Operations - EMT Exam 6 (LAST ONE LET'S GO)

approaching a vehicle

let firefighters to guide and handle most things

approach from the sides!!

might have to prioritize certain pts and communicate that to the fire

airbags

super super fast, cornstarch and talc are used for the chemical reaction, may see smoke after deloployment

5 in clearance for side airbags

10 in clearance for driver airbags

20 in clearance for passenger airbags

Extrication

removal of an entrapped individual

pt may be able to do themselves

Entrapment

condition in which a person is caught within a closed area with no way out or has a limb or other body part trapped

confinement

doors and other routes of exit blocked, pt is fine

Preparation/Enroute to Scene (accidents)

rescue/extrication gear, get updates from fire/police,

Scene Arrival (accident)

position the ambulance to block the scene from oncoming traffic

1 vehicle angled in front of accident, 2nd vehicle past accident (enters away from traffic)

Examining Vehicle (accident)

note the airbags and steering wheel and check interior

spiderweb crack on windshield

must document!!

Electrical wires

call PECO/PPL

assume power is on until canary proves otherwise

communicate to pts via public announcement/in front of them to stay put

alternative fuels

fuels such as propane, natural gas, methanol, hydrogen

most (40%) - batteries located in trunk

may take 10 minutes to fully deenergize - hybrid (for electricity)

avoid strange odors

Rapid vehicle extrication

quickly removing pt is the environment is threatening or if pt is critical, not in imminent life danger

will have extra gear

at least 4 providers, about a 1

Emergency Extrication

threat to XABCS, yank out as quickly as possible, imminent

structure fires

ambulance and fire dispatched

ask incident commander where the ambulance should be staged, at least 1 block away

allow fire trucks ample room tot he scene and hydrants so you can transport as quickly as possible

CBRNE

Chemical, Biological, Radiological, Nuclear, and high-yield Explosives

vesicants

blister agents, ex. mustard gas, lewisite, phosgene oxime

produce vapors that can impede airway

easily spreadable, DO NOT TOUCH

weird color smoke

burn centers

pulmonary agents

gases

damage lung tissue

pulmonary edema

may displace oxygen in the air

ex. chlorine gas

no antidotes

phosgene

vesicant and pulmonary agent

blistering on skin and respiratory tract

nerve agents

one of the most deadly

cause cardiac arrest, attack autonomic

• organophosphates

organophosphates

found in household bug and agricultural spray

block an essential enzyme in the nervous system

• nerve agent

nerve agent treatment

duo-dote auto-injector (antidote treatment nerve agent auto-injector)

SLUDGEM

Salivation

Lacrimation (tearing)

Urination

Defecation

Gastrointestinal distress

Emesis (vomiting)

DUMBELLS

helps identify the signs and symptoms of a cholinergic crisis

D - Diarrhea / Diaphoresis

U - Urination

M - Miosis (constricted pupils)

B - Bradycardia (slow heart rate) / Bronchospasm

B - Bronchorrhea (excessive mucus in the lungs)

E - Emesis (vomiting)

L - Lacrimation (tearing)

L - Laxity of muscles / Loss of muscle control

S - Salivation / Sweating

metabolic agents

• cyanogen chloride

• hydrogen cyanide

affects body’s ability to use oxygen

dizziness, light-headedness, headache, vomiting

off gassing

exhaling toxic agents (like cyanide)

biologic agents

virus, bacteria, toxins

neurotoxins

plants, marine animals, mold, etc

affects neuro

botulinum toxin

extremely high mortality rate

peripheral then central paralysis

produced by bacteria

affects nervous system

Ricin

mash of the castor bean

types of radiation

alpha - paper

beta - clothing

gamma - penetrates almost everything, most dangerous, X-Ray, nuclear center explosions

neutron - penetrates everything, so small that it’s not very dangerous

primary blast injury

blast wave

secondary blast injury

debris injury

tertiary blast injury

injury from being thrown

quaternary blast injury

burns, inhalation, etc

Incident Command System

standardized terminology

flexible and adaptable

multi-agencies

roles ICS

incident commander

• may have command staff: safety, liaison, public info officers

general staff: logistics, operations, planning, finance and admin

operations branch

branches, divisions/group - strike team (ex.EMS), task force (multiple resources), single resource (you!)

perform operation to meet incident goals

develop tactical assignment and organization

direct all tactical resources

planning section

resources, documentation, situation, demobilization, technical specialists

collect, eval and disseminate information pertaining to the event

logistics section

produce support resources an all other services needed to meet incident objectives

• personnel

• materials

• faciliaties

• services

service and support branches

Finance/Admin Section

monitor cost associated with incident

provide accounting procurement time and recording and cost analysis

Incident Action Pkan

plan of incident goals

• required for each incident

• provides directino

• written

Span of Control

ideal number of resources or individuals ONE person can command

1:5 ideal

1:3 low, 1:7 expand

unified command

multiple agencies involved in an incident

• develop incident objectives

• facilitate info flow

• eliminate redundancy

they are incident command together

area command

oversees multiple incident command posts

• multiple incident sites

• large, complex incidents

Establishing Incident Command

first person on scene becomes incident commander until relieved

command post identified