Transport

EMTs must effectively coordinate the transport of equipment and personnel to the site and throughout the operation.

Transportation is a key factor for both national and international EMTs and must be planned and tested. Access to transport means, replenishment of consumables and equipment, and the transfer of patients are the important fleet and transport functions.58

1. EMTs should have electronic and hardcopy manifests that reflect the weight, volume and any dangerous goods carried.
2. Secure equipment during transportation in compliance with local regulations relevant to vehicle/aircraft type; mark and identify each box and goods even if only one side is visible.
3. Establish a management and maintenance plan for the fleet (or machinery park), as well as a registration mechanism on paper or digitally to allow traceability.
4. Dangerous goods must be packaged according to International Air Transport Association (IATA) regulation and packed and stored to allow easier access for inspection.
5. The transport plan includes assessment of the operating environment considering road conditions, security, journey times, seasonal weather changes and hazards.
6. Ensure that all vehicles are registered with the appropriate local authority and where mandated by law have evidence of annual safety inspection and have valid third-party liability insurance.
7. EMTs working in maritime settings should ensure that boat riders have access to maritime safety equipment including flotation aids and an emergency beacon.
8. EMTs should have medical transport equipment that can be taken on board non-specialist vehicles acting as temporary ambulances, considering occupants safety, patient care, ergonomics, medical equipment selection and placement.

1. Coordinate arrival and departure plans with local and national authorities, including entry and departure points.
2. EMTs should check that local unloading facilities are undamaged and available (for example forklifts). Larger teams may be able to bring their own unloading equipment and offer it to other response teams. Ground handling equipment, including but not limited to a pallet mover, off-road capable forklift or multipurpose mini tractor, side by side quad, preferably with patient litter.
3. Specialist advice on customs clearance should be sought for transportation of specific equipment and supplies due to possible in-country restrictions.
4. Prearranged agreement on chosen logistics platform including regular testing to speed up deployment processes.
5. EMTs bringing ambulances from other countries should be aware of the special licensing regulations and importation of the vehicle must be pre-agreed by national authorities.

• Packaging and boxes should be resistant to the operational and environmental conditions. Packaging should ideally be multi-use, able to be later used for operational functions and not constitute an environmental disposal hazard.
• Insignias and markings on vehicles can be helpful, depending on local advice and security situation. Motor vehicle accidents remain one of the major cause of staff injury and death in emergency response. EMTs must instil a safe culture for driving, controlling speed to local conditions and use of safety measures such as seat belts.