Ambulance Logistics in

State
Group -3
Members
1 Vishal Bhanushali
2 Vidhi Gohil
3 Mihir Kothari
4 Sneha Merani
5 Yuvraj Singh
6 Kartikey Purwar
7 Mansi Vora
 Introduction
Ambulance Logistics is the planning, implementation, control of resources and operations.

According to the definition above, ambulance logistics covers more or less all aspects of maintaining an efficient
and effective ambulance health care.

The point of origin” is when the request for an ambulance is received, and the “flow and storage of goods,
services and related information” that takes place between the point of origin and point of consumption can in
ambulance services be translated to :

• flow of goods

• flow of services

• storage

• information
In Global How ambulance logistics is working and its
Comparison with India’s ambulance Logistics

UK System
• In the United Kingdom, emergency medical services (EMS) provide free urgent care services to individuals
suffering from illnesses ranging from acute illnesses to minor injuries 24 hours a day, seven days a week.
• Ambulance crews are highly trained specialists who can stabilise patients while transporting them and deliver
medication.
German System
• Emergency rescues and patient transportation are the two main activities covered by the German EMS
system, which is part of the German Emergency Health System (EHS).
• . In addition to these vehicles, helicopters and planes are utilised in Germany for emergency rescues and
intensive care transports, but only during daylight hours.
Ambulance Logistics in India
• India has two separate but intertwined government financed ambulance
systems, both of which are known by their helpline numbers, 108 and
102, respectively.

• They have almost 17,000 ambulances between them across the union's 31
states and territories.

• Individuals, charities, commercial and public-sector hospitals, self-help

groups, non-profits, political entities and parties, and religious institutions
all operate ambulance services in India, particularly in urban areas.
Concerns in Ambulance Logistics in India
Sub-optimal response times and unanswered calls are two of the most common problems.

Inadequate state government monitoring.

Lack of due diligence in the tendering process.

 Rising costs and idling of ambulances due to procedural delays in tender procurement.

 Delay in payment of operating expenditure to the private provider.

Inadequate performance monitoring, and forwarding commercial gains at the expense of public
interest
In state how the ambulance Logistics is working

• Chennai is a metropolitan city and the capital of Tamil Nadu happens

to be an important place in India.
• When people come out of their houses to work, they must be
assured about safety. Ambulance Services in Chennai is continuously
working 24/7 to lessen the risks and inculcate the assurance about
the availability of ambulances in every time of need.
• In this case, you need to know the most trustworthy friend.
Ambulance Services in Chennai reaches you in the shortest time
possible.
 In State How the ambulance logistics is working

• Transport Ambulance Services in Chennai are provided by Ambulance on Call for both short and
long distances
• All of our technical, medical, and transportation employees go through extensive hiring and
training.
• We make sure that our employees are well-trained and compassionate when serving patients,
elders, and those who require special attention during medical transportation.
• Patients are assisted in receiving enough care and comfort in a personalized manner by the private
patient transportation service provider.
• Patient logistic support include relocating patients who have little or no physical mobility. As a
hard or incorrect shift could inflict a lot of bodily discomfort or injury, this demands a lot of
attention and adequate support
State in percentage relation to India

Relevance
• Through the creation of eighty (80) Comprehensive Emergency Maternal Obstetrics and Neonatal Centers
(CEMONCs) and 108 ambulance services, Tamil Nadu considerably expanded secondary health services in
rural areas.
• Government ambulances are accessible in government hospitals and the primary health care network in
Tamil Nadu .
Effectiveness
• Rural women in Tamil Nadu are expected to be able to reach a comprehensive emergency obstetric and
neonatal health centre within half an hour of leaving their homes.
Efficiency
• State extensive road network is also a key contributing factor to efficiency .
• The distance between ambulances in Tamil Nadu was roughly 20 kilometers, which improved the
efficiency of reaching patients in rural areas.
Innovation
• In specialized ambulances, such as neo-natal ambulances, multi-para monitors are used instead of ventilators, and vibration is
decreased.
• Improved software for locating ambulances using GPS, vehicle allocation, automatic notifications, dynamic deployment (deploying
an ambulance close to the scene of an incident), optimization of options (based on ambulance movements), and live tracking.
•No of commercial vehicles in use as ambulance
•No of ERS vehicles operational under NRHM

•No of commercial vehicles in use as ambulance

No of
•No of ERS vehicles operational under NRHM No of ERS No of Required
•No of commercial vehicles in use ascommercial
ambulance vehicles ambulances number of
vehicles
•No of ERS vehicles operational under NRHM
•No of ambulances operational other than NRHM
in use operational operational ambulances
•Required number of ambulances (as asperambulance under
WHO standards- emergency NRHM
responsive
•number of ambulances (as per WHO standards- emergency responsive system)
system) other than (as per WHO
•number of ambulances (as per WHO standards- emergency responsive system) NRHM standards-
•No of commercial vehicles in use as ambulance emergency
•No of ERS vehicles operational under NRHM
•No of ambulances operational other than NRHM
responsive
•Required number of ambulances (as per WHO standards- emergency responsive system) system
Tamil Nadu 10561 936 950 755
•No of commercial vehicles in use as ambulance
•No of ERS vehicles operational under NRHM
India 39259
•No of ambulances operational other than NRHM
25450 11096 13234
Key Players in Ambulance Logistics:
• Key Players in Ambulance Logistics:
• These are the key market players Globally as well as Indian.
• India has a very versatile ambulance services depending upon the
need and the demand. Classification is usually through operations,
transport route, emergency/ non – emergency, equipment type
(advance life support / basic life support) and region.
Key Players in Ambulance Logistics:
Global Key Players
Indian Key Players
 Acadian Ambulance
service  SACO Shipping GmbH ·
 CIR Group
 Med Speed  Go Aid ·
 ABX
 Uzurav holdings  Patient Care 247 ·

 Care Chennai ·

 Hifly ICU Air & Train

Ambulance

Services ·

 Maxcare24 ·

 AMB Life.
Ambulance Logistics on Ground Transport
Positive
 Service from door to door
 Rapid Deployment
 Shorter distances are
covered more quickly.
 Suitable for distances of up
to 30 miles (48.3
kilometers) for unstable
patients and up to 100
miles (160.9 kilometers) for
stable patients.
 less weather-dependent
Negative
 Over large distances, slow.
 There isn't much room.
 During transportation,
medical treatments may be
difficult to administer.
 Noise from acceleration and
vibration.
 Depending on the traffic
situation.
Ambulance Logistics on Air Transport (Helicopter)
Positive
 When ground transportation
is unavailable, rapid transit is
used.
 Suitable for a radius of 100-
250 miles (160.9-241.4 km).
 Reduces time spent on out-of-
hospital transportation.
 High-level medical teams are
involved.
Negative
 Slow mobilization.
 Helipads are required.
 Cabin space is limited.
 During transportation, medical
treatments may be difficult to
administer.
 Changes in air pressure might have
an impact on the patient's medical
and laboratory equipment.
 During flying, the temperature is
unstable.
 Vibration and noise associated with
acceleration.
 Depending on the weather.
 The hours of operation are restricted
to daytime intervals.
CASE STUDY - 1 : Yorkshire Ambulance Patient Transport Services use
Telecom Wireless Delivered™ technology and Co-pilot® Live™ Professional to
enhance patient care, improve reporting efficiency and reduce the
organizations carbon footprint

•The Challenge -Before the implementation PTS crews would pick up their paper log sheets along
•with their vehicle prior to working the day’s shift.  
•With the exception of some crew members none of the PTS vehicles were equipped with satellite navigation, leaving crew
members to plan out their own daily routes.
•Measurement was limited to a spot check of 10% of the job sheets that would be manually input and analysed monthly to
meet with NHS KPI criteria.
•This was proving to be a time consuming and inefficient method of measuring overall performance objectives.  
•The Solution- Telecom have provided a Wireless Delivered™ solution incorporating the existing backend patient planning
system through to integrated Co-pilot Live Professional satellite navigation on a multi-function Motorola Solutions ES400
mobile computer.
•Using Telecom's on-board software, the crew are able to record any patient notes on the mobile computer prior to launching
Co-pilot Live Professional and navigating to the next patient.
•A combination of Telecom's tracking service and geofencing technology monitors the progress of the vehicle and
provides accurate timing of when the Ambulance arrives and leaves the patient’s address with the details being flagged
with the controller automatically.
Case -2 Air Ambulance Case Study: Combination with
commercial flight

• Background : While visiting Beirut an Australian woman suffered a stroke .There was reduction
in consciousness and a paralysis of the right side of her body.
• Challenge :The patient needed to be flown home to Australia for therapy, which required a
stopover in Frankfurt so that her condition could be stabilized. Biggest problem with a patient in
this condition is ensuring that the airways are protected. “These patients often display problems
with swallowing,”
• Solution:
• 1-A flight was arranged via a European Air Ambulance dedicated air ambulance aircraft from
Beirut to Frankfurt. The state-of-the-art equipment aboard all EAA air ambulances includes
monitors, defibrillators, ventilators and infusion systems, which allows the operator to transport
all manner of seriously ill or badly injured patients. The day of the mission the medical crew
undertook an examination of the patient and prepped her for the four-hour air ambulance
transport.  They maintained a constant watch over the patient during the return flight and
administered medication.
• 2-Landing in Frankfurt at 19.45 CET, the patient was immediately transported to the
University clinic by a waiting ambulance. The plan was to stabilize the patient’s condition so
that she was capable of undertaking the long flight to Sydney a few days later. EAA was still
in charge of the transportation and so had to coordinate logistics and medical care with the
airline.
• An EAA medical team consisting of an emergency doctor and a paramedic would accompany
the patient, who would be secured on a stretcher in a curtained off area of the passenger cabin
at the rear of the plane. The crew had to prepare a special “commercial flight bag” which
contains basic equipment and medication, but is then customized for each specific case.

• 3-Completition of Mission- The flight was booked as soon as possible, leaving Frankfurt at
11.50 CET and landing in Sydney at 18.10 local time the following day. The flight passed
without further incident and upon landing in Sydney on schedule, the medical team
accompanied the patient on the ambulance for the short ride to the hospital. There they
handed her over to the admissions unit.
• Two days later the medial team flew back to Frankfurt and, after completing and handing in
their report, the mission was finally deemed accomplished
Case Study -3 : Neonatal ECMO transport within the US
• Background A neonatal patient on ECMO needed a short transfer within the US,

• which required very meticulous planning and preparation

• by AirCARE1's air medical team

• Risk mitigation

• ECMO support is a highly specialized treatment modality that has inherent risks during transport, as there are many
unique considerations needed for a successful flight. The team consisted of two cardiac perfusion specialists, one
critical care flight nurse and two critical care flight paramedics, all of whom were trained in ECMO transports.

• Complexities:- Increased due to the young age and fragility of this patient, who weighed only 4.8 kilograms. Any
movement of just a few millimeters in the wrong direction of either the patient or cardiac circuit could dislodge the
chest cannula, causing the patient to exsanguinate and die. Other complexities included managing multiple drips and
ventilation of the patient while ensuring the patient did not inadvertently become extubated.

• Flight considerations- Extreme care needed to be taken when switching the ECMO circuit over to the transport
ECMO team’s circuit to ensure there was not even the smallest micro air bubbles in the system, which, if left
unnoticed, could flow to various parts of the body, and cause major damage
• ECMO patient preparation for flight- The patient was on multiple drips that included cardiac medications,
paralytics, and anticoagulants. Additionally, the patient was on a ventilator with an uncuffed ETT and had
four chest tubes, along with being on ECMO.After ensuring all drips were functioning properly, the patient
was then transferred to the AirCARE1 Hamilton T1 ventilator and monitor.

• Great care needed to be taken to ensure a smooth transport via the ground ambulance to and from the
facilities, as well as loading the patient into the aircraft.

• During the course of the transport, the patient was continuously monitored.

• The patient successfully tolerated the flight.

• What we know

• Successful ECMO flights take a highly trained and well-organized team who have a methodical approach to
packaging the patient for transport.

• It is imperative the team work together and communicate effectively during the transport to ensure a safe and
positive outcome for the patient