New Vehicle Training

   When an agency places a new vehicle in service, it is imperative that personnel train on that vehicle's hazards, safety features and proper equipment storage

   My HEMS service just received a new EC145 helicopter. Prior to taking delivery, our department operated a Bell 222 that was built in the 1980s. Don't get me wrong, there was nothing wrong with the 222 from an operational or safety perspective. Helicopters, like cars, are discontinued as new ones are developed. Since no more 222s are being built, it had become too difficult to ensure a safe and continuous supply of replacement parts for ongoing maintenance.

   Transitioning from a Bell 222 to an EC145 is like going from a 1980 Buick Regal to a 2010 hybrid SUV. Management recognized that this posed a serious change for the pilots, mechanics and medical crew and knew there would be a very steep learning curve for everyone. To help make the change, in the fall our service shifted to a BK-117, which is similar to the EC145 in many respects, providing us a stepping stone during our transition. One of the first things we realized is that we had thousands more questions and unknowns than we ever fathomed, and learning didn't take place over a period of days or weeks, but rather months. As we learned, we developed many strategies to help everyone understand the changes. Some of the strategies included:

• Having conversations with pilots, mechanics and medical crews at other programs already using the BK-117 and EC145.
• Taking photographs and creating a PowerPoint presentation showing the placement of all equipment and supplies inside the BK-117 and EC145.
• Charging one of our pilots with developing a weekly e-mail blog to identify the "lessons learned," which was shared with everyone.
• Developing a competency checklist for use by safety officers to ensure everyone had a minimum baseline knowledge about the helicopter-specific operations.
• Utilizing a simulator for the medical crew to practice inside the new patient care space, improve familiarity with equipment location, and gain some comfort with the new vehicle.
• Sharing the simulator with regional hospitals, fire and EMS services so they could gain familiarity with our new operational space.
• Having classroom and hands-on education provided by a company representative for all crew members on the vehicle's features and operations.
• Announcing publicly that our new helicopter would not go into service until all of our pilots and medical crew were properly trained in its operation.

   As I discussed this one evening with a colleague who is also involved in EMS, education and writing, he said that his ground ambulance service had just received a new ambulance--"one of those big ones all the fire departments have." Being the fairly inquisitive and rather logical individual he is, he decided to take this vehicle he had never been in for a drive on his last shift. When he got back, one of his coworkers asked, "Did they show you how to drop the back yet?" Needless to say, there was some confusion.

   What struck the two of us was how much effort went into educating everyone on the features, changes and safety differences for one EMS vehicle, and it was completely missing for another. I won't pretend for a moment that our department did everything perfectly for our learning curve--nobody ever does. It is a learning curve!

   There are many different types of ambulances, and individual programs often have multiple sizes of ambulances from different manufacturers. In a quick nonscientific poll of some of my friends across the industry, I found one consistent and disconcerting fact: While fire departments require vehicle-specific training for every single engine, rescue truck, ladder truck, tanker, etc., it seems a driver's license is often all that is needed to operate an ambulance. Nearly every program requires CEVO or EVOC, but even these courses are quite general. As the EMS industry grows, the need for developing and emphasizing a culture of safety needs to become ever more prevalent. Part of developing a culture of safety is emphasizing safety in training.

   Too often, placing a new ambulance into service is taken for granted. Each new model produced has its own hazards and safety features, new electronics, lighting, warning systems, maintenance, and often new equipment placement. These are not insignificant changes. Whether a new EMT or a seasoned veteran, no one should ever get into a new vehicle and have to ask, "What is that switch for?" or "What does that light mean?"

   Knowing the function of every switch and button is the responsibility of everyone who uses a vehicle. Nobody should drive an ambulance without being trained on that model. If you drive an ambulance without first being shown its features, you may miss a warning light, underestimate stopping distance, not know how to turn on suction or medical air, or not know where a piece of vital equipment is stored.

   The next time your service purchases a new vehicle, whether it's an ambulance, fly car or helicopter, make sure adequate training is provided, including:

• Safety features
• Emergency lights and siren operations
• Braking distance
• Tipping hazards
• Door and cabinet locks
• Heating and cooling systems
• Patient loading and unloading
• Airbag use (if applicable)
• Warning lights and their meanings
• Function of all switches and buttons
• Interior lights operation
• Safety equipment placement (flares, fire extinguisher, etc.)
• Medical equipment placement and storage
• Electronic features (timers, patient status, door alarms)
• Oxygen and suction switches
• Radio use.

   Set your program up by training everyone for success in every vehicle. Proper training helps minimize safety hazards, builds confidence and promotes information sharing. Purchasing a new vehicle is a very proud moment for any department. Make a big deal out of the purchase, highlighting how new vehicles improve patient care through crew education. New vehicles are selected for their safety and patient care features; make sure they are used correctly. Be a patient advocate by being an advocate for proper vehicle use. Training can be done on the job, but not during the moment of need.

   Also consider doing the following:

1. Have a manufacturer's representative present the new vehicle and its features to the program.
2. Take photographs and develop a brief PowerPoint showing where equipment is kept in the vehicle, explain how it is secured and why equipment location changes may have been made.
3. Require all service members to demonstrate proper use and troubleshooting of the vehicle's unique features (e.g., airbags, electronics, lighting).
4. Develop a competency checklist to be completed by each employee to ensure basic vehicle and equipment location knowledge prior to using the vehicle.
5. Require everyone who may drive the vehicle to take it for a test drive with a field training officer.
6. Establish vehicle-specific driving policies, identifying maximum speeds, stopping and following distances, headlight use, identifying blind spots, etc.
7. Develop a written safety test.
8. Alert the public that a new vehicle is being placed into service, highlighting how it improves patient care and safety.
9. Invite the public to a vehicle dedication. Remember, it was purchased to serve them.
10. Keep track of feedback provided by crews using the vehicle, and use that feedback to determine if the vehicle's type meets your program's needs, or identify what is missing and use that to determine future purchases.

   Kevin T. Collopy, BA, CCEMT-P, NREMT-P, WEMT, is an educator, e-learning content developer and author of numerous articles and textbook chapters. He is also a flight paramedic for Spirit Ministry Medical Transportation in central Wisconsin and a lead instructor for Wilderness Medical Associates. Contact him at kcollopy@colgatealumni.org.