• Allow SAFE rescue of patients from a variety of predicaments
• Be able to understand and integrate the principles of rescue awareness and operations, thus…
Lecture Objectives:
• Water • Hazardous atmospheres • Motor Vehicles/ Highways • Hazardous terrain
The ‘Common’ Rescue Situations:
• “The act of delivery from danger or imprisonment.” • “To free from confinement or danger.” • “To free from danger or death or destruction by prompt and vigorous action.” • “The safe, efficient, and orderly removal of victim(s) to definitive care.”
EMS Fire Dept. Police Communications Public Works Utilities Media And many more!
Rescue Operations Involve Many Resources:
• Must have a well coordinated effort between medical care and the specialized rescue effort. • The rescue effort must be based on the patient’s needs and details of the situation. • The rescue ‘chain’ is only as strong as the weakest ‘link.’ • SAFETY
It all comes down to TEAMWORK
• • • • • • •
Proper training Proper equipment Master of EMS skills Master of special skills Understand hazards Know when to act Know how to act
EMS role in Rescue Operations
Bystanders?
- You and Your Partner?
- The Patient?
Who comes 1st ??
• • • • • • •
Arrival and Size-up Hazard Control Gain Patient Access Medical Treatment Disentanglement* Patient packaging Transportation
Lets breakdown each phase
• Each phase is as important as the next. • No phase can be skipped or minimized. • Safety is compromised when minimizing and complacency exist!
Phases of a Rescue Operation
• Understand the environment and risks • Establish Command* • Conduct a scene assessment • Determine number of patients and triage • Search, Rescue, or Recovery?
Arrival and Scene Size-up:
• Use the ICS/NIMS as a command/scene control mechanism • Don’t get ‘sucked’ in…avoid tunnel vision!
– Better to have too many…in staging
• Make a risk vs. benefit analysis • Request any needed additional resources
Arrival and Scene size-up con’t
• Control as many of the hazards as possible • Manage, reduce, and minimize the risks from uncontrollable hazards • Make the scene safe • Proper PPE for all !!!
Hazard Control
– Tunnel vision! – Blood and screams! – Children
• Determine the best method • Stabilize the physical location of the patient • Then…approach the patient(s).
Gain Access to the Patient
• Appropriate to the patient’s medical condition and needs. • Is time a factor? • Consider what type equipment you will need prior to ‘committing’ yourself. • ABCs …not band-aids
Provide Medical Treatment
• Release from physical entrapment • Of the many methods, which would best serve the patient’s needs? • Risk vs. Benefit • Specialized equip and skills may be required!
Disentanglement
• Package so as to ensure patient’s medical needs are addressed • Package so as to ensure patient’s safety needs are addressed • Prevents injury to patient and to you!
Patient Packaging
• • • • • • • •
Carrying Assisting Rope raising/lowering Water evacuation Air evacuation Ground transport Air transport Mass Casualties
Transportation
Don’t become a victim of complacency !!
Minimizing any of the phases minimizes YOUR SAFETY
• Different emergencies require different protective equipment • Firefighting turn-out gear often hinders more than helps • Most PPE is not made solely for EMS
• PPE does not always prevent injury and exposure…but usually minimizes the risk of injury/exposure • Always think one step in advance: What PPE may I need if the current situation changes?
Personal Protective Equipment -PPE-
– – – –
Firefighting (NFPA) Climbing Rafting Must meet the safety recommendation for the given application.
• Head: Helmet
Types of PPE
Head Protection
• The face shield on firefighting helmets is usually inadequate. • Approved safety goggles/glasses with side shields work best. • Most medics use clear safety glasses with side shields.
Eye protection
Heat Chemical Sharps Blood and Body fluid Etc
• Must allow for adequate dexterity
– – – – –
• Protection based on type of rescue
Hand Protection
• Ankle Support • Steel toe/shank • Insulation in cold environments • How do Firefighting boots work for ice rescue?
Foot Protection
• Reflective trim should be on all outer-wear. • Orange clothing or safety vests should be used when working in and around vehicular traffic. • Keep Firefighting gear clean !!!
Visibility
These do!
Blue sweatshirts don’t work so well at night in traffic !!!
