral HCF must be properly communicated to the staff of that ambulance service.

3. SCOPE

This policy will be applicable to all HCFs (Public & Private) in Emirate of Abu Dhabi.

4. TARGET AUDIENCE

All health care providers and staff

5. RESPONSIBILITY

The management of the referring/transporting HCF will be responsible for the safe transportation of patient through an ambulance.

6. PROCEDURE

6.1. Physician attending the patient of referring HCF will assess the need for

transportation of patient through an ambulance to the referred health care facility.

6.2. Designated staff at the HCF will immediately start the process as per the facility protocol to arrange for an ambulance for safe and efficient transportation of the patient to the referred facility.

6.3. Timely arrangement and availability of the appropriate ambulance services as per international standard will be established by the person responsible at the referring facility.

6.4. The health care provider must stabilize the patient and ensure that the treatment given to the patient at the facility is fully documented and signed. The necessary document (file) must accompany the patient at the time of transportation to the referred facility.

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6.5. The referring physician will also ensure that the ambulance (vehicle) is designed and equipped to respond to medical emergencies and as per need of the patient.

6.6. Before transporting the patient, it is the responsibility of referring HCF to complete the appropriate communication regarding the referral of patient to the receiving hospital. 6.7. Designated clinical staff will accompany the patient during the transfer and record in the

patient file all care and treatment administered during transfer. The names individuals accompanying the patient will be recorded in the patient file.

7. DEFINITIONS

Ambulance The term ambulance is most commonly associated with the land based, motorized emergency vehicles seen throughout the world administering emergency care to those with acute illnesses or injuries, hereafter known as emergency ambulances. These are usually fitted with flashing warning lights and sirens in order to facilitate their movement through heavy traffic.

A vehicle which is equipped to assist patients in all aspects of care to ensure a smooth, safe and efficient transfer of the patient.

Ambulance Service The ambulance service provides the first point of access to health care for a wide variety of patient conditions, ranging from life-threatening emergencies to chronic illness and social care.

Appropriate Health Care

Facilities Appropriate health care facilities means that those health facilities which are well equipped to provide the required treatment.

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8. REFERENCES

1. Wikipedia. Definitions of Ambulance. Available at

http://en.wikipedia.org/wiki/Ambulance. Accessed 27, January 2007.

2. Government of British Columbia: Ministry of Health. Overview of the British Columbia Ambulance Service. Available at http://www.healthservices.gov.bc.ca/bcas/overview/. Accessed 27, January 2007.

3. Idaho Board of Health & Welfare. Minimum Equipment Standards for Licensed EMS Services. Version 3.0. Available at http://www.healthandwelfare.idaho.gov/. Accessed 27, January 2007.

4. Silverman RA, Galea S, Blaney S. "Vertical response time: The hidden component of ambulance response time." Academic Emergency Medicine. Available at

www.aemj.org/cgi/content/abstract/12/5_suppl_1/142. Accessed March 2007

5. Fitch, Jay. “Response Times: Myths, Measurement and Management”. JEMS 2005; Vol. 30. Available at www.jems.com/paramedics/ch1e.html. Accessed March 2007.

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9. APPENDIX I

Minimum Equipment Standards for a Licensed Ambulance Service:

1. Any vehicle used as an ambulance must be designed and equipped to respond to medical emergencies and, in non emergency situations, be capable of transporting beneficiaries with acute medical conditions.

2. The vehicle must comply with state or local laws governing the licensing and certification of an emergency medical transportation vehicle.

3. At a minimum, the ambulance must contain a stretcher, linens, emergency medical supplies, fixed and portable oxygen equipment, fixed and portable suction machine; Sphygmomanometer with different size of cuffs, stethoscope, sharp containers, disposable gloves, vomiting bags and intravenous administration sets and is equipped with emergency lights, sirens and telecommunication equipments as required.