WestCoast EMT Chapter 40 Flashcards

Mass Casualty Incident

Any call that involves three or more patients, or any situation that places such a great demand on available equipment or personnel that the system would require a mutual aid response.

Goals of ICS

Make best use of resources to manage environment and treat patients, control freelancing, limit the span of control.

Command

Incident commander (IC) is the person in charge of the overall incident. Large incidents require a multiagency or multijurisdictional response and need to use a unified command system.

Finance

Responsible for documenting all expenditures at an incident for reimbursement.

Logistics

Responsible for communications equipment, facilities, food and water, fuel, lighting, and medical equipment/supplies for patients and emergency responders.

Operations

At a very large or complex incident, the operations section is responsible for managing the tactical operations usually handled by the IC.

Planning

This section solves problems as they arise. Another function is to develop an incident action plan, which is the central tool for planning during a response to a disaster emergency.

Safety Officer

Monitors the scene for conditions or operations that may present a hazard to responders and patients (can stop operations).

Public Information Officer (PIO)

Provides the media with clear and understandable information.

Liaison Officer

Relays information and concerns among command, the general staff, and other agencies.

If the incident command system is already established at the scene of a terrorist attack,…

EMT should locate the medical staging officer to obtain his or her assignment.

Accountability

Keeping your supervisor advised of your location, actions, and completed tasks.

Preparedness

Decisions made and basic planning done before an incident occurs.

Establishing Command

Command should be established early and by the most senior official, notification to other responders should go out, and necessary resources should be requested.

Medical Incident Command

The medical branch of the ICS. Medical branch director will supervise the primary roles of triage, treatment, and transport of injured people.

Triage Supervisor

In charge of counting and prioritizing patients. Ensures every patient receives initial assessment of his or her condition.

Treatment Supervisor

Locate and set up the treatment area with a tier for each priority of patient. Ensure that secondary triage of patients is performed and that adequate patient care is given as resources allow.

Transportation Supervisor

Coordinates the transportation and distribution of patients to appropriate receiving hospitals.

Staging Supervisor

Assigned when an MCI or disaster requires a multivehicle/multiagency response. Ensures emergency vehicles have permission to enter the scene and only drive in the directed area.

Morgue Supervisor

Work with area medical examiners, coroners, disaster mortuary assistance teams, and law enforcement agencies to coordinate removal of the bodies and body parts. Should attempt to leave the dead victims in the location found, if possible, until a removal and storage plan can be determined.

Triage (In order to do good for most people..)

Triage assessment is brief and the patient condition categories are basic.

START Triage

Simple Triage and Rapid Treatment. First step is to call out to patients and direct them to an easily identifiable landmark (green). Assess respiratory status, if the patient is not breathing open airway, if still not breathing they are assigned black. If they are breathing, look for faster than 30 or less than 10 breaths per minute. Assign these a red tag. Check for bilateral radial pulse, if you don't feel one the patient is hypotensive and going into shock (assigned red). If there is a radial pulse, the last step is to assess their ability to follow simple commands. If unconscious or cannot follow commands, they are assigned a red tag.

JumpSTART Triage for Pediatrics

Anyone below 8 years of age or fewer than 100 pounds. Infants or children not developed enough to walk should be taken as soon as possible to the treatment sector for immediate secondary triage.

First, assess if the child is breathing. If not, reposition and assess breathing (red if breathing). If not breathing, check the pulse. If there is no pulse, label as black. If no breathing but a pulse, provide 5 rescue breaths. If the patient still is not breathing, assign black tag. If they do assign a red tag.

Look at the respiratory rate between 15 and 45. If not within this range, assign a red tag. Then assess any pulse. If the pediatric patient has no palpable pulse, assign a red tag. Then we do an AVPU test: unresponsive or responds to pain by posturing, assign red. If responds by withdrawing, yellow tag.

Destination Decisions

All patients triaged as immediate (red) or delayed (yellow) should be transported by ground or air ambulance. Immediate-priority patients should be transported two at a time.

Placards

Diamond-shaped indicators that are placed on all four sides of highway transport vehicles, railroad tank cars, and other forms of transportation carrying hazardous materials.

Labels

Smaller versions of placards, placed on the four sides of individual boxes and smaller packages being transported.

Some chemicals are so hazardous that shipping any amount requires the use of labels or placards:

Explosives, Poison gases, Water-reactive solids, High-level radioactive substances.

If any signs suggest that a HazMat incident has occurred:

Stop at a safe distance and park upwind or uphill. Call for the HazMat team, do not reenter the scene or allow bystanders to. Establish control zones.

Hot Zone

The area immediately surrounding the release, which is also the most contaminated area.

Warm Zone

Where personnel and equipment transition into and out of the hot zone and its also the decontamination area.

Cold Zone

A safe area where personnel do not need to wear any special protective clothing for safe operation.

Role of the EMT

Report to designated area in cold zone and provide: Triage, Treatment, Transport, Rehabilitation.

Toxicity Levels

Measures health risk that a substance poses to someone who comes into contact with it:

Level 0: Includes materials that would cause little, if any, health hazard if you came into contact with them.

Level 1: Includes materials that would cause irritation on contact but only mild residual injury, even without treatment.

Level 2: Includes materials that could cause temporary damage or residual injury unless prompt medical treatment is provided.

Level 3: Includes materials that are extremely hazardous to health.

Level 4: Includes material that are so hazardous that minimal contact will cause death.

PPE Levels

Indicate amount/type of PPE to prevent injury from a substance:

Level A: Fully encapsulated, chemical-resistant protective clothing that provides full body protection, as well as SCBA and special, sealed equipment.

Level B: Nonencapsulated protective clothing or clothing that is designed to protect against a particular hazard.

Level C: Use of nonpermeable clothing and eye protection, face masks that filter all inhaled outside air.

Level D: Requires a work uniform, such as coveralls, that affords minimal protection.

All reuqire use of gloves.