Flashcards in Chapter 38-41 Deck (135):
What do you do at the start of a shift?
Check equiment and supllies at start of shift by readiness. Talk to previous shift of oproblems. Check car head to toe when ambulance is on loo k for lights, brakes, or windsheilf wipers, check heat and air condition. If major thing isnt working have ambulance be out of service. Make sure doors work, doors lock, AED fully charged make you have four sets of some things expiration dates, make sure to have extra batteries for stretcher. document what you do, in house oxygen is full and how much is in it
What is the job of the EMD?
answer questions a ssign priority, mrfical instructions and coordinate, location nmber, problem, how old, sex conscious and breathing staying on line if hot or nonbreathing fast with lights
What do you do when driving?
tolerant of other drivers and mentally ready inn nonemergency siuations follow laws. Can park vehicle anywhere wont hurt or damage proerty orr person slowing only at stop signs pass other vehicles in no passing zones and go improper directions on streets . Can speed if wont hurt unders with limmits. Use sirens in only emergency when there is possible loss of life or limb of only when using driver exemptions and horns use similarly. Headlights on day or night use all lights when emergency approach intersectiond with caution no fast turns signal lane changes and turns be careful driving in grpup people cut off. Slow when approaching school don pass when lights flaashing. Have maps in ambulance
How do you respond to a crash?
keep people parked off highway, dont do u-turns, if first unit- blocks incident by parking upstreatm block traffic by using vehicle as barrier best use of this is fire truck and ambulances are best downstreatm. If extrication where vest helmet and wear gear. Place cones and flares upstreatm to warn and direct traffic reduce emergency lights, dont drive over debris and skid marks keep ambulance on same side as road avoid backin g up
What is packaging?
getting patient and the patient carrying device in one unit to be secured and transport. Apcakage so condition isnt aggravated caring for wounds, stabilize impaled objects, check all dressings and splints before placed on devicrr with it secured and covered. Always cover patient to protect and keep private and place plastic over when wet. Carryind device needs a minimum of three straps, chest, hip, and lower extremities. Lock stretcher in ambulance,
What do you do if a patient needs to bring someone else along?
If friend must come along try to have them use some other transportation if not have them travel in the operator’s compartment if child bring car seat and put in truck fill forms if bringing personal effects. Dont drive hot unless necessary.
What do you do once the patient is at the ED?
May have to wait in ambulance or with patient if ED is busy and continue care until they transfer care never put in bed and leave without transferring care. Help staff give verbal and PCR and transfer effects, then get release from hospital
What do you do after you drop off the patient?
Clena up ambulance getting rid of body fluids and splash sites putting towels in red bag, sweep away dirt, bag for laundry, deodorize. Clean and disinfect respirtory equipment. Replace expendable items masks gauze, splint and spine boards. Stretcher raise to high-level position making it easier flat with side rails lowered and unfastened straps, remove unsoiled stuff placing on clean and soiled stuff to designated, clean mattress (if blood use bleach) turn mattress, put sheet and disposable mat on center of mattress, open blanket fully, top sheet on top tuck everything under beat
What do you do if the patient is unconscious with no spinal injury?
or a patient with an altered mental status onto their side. If patient may go in cardiac arrest put board under him just in case. Loosen clothing.
What do you do after leaving the hospital?
Let EMD know u are on your way back and serviceable or not, and notify is you stop and leave for any reaosn, open windows on way back if had airborn disease or ventilating system not recirculation to air out, filll up ambulance. Clean patient care equipment anywhere it touched, clean and sanitize respiratory equpment (soak in germicidal solution), clean interior wash ahnds, replace extendable, replace oxygen, replace patient care equipment, maintain ambulance, clean exterior, report for service, complete unfinished report
What are the different kinds of disinfectants and what do you use them for?
Low-level disinfetant clean and kill germs on abmbulance floor and walls, intermediate-level disinfectant mixture of 1:100 bleach to water used to clean and kil germs on equipment surface, high level disinfectant cidex plus destory all forms of microbial life except high numbers of spores, sterilization of invasive equipment.
How do you prepare yourself for the next call?
Clean hands under fingernails change clothes with communicable disease blood or body fluid-soiled clothes cant be taken home to wash
When do you use air rescue?
speedy transport to distant trauma station, extrication of high-priority patient is prolonged or rescued from remote location. Clinical: in shock, glasgow coma scale 10 or less, head injury with altered mental status, chest truamama dn respiratory distress, penetrating injuries to body cavity, ampuation proximal to hand aor foot, extensive burns, serious mechanism of injury post-cardiac arrest with a pulse. Catheterization or surgery, stroke patients and hyperbaric oxygen (carbon monoxide) transfer from one hospital to another cardiac arrest if hypothermic. Name, call-back number, agency name, nature of situation, exact location crossraods and major landmarks and exact location of safe landing or gps coordinats. 100by 100 feet. Dont approach helicopter unless escorted by flight personnel direct loading of patient stay clear or tail rotars dont smoke within
What are the different kinds of specialty training?
vehicle rescue, water rescue, ice rescue, high-angle rescue, hazardous material response, trench rescue, dive rescue, backcountry or wilderness rescue, farm rescue, and confined-space rescue.
when u first arrive to a highway scene what do you do?
First person that arrives blocks scene to protect area, fire is best for this. Limited access highways first-due units go to seen backup wait outside until requested rescue trucks downstream of initial blocking vehicle park in same direction as traffic and stay in single file only turn when it won’t obstruct the flow of traffic. Have it block one and a half to two lanes of traffic workings toward work zone to protect crew wheels away from incident.
Where does EMS park in a highway scene?
EMS downstream and should be in between fire and crash only exit in safe zone and be in class 2 traffic safety vests and helmet cones and flares at angle across road and around site leave red/amber warning lights on ambulance.
What are the steps of vehicle extrication?
preparing for rescue, sizing up the situation, recognizing and managing hazards, stabilizing vehicle prior to entering, gaining access to patient, providing primary patient assessment and rapid trauma assessment, disentangling patient, immobilizing and extricating patient from vehicle, providing assessment care and transport, terminating rescue
What are the PPE EMTs where?
For gloces wear firefighters gloves but if u need more dexterity use intermediate-weight leather gloves. Turnout coat and everything that is brgithly colored wear stuff without rear brimand everything bright wearing safety glasses with side shields and lenses are vital.
How do you protect the patient?
aluminized rescue blanket protects form bad weather and flying particles, lightweight vinyl-coated paper tarpaulin from bad weather, wool blanket with aluminized blanket- when cold, short and long spine board, hard hats goggles hearing protectors disposable dust masks and thermal masks, emotional support.
When do you use flares?
avoid spilled fuel, dry vegetation, and other combustiles, dont throw flares out of moving vehicle position few at edge of dangers zone as soon as it is parked walk with flares toward oncoming traffic every ten feet dont turn back held away from body when igniting never use as traffic wand.
What do you do with airbags?
Smoke when airbag goes off wear protective and eye equipment can hurt patitne look at dash weheel and air bag to see if damaged. Must disconnect battery to make sure it doesnt go off 2-3 minutes. Dont step in front of bumper as it is spring loaded. Keep crowd control may have to ask bystander to help but will be liable if they were hurt
What is the danger zone?
zone where controling hazard for electrical
What is the safe zone?
nothing could harm keep yourself and others away form anything somewhat electrical. Keep people in cars or in wreckage wood handles can also conduct. Ground can be energized, if feel tingling means on energized ground. If feel tingling hop to safe place on one foot, shuffle away from danger area with both feet no break in contact between two feet and ground to incomplete circuit
What do you do when confronting a fire?
put on full protective gear, if hood open back to wind across base of fire with short bursts direct it in any direction toward engine if hood closed leave it be and get patients out. Fire in dash or upholstery apply directly but sparingly if in trunk leave. If people inside and fire is under vehicle try sweeping keeping source away. Never stand directly in front of a truck wheel approach from 45 degree angle.
How do you cut the battery when do you cut it?
Dont cut battey unless for airbag or gasoline under vehicle only negative cable.
What do you assume about vehicles post-crash?
Assume all vehicles are unstable place a chock under car or stabilizing on side with cribbing or struts. If don't have equipment stand by until rescue unit stabilizes
How do you secure the vehicle?
Make sure keys out, in park, engine off, keys are removed and parking brake on, deflate tired and place stop chocks to keep from rolling. Stabilize in the position it is found to not injury people,
What do you do to try to get to the patient?
Once stable ask if they can open door or window, laminated glass- break into small pieces in passenger car side and rear windows
Flathead axe- used for windshield, place tarps over patietn crawl in through window and do primary assessment.
Just take the roof and doors off for easy access or cut front end of car off after everything has been turned off and stay away from deplyoying things
What is terrorism?
the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives. Have to pay attention to rime scene and further destruction
What is domestic terrorism?
terrorism directed against one’s own government or population without foreign direction. Is no longer organized but is becoming fragmented and leaderless
What is international terrorism?
terrorism that is purely foreign-based or directed outside the targeted country or whose acitivites cross national boundaries
What are weapons of mass destruction?
weapons, device, or agents intended to cause widespread harm and/or fear among a population usually CBRNE agents (chemical, biological, radiological, nuclear, and explosive)
What are multiple devices?
destructive devices, such as bombs, including both those used in the initial attack and those placed to be activated after an initial attack and timed to ijur emergency responders and others who rush in to help care for those targeted by an initial attack
What are secondary devices?
destructive devices, such as bombs, placed to be activated after an initial attack and timed to injure emergency responders and others who rush in to help care for those targeted by an initial attack
What is OTTO?
(occupancy or location, type of event, timing of event, on-scene warning signs). O- place or business that terrorists might target, type perhaps with large ground, timing holiday or anniversary, on-scene clues chemical containers or out of place items.
What are the targets of terrorists?
symbolic and historical targets (some organization or even particularly effensive such as government buildings, statue of libery, liberty bell, wall street, world traid center). Public buildings or assembly areas (shopping malls, convention centers, entertainment venues, sporting arenas, and tourist destinations), controversial businesses (familt planning, nuclear faciilites, animal research, car dealerships, large commercial developments), infrastructures systems (bridges, power plants, phone companies, water-tereatment plants, mass transit,a nd hospitals.
What are some events that raise awareness of terrorism?
explosions/incendiaries, incident with firearms (aniper attack or hostages), nontrauma mass casualty. Also dates and holudays and times-rush-jour
What is exposure?
dose or concentration of an agent multiplied by the time, or duration substance taken in. . Pay attention to unusual lab or weird containers
What is TRACEM-P?
thermal harm extreme heat from burning liquids, metals, extreme cold from cryogenic with heat melting protective clothing secondary harm; radiological harm; secondary harm-asphyxiation argon carbon dioxide or chemcial vapors in dusty spaces; primary- chemical harm (toxic or corrosive materials); etiological harm (causes of disease); secondary- mechanical harm (gunshot wounds, slip trip and fall injuries, and injury from bomb fragments or shrapnel; seconadary- psychological harm (violent or traumatic event creating fear, invoke panic, reduce faith in government).
What is a biological incident?
Protect yourself first- respiratory proteciton prioriry skin face hands feet head and body. Potential use as infectivity (small number of virsuses), virulence (severity of disease), toxicity (incapacitation), incubation period, transmissibility (person to person), lethality, and stability.
What are bacteria?
ingle-celled organism grow in variety of environments from growing in body or grow outside producing toxins treated with antibiotics look for fever, nausea, vomiting, and diarrhea with sudden onset multiple patients in same area. No cure to viruses which rely on cell.
What are things associated with bacteria?
Fever, chills cough: Anthrax (1-6 days no Human to human H-H), cholera (1-5 days rare H-H incapaciting not deadly with death from dehydration and and electrolyte imbalance), bubonic plague (2-10 days high H-H), pneumonic plague (high H-H2-3 days), Q fever 2-10 days rare H-H, tularemia (2-10 days no H-H)
What are toxins?
posionous chemical produced by living organism ricin (24-72 hours no H-H dangerous via inhalation with supportive treatment), mycotoxin (minutes to hours H-H can go through skin weight loss, vomitng, diarrhea, weakness, dizzines,s, hypotension, and shock death within 12 hours use soap and water ), staphylococcola enterotoxin (4-6 hours no H-H fever 103-106 general weakness and nonspecific respiratory sumptoms chest baina nd pulmonary edema mostly incapacitating), botulin (deadliest toxins in planet 24 hours to several days no H-H).
What are viruses?
smallpox (10-12 days high H-H citizens do not have immunity to it acute onset fever, weakness, headache, backache, and vomiting 2-3 days rash and blisters around mouth throat and face spreading to extremities 30% mortality droplet transfer), VEE encephalitis (2-6 days low H-H only transfered via animals causing swelling of brainfever profoudn CNS effects headache phtophobia and altered consciousness incapacitating), Viral Hemmorhagic Fevers VHF-ebola, dengue fever, marburg, lassa fever (3-21 days moderate H-H clotting characteristics of blood and permeability of capillaries with systemic hemorrhage and liquefaction of solid organs highly ocntagiousa nd lethal rapid onset of fever, weakeness easy brusing and bleeding, sclera of eyes with bleeding and leaking of capillaries respiratory portal)
What are chemical doses?
Chemical doses milligrams per kilogram of body, biological doses fractions of micrograms per kilogram of body weight concentration in parts per million limiting dose concentration or time near agent you will reduce exposure. Based on 150 poind man in good health.
What are the results of a biological incident?
Results in chemical harm (secondary), etiological harm (primary), mechanical harm (secondary), and psychological harm (secondary).
What are some routes of entry?
pathways into the body, generally by absorption, ingestion, injection (vector (disease carrying organism), jagged glass or metal, syringe, high-oressure devices) , and inhalation. Injury to skin allows entryway, skin temp/blow flow, higher concentration more exposure, more hair more exposure, length of exposure, type og agent .
What is contamination/
contact with or presence of a material (contaminant) that is present something cloing where it does not belong and that is somehow harmful to persons, animals, to the environment. Contaminating hard and soft surfaces, skin and hair, and clothing.
What is permeation?
the movement of a substance through a surface or, on a molecular level, through intact materials; penetration, or spreading
What are dirty bombs?
medical waste or low-lvelevl radioactive sources
What are the radiological/nuclear incident?
thermal harm (primary- nuclear explosion), radiological harm (primary) more dangerous to children pregnant woman and the elderly with signs of nausea vomtiing and diarrhea, chemical harm (secondary), mechanical (primary explosion), psychological harm (secondary). Radiological detection, search all patients at scene may be bomber. Can be activated by lighht, pressure, ovment or radio transmission dont attempt to handle or neutralize.
What is a high order explosive?
defining supersonic overpressuizaiton shock ex. Nitroglucerin dynamite and ammonium nitrate
What is a low order explosive?
subsonic explosion adn lack overpersssurization ppe bombs gunpowder petroleum based
What is dissemination/
spreading usually through respiratory system. Nerve agents- sarin, smona or tabin can penetrate skin causing systemic efforts. Things with delayed incubation including smallpox, pneumonic plague, and viral hemmorhagic fevers
What is weaponization?
packaging or producing a metial, such as a chemical, biological, or radiological agent, so it can be used as a weapon, for example, by dissemination in a bomb detonation or as an aerosal sprayed over an area or introduced into a ventilation system
What are chemical agents?
choking agent ( respiratory irriatnt weaponized and industrial chlorine), vesciating (blistering cells of exposed tissues hours later), cyanide (cellular asphyxiants), nerve agents- smell of petroluem milk-off white color (SLUDGEM salivaiton, larimation, urination, defecation, GI upset, emesis (vomiting), misosis (pupils)), riot control agent (irritationg material lacrimators- tear flow) respiratory distress in people with asthm).
What is zoonotic?
able to move through the animal-human barrier; transmissible form animals to humans ex. Anthrax with cattle, sheep and horse wool need to be treated 12-39 hour window with recovery but appears respiratory looking then dies 2-3 days later. Plague (bubonic- if on flees swollen or enlarged lymph nodes in legs progressing to systemic and is highly contagious pneumonic if inhaled) nonspecific respiratory bloddy sputum and severe dypsnea
What are the harms associated with chemical incidents?
chemical harm is primary potnetial haarm keep exposure to minimum (rotate teams for short people decontaminate as quickly as possivle) be distance outside area or shield yourself with sel-contained breathing apparatus
What are the harms associated with biological incidents?
eitological harm is primary, keep exposure at minum, decontamination propmty stay distance away get vaccinatioand na innoculations protect ksin face hands feet, head body and respirtory
What are the harms associated with radiological/nuclear incidents?
radiological harm is proarmy with thermal or mechanical harm. Time limits for exposure shield behind impervious structures
What are the harms associated with explosive event?
thermal and mechanical harms with etiological or chemical posisble limit time around turnout gear hard hate, protective gloves, fire proof clothing or wear chemical biological or radiological
What are the effects of radiation?
blood forming system (bone marrow) need 150 rem white blood cells die with opportunistic diseases-7 days anemaia as RCs die- 30 days clotting difficulties (30-60); gastrointestinal (500 rem) death of tissues nausea and vomting with fluid loss hypovolemia and shock bad prognosis if within 2 hours and nervous system (1000 rem vascular bed damage cerebral edema swlling of brain (headache blurred vision, strokelike symtpoms).
What are the blast impacts?
blast lung, ear injury, abdominal injury, brain injury
What is blast lung?
from direct overpressurization wave most common cause of death. Apnea, bradycardia, and hypotension (pauses in breahing, slow heart rate, and low blood pressure. Suspect if Breathing difficult, cough, coughing up blood, or chest pain
What is ear injury?
primary tympanic membrane commonwith eharing loss, ringing in ears, bleeding from external canal hand signals or cards
What is abdominal injury?
cause immediate rupture of large or small intestines, hemmorange, mesenteric shear injureis, solid organ lacerations and testicular ruptures. Look for epople with abdomminal pain, nausea, vomitng of blood, testicuar pain, unexplained hypovolemia, acute abdomoen.
What is brain injury?
concussions or mild traumatic brain injury look for if headache, fatigue, ppoor concentration, lethargy, depression, anxiety, insomnia
What is zoonotic? what are some zoonotic things?
able to move through the animal-human barrier; transmissible form animals to humans
anthrax, plague, Q fever, tularemia
What is anthrax?
Anthrax with cattle, sheep and horse wool need to be treated 12-39 hour window with recovery but appears respiratory looking then dies 2-3 days later.
What is the plague?
(bubonic- if on flees swollen or enlarged lymph nodes in legs progressing to systemic and is highly contagious pneumonic if inhaled) nonspecific respiratory bloddy sputum and severe dypsnea. Treatable within 24 hours
What is Q fever?
Q fever, from livestock similar to anthrax fever chills and headache pneumonia is common sweating malaise fatigue loss of apetit eand weight loss with low fatailty treatable
What is tularemia?
Tularemia from bites of infected animals, deer flies, ticks or mosquitoes with fever, ehadache, and weight loss with respiratory symptoms, substernal discomfort and nonproductive cough with pneumonia 5-10% mortality isolation not required. trateable
What is rem?
roentgen equivalent (in) man; a measure of radiation damage
What are strategies?
braod general plans designed to achieve desired outcomes
What are tactics?
specific operational actions to accomplish assigned tasks
What is the outer perimeter?
most distant point or boundary of incide used to restrict all public access to the incident
What is the inner perimeter?
hot zone islates known hazards within outer paremeter used to control movement of responders established when several suspcious things are sited controlling access to suspicious area
What is force protection?
EMS forces are protected to ensure mission accomplishement. Make scene size up to determine threats, request protection, establish vehicle staging adn triage/treatment areas in protected locaitons, advise EMS command, report suspciiosu people
What do you do in response to a possible terrosit event?
In reponse to a possible terrorist even: dont rush in wait until appropriate authority said the scene is safe, incident comment, wear PPE, beware of booby traps, search all patients for explosives or weapons if found evacuate
What is hazardous material?
any substance or material in a form that poses an unreasonable risk to health, safety and property when transported in commerce or kept in a stroage at a warehouse, port, depot, or railraod facility
What are likely hazmat locations?
highway incidents involving common carriers, trucking terminals, chemical plants or places where chemicals are used, delivery trucks agriculture and garden centers, railway incidents, and laboratories
What should you consider of people at hazardous sites?
All patients leaving site of incident should be considered contaminated until proven otherwise
What is a safe zone?
same level as and upwind from incident. Avoid downhill in case of flowing. Avoid low-lying areas in case of fumes avoid downwind and sewer system can spread.
Who do you call?
fire, special rescue personnel, local or state hazmat experts, and law enforcement personnel if around company or industrial site or railway call company as well as private stakeholders
What is a hot zone?
area immediately surrounding a hazmat incident; extends far enough to prevent adverse effects outside zone. When multiple hazard patients think hazmat, find out what substance is and what properties and dangers might be whether imminent danger what you can hear, see and smell how many patients. Pay attention to those entering hot zone monitor them if have elevated herat rate or body temp must be assessed until baselline with hydration rest and nourishment for members
What is the warm zone?
area where personnel and equipment decontamination and hot zone support take place; it includes control points for the access corridor and thus, assists in reducing spread of contamination hazmat team decontaminates patietns and other hazmat members.
what is the cold zone?
area where incident command post and support functions are located. Everyone must be staged in to take care of hazmat and injured. Protected from weather, large enough to accommodate multiple rescue crews, easily accessible to EMS free from exhaust fumes rapid re entry into emergency operation receiving decontaminated patients.
What do you look for?
labels, check invoices bills of lading (trucks) and shipping manifests review safety data sheets (name substance properties and hazard information) and interview workers or others leaving the hot zone.
What are the health hazard people label?
carcinogen, mutagenicity, reproductive toxicity, respiratory sensitizer, target organ toxicity, aspiration toxicity
What is fire label?
flammable, pyrophoric, self-heating, emits flammable gas, self-reactive, organic peroxides
What is exclamation label?
irritant (skin and eye), skin sensitizer, acute toxicity, narcotic effects, respiratory tract irritant, hazardous to ozone
What is corrosion label?
skin corrosion/burns, eye damage, corrosive to metals
What is an exploding bomb label?
explosives self--reactive, organic peroxides
What are flames over circle label?
What is environmental label?
What is skull and bones?
acute toxicity fatal or toxic
What do you tell people you call?
chemical transportation emergency center, Chem-TeL. Give name, call-back number, email address, fax number, explain nature and location of problem. Report ID number of material, give name of carrier shipper manufacturer consignee and point of origin. Describe container type and size. Report where located. Estimate quantity, report loca conditions weather terrain proximity. Report injuries and exposure. Report local emergency. Keep lines of
What is decontamination?
chemical and/or physical process that reduces or prevents spread of contamination from persons or equipment; removal of hazardous substances from employees and equipment to extent necessary to preclude foreseeable health effects. Not complete some common areas are scalp/hair, groin, buttocks, armpits, and between fingers and toes and are hard to get and can get passed to EMS so they wear tyvek coverallas and booties with double layer of gloves nitrile or neoprene). Cover inside of ambulance with plastic or hae them sit in a disposable decontamination pool use disposable equipment and not firefighting gar.
What do you do when decontomating?
manage critical needs. Patients must be decontaminates before entering hospital scene. Irrigation with water which dilutes not neutralizes cut patient’s clothing and irrigate body with large amount of water contianing runoff use tepid warm water to prevent hypothermia. Avoid flushign contaminants directly into open wounds pay attention to cleaning asreas like dense body hair, ear canals, navel, fingernails, crotch, armypits. Decontaminate yourself
What is gross decontamination?
removal or chemical alteration fo majority of contaminant some resideual will always remain causing corr=sonctamination
What is secondary decontamination?
alteration or removal of most of redisual product contamination.
What is emulsification?
production of suspension of ordinariyl immisble (unmixable)/insoluble materials using emulsifying agent like surfactant, soap or detergent
What is a chemical reaction?
neutralized, degrades or chemically alters contaminat not recommended for livin tissue
What is disinfection?
removes biological (etiologica) contamination hazards as disinfectant destroys microorganisms and toxins
What is dilutioN?
process that simply reduces concentration of contaminant used for substances that are miscible/soluble huge quanitites may be required to dilute.
What is absorption nd adsorption?
penetration fo liquid or gas into another substance
What is removal?
removing by pressure of vacuum using water wipes burhses or air
What is disposal?
aspetic removal of contaminated object from host where its disposed.
What is the responsibility of the EMT at hazmats?
EMT responsibility, determine level of PPE based on hazards, establish operating time log, set up and operate decontamination line, prioritze decontamination of patients according to triage system, perform triage in PPE, communicate in PPE.
What are the list of things needed for decontamination?
buckets, brushes, decontamination solution, decontaminition tubs, dedicated water supply, tarps or plastic sheeting, containment vessel for water runoff, pump to transfer wastewater from decontamination tubs to a containment vessel, rinse patient head to dtoe scurbbing heavily contaminated rinse again remove contain runoff.
What do you have people who are not covered do?
remove shoes, socks, jewelery watches, other items trap materials against skin, remove contacts as soon as possible, double bag clothing for disposalble valuables and identification bagged and may be carried with patients 2-5 minute rinse solid contaminants burshed off before washing if viscous liquid blotted off if water reactive brushed off. Open wounds irrigated from area nearest body outward isolating wound once cleaned using low pressure.
What is the multiple-casualty incident?
any medical or trauma incident involving multiple patients. As little as three patients is considered usually automobile collision with three or more patients plan must be flexible and expandable enough to be used form small three-patient incidents to large=scae incidents 15 incidents.
What is the disaster plan?
predefined set of instructions for a community’s emergency responders
What is the national incident management system (NIMS)?
management system used by federal, state and local government to manage emergencies in US
What is incident command system?
subset of national incident management system (NIMS) designed specifically for management of multiple-casualty incidents
What is command?
first on scene to establish order and initiate incident command system done at all incidents manageable span of control is 6 people as it escalates too large for one person to manage
What is single incident command?
command organization in which a single agency controls all resources and operations
What is unified command?
command organization in whcih several agencies work independently but cooperatively better allowing for large=scale incidents.
What is incident command?
person or persons who assume overall direction of a large-scale incident assumed y most senior member of first service on scene usually EMS. given to someone who can observe scene but secure enough to permit management of incoming resourcs and communication with others. Placing two cones on roof. Walk around scene assess nmber of patintes, hazards, and degree of ientrapment apparent priotirt of care need for extrication number of ambulances needed other factors affecting scene and corresponding resources needed to address them. Give yourself unique command name, what equipment to bring, plan on doing once arrive, how best to access scene and where to park try not to use radio once there. Only command talks to command center and requesting resources. Ask for extra resources and groups just in case, think about supply and staging locations and restrict access to scene.
what is branch areas?
mobile command center, extrication, staging area, triage area, treatment area, transportation area, and rehabilitation area.
What is triage?
process of quickly assessing patient at a multiple-casualty incident and assigning each a priority for receiving treatment
what is triage supervisor?
person responsible for overseeing triage at a multiple-casualty incident. Calls for additional help assigns available personnel and equipment to patients, and remains at the scene to assign and coordinate personnel, supplies, and vehicles.
What are the patient priorities?
1- treatable life-threatening illnesses or injuries (airway and breahting difficulties, uncontrolled or severe bleeding decreased mental status, and severe medical problems shock and/or severe burns), 2- serious but not life-threatnening illnesses or injuries (burns without airway problems, major or multiple bone or joint injuries and/or back injuries with or without spinal cord damage),3- walking wounded (minor musculoskeletal injuries or minor soft-tissue injuries) conscious able to follow comands and walk, 4/0- dead or fatally injuries (exposed brain matter, cardiac arrest no pulse for more than 20 minutes except cold-water drowning or severe hypothermia decapitation severed trunk and incineration) dont deal with when limited resources.
How do you distinguish the group?
Call people over loudspeaker and have them move to triage area to secure area as well as see who is fatal stop only to secure airway or stop profuse bleeding if priority 3-green are nearby and well enough to help assist you maintiang airway or direct pressure on bleeding wounds or other patients if dont want to leave friends and find let them stay.
Who do you render car to?
RPM: respiration (if fix airway and don’t start breathing tag as priority 0 if breathing after airway is opened then tag as priority 1 if breathing more than 30 per minute priority 1 and if less than 30 go to next step), pulse (if unresponsive, not breathing and no pulse tag priority 0 if breathing but has no pulse tag as priority 1 if breathing and has pulse good skin signs go to next step), and mental status (if alert priorty 2 if altered mental status tag as priority 1) 30 second per patient treatment limited to position airway, raising extremities and applying direct pressure.
Priority 1- red: altered mental status, or absent radial pulse, or respirations greater than 30
Primty 2- yellow: are alert and have radial pulses present and have respirations less than 30/minute
Priority 0-black or gray: not breathing (after an attempt to airway) have no pulse and are not breathing
What is a triage tag?
color-coded tag indicating priority group to which patient has been assigned use duct tape laundry marker when wet
What is a triage area?
area where secondary triage takes place at a multiple casualty incident patients
What is a treatment area/
area in which patients are treated at a multiple-casualty incident. physicalyl separated itno treatment groups based on priority level
What is a treatment supervisor?
person responsible for overseeing treatment of patients who have been triaged at a multiple-casualty incident at certain area for each should retriage patients in area to determine order in which receive treatment based on if deteoriated or improved
What is a staging area?
area where ambulances are parked and other resources are held until needed.
What is a staging supervisor?
person responsible for overseeing ambulances and ambulance personnel at a multiple-casualty incident responsible for communicaitng with each treatment area regarding number and priority of patinents in area.
What is a transportation supervisor?
person responsible for communicating with sector officers and hospitals to manage transportation for patients to hospitals form a multiple-casualty incident telling who goes to the staging area or not ambulance cant leave without permission who needs to tell receiving hospital
What is surge capacity?
measurebele repsresntation of ability to manage a sudden influx of patients. It is depdendent on a well-functioning incident management system and the variable of space, supplies, staff, and any special considerations (contaminated or contagious patients for example). Dont have to do PCR because wont be same emt that transports
What are some things to remember when stocking?
If minimum isnt there you would stock it, is there enough paper work. Know where everything is turnout gear initial what you did ont eh checklist if two people do it. Can mark if it is your designated truck? Dont forget stretcher, clean grab bar every time you use or inside handles check ceiling.