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The school is never allowed to pass a school bus that is stopped and when no children get the lights are turned off by the school bus driver. Do not speed for a school zone. You know school zones say 20 miles an hour with the lights flashing? Do not speed to a school zone. Kids run behind every bouncing ball is a running child. Use a warning light and sirens. The unit must be on a true emergency call. God forbid you turn on your lights and sirens because you want to get out on time and you get into an accident. You will not only get fired, you will probably be responsible for the damage you caused. You only turn on the lights when it's, if you get dispatched to a call, dispatch will tell you to respond to or they'll say with traffic, they say with traffic don't put the lights on. Now once you get to the call if you believe the patient warrants high priority transport that's your decision, just be able to back it up. No such thing, you're not supposed to be driving down the highway, driving down the roadway with the lights on and no sirens. I know they do that in the middle of the night because they don't want to wake people up in neighborhoods so they turn the siren off. Technically if you've got the lights on, you're supposed to be working in sirens. You must operate with duly care for others, due care and regard for other safety measures in law enforcement. Emergency vehicles have the right to disregard the rules of the road when responding to emergency to not endanger people or property. If you do so, know the law. Use of escorts. I don't like escorts. I've used them, I've gone with them, especially if you have like a police, firefighter, EMS person injured or maybe a family member of somebody, they'll, you know, the cops will say follow me. And they say okay, I'll follow you. You know how fast a state police car goes? Ask a state trooper how fast does your car go? You know what he'll tell you? As fast as I want. You know how fast mine goes? About 90. So I'm not going to try and keep up with him because he's going to be gone. He's going to be five or six hundred car lengths ahead of me. And he's going to go left and right so I will say I'll follow you and then I'll just drive my own way. And when he says, well, I lost you. It's dangerous. Many people have been injured. Many, many accidents have happened in the tunnels in Boston because you'll have two or three emergency vehicles traveling. One emergency vehicle gets way in the front and he goes. And once he goes by, everybody else says, oh, I'm going to get behind him. He's clear on the road. And everybody cuts out. And in the meantime, you've cut out into another emergency vehicle coming up behind you. I don't like escorts. But if you're involved in one, if the cop says follow me, sure, I'll follow you. And I break. Stay. Speed. Intersection crashes are the most common and most serious. Come to a complete stop at all intersections. At least do a rolling stop and make sure it's clear. Highways, shut down your emergency lights and sirens until you have reached the left lane. No, put your lights on when you're going in. Just don't think that lights and sirens means everybody's going to stop and you can just drive right over into the left lane. Unpaved roads. Slow down. School zone. Do not drive over the speed limit. Focus on driving and anticipating roadway hazards. You shouldn't be eating, drinking. No cell phone use of any kind. Don't even pull it out. Don't even think about it. Minimize distractions from things like your GPS. You shouldn't be playing with your GPS. You obviously will be using a radio, so you're going to have to remember that. No cell phone eating and drinking. And I've been known to do all of those at the same time. Don't do that. Driving alone. It is a responsibility to focus on figuring the safest route while mentally preparing for the call. You will be, the driver will be alone in the front. Maybe he'll have a family member, but you might be alone. And especially when we do long distance transports, I mean it's not uncommon for us to do 100 mile transport. You're going to be driving for the 100 miles, so make sure that you pay attention and you don't fall asleep losing attention. Recognize when you're tired. Tell a partner or supervisor. It's tough because we do do 24s. I highly recommend when I tell people they want to work a 24, I tell them rest when you can. We talked about this earlier, right? Take naps. Sleep when you can. Come in well rested. You could have a 24 hour shift when you don't sleep. I've done it many times. Many times. You should be placed out of service for the remainder of the shift. No, that's not going to happen. We're going to send you home. If you're too tired to drive, you're going to go home and you're not going to get paid. So make sure you're well rested. Two types of air vehicles. You have air ambulances that are fixed wing and rotary wing. Rotary wing are for, you know, short emergency transports. The fixed wing are usually for long distances going like interstate between states. Especially train crews. We kind of talked about these. The EMTs provide ground support, sometimes transport. Lifelight doesn't fly. We take Lifelight where they need to go or other companies do that for other ones. Why do we call Medevac a Lifelight? Transport time is longer than 25 minutes, especially with a delayed transport. You will need a higher level of care. Things like blood products, antibiotics, you know, maybe needle cripes or surgical cripes, airways, things like that. Or you just need another ambulance and they're the only ones available. You have a multi-casualty incident, you need another ambulance, they're the ones that are available. Or any one of those three in combination. What we see is that patients with time-dependent injuries or illness. It doesn't have to be life-threatening. It can be a compartmental syndrome with a 30-minute transport called Lifelight. Patients with stroke, heart attack, and spinal cord injury, scuba diving accidents because they need to be... They need to have the hyperbaric chamber. Near drowning, skiing, wilderness accidents, especially wilderness with the delayed extrication because the helicopter has flown to purgatory chasms. Countless times, countless times. From a patient's cage, the limb replantation. They will take the limb and the patient with them to get it replanted. Birth centers, hyperbaric and venomous bite centers. Who calls? You can call dispatch, you can call C-Med directly, the police can do it, the fire department can do it. Anybody can call for Lifelight. We kind of talked how it works. Establish a landing zone. A minimum of 60 by 60 feet. If you want 100 by 100, make sure it is completely clear of all debris. Sticks, rocks, make sure that your stretcher, any wires, any clothing, any belongings, everything is secured. The down draft on a helicopter can be upwards of 90 miles an hour. It will suck up everything right in the rotors and you don't want to do that. I'll give you one example. We were doing maneuvers at Fort Drum and we had a guy that needed Lifelight out. He was having a cardiac event and it was like 25 miles down the tank trail to get him to the nearest ambulance. So we called and Lifelight came out. One of the Black Hawks came out. So we called it in. We had a landing zone. We took all the Humvees and we pointed all the headlights in the center so we lit up the road. Never shine a flashlight at the helicopter because they got night vision. You don't want to blind them. We shined it and we did everything. We made sure we walked the whole area. It was clear, ready to go down. We forgot one thing. Port-a-potty. So when the helicopter came down, it took that port-a-potty, flopped it over and blew it about 30 feet down. That's how powerful it is. It took a full-size port-a-potty and blew it 30 feet down the road. So just be aware of that. The downwash will really suck up stuff. Sand. Make sure you're just blocking your eyes because you're going to get sandblasted if it's dirty. Make sure you notify them of any overhead wires, tall trees, buildings, poles, especially things they might not see. These guys have plenty of experience, a minimum of 5,000 flight hours. Like light flight, you have to have 10,000 flight hours before they'll let you fly. So they have a lot of flight time. Never use caution tape. Do not use flares because that just blows them all over the place. It'll start a fire. Never approach the helicopter until the flight crew will call you over. When the helicopter lands, one of the medics will get out and walk around the helicopter and he'll call you over. He'll call you over. Don't go over. And the helicopter blades, like the Blackhawks, like this one, you can see the things up like 12 feet. But some of the smaller helicopters, they'll have bow blades. And when the blade's slowing, it can actually drop to almost 4 feet. And it'll take your head right off. So be very careful. Good way to get one hell of a haircut. There are two types of landings. There's a hot landing and a cold landing. The cold landing is when they shut the engines down completely. A hot landing, maybe the engine's up but the blade's not turning. Or the engine's up and the blade is turning. So you have to be very careful. Stay away from the tail rotor. Sometimes that tail rotor spins at 3,000 RPM. It's like a blender. You might not even see it spinning. Never go near the tail rotor. Always approach it from the front and only approach after you make eye contact. You look at the guy, you see his eyes, and he tells you to come. Otherwise, you don't. And that's that. Especially if the helicopter's landing on an uneven surface, like if it's a slope and the helicopter lands, that can actually touch, almost touch the ground. Become familiar with hand signals? Don't do hand signals. Don't do semaphore. They're just going to laugh at you. These guys know what they're doing. They know how to handle it. Do not approach unless accompanied by a flight crew, make certain that equipment and everything is secured on the stretcher. No smoking, open flames, or flares. Wear eye protection. You're going to get pelted by sand. Don't do this. Why? And they're going to go, uh! Night landings, never shine spotlights, flashlights, or anything off at the pilot. They have night vision. Direct low intensity headlights to the ground, like we took all the Humvees and we just put them in a circle and we shined all the light into the center where the helicopter was going to land. Illuminate. You can shine a light to illuminate like a tall tower or a tree. You can shine a light up like that, but don't shine it directly at the helicopter. Always approach from the low side. Notify special considerations. In a hazmat incident, notify the flight crew. Notify before the helicopter takes off that it's a hazmat. I don't think lifelight takes hazmat patients. I don't think they even take them. Even if the flight department will decon them, I don't think they'll take them on the helicopter. What type of hazmat? Like what type of hazmat? Well, like a chemical hazmat. Like a chemical hazmat situation. Unless they can completely decontaminate, because that's a closed, closed thing. Assess the severity of landing. Don't worry about the weather, but if you call lifelight, they'll either fly or not fly. All of the helicopters in the area fly based off of MedFlight in Boston. If MedFlight doesn't fly, they're not going to fly. And sometimes you look out and you go, geez, it's a beautiful day. It has nothing to do with what it's like here. It's what it's like at 5,000 feet and what it's like from where they take off and what they've got to fly through. So it may look good here, but that doesn't mean it's good where they're flying. Most helicopters are limited to flying below 10,000 feet and they travel at about 140 miles an hour and they usually have a 70 mile range. So they go 70 miles out, 70 miles back, for a total of 140. So they have a flight time of about an hour. And I think they have about an hour and a half worth of fuel. So they have like a half an hour of emergency fuel in case they have to hover and things like that. Because the cabin is a confined space, they have limits to weight. Usually, I remember the old helicopters years ago, there were stories of guys because years ago, my flight, you used to be able to fly a fly-along. And you used to be able to go on a fly, you signed up for it, you could fly along on a day. And there were stories of there was one guy, one EMP who did a fly-along and he got left in Martha's Vineyard because the helicopter went to do a call in Martha's Vineyard and the patient was like 500 pounds or 400 pounds and it was over the weight limit. And so they're not going to leave the patient so they're left in there. And luckily the state police popped him. He met up with different state troopers along the way and they got him back. Like the helicopter they have now has a pretty big weight limit but they've got a lot of equipment on and especially if you've got a couple of big flight medics and flight nurses, they could really weigh down the helicopter. Typical medevac flights are extremely expensive. In 2017, my father was lifelighted from Milford to UMass. So Milford to UMass if not that far was like $28,000 for that flight. It depends. If you're a bariatric patient make sure you notify lifelight of the weight because it depends on the weight. They won't take an 800 pound patient. So all of the following are examples of the standard patient transfer equipment except what is not standard. The stokes basket. The stokes basket. That's high angle rescue. That's like terrain, right? I remember one time we were doing I used to be a flight medic in the army. I did that for a little while when I was down at the cave. And I remember one time we were doing training on basket. We had stokes basket. You have to be a belay rope. Somebody's got to hold it because the helicopter it'll spin as fast as the helicopter rotor does if you don't hold it. I forgot what it was. I was doing something and I went to grab the rope and it got away from me and thank God it wasn't a real person it was a mannequin. It got about 50 feet and that thing started spinning. That thing spun so fast the mannequin was thrown about 500 feet. And you had to go and look for it. It was just like you could see it go like this and I was like... There was a video of that that went viral a couple of years ago It was a guy that was on it. There was a patient on it. It was an elderly female. And she didn't get thrown but I mean that could be like threatening. She was like red and she was like not funny? Yeah. And it's funny but bad. The primary... Not for her it wasn't. The primary purpose of the jump is...