Emergency Procedures Flashcards by William Butler

EMERGENCY PROCEDURES
DISENTANGLEMENT

The rule of 5-10-20 should be observed;

at least 5” from side airbags

10” from driver airbags

20” from passenger airbags.

Removal of the seatbelt from a patient as soon as practical is recommended.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Factors that will play a role in determining the appropriate actions taken and the order in which they are carried out will be

Type and number of vehicles involved

Positions

Number and condition of patients

External hazards at the scene.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

First arriving officers must immediately notify the dispatcher when a person is pinned in the vehicle.

Transmitting a 10-75 for an emergency should be considered when there are several vehicles with numerous patients.

Disentanglement -

The removal of wreckage from around the victim.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Extrication -

Extrication - The physical removal of the victim from the vehicle.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Ladder Company Operations

Officer and inside team proceed to scene of accident to initiate a

perimeter survey,
chock the vehicle and
gain access to victim

Inside team will ensure

car is in park
windows are opened
seats are moved back
seatbelts removed before shutting down ignition.

If an engine or EMS is not on scene, members shall stabilize the patient. Once an engine or EMS arrives, the inside team can pass off patient stabilization and assist the outside team with disentanglement.

The Officer should ensure the disconnection of the battery.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Ladder Company Outside Team Operations

Roof and OV bring Hurst tool equipment to scene of accident and initiate operation.

Chauffeur initially uses the apparatus to block off traffic and can be used to bring additional equipment to scene.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

DOOR REMOVAL

The hinge side may be an improved approach with new car construction.

Cut top and bottom hinges using cutters in that order.

When a hinge has a spring, it must be removed prior to cutting the hinge.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Total Roof Removal

Cut low on the A Post and high on the B, C and D Posts

Cut across the bottom of the windshield using the sawzall with wood cutting blade. End the cut at the A Post on both sides of the vehicle. The windshield hand saw or axe can also be used to cut windshield.

DASHBOARD DISPLACEMENT

The lower cut is made below the hinge, parallel to rocker panel.

The second cut is made approximately 6-8 inches above first cut.

A metal hook should be positioned between the cutters and the rocker panel to prevent the tool from moving in towards the passenger compartment.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

GLASS REMOVAL

Laminated safety glass which is used for the windshields

Tempered glass which is found on the sides and rear of a vehicle. Tempered glass is being replaced on side and rear windows by laminated glass or rigid plastics due to it being highly resistant to breaking.

Before any glass removal procedures are started, victims and/or rescuers should be protected from airborne glass debris.

Salvage plastic or yellow exposure blankets are a good choice of protection.

Fabric blankets are not a good choice as they tend to keep pieces of glass in the fabric which could cause injury later to a victim or rescuer.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Windshields:

One of three tools may be used when removing a windshield;

Windshield saw

Sawzall

Axe.

The axe should be considered as a last resort for this procedure.

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EMERGENCY PROCEDURES
DISENTANGLEMENT

Prolonged and repeated contact with the hydraulic fluid may be irritating to the skin. If a member gets hydraulic fluid in their eyes, the member should flush their eyes with clean water for ________________ and immediately seek medical attention.

at least 20 minutes

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EMERGENCY PROCEDURES WATER RESCUE 1

It should be emphasized that any entry into the water or onto ice be considered as a last resort.

A member with lifeguard experience or a trained scuba diver should be considered for this assignment.

It would not be good practice to assign your primary water rescuer as a riding position.

Positions should be discussed and determined at roll call.

There will be times when we should not enter the water. This goes for drill as well as a rescue situation. Some factors that would affect this decision are:

Water/weather conditions – factors such as wave height, presence of riptides or sweep tides and lightning storms.

Location of Victim- how far out the victim is and if they can be reached safely.

Skill level of rescuer - can the rescuer reach the victim under the above circumstances or will the rescuer eventually become a victim.

Night operations - Members should not be allowed past the line of sight from the shore. Portable lights should be brought to the scene.

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EMERGENCY PROCEDURES WATER RESCUE 1

MEDICAL CONSIDERATIONS

Do not massage or rub the victim because rough handling could cause cardiac arrest.

Hypothermia

The loss of body heat occurs 25 times faster in cold water than in air. Hypothermia (subnormal body temperature) begins when the body’s core (brain, spinal chord, lungs and vital organs) temperature falls below the level of 98.6 degrees Fahrenheit. Cold water cools the body’s skin and outer tissues very quickly. In approximately 7 to 15 minutes, core body temperature begins to drop significantly, affecting utilization of the arms and legs. Blood pressure, pulse and respiration rates all decrease. Muscles tense and shiver. Irrational behavior (resisting help) is a good indicator of hypothermia.

When the body’s core temperature begins to drop below 90 degrees Fahrenheit, the victim transgresses from non-ambulatory into unconsciousness. Low core temperature, in conjunction with stress and shock, can cause cardiac and respiratory failure.

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EMERGENCY PROCEDURES WATER RESCUE 1

MEDICAL CONSIDERATIONS

There are a considerable number of authenticated cases of drowning victims who were submerged in cold water for 30 to 60 minutes and then resuscitated with no brain damage or other serious health effects.

It reduces the heart rate (bradycardia), increases blood pressure and shuts down blood circulation to all the body’s core, resulting in a lower metabolism. MDR also protects the victim from the rapid inhalation of water into the stomach and lungs.

MDR is more pronounced in young people and, therefore, they are the best candidates for resuscitation. The colder the water and the younger the victim, the better chance they have of survival.

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EMERGENCY PROCEDURES WATER RESCUE 1

TIDES
There are 4 tides in 24 hours:

Rip Tides or Currents - occur when the tide is going out.

2 tides are coming in (High)
2 are going out (Low).

Slack tide is 45 minutes between High and Low tides.

To escape a rip current you should swim parallel to the shore line.

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EMERGENCY PROCEDURES WATER RESCUE 1

Sweep Tides

This tide runs parallel to the beach. It is more pronounced on out-going tides. The waves are diagonal to the beach and can sweep swimmers into a rip current.

Rescuer should enter the water upstream of the sweep. This will pull the rescuer towards the victim. Contact with the victim will be difficult if the rescuer takes a straight on approach because they will be swimming against the sweep to get to the victim

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EMERGENCY PROCEDURES, WATER RESCUE 1, ADD. 1
INFLATABLE WATER RESCUE HOSE

To fill the hose using a SCBA or Fast-Pak, members shall disconnect the low pressure hose at the Hansen fitting. Attach air hose to male plug of hose fitting. Inflate the hose until it is completely filled and possesses rigidity similar to charged hose line.

One 45 minute cylinder can fill five lengths of 2 1/2” hose inapproximately 2 minutes and 30 seconds.

To fill the hose using the apparatus air outlet, members shall connect the male plug from hose directly to the air outlet on apparatus. The apparatus air outlet can fill two lengths of hose in approximately 20 seconds

EMERGENCY PROCEDURES, WATER RESCUE 1, ADD. 1
INFLATABLE WATER RESCUE HOSE

Inflatable water rescue hose can be deployed in either a straight line or loop.

Straight line deployment can be used in incidents from a pier or shore involving only a few individuals who are close to shore.

The loop deployment increases buoyancy and can be used for multiple victims.

EMERGENCY PROCEDURES, WATER RESCUE 1, ADD. 1
INFLATABLE WATER RESCUE HOSE

Each length of 2 ½”hose filled with air can keep afloat approximately ___ people.

10 people

EMERGENCY PROCEDURES, WATER RESCUE 2
ICE AND COLD WATER RESCUE

200 Foot Tether Reel

The 200 Foot Tether Reel shall have the small carabineer secured at the end of the tether line using a Figure 8 on a Bight. The large ice rescue carabineer is placed in-line on the tether rope 4 feet from the small carabineer using the Butterfly Knot.

Utility Rope shall be used during drills.

EMERGENCY PROCEDURES, WATER RESCUE 2
ICE AND COLD WATER RESCUE

POSITIONS

Rescue Coordinator – Company Officer assumes this position. (In a 4-Firefighter Engine Company, the Officer will also assume the responsibilities of the Spotter until an additional unit arrives.)
***Officer takes thermal imaging camera at night.

Spotter – Shall be positioned where they can keep sight of the victim. This may include using the apparatus as a vantage point. An aerial or tower ladder may be raised to facilitate spotter positioning

Primary Rescue Team (Team # 1)

Primary Rescuer - Member will don the Cold Water Suit (CWS), establish and maintain communication with the victim and implement rescue procedures. This Is the only member that will approach the victim.

Primary Tether - Member will assist the Primary Rescuer in donning the CWS and attach tether line to the suit’s harness. Feed and control the tether line. Pull rescuer and victim back to safety.

EMERGENCY PROCEDURES, WATER RESCUE 2
ICE AND COLD WATER RESCUE

POSITIONS

Secondary Rescue Team (Team # 2)

Secondary Rescuer - Don the second CWS and be tethered to a second line in the stand-by position. Chart at end states: If necessary:
Advance on ice taking a different route and stay away until needed.

Secondary Tether - Assist the Secondary Rescuer in donning the CWS and ensure the second tether line is attached to the suit harness.

EMERGENCY PROCEDURES, WATER RESCUE 2
ICE AND COLD WATER RESCUE

Generally, there are three methods used for cold water/ice rescue.

Reach

Throw

In the chart at the end it mentions, prior to Reach/Throw/Go: Self rescue: get victim to rescue themselves.

EMERGENCY PROCEDURES, WATER RESCUE 2
ICE AND COLD WATER RESCUE

_____________________is used when a victim is ambulatory and can assist in their own rescue. The rescuer uses a hook, pole or other device extended to the victim. When the victim has gained a hold on the object, rescuers can pull the victim to safety.

The Reach method

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE ____________________is used when the reach method is not feasible. Using a throw rope, the rescuer hurls the rope to the victim. The victim should wrap the rope around their arm to be pulled to safety.

The Throw method

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE ____________________is used for a non-ambulatory victim (unable to assist in their rescue) or is too far from shore. Victims exposed to cold water will have problems with their motor skills and manual dexterity, making them unable to hold a pole or a rope. This should be the last method tried since it is the most dangerous.

The Go method

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE WATER RESCUE PROCEDURES Tether Attached to Rear of Suit Water rescue torpedo is attached to the front of the suit’s harness. Upon reaching an ambulatory victim, the rescuer passes torpedo to victim while keeping a safe distance, if possible. Upon reaching a non-ambulatory victim, the rescuer reaches under the victims armpits and places torpedo on victim’s chest and holds onto the torpedo.

ICE RESCUE PROCEDURES Reach Method Tether Attached to Front of Suit Victim to grab onto hook and to kick their legs as if they were swimming. The rescuer helps pull the victim onto the ice. Throw Method Throw the bag over and past the victim. Have the victim wrap the rope around their arm and hold the rope. Go Method Approach the victim from the side. The Secondary Rescuer should stay off the ice. When needed, the Secondary Rescuer will approach from a different angle, as not to break ice that is already weakened by the Primary Rescuer and victim.

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE Ice Rescue For an ice rescue, the tether is attached by the small carabineer at the end of the rope to the front of the rescuers chest harness. The flotation sling is used to assist an ambulatory victim. The tethered rescuer crawls across ice with rescue sling attached to the large carabineer. STRETCHER PROCEDURES

STRETCHER PROCEDURES Placing a victim in the stretcher requires both rescuers. The victim is brought to the stretcher where both rescuers will maneuver the victim so the victim’s head is loaded into the end of the stretcher with the floatation collar. The victim shall be secured to the stretcher as follows: A. The top strap gets attached under the victim’s armpits, and across chest. B. The middle strap gets attached across the waist of the victim. C. The bottom strap gets attached under one leg and over the other. The stretcher is not intended to be brought out to the victim. It will be more effective to bring the victim to the stretcher. Upon retrieval of the victim, the stretcher can be passed down to the rescuers where the victim will loaded onto stretcher.

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE COMMUNICATIONS One hand placed on top of the rescuer’s head indicates _____________. One arm waving in the air indicates _________________.

the rescuer is ready to be pulled to shore stop pulling

EMERGENCY PROCEDURES, WATER RESCUE 2 ICE AND COLD WATER RESCUE EQUIPMENT CARE AND MAINTENANCE Rinse and air-dry all ropes and suits after each use. All ice and cold water equipment shall be inspected during January, April, July and October. In January and July, the suit should be removed from the carrying bag and hung on a broad shouldered hanger for at least 48 hours to allow moisture inside the suit to dryout, prevent mildew and help extend the service life of the suit. Before repacking the suit into its carrying bag, the zipper should be lubricated. Close the zipper and run a lubricating stick (candle wax) up and down the outside of the zipper. Open and close the zipper 2-3 times. Store the suit with the zipper in the open position.

Repack the suit by laying it on a flat surface with the front of the suit upward. Tuck in the hood/head support, cross the arms over the hood/head support, then roll the suit from the feet upwards. Slip the suit into the carrying bag and close. If the suit should become soiled or contaminated with oil, scrub with a mild soap solution (dish soap), rinse with fresh water and allow drying before repacking. Do not use solvents or dry clean. Some solvents may degrade seams and suit material. Damaged equipment can be sent to Tech Services through normal RT-2 procedures.

EMERGENCY PROCEDURES, WATER RESCUE 3 SURF RESCUE An aerial or tower ladder may be raised to facilitate spotter positioning. Primary Rescuer – The member will don a PFD, fins and be equipped with the torpedo. This will be the first member to approach the victim. Secondary Rescuer - The member will don a PFD and fins. The member will be equipped with the tether line only or a tethered surfboard depending on water conditions.

Primary Rescuer enters the water walking backwards OPERATIONAL CONSIDERATIONS Once it has been confirmed that there is a victim to be rescued, notify the dispatcher and request additional resources. All members entering water are to wear life preservers. If the surf board is used it must be tethered. Members pulling in the tether line are to time the waves when pulling victim and rescuers to shore. The victim should be removed from the waves before beginning medical treatment including spinal immobilization. IF an NYPD helicopter is on-scene, the Incident Commander or their designee shall utilize the TAC “U” channel to communicate directly with the helicopter. Special care should be used to ensure that all members are removed from the area underneath the helicopter due to the danger of the rotor downwash pushing the member underwater.

STEAM SYSTEM EMERGENCIES Concrete slabs typically cover steam vaults with access manholes placed in pairs. Steam pressures in generating plants can be as high as 2,000 psi with temperatures reaching 900ºF. Steam pressures in the buried supply piping and in supplied buildings can be as high as 170 psi and temperatures as high as 350ºF.

When water comes into contact with the outside of a high pressure steam pipe, the water boils and steam is generated. This water may come from a heavy rain or a leaking water main. If enough water contacts the pipe, it can cool the steam inside the pipe, causing it to condense into water. Normally, this water is drained off by a series of drains called “Traps.” If not drained off, a water slug will form which can damage piping in a number of ways. Water slugs can be pushed through the piping by the steam at speeds as high as 200 mph. If this steam slug encounters a bend in the piping, the impact can cause the pipe to rupture, resulting in a release of high pressure steam. Con Edison workers refer to a steam pipe rupture as a High Energy Line Break (HELB).

STEAM SYSTEM EMERGENCIES Tactics Plant: Never enter a Con Edison generating plant without Con Ed personnel. Instead, respond to the designated mustering site outside the plant. Plant personnel will mitigate the emergency. FDNY should only enter the plant to perform search and rescue for missing plant personnel.

Street: Will likely result in an asbestos release that spreads over a large area. A steam main break is a haz-mat incident. > Asbestos has been removed from Con Edison steam manholes but remains on most of the underground piping. > Escaping high pressure steam can hurl debris at 200 mph. Approach an outdoor HELB from upwind and stay clear of the vapor plume. Limit the number of firefighters exposed to probable asbestos contamination. Prepare for decontamination of civilians, firefighters, bunker gear, tools, equipment and vehicles. Consider shutting the HVAC systems of nearby buildings.

STEAM SYSTEM EMERGENCIES Steam Leak in the Street If a vent pipe has a blue stripe on the top of it, this indicates that the steam is the result of a water leak, not a leaking steam main.

Buildings supplied with steam will have a steam control room filled with pipes. There will be a number of valves to control the supply of steam. Do not randomly shut steam valves inside of a supplied building. Shutting the wrong valve can cause damage to the system creating other hazardous conditions. a) In an emergency, members may shut the Inside Service Valve. It will be labeled and sealed. If possible, wait for Con Ed steam personnel to shut the necessary valves. b) Once a steam valve is shut, do not reopen it. The system will have to be drained before reopening the valve. c) Notify Con Edison if a valve is shut. Failure to do so can result in damage to the system and injury to Con Edison personnel working to restore the system. d) There is a building steam shutoff located outside the building. FD members should not attempt to shut this valve. This valve should only be shut by Con Edison steam personnel.

Steam pressures in generating plants can be as high as _____ psi with temperatures reaching _____ degrees F. A: 2,000 psi; 900 degrees F B: 170 psi; 350 degrees F C: 900 psi; 2000 degrees F D: 350 psi; 170 degrees F

A: 2,000 psi; 900 degrees F

For a surf rescue, what is the most correct way the primary rescuer should enter the water? A: The Primary Rescuer enters the water walking backwards and swims out to victim letting torpedo drag behind on the down sweep side. The rescuer should keep the victim in sight. B: The Primary Rescuer enters the water walking forward and swims out to victim letting torpedo drag behind on the down sweep side. The rescuer should keep the victim in sight. C: The Primary Rescuer enters the water walking backwards and swims out to victim keeping the torpedo out in front of him/her. The rescuer should keep the victim in sight. D: The Primary Rescuer enters the water walking forward and swims out to victim keeping the torpedo out in front of him/her. The rescuer should keep the victim in sight.

A: The Primary Rescuer enters the water walking backwards and swims out to victim letting torpedo drag behind on the down sweep side. The rescuer should keep the victim in sight.

During an operation where vehicle disentanglement is required, an experienced officer should know to avoid crushing/cutting areas that might contain live airbags, cylinders and sensors that will activate any safety systems. The cylinders may contain up to _____ of stored gas pressure. A: 10 psi B: 1,500 psi C: 9,500 psi D: 40,000 psi

C: 9,500 psi Explanation: Removing the interior trim inside of a vehicle might help in determining the locations of these devices. EP Disentanglement 14.10

All ice and cold water equipment shall be inspected during January, April, July and October. When should the suit be removed from the carrying bag and hung on a broad shouldered hanger, and for how long? A: In January and July; for at least 48 hours B: In April and October; for at least 48 hours C: In January, April, July, and October; for at least 24 hours D: In January and July; for at least 24 hours

A: In January and July; for at least 48 hours Explanation: This allows moisture inside the suit to dry out, prevent mildew and help extend the service life of the suit. EP Water Rescue 2 9.2

The FDNY has taken a more active roll in water rescue procedures. Which choice below contains incorrect information regarding a surf rescue? A: Once it has been confirmed that there is a victim to be rescued, notify the dispatcher and request additional resources. B: All members entering water are to wear life preservers. If the surf board is used it should be tethered unless an undue delay will occur. C: Members pulling in the tether line are to time the waves when pulling victim and rescuers to shore. D: The victim should be removed from the waves before beginning medical treatment, including spinal immobilization.

Explanation: B) All members entering water are to wear life preservers. If the surf board is used it MUST be tethered. EP Water Rescue 3 4.1-4.4

If a member gets hydraulic fluid from the Hurst Tool in their eyes, the member should flush their eyes with clean water for at least ___ minutes and immediately seek medical attention. A: 10 B: 15 C: 20 D: 5

C: 20 Explanation: Yes....20 minutes. Don't confuse this with other sections of our books! EP Disentanglement 14.14

During the "Go" phase of an ice rescue, the Primary Rescuer should be the only member to approach the victim unless assistance from the Secondary Rescuer is needed. Which choice below reflects appropriate ice rescue procedures? A: The Primary Rescuer should approach the victim from the side. When needed, the Secondary Rescuer will approach from a different angle. B: The Primary Rescuer should approach the victim from the rear. When needed, the Secondary Rescuer will approach from a different angle. C: The Primary Rescuer should approach the victim from the side. When needed, the Secondary Rescuer will approach from the same direction. D: The Primary Rescuer should approach the victim from the rear. When needed, the Secondary Rescuer will approach from the same direction.

A Explanation: The Primary Rescuer should approach the victim from the side. Approaching from the front may cause the already weakened ice to break causing the victim to become aggressive and impede the rescue. The Secondary Rescuer is suited up and ready to assist. The Secondary Rescuer should stay off the ice. When needed, the Secondary Rescuer will approach from a different angle, as not to break ice that is already weakened by the Primary Rescuer and victim. EP Water Rescue 2 6.3.2, 6.3.3