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How to Prevent Critical EMS Vehicle Failures

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I survived a grade-school environment where academic failure meant physical pain. My teacher would command me to put my hands on my desk, and she would play rap music on them with a maple pointer. And that was nothing, compared to what awaited me at home when my dad returned from work.

My crime: not “applying” myself. Nothing less than a B would do, because in Pop’s view, non-achievement meant lack of effort.

Looking back, I don’t recall my slightly neurotic teachers enjoying their work any more than I did mine. And not surprisingly, they sucked at it.

I loved auto shop, though; got straight As in auto shop. Auto shop, music and writing. Grew up with Rochester QuadraJets, 235 and 327 Chevy engines, and VW bugs. Listened to the Wolf Man every night, playing Patsy Cline, Gene Pitney, The Righteous Brothers, Motown, and later The Beach Boys and Beatles. Idolized Walter Cronkite and dreamed of being him someday. Then in 1970, as a young journalism student, I found a job as an ambulance attendant. I instantly recognized my calling in life. Of course, if you worked for an ambulance service in those days, it was probably a small one. And in small organizations, everybody does more than one job.

One of my jobs between calls was managing a fleet: tracking the licenses, buying the batteries, checking the tires and logging the maintenance. I was untaught, so I made a lot of mistakes. But I loved ambulances, and I learned a ton about what makes them safe and reliable. I take care of a fleet to this day.

There are two kinds of vehicle failures, Life-Saver. One is the kind that takes you out of service immediately. Most agencies call those critical failures. The other kind, a non-critical failure, needs to be fixed nonetheless. But it won’t keep you from running a call.

As you know, an ambulance can either earn you a living or kill you on any day of your career. It can kill other people, too. To operate, it needs to be able to start, steer, stop and stay running. It also needs to provide a stable interior environment, and its safety restraints need to work. You don’t need a mechanic or a supervisor to tell you when any of those systems fails; and when they do, you’re like a pilot. Nobody gets to argue with your decision to put yourself out of service.

I’ve learned to see critical failures not just as events that prevent you from running calls, but as events that could prevent you from running calls. So, an engine that cranks hard or leaks fluids needs to be taken out of service. So does a tire that reveals excessive or unusual wear.

In fact, your ambulance will almost always warn you before it fails. So you probably deserve to understand how it works and what it’s telling you.

Mechanical education is partly your agency’s responsibility and partly yours. Given your access to the Internet, there’s no reason why you shouldn’t know some of the same stuff your vehicle tech knows. For instance, that a cracked windshield can defeat your airbag restraints. That your late-model diesel depends on a supply of urea (and why). And that if you’re having steering issues, the first thing you should wonder about is the air pressure in your tires. Think of it the way you think about anatomy and physiology.

By far, the most common kinds of critical failures I’ve seen are failures to start. It turns out, they’re also the easiest to prevent—partly by crews who understand their instruments, and partly by proactive agencies that adhere to scheduled preventive replacement of their batteries.

The thing about batteries is they all eventually fail. A good commercial ambulance-sized battery should cost about $200, and the average ambulance has two of those. They should be replaced about once a year (even if they work just fine), they should be protected from rapid-charging, and their connections should be kept tight and squeaky-clean. You know what they’ll cost, so you can budget for their replacement.

Now let’s think about the consequences of a failure. When a battery fails, it’ll typically do so when you least expect it to. You can’t project what it’ll cost. A pair of dead ones is too big to jump-start, they place unacceptable stress on alternators, they generate towing bills and they’re surrounded by three-sided billboards that say “we screwed up.” And worst of all, they interrupt our basic mission of helping sick people.

Don’t think this is important? OK, Life-Saver. Put your hands on the table in front of you. ... 

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