AmBus Provides MCI Flexibility for San Antonio FD

When an event occurs that results in a high number of casualties, the process of triage and moving these patients to hospitals is a key component to mitigating the event. First Responders in south and central Texas are now better equipped to deal with mass evacuation incidents thanks to the acquisition of a new ambulance bus (AmBus) by the San Antonio Fire Department (SAFD).

Hospital evacuations during hurricanes along the coast of Texas continue to overtax the EMS system and this new asset will provide a superior method of evacuation. “The San Antonio Fire Department’s new AmBus is able to transport up to 20 stretchered patients at one time, while providing them much needed medical assistance along the way,” says SAFD Chief Charles Hood.

The new AmBus is only the second of its kind in the region and one of only 13 across the state of Texas. The vehicle may be used for a variety of missions, including rehabilitation, local or regional mass casualty incidents and state deployments. Rehab missions will consist of emergency/disaster incidents of an extended nature in which firefighters, paramedics and other first responders will be able to utilize the vehicle to escape the elements, rehydrate and have their vitals monitored. Local or regional mass casualty incidents will be responded to as any other 9-1-1 request for assistance since they are considered no-notice incidents.

Within its first week of operation in August, the AmBus was placed on standby following a motor vehicle accident involving a charter bus carrying 21 passengers in a rural area of Atascosa County, located about 50 miles southeast of San Antonio. The specialty ambulance did not end up being deployed, but this situation highlighted how useful the AmBus could be, since its deployment would have been the equivalent of dispatching 10 ambulances to the scene. Just prior to that incident, the AmBus also stood down after being placed on standby to assist in the aftermath of Hurricane Isaac in Louisiana. State deployment missions will be in response to any large scale incident outside of the central and south Texas region, or mutual aid area, as a component of Texas’ Emergency Medical Task Force (EMTF) Region (EMTF-8).

The AmBus is licensed as a specialty ambulance by the Department of State Health Services as a part of the Texas’ Emergency Medical Task Force System, and the $381,270 vehicle was paid for by a grant through the Urban Area Security Initiative (UASI). The vehicle was granted to the SAFD by the Southwest Texas Regional Advisory Council (STRAC). The AmBus includes full oxygen and suction plumbed to each litter—20 in total—and electrocardiography monitoring, along with loading ramps and a motorized winch capable of supporting ambulance gurneys for the ease of loading and unloading. Twenty wireless vital sign monitors were purchased for use inside the AmBus using Metropolitan Medical Response System (MMRS) funds at a cost of nearly $105,000, which also covered a Toughbook CF-19, ELO Touchcomputer, 24-inch monitor and computer software.

The AmBus will be staffed with EMT-paramedics from SAEMS and the minimum staffing level will be dictated by the type of mission to which the vehicle is responding. During rehab missions, staffing will be three healthcare provider personnel and one driver/operator from our Technical Services Division. During local or regional mass casualty incidents, the AmBus will be staffed with a driver, crew chief, load master and up to three healthcare providers. During patient care and treatment situations, the patient to provider ratio will be maintained at no more than four patients for one provider.

One of the biggest obstacles when it comes to mass evacuations is the evacuation of the community’s most vulnerable from hospitals and nursing homes. The AmBus will play a vital role in helping to overcome this obstacle. “The AmBus will be able to provide a stable platform while paramedics perform medical interventions and transport,” says Noel Horan, deputy chief of emergency services for SAFD. The specialty ambulance can be configured to transport between 14 and 20 patients, depending on the medical needs of those individuals. “During an evacuation, the AmBus will be able to make multiple stops at different hospitals so as not to overwhelm any single facility unless they can take the entire patient load,” adds Horan.

The second AmBus for the region is located just north of San Antonio with Schertz Fire Rescue, and 11 more are stationed across the state within the eight EMTF regions. These vehicles can cover almost the entire state of Texas, including portions of bordering states, within just two and a half hours. The first AmBus deployment in Texas was from Atascocita Fire Department in September 2011, when the department dispatched the specialty vehicle to assist with rehab during the Bastrop Complex Wildfire in Bastrop, TX, which was noted as the worst wildfire in Texas history.

While the vehicle belonging to SAFD has yet to be deployed, the AmBus will undoubtedly prove to be an essential tool the San Antonio Fire Department can use to save the lives of not only residents of south and central Texas, but also those of our neighboring counties and states. “It’s a big opportunity for us as San Antonio to not only help our city, but to also help the other communities around us,” says Brett Joiner, SAEMS lieutenant.

Christian Bove is the public information officer for the San Antonio Fire Department.