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Chapter 48, Part 3 Rescue Awareness & Operations

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Introduction Rescue is the “act of delivering from danger or ____________________________________ .” In EMS, rescue means extricating and/or ____________________________________ the victims who will become your patients.

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Role of the Paramedic • The role of EMS in rescue ____________________________________ from area to area. • Some areas may require training beyond the ____________________________________ level. • In general, all Paramedics should have the proper training and personal protective equipment (____________) to allow them access to the patient, to provide assessment, and establish incident ____________________________________ .

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Rescue • Rescue is a dangerous activity • ____________________________________ is the number 1 priority -Rescuer and ____________________________________ • Use of proper personal protective equipment is critical for your and your ____________________________________ protection

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Patient Protection • • • •

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Rescue Operations • • • • • • •

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____________________________________ protection ____________________________________ and respiratory protection Protective ____________________________________ Protective shielding

Phase One—____________________________________ and size-up Phase Two—____________________________________ control Phase Three—Patient ____________________________________ Phase Four—____________________________________ treatment Phase Five—____________________________________ Phase Six — Patient ____________________________________ Phase Seven —Removal/ ____________________________________

Phase 1: Arrival and Size Up • Park unit is an appropriate location • Safety is first concern – LOOK for dangers • Analyze all potential ____________________________________ • Be prepared to ____________________________________ off • Evaluate MOI

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Phase 2: Hazard Control

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• On-scene hazards must be identified with ____________________________________ and clarity. • A sampling of dangerous conditions you may encounter: - Poisonous/Flammable substances - ____________________________________ agents - Swift-moving ____________________________________ - Extreme ____________________________________ - Dangerous ____________________________________ 9

Phase 3: Patient Access • Gaining access to your patient may be ____________________________________ • Don’t allow anyone to talk you into doing anything that you are not ____________________________________ to do. • Don’t attempt without proper training and equipment

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Example of Patient Access

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Phase 4: Treatment • • • •

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ABC’s ____________________________________ and treat appropriately Begin treatment before ____________________________________ if necessary Be aware of special injuries - ____________________________________ - ____________________________________ Syndrome -Entrapments

Goals of Rescue Assessment • Identify and care for existing problems. • Anticipate ____________________________________ patient conditions and determine in advance the assistance and equipment needed.

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In responding to rescues, you must be prepared to “shift gears” mentally to an ____________________________________ -care situation.

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Phase 5: Disentanglement • • • •

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The actual release from the cause of the entrapment You must develop a ____________________________________ Be prepared to change plans Sometimes it is better to remove ____________________________________ injured patients to give better access to the more serious injured

Phase 6: Packaging • Procedures will vary with ____________________________________ • Must be ____________________________________ • Some rescues may require specialized equipment for packaging and removal: – ____________________________________ basket – Lifts or ____________________________________

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– ____________________________________ space equipment 16

Phase 7: Removal/Transport • • • •

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Selection of appropriate ____________________________________ is crucial Do not overload any one facility Notify hospitals ____________________________________ in operation Consider ____________________________________ transport as needed

Surface Water Rescues • Water rescues may involve many kinds of water bodies—pools, rivers, streams, lakes, canals, flooded gravel pits, or even the ocean. • It is imperative that paramedics participating in water rescues are ____________________________________ and equipped properly. -Always use personal flotation device

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The Basic Water Rescue Model Is: REACH ____________________________________ ROW ____________________________________

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Moving Water • By far the most dangerous water rescues involve water that is ____________________________________ . • Competency at handling the power and dynamics of ____________________________________ -water rescues comes only with extensive training and experience.

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The movement of currents can create a “drowning ____________________________________ .”

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Currents can force a person up against a “____________________________________ .”

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Water Rescue With Possible Spinal Injuries • Consider in all diving injuries or water rescues with unknown ____________________________________ • Immobilize in ____________________________________ • Begin ____________________________________ in water if necessary

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Immobilization in Water

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Where People Drown Salt Water: 1-2% Fresh Water: 98-99% • Swimming pools: – ____________________________________ : 50% – Private:3% • Lakes, rivers, streams, storm drains: 20% • ____________________________________ : 15%

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Factors Affecting Survival • • • • • •

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Buckets of water: 4% Fish ponds or tanks: 4% ____________________________________ : 4% Washing machines: 1% Age ____________________________________ in water Lung ____________________________________ Water temperature Use of ____________________________________ Mammalian diving reflex

Mammalian Reflex • Stimulation of the ____________________________________ system in water less than 68 degrees F. • Heart rate decreases • ____________________________________ occurs and BP drops • Blood is shunted to ____________________________________ organs • ____________________________________ the opportunity for rescue and resuscitation

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Hazardous Atmosphere Rescues • Confined-space rescues present any number of potentially fatal threats, but one of the most serious is an ____________________________________ -deficient environment. • ___________% of all fatalities associated with confined spaces are people attempting to rescue a victim!

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Confined-Space Hazards • • • • • •

Oxygen-deficient atmospheres Toxic or explosive ____________________________________ Engulfment Machinery entrapment ____________________________________ ____________________________________ concerns

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Look For ____________________________________ Signs.

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Treat a ____________________________________ for what it is—a dangerous confined space.

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Confined spaces, such as ____________________________________ vaults, may be hazardous.

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Entering confined spaces, such as silos, requires ____________________________________ , equipment, and experience.

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Highway Operations & Vehicle Rescues

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Traffic Hazards: • Staging • ____________________________________ of apparatus • Emergency ____________________________________ • Redirection of traffic • High ____________________________________ Other Hazards: • Fire and ____________________________________ • Alt. fuel systems • Sharp objects • Air ____________________________________ • ____________________________________ cargoes • ____________________________________ vehicles

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Danger Zone From Downed Electrical Wires

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Rescue Strategies • • • • •

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Initial scene size-up. Control ____________________________________ . Assess the degree of entrapment. Establish circles of operation. Treatment, ____________________________________ , removal.

Hazardous-Terrain Rescues Activities such as mountain climbing, rock climbing, cross-country skiing, snowboarding, and hiking have drawn more people into ____________________________________ areas.

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3 Types of Hazardous Terrain • ____________________________________ slope or low-angle terrain • ____________________________________ or high-angle terrain • ____________________________________ terrain with obstructions

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____________________________________ -angle rescue is dangerous and difficult.

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____________________________________ -angle situations are not as difficult and are often used for training.

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A ____________________________________ stretcher is often used to carry patients over rough terrain.

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Ladders or other ____________________________________ apparatus should NOT be used as a crane to move a litter unless it is designed to do so.

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Use of Helicopters • Helicopters can be useful in hazardous-terrain rescues. • You must understand the ____________________________________ of helicopters along with their advantages and disadvantages.

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Extended Care Assessment Used in situations where transport is ____________________________________ significantly In such cases, consider protocols addressing the following areas: • Long-term ____________________________________ management • Repositioning of ____________________________________ • Cleansing and care of wounds • Removal of ____________________________________ objects

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Good ____________________________________ skills are mandatory in hazardous terrains, but limit ALS skills to those that are really needed. Do not complicate any already complicated operation.

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Summary • • • •

No 2 rescues will ever be exactly alike You must look at “the big ____________________________________ ” Don’t get ____________________________________ vision Develop and inform all concerned of a ____________________________________ of action • Adapt plan as needed • ____________________________________, Safety, Safety • NEVER attempt anything that you are not trained to do and then only with proper PPE

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