A.R.P. Ambulance Work
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Must Be Soundly Organized IN connection with the activities now occupying the attention of local government centres, whereby voluntary workers are being trained for first. aid and other services, the question of suitable road-transport arrangements assumes considerable importance. Througnout the country, every local council has, or should have, complete registers of all transport vehicles available for such duties as ambulance work, decontamination, demolition, fire-fighting and so on.
From active experience in A.R.P. exercises, however, the• writer is convinced that something further should be done to place voluntary transport work on a fully organized basis.
Practical experience has proved that, whilst owners of commercial vehicles are eager to co-operate in A.R.P. work, few are acquainted with the kind of service to be expected of them in the event of emergency. The obvious course that suggests itself, therefore, is that of organizing local transport facilities and maintaining, at least, a skeleton service in efficient working order by inviting commercial-vehicle -owners to assist in A.R.P. exercises arranged by the local councils, say, once a month.
The Needs of a Rural Area.
Let us consider, for the moment, the transport requirements in a rural area, where first-aid posts and casualty clearing stations are equipped and stalled for the training of voluntary workers, recruited from all classes of the community. In the area for which the writer is responsible for all A.R.P. transport arrangements, there are six first-aid posts, situated several miles apart, in small villages, and facilities for medical and surgical training in a building suited for the purpose.
as For the periodical exercises, " casualties " assumed to be suffering from injuries, severe and otherwise, are collected at the first-aid posts, to receive temporary treatment before being conveyed to the main dressing station. here, medical officers are in attendance to inspect the temporary treatment applied to each patient and to instruct. the first-aid personnel should further action be necessary.
On these occasions, some 50 casualties are collected and first-aid knowledge is imparted to at least three times as many voluntary trainees. The whole scheme would, of course, be impracticable in the absence of reliable transport services provided, again, by volunteers working in accordance with carefully planned arrangements.In these circumstances, it is essential to solicit the aid of commercial-vehicle owners by personal contact. As a' rule, one finds great readiness, on their part, to assist wholeheartedly, but plans must be made whereby the use Of suitable vehicles can be guaranteed without undue cost or trouble for their owners.
That is to say, of the vehicles operated in the district, those must be chosen that are most suitable for ambulance work, to the approval of the inedical-offiCer with whom the transport official co-operates. Knowledge of the normal work performed by vehicles and thehours when they are most likelY to be free for A.R.P. work is .also essential, so that when a ca.11 is made for• " ambulances "one may be sure of getting the necessary transport for• any given exercise and of having one in reserve for emergency requirements. If a sufficient number of genuine ambulances were available for use at A,R.P. medical exercises, the or ganizer's work would be simple enough Since other vehicles, however, must be requisitioned for the purpose, it is necessary to examine carrying capacity and general suitability, to ensure the safe and speedy conveyance of casualties from the distant first-aid posts to the main dressing station.
Boxvans of 1-ton to 30-cwt. capacity, as used by laundries, grocers, stores and furniture removers, are ideal for the purpose, as they provide body lengths 9Fat'reast 7 ft. 6 ins., to accommodate •Stretchersof. standard
dimensions. •
Unfortunately, the :bodies of the small delivery vans used in such large numbers, by tradesmen are "just too short to carry stretchers, unless the patients feet project through: the open doors—an arrangeinent unlikely to meet with the inecliCal officer's approval. Neither does the .Iimited space permit of quick Work by the stretcher-bearers, and thus the efforts of a first-aid party to' perform its work in scheduled time will be handicapped unduly.
The Time Facie'. :is Vital.
This is a very important detail in arranging A.R.P. transport for medical exercises, because the umpires who award marks to the' parties take the time factor into consideration, counting the minutes that elapse between the " zero " hour, When the casualties are first collected, and the time when they are passed as being properly treated by the medical officer -at the dressing station.
To make sure that all first-aid parties have equal chances of proving theiu efficiency, the transport officer must provide each post with the best ambulances" available. Should no larger vehicles be obtainable, vans of the I0-12-cwt. class can be used, provided temporary measures allow the front end of the stretcher to occupy the space alongside the driver's seat.
Next to the boxvan-type of vehicle, those which can be fitted with hoopsticks and tarpaulin covers prove quite useful, having, on several occasions, served as " ambulances " in the writer's A.R.P. transport fleet. In such cases, the handling of the stretchers is facilitated by the use of short step-ladders.
Another particularly serviceable form of vehicle is the standard type of horsebox, in which from four to six stretcher cases can be carried with ease.
Make Stretcher-handling easy.
As part of the training of women first-aid workers consists of the actual handling of stretchers carrying , the casualties, everything possible should be done, when the vans are being--Prepared to act as ambulances, to reduce the physical effort needed in such operations. The stretcher-capacityof most vehicles can be increased by the simple expedient of fixing . a .crosi.hearer at each end of the body, when two extra casualties can be carried.
Having examined the vehicles suitable for ambulance duty in his area and obtained the consent of their owners for their use when required, the transport officer should then prepare his own A.R.P. vehicle register. This will record the make, type, stretcher
carrying capacity and other details enabling him to call the required number of vehicles into service at short notice as needed by the medical officer.
Arrangements for periodical A.R.P. exercises will be rendered more simple and efficient if a given day in each month be set apart as a fixed date.
By such means, all the voluntary helpers become accustomed to routine procedure, ready for similar work at once, should an emergency thtnaten., The transport workers, too, can make sure that their vehicles will be available ' for a couple of hours, one evening a month, without loss of business._ Official notifications of a forthcoming exercise trill serve as reminderS.
Work of this kind is liable to become confused unless everyone concerned knows his or her job thoroughly. To
that end, the writer has found that tire issue of simple standing instructions proves Of great value and these may be drafted on. the lines indicated below, -:1 or the' guidance of the persons in charge of the first-aid posts:—
Transport for A.R.P. Medrced Exercises.
To all section leaders:
To facilitate transport operations and avoid congestion at the main dressing station, will you please observe the following points:— (1') Drivers of ambulances, etc., will report to you On arrival at the first-aid point. (2) They will remain under your orders until arrival at the main
dressing station. (3) One of your
transport volunteers should travel in the cab, to observe how a commercial vehicle is handled. (4) On arrival at the main dressing station, a marshal will indicate where vehicles must park, pending further instructions. (5) Please see that the entire personnel of your section remains with the vehicles until you are told that the medical officer, is ready to deal with your casualties. -(6) Should any Vehicle detailed to your post fail to arrive at the proper time, please telephone_ 'at once to the main dressing station for a reserve vehicle.
Planning Carefully Carried Out
Perusal of the above instructions will indicate the existence of a carefully planned transport organization. yo begin with, the ambulances proceed direct to their respective first-aid points to act under instructions of the section leader, who superintends the leading of :.'stretcher cases and "' directs 'tbe convoyto the main dressing station. On the way there, each driver Will have . a transoort. volunteer as his passenger, for instruction in driving. Later, the transport vOlnnteers will be invited to attend lectures on driving commercial vehicles for emergency work.
Arrangements for vehicle parking at the main dressing station must ,provide against the probability of congestion.
Finally, with regard to transport expenses, such as those for fuel and drivers' time, it is customary for the local councils concerned to meet the charges incurred.