All Aboard Bus No. 911

Jim Luff
Posted on February 10, 2010

A medical emergency is a question of when it will occur rather than if. An estimated 750 million passengers are transported each year by charter bus based on numbers from the U.S. Department of Transportation in November 2009. A third of those passengers are senior citizens, says Paul Bourquin, a charter bus industry analyst for Nathan and Associates. Collectively, charter buses travel some 1.9 billion miles each year.

Being Prepared

This is perhaps the most critical component of achieving a positive outcome when a medical emergency arises. Having a specific plan of action, basic medical training, and a well-equipped vehicle can mean the difference between life and death when a medical emergency occurs miles from the nearest medical facility.

In a USA Today report, the average nationwide response time for first-responders such as the fire department or an ambulance is 6 to 15 minutes. Linda Ford, an emergency room RN with Mercy Hospital of Bakersfield, Calif., says medical professionals consider the “platinum 10 minutes” and the “golden hour” the benchmarks in survival of a massive heart attack or stroke. Drivers should be taught to follow a sequence of events that includes asking other passengers to assist, especially anyone with medical training who may be on board, and calling 911 for help immediately.

Calling 911

In most cases, when you dial 911, you will reach a law enforcement agency, says Hillary Luff, a 911 dispatcher in the Kern County Emergency Communications Center in California. [Luff is the wife of Jim Luff].

Luff says it is critical to tell the operator that you have a medical emergency as soon as the phone is answered. You will be transferred to a dispatcher who can provide medical instructions while the first responders are en route. Luff says one of the biggest frustrations for 911 operators handling highway emergencies is the lack of awareness by callers of their location.

When stating your location, name the highway, road or street you are on, the direction you are traveling, and the last offramp, mile marker, or other landmark you remember passing. If you know the next offramp or landmark ahead of you, state that information and the fact that you are between the two locations. If you are using a GPS navigation system, provide the coordinates shown by your GPS. Describe your vehicle.

Remember that the dispatcher who answers the phone works with a team of people, and other dispatchers are sending help to you, Luff says. She says many callers get frustrated believing the dispatcher is asking questions instead of sending help. The dispatcher will remain on the phone with you until help arrives, providing you with instructions that must be followed exactly. Do not hang up until you are told to, Luff says.

Reporting Patient Condition

Be prepared to provide as much information as possible about the symptoms of your passenger to determine what type of medical emergency is occurring. This can include the passenger’s approximate age, sex, skin condition such as dry and hot, cold and clammy, turning red or blue. Check to see if the passenger is breathing and has a pulse. See if the passenger is conscious and aware of surroundings or confused and dazed. Luff says reporting these “vital conditions” as soon as possible in the 911 call can help determine what action will be taken. “Never move a patient unless there is an immediate danger to the patient,” Luff says.

Equipment Considerations

For vehicles that make long distance trips that include long desolate stretches of highway, a full complement of emergency medical supplies should be carried such as an AED, portable oxygen such as OxySure, a well stocked First Aid kit, and a blanket. These lifesaving items would be invaluable if a passenger suffers a major heart attack.

Training Considerations

At minimum, drivers should be trained in CPR, the Heimlich maneuver, and mouth-to-mouth resuscitation. For vehicles equipped with an AED and portable oxygen systems, drivers should be trained in using them and practice with them at least once every six months for familiarization.

The Red Cross offers many classes including Basic First Aid, Advanced First Aid, and CPR. Individuals may sign-up for classes held by the Red Cross or the Red Cross will provide group instruction to a group of employees at your location. Fees vary among communities, says Richard Temple of the Red Cross. See the Red Cross Web site for your local chapter of the Red Cross for upcoming classes.

Other companies known as “safety companies” also can help in creating and implementing training classes and safety programs, and can provide you with such equipment as fire extinguishers, First-Aid kits, AEDs, and portable oxygen kits, and provide specific training for each device.

Recognizing Medical Emergencies

Some common emergencies that may arise are heart attacks, strokes, choking, and abdominal cramping which can be caused by many conditions, Ford says. Heart attacks, strokes, and choking require action within the “platinum 10 minutes,” she says. The longer a person stops breathing and pumping blood through the body, the more permanent and long lasting damage occurs. Because of this, restoring breathing, airway clearing, and CPR or administration of a shock from an Automated External Defibrillator (AED) within 10 minutes is critical.

Recognizing Choking

  • International choking sign of hands on throat.
  • Inability to speak or cough
  • Face becomes red
  • No breathing

Recognizing a Heart Attack

  • Chest pains
  • Pain in arms, neck, back or jaw
  • Shortness of breath
  • Lightheaded or dizzy
  • Cold sweat/clammy

Recognizing a Stroke

  • Numbness on one side of body
  • Confusion/trouble speaking
  • Vision problems
  • Loss of balance/dizzy

For more information about recognizing a medical emergency, visit the American Red Cross.

Related Topics: driver behavior, emergency preparedness, vehicle safety

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