In the past, having a dedicated rehab or mass casualty incident (MCI) unit was a luxury for most emergency services. Providing BLS and ALS services took most of an agency’s resources. But times have changed, and even though budgets haven’t really increased, agencies understand that these vehicles can be extremely helpful at MCIs or scenes that require rehab of emergency response personnel from fire, EMS and law enforcement agencies.
One of those agencies is Fame EMS (FEMS) in Mifflin County, Pa.—a nonprofit organization serving more than 26,000 residents in six municipalities. According to its website www.fameems.org, FEMS “operates four ALS ambulances, one BLS ambulance, two nonemergency transport vans and one special operations rehab unit. Staffing is provided by more than 90 dedicated career and volunteer members.”
Because all equipment was measured and eighed beforehand, FEMS was able to make sure everything would fit without weighing down the vehicle. Photo courtesy Fame EMS
Several years ago, FEMS decided to design a true specialty MCI/rehab unit after a motorhome and a few makeshift ambulances had been converted and didn’t truly meet the service’s demands. According to FEMS Chief Pat Shoop, the agency decided the only way to truly deliver specialized services was to design a vehicle meant for each task.
The organization began writing specs for a dedicated MCI/rehab unit. “We wanted a unit to be a dual-purpose vehicle that could be used in our first-due area as well as respond to incidents in four neighboring counties,” Shoop said. “We also provide EMS support and standby service to the Pennsylvania State Fire Academy in Lewistown on a contract basis 22 weeks per year, so that was another area of concern for us.”
After visiting a lot of units in the Washington, D.C., and Fairfax, Va., area, the committee began the two-year-long design process. The body of the vehicle was designed on the premise that one side would be outfitted for MCIs and the other side rehab.
The vehicle arrives, sets up a perimeter and lighting, and inflates a large rehab shelter near the scene, all sustained by the truck’s power supply systems. Photos courtesy Fame EMS
FEMS personnel initially compiled a list of equipment they wanted to carry in the vehicle, detailing the weights and sizes, so the vehicle chassis and compartments would be large enough to hold everything, and to make sure the vehicle wasn’t overloaded or unsafe to operate.
“After the specs were written, we went out for competitive bidding,” said Shoop. “Two manufacturers bid, with Pierce chosen as the winner, and Glick being the local dealer.”
To support all the equipment, the vehicle was built on an International 4300 chassis that was purchased locally and sent to Pierce’s Bradenton, Fla., facility.
“Between our normal runs with the unit and the contract work with the Pennsylvania State Fire Academy, we keep pretty busy,” said Shoop. “Our mutual aid runs outside the county are specially called by the fire chiefs in the outer areas. The unit has been well accepted by the many agencies using its capabilities.”
The unit’s medical supplies and water cache are unloaded and staged near the vehicle and rehab shelter. A tarp at the entrance allows personnel to remove turnout coats and equipment before entering the well-lit and environmentally controlled area. A special rehab tag and logging system are used to document all care and hydration rendered. Photos courtesy Fame EMS
At MCI scenes, essential triage supplies, patient treatment tarps/flags, demarcation cones and other essentialsupplies can be quickly deployed from the vehicle. Photo A.J. Heightman
FEMS’ MCI/rehab vehicle:
>> Can treat up to 24 patients at one time;
>> Has an 80,000 HCU heating unit on wheels;
>> Was designed with rollup back doors and specially built ramp for easy unloading and loading;
>> Carries a 22 x 100 portable, self-inflatable tent;
>> Holds a 20 KW PTO driver generator that powers a 4000 W Wilburt light tower and 250 feet of electrical cord reels; and
>> Carries large tarps, incident management scene vests, traffic cones, telescopic light masts and tripod lighting, folding tables and chairs, and coolers for ice, multiple Masimo RAD-57 SpO2 and CO portable monitors, and a complete set of BLS and ALS equipment.
A great deal of planning should take place before purchasing a vehicle like this. How the unit will fit into your organization, the services it will provide and the size of your response area should be considered first. Your budget will also determine the size of the unit and the scope of the equipment it can carry. For your next specialized EMS unit purchase, consider not only how you will operate it now, but also in the future, and its long-term benefits.