1. The ramp system requires too much space to deploy.
The ramp alone extends 9.5-feet from the side of the bus. Add to this the length of the PIB, (I believe that is 7-feet), the leveler and the person operating the leveler, and they are approaching 20-feet. Every time I addressed this issue with Platt, I received the response, “There is always a street corner, nearby.” The thought of parking the vehicle across an intersection, extending the ramp on the perpendicular street, and rolling the patient down the roadway in the PIB is absurd.
2. The leveler system is clumsy and unsafe.
During the in-house training session, even with several people working together, the PIB was seldom perfectly level. At times, one, or more, wheels were dangling off the side of the ramp. We had to back down the ramp and re-align the PIB, before continuing. If the person operating the leveler had slipped, some of the wheels would have missed the ramp and the PIB could have toppled over, spilling the contents.
The images on SA’s web site are misleading. I would guess that many shots were taken to get this series of photos that appear to be a flawless operation of the ramp/leveler/winch system. I also assume Charles had to constantly instruct Erico in the adjustment of the leveler, in order to keep the PIB level, as he was taking the photos. If we had an unedited video of the operation of the ramp system, it wouldn’t paint such a pretty picture. I would like to see Erico load the PIB, filled with a patient plus a couple hundred pounds of possibly fecally-contaminated ice water, by herself.
3. The winch is unsafe, especially when used in the presence of oxygen.
During one SA training session for the standby team members, the winch was sparking in the bus. The EMTs and paramedics got very upset thinking about the presence of large amounts of oxygen being used for the Thumper and ventilation. Charles said the emergency personnel were over-reacting; I say he was under-reacting. He said, “It was just a malfunction; Ken will fix it.” How can they guarantee there will never be another malfunction? They are working toward replacing the Thumper with the AutoPulse. This raises new issues in CPS, a topic which will be discussed here, sometime soon.
4. Using the ramp system contributes to the risk of medications and expensive equipment being dropped into the PIB.
Suspended Animation has a tray designed to rest across the top of the PIB. Anytime the PIB is not perfectly level, (and there will be times when it is not, when using the ramp system), they risk dropping medications and/or expensive equipment, from the tray into the ice and water.
5. A lot of time and money has been invested in the ramp/leveler/winch systems and they still do not perform as well as lift gates or PIBs with collapsible legs.
I believe if you add up the man-hours and materials, SA has far-exceeded the costs of lift gates, or a PIB with collapsible legs. At last count, they were on Platt’s third revision of the leveler design, and in my opinion, the performance was still unsatisfactory. The ramp systems are impractical and unsafe.
1. SA should have the proper doors and a lift gate installed on the bus, immediately.
When I suggested this, after Platt’s resignation, Gary Battiato of SA agreed with me. My suggestion included leaving the ramps as a backup system, but Battiato said we should make sure the new lift gates had manual backup systems and remove the ramps, altogether.
2. SA should either sell the Sprinter, or design a PIB with collapsible legs for it.
The Sprinter is too small to do procedures in, so I’m unsure of why the fact that it is “tall enough for people to stand up in” has been given as a rationale for the purchase of this vehicle. There’s a reason the gurney goes on the floor and the emergency personnel are seated, in emergency vehicles. It defies common sense to think about being able to stand, to take care of a patient in a moving vehicle.
This vehicle should be replaced with a van suitable for rushing standby personnel and equipment to the airport, and short enough to be parked in an airport garage, as this van is not.