Chapter 26 Terms and Objectives

Cold Zone

The safe area at a hazardous materials incident where normal triage, assessment, treatment, and transport occur. Personnel must remove contaminated gear before entering.

Complex Access

Gaining access to a patient using specialized tools and equipment, usually performed by trained rescue personnel.

Due Regard

The legal and ethical responsibility to operate an emergency vehicle with careful consideration for the safety of all people on the roadway.

Extrication

The process of safely removing a patient who is trapped or entangled in a vehicle, building, or other environment.

Hazardous Materials (Hazmat)

Substances that pose a risk to health, safety, property, or the environment because of their chemical, biological, or physical properties.

Hazardous Materials: Emergency Response Guidebook (ERG)

A reference guide used by emergency responders to identify hazardous materials and determine isolation distances, protective actions, and initial response procedures.

HAZWOPER

Hazardous Waste Operations and Emergency Response; OSHA standards that establish training requirements and procedures for hazardous materials responders.

Hot Zone

The contaminated area immediately surrounding a hazardous materials incident where only properly trained personnel wearing appropriate PPE may enter.

Placard

A diamond-shaped warning sign placed on vehicles or containers that identifies the type of hazardous material being transported.

Simple Access

Gaining access to a patient without specialized tools, such as opening an unlocked door or entering through an open window.

Warm Zone

The area surrounding the hot zone where decontamination procedures and limited emergency care occur while preventing contamination from spreading.

26.2 Describe the common equipment necessary to appropriately respond to an emergency

Medical supplies, nonmedical supplies, PPE, communication devices, emergency vehicles, warning devices, and properly trained personnel are necessary for an effective emergency response.

26.3 Explain the importance of keeping all equipment serviceable and ready at all times

Ready and functional equipment ensures rapid response, protects patients and responders, and prevents delays during emergencies.

26.4 Describe the phases of an emergency call

The six phases are preparation, dispatch, en route to the scene, arrival at the scene, transfer of care, and post-call preparation.

26.5 Explain the appropriate use of lights and sirens when responding to or from an emergency scene

Emergency lights are used during responses, while sirens are used when necessary to alert traffic. Both must be used according to local policies and with safety as the priority.

26.6 Explain the concept of due regard when responding in an emergency vehicle

Due regard means operating an emergency vehicle with reasonable care and concern for the safety of patients, responders, and the public.

26.7 Describe common devices used at the scene of an emergency to keep personnel and the scene safe

Common devices include traffic cones, flares, flashing warning lights, emergency flashers, and high-visibility safety vests.

26.8 Explain the role of the Emergency Medical Responder during extrication operations

The EMR maintains scene safety, provides patient care, communicates with rescue personnel, and assists with patient removal when appropriate.

26.9 Describe common hazards during vehicle extrication operations

Hazards include moving traffic, unstable vehicles, fuel leaks, fires, undeployed airbags, broken glass, sharp metal, power lines, and hazardous materials.

26.10 Differentiate various methods for gaining access to an entrapped patient

Access methods include opening doors, using windows, unlocking mechanisms with simple tools, breaking side or rear windows, or using specialized rescue equipment.

26.11 Differentiate simple versus complex access as it pertains to patient extrication

Simple access uses normal entry points without specialized tools, while complex access requires specialized equipment and trained rescue personnel.

26.12 Discuss strategies for safely gaining entry into buildings

Use the least destructive method possible, try open doors or windows first, look for keys, request additional resources, and avoid entering unsafe structures without proper training.

26.13 Discuss strategies for safely managing a scene where fire is present

Never enter burning or smoke-filled buildings without training, wear proper PPE, work with a team, avoid elevators, check doors for heat, and stay low if exposed to smoke.

26.14 Discuss strategies for safely managing a scene where there may be evidence of a natural gas leak

Evacuate patients and bystanders, notify dispatch, request gas shutoff, and never operate electrical switches or appliances that could create sparks.

26.15 Discuss strategies for safely managing a scene where high-voltage electricity may be present

Assume all power lines are energized, stay at least one utility pole away, request power shutoff, and instruct occupants to remain inside vehicles until the scene is safe.

26.16 Explain the role of the Emergency Medical Responder at a hazardous materials incident

The EMR recognizes hazards, notifies appropriate agencies, isolates the area, protects bystanders, and avoids entering contaminated zones without proper training.

26.17 Describe the common signs of a potential hazardous materials incident

Signs include placards, leaking containers, unusual odors, vapor clouds, dead vegetation or animals, multiple sick patients, and unusual colors or sounds.

26.18 Differentiate the purpose of the cold, warm, and hot zones at a hazardous materials incident

The hot zone contains the hazard and contamination, the warm zone is used for decontamination and contamination control, and the cold zone is the safe area for treatment and transport.

Risk vs. Benefit Analysis

Responders should determine whether the potential benefits of an action outweigh the risks before acting.

Personal Safety Priority

The responder's first responsibility is ensuring the safety of themselves and their crew before providing patient care.

Five Levels of Hazmat Training

First Responder Awareness, First Responder Operational, Hazardous Materials Technician, Hazardous Materials Specialist, and Incident Commander.

Fire Safety Rules for EMRs

Never work alone, never enter smoke-filled structures without training, never use elevators during fires, and always follow SOPs.

Natural Gas Safety Rule

Never turn electrical devices, switches, or appliances on or off when natural gas is suspected because sparks may cause an explosion.

Electrical Wire Safety Rule

Never assume power lines are de-energized; keep victims inside vehicles until utility personnel confirm the area is safe.

Vehicle Stabilization Principles

Ensure vehicles are in park with the ignition off and stabilized using cribbing, wheel chocks, ropes, or other stabilization methods before approaching patients.

Window Access Procedure

Choose a window away from the patient, wear PPE, apply tape if possible, use a spring-loaded center punch, and safely remove remaining glass.

Post-Call Preparation

Clean and disinfect equipment, restock supplies, refuel vehicles, complete documentation, participate in debriefings, and notify dispatch that the unit is back in service.