WestCoast EMT Chapter 39 Flashcards

Extrication/Disentanglement

The removal from entrapment or a dangerous situation or position.

Entrapment

A person is caught within a closed area with no way out or has a limb or other body part trapped.

Ten Phases of Extrication

Preparation, En Route to Scene, Arrival and Scene Size-Up, Hazard Control, Support Operations, Gaining Access, Emergency Care, Removal of the patient, Transfer of the patient, Termination.

EMS personnel are responsible for:

Assessing and providing medical care, triaging and providing medical care, providing additional assessment/car once patients are removed, transport to the ED.

The rescue team is responsible for:

Securing/stabilizing the vehicle, providing safe entrance and access to patients, extricating any patients.

Law enforcement is responsible for:

Controlling traffic, maintaining order at the scene, establishing/maintaining a perimeter.

Firefighters are responsible for:

Extinguishing fire/preventing ignition, ensuring scene safety, removing spilled fuel.

Arrival and Scene Size-Up

Position ambulance to block scene/put back of ambulance toward scene. The main objective of traffic control at the scene of a motor vehicle crash is to: warn oncoming traffic and prevent another crash. The scene size-up at a motor vehicle crash or other incident is an ongoing process until the incident is terminated.

Situational Awareness

MOST accurately defined as the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.

Scene Size-up

Survey the area for hazards at arrival (360 look around and PENMAN). Evaluate need for additional resources and hazards.

Coordinate youe efforts with:

Rescue teams and law enforcement. May enter vehicle when approved by incident commander.

Alternative Fuel Vehicles

Rescue personnel must disconnect the battery to prevent further damage. Hybrid vehicles may take up to 10 minutes for a high voltage system to de-energize.

Support Operations

Fire and rescue personnel will work on these functions. Lighting the scene, establishing equipment and staging areas, helicopter landing zones.

Gaining Access

Ensure vehicle is stable and hazards are eliminated or controlled. During the access and extrication phases, make sure the patient remains safe.

Simple Access

Trying to get to the patient as quickly and simply as possible without using any tools or breaking any glass (open doors, roll down windows).

Complex Access

Requires special tools.

Emergency Care

Perform a primary assessment (ABC’s) and provide care before further extrication.

Transfer of the Patient

Perform complete primary assessment and critical interventions. Ensure spine is stabilized while moving in slow, controlled steps.

Termination

Returning the emergency units back to service (clean, restocking, reports).

Search and Rescue

Ambulance usually summoned to the command post when a person is lost. Once the missing person is found, you will be guided by search personnel to the location where you can begin treatment (may need to relocate ambulance).

Trench Rescue

Cave-ins and trench collapses usually involve large areas of falling dirt that weigh approximately 100lbs per cubic foot. Park response vehicles at least 500 feet from the scene to prevent risk of secondary collapse from vibrations.

Tactical Emergency Medical Support

SWAT may secure scene and provide initial care. Report to incident commander and turn off lights and sirens.

FAILURE- Reasons for Rescue Failure

Failure to understand the environment or underestimating it. Additional medical problems not considered. Inadequate rescue skills. Lack of teamwork or experience. Underestimating the logistics of the incident. Rescue vs recovery mode not considered. Equipment not mastered.