Lecture 11: Human Trafficking, Lifting and Moving Patients, Transport Operations, Vehicle Extrication, and Incident Management

Human trafficking is the use of _____, _____, or _____ in exchange for _____, _____, or _____, with the key principle of _____. Traffickers often impose debt, fraudulent job opportunities, promises of a better life or jobs, violence or threats of violence, or psychological coercion. Victims do not need to be moved from one place to another.

Force; fraud; coercion; labor; services; commercial sex

Populations that are vulnerable to human trafficking include victims of _____, _____ people, people that are _____, and people with _____.

Child abuse; homeless; running away; economic hardship

Whenever working with a patient with an abnormal back, make sure to _____.

Pad any voids

Whenever you are lifting a patient, make sure your shoulders are aligned with your _____, lift with your _____, keep weights _____, grab items _____, and use the _____ method appropriate for the situation.

Pelvis; legs; close; palms up; least strenuous

Whenever a move involves directions and commands, moves must be coordinated by _____, consist of a _____ command and _____ command, have enough _____ to safely lift a patient, and place the strongest EMT at the _____.

Single leader; preparatory; lift; rescuers; head

To perform a power lift, _____, grasp the patient with your _____, and lift by _____ with _____.

Spread your legs; arms at your sides; straightening your legs; palms up

The diamond carry is the ideal technique for patients on a backboard or stretcher. This consists of _____ EMTs lifting the device while _____ before _____.

Four; facing the patient; adjusting to face forward

If using the one-handed carry to lift a patient, at least _____ EMTs should face other before using _____ to lift the backboard, _____, and then carrying with one hand.

Two; both hands; turning to face the direction you will walk

If carrying a patient up or down stairs using a backboard or cot, first _____ and always carry them down the stairs with _____ and up the stairs with _____.

Strap the patient to the backboard; feet down; head up

If carrying a patient up or down stairs using a stair chair, make sure to _____, with the rescuer at the _____ giving directions.

Strap the patient to the chair; head

Moves you can use to transfer a patient include _____ and _____.

Direct carry; draw sheet

A non-urgent move you can use to move a patient is the _____.

Extremity lift

Emergency moves should be used when there is _____, you need to _____, or you cannot _____. These moves include _____ drag, _____ drag, _____ drag, and _____ drag.

Potential danger to you or the patient; access another critical patient; properly assess the patient due to the position; blanket; clothes; arm; underarm

One-rescuer drags, carries, and lifts include the _____, _____, _____, and _____.

Front cradle; firefighter’s drag; pack strap; fireman’s carry

Bariatrics refer to the care of _____ patients, where _____ are especially important, there is an increased risk for _____, and a need for _____. Contact dispatch for a _____ and/or _____.

Obese; proper lifting techniques; back injuries; specialized equipment; lift assist; bariatric gurney

Patient-moving equipment includes _____, _____, _____, _____, and _____.

Stretchers; stair chairs; backboards; neonatal isolettes/incubators; Kendrick extrication devices (KEDs)

Kendrick extrication devices (KEDs) are used for _____ when _____ and _____. If these conditions are not met, a _____ should be used instead.

The strapping sequence for a KED can be remembered using the mnemonic “my baby looks hot tonight:” _____, _____, _____, _____, then _____.

Seated spinal immobilization; the scene is safe; the patient is stable; rapid extrication; middle torso; bottom torso; legs; head; top torso

Gurneys (wheeled ambulance stretchers) have _____ and _____ ends, as well as a _____. Whenever loading the gurney into the ambulance, first _____, then _____, then roll the gurney into the ambulance and secure to the ambulance clamps.

Head; foot; lift the end of the cot upward; release the undercarriage lock and lift

Rapid extrication should be used when the vehicle or scene is _____, the patient is too _____, the patient requires _____, the patient cannot _____, or the patient is _____.

Unsafe; unstable for seated spinal immobilization; immediate care; be properly assessed; blocking access to another critical patient

The process of rapid extrication begins with _____, then _____, then _____, then _____, then _____, then _____.

Manual immobilization; applying a cervical collar; rotating the patient; sliding a backboard under their butt; lying the patient down on the board; sliding the patient as a unit to the top of the board

Ambulance licensing and certification standards are established by the _____.

State

The components of a modern ambulance include the _____, _____, _____, and _____.

Driver’s compartment; patient compartment; standard minimum complement of equipment; two-way radio communication

A Type I ambulance has a _____ front and _____ back. A Type II ambulance has a _____ front and _____ back. A Type III ambulance has a _____ front and _____ back.

Truck; box; van; van; van; box

The preparation phase of ambulance call involves preparing equipment and supplies, which involves ensuring you have the _____, _____ equipment, a _____ for the _____, and equipment for _____. Items for life-threatening conditions are typically found _____, and all cabinets and drawers should be _____ or _____.

Standard minimum complement of equipment; personal protective; jump kit; first 5 minutes of patient care; work areas; at the head of the gurney; transparent or labeled

During the dispatch phase, the minimum information the dispatcher must gather is the _____ of the call, the _____, _____, and _____ of the reporter, the _____ of the patient, the _____ of patients and _____, and other pertinent information.

Nature; name; location; call-back number; location; number; severity of conditions

The _____ phase of an ambulance call is the most dangerous phase for EMTs. This phase involves confirming your _____ and the _____, and preparing for arrival by _____.

En-route; response; location; deciding what equipment to take

During the arrival phase, begin with _____ and _____. Make sure to _____ safely away from _____, _____, and _____. If at a safe crash scene, you should _____ and _____.

Confirming arrival; assessing scene safety; park; hazards; traffic; other units; park at least 100’ away; use a warning device on both sides of the accident

The transfer phase of an ambulance call involves _____ and _____.

Providing lifesaving treatment; preparing the patient for transport

The transport phase of an ambulance call involves _____, reporting the _____, _____, and _____, and performing _____.

Confirming your departure; number of patients; nature of their problem(s); receiving hospitals; ongoing assessments

The delivery phase of an ambulance call involves _____, _____, and _____.

Confirming arrival at the hospital; giving a verbal report to staff and transferring care; completing a written report and leaving a copy

The return phase of an ambulance call involves _____, _____, and _____.

Notifying dispatch when you are back in service; cleaning the ambulance and equipment; restocking supplies

The post-run phase of an ambulance call involves informing dispatch of your _____, _____, and _____, and completing your _____. After every call, make sure to _____ and place into a _____, discard _____, and clean the _____.

Status; location; availability; PCR; strip linens; biohazard bag; medical waste; stretcher

Whenever driving an ambulance, make sure to get to know your vehicle, wear your seatbelt, anticipate the actions of other drivers and pedestrians, and keep a good _____ by maintaining a _____, watching for _____, being aware of _____, and using a spotter whenever _____. Do not speed, as this results in decreased _____ and increased _____ and _____. _____ are the most common place for collisions.

Cushion of safety; safe following distance; tailgaters; blind spots; backing up; reaction time; stopping time; stopping distance; intersections

Decrease your speed and increase your following distance in poor conditions, as potential hazards include _____, _____, and _____.

Hydroplaning; ice/slippery surfaces; decreased visibility

To use your warning lights and sirens, you must be on an _____, use _____, and have a _____ (meaning that lights and sirens are a request, not guarantee, that other people yield the right of way).

Emergency call; both simultaneously; due regard for public safety

Medical evacuation (medivac) helicopters are used when _____ would take too long, _____, _____, or _____ conditions prohibit the use of ground transport, the patient requires _____, or when _____ will overwhelm resources at the hospital accessible by ground transport.

Ground transport; road; traffic; environmental; advanced care; multiple patients

People who receive a medivac include patients with _____, such as stroke, heart attack, spinal cord injury, scuba accidents, near-drownings, skiing and other wilderness accidents, major trauma, and candidates for a limb transplant, burn center, or pediatric trauma center.

Time-sensitive injuries or illnesses

To establish a landing zone, find a _____ or _____ _____ surface at least _____ big, then _____.

Hard; grassy; level; 100’ x 100’; mark the area with cones or highlights

When working with a helicopter, never _____, nor _____.

Approach a helicopter unless directed; approach the helicopter from the rear

Entrapment refers to _____, while extrication refers to _____.

Being caught within a closed area; removal from entrapment or dangerous situation/position

Vehicle safety systems include _____ and _____, which may _____.

Shock-absorbing bumpers; airbags; deploy suddenly during extrication

The arrival phase of an extrication call consists of scene size-up, which refers to _____; situational awareness, which refers to _____; and a walk-around, which involves _____.

Ongoing process of information gathering and scene evaluation; ability to recognize possible issues and act proactively; doing a 360º scan for MOI and possible hazards

Hazard control in an extrication call is typically handled by law enforcement, firefighters, and the rescue team. Never attempt to _____; instruct patients to _____ and make sure you _____.

Move a downed power line; stay in the car until power is turned off; stay in the safe zone at least 500’ away

As an EMT, your role in an extrication call is generally limited to _____, _____, _____, and _____.

Gaining access to the patient; providing emergency care; disentanglement; removal and transfer

Simple access refers to _____. Complex access refers to _____. Rapid access/extrication refers to _____.

Access without the use of tools or force; access requires the use of tools or force; access when the patient is unstable or the scene is unsafe

Providing emergency care during an extrication call involves _____, _____, _____, _____, and _____.

Manually immobilizing the C-spine; maintaining the airway; providing high-flow oxygen; controlling significant bleeding; treating all critical injuries

Disentanglement during an extrication call involves _____.

Removing the vehicle from around the patient

Removal and transfer during an extrication call involves _____, _____, and _____.

Determining the urgency of the move; reassessment; moving the patient as a unit

Multi-casualty incidents refer to _____.

More than one patient

Mass-casualty incidents refer to _____.

3 or more patients involved

The _____ is a consistent nationwide template enabling federal, state, and local governments to work together, leading to improved coordination and cooperation. The organizational structure of each government must be flexible enough to be rapidly adapted.

National Incident Management System (NIMS)

The purpose of the Incident Command System (ICS) is to ensure _____, achieve incident management goals, ensure _____, control _____, and limit the _____.

Responder and public safety; efficient use of resources; duplication of effort and freelancing; span of control

The _____ has overall responsibility for the scene of an MCI, meaning they control, direct, and coordinate resources.

Incident commander

The _____ is the second in command during an MCI.

Safety officer

During an MCI, EMTs will typically be stationed at a _____. Do not _____.

Staging area; deviate from the orders given by the incident commander

Communications during an MCI should be integrated. If possible, use _____ to limit radio traffic. If you communicate via radio, do not _____.

Face-to-face communication; codes or signals

Triage refers to _____. In general, patients in _____ receive the highest priority, while patients in _____ receive the lowest priority.

Determining treatment based on priority/severity; decompensating shock; cardiac arrest

Patients with a minor/green triage tag are _____.

Ambulatory with minor injuries requiring only first aid

Patients with a delayed/yellow triage tag are _____; they can be thought to be in _____.

Not immediate but will require a gurney; compensating shock

Patients with an immediate/red triage tag have severe respiratory, circulatory, or neurological symptom such as _____, _____, _____, or _____, and require rapid assessment and treatment for survival. They can be thought to be in _____.

ALOC; absent radial pulse; delayed capillary refill; respirations greater than 30 breaths/min; decompensating shock

Patients with a morgue/black triage tag have _____; they can be thought to be in _____.

No spontaneous breathing after positioning the airway; terminal shock

When triaging a patient, you generally check _____, _____, and _____ in that order.

Respirations; perfusion; mental status

You begin triage on a patient by assessing respirations. If you see that the patient is not breathing, first _____. If the patient responds, tag them _____. If the patient does not respond, tag them _____. If the patient is breathing, anything over 30 breaths/min per should be tagged _____ and anything under 30 breaths/min can proceed into the next part of the assessment.

Position the airway; immediate; decreased; immediate

During triage, if you find that your patient is breathing under 30 breaths/min, assess their perfusion next by checking _____ and/or _____. If either of these is poor or absent, _____ before tagging them _____. If both are sufficient, continue to the next part of the assessment.

Radial pulse; capillary refill; control bleeding; immediate

During triage, if you find that the patient has a radial pulse, assess their mental status next. If they cannot follow simple commands, tag them _____. If they can follow simple commands, tag them _____.

Immediate; delayed

In pediatric patients, an alternative triage system known as _____ is used instead of the general triage framework for adults. Always begin by assessing the need for _____.

Jump START; decontamination

After assessing the need for decontamination in a pediatric patient, determine if they are _____ vs. _____.

Ambulatory; non-ambulatory

A pediatric patient that is ambulatory should be tagged _____, while a pediatric patient that is non-ambulatory should receive further assessment.

Minor

After assessing the ambulation of a pediatric patient, assess their _____.

Respirations

When assessing the respirations of a pediatric patient, if the patient is not breathing, first _____. If the patient responds, tag them _____. If the patient does not respond, assess a _____. If none is present, tag them _____. If it is present, provide _____ before tagging them _____.

Position the airway; immediate; peripheral pulse; deceased; 15 seconds of ventilations; immediate

When assessing the respirations of a pediatric patient, if the patient is breathing, first assess if they are normal vs. not normal. If the respirations are not normal, tag them _____. If the respirations are normal, continue with the assessment.

Immediate

If a pediatric patient presents with normal respirations, assess _____ next by checking for a _____. If none is present, tag them _____. If it is present, continue with the assessment.

Perfusion; radial pulse; immediate

If a pediatric patient presents with a radial pulse, assess mental status next. If they are unable to follow simple commands, tag them _____. If they are able to follow simple commands, tag them _____.

Immediate; delayed

Hazardous materials can be _____, _____, and _____.

Colorless; odorless; tasteless

When dealing with hazardous materials, always make sure you are _____, _____, and _____.

Upwind; uphill; upstream

Indications of a possible hazmat incident include _____ and _____.

Visible cloud or smoke; leaks or spills from tanks, containers, truckers, or railroad cars

The decontamination area of a hazardous material call refers to the area after _____ but before _____. The hazmat team will typically _____ after being decontaminated.

Extrication; triage; bring patients to you

During a hazardous material call, _____ represents the highest level of chemical protection and consists of a _____.

Level A; fully-encapsulated suit

Class 1 hazardous materials are _____.

Explosive

Class 2 hazardous materials are _____.

Non-flammable gases

Class 3 hazardous materials are _____.

Flammable liquids

Class 4 hazardous materials are _____.

Flammable solids

The 4-digit number on a placard specifies _____.

Individual hazardous materials