Emergency Medical Response Team Notes

Overview of Emergency Medical Response Team

• Operate at Garcia Newgard Memorial Hospital (GNMH).
• Respond to accidents, natural disasters, and health emergencies in remote areas.
• Mission: Provide medical care where access to services is limited.

Career Roles in Emergency Response Teams

• Field Roles:

  • Paramedics
  • Emergency Medical Technicians (EMTs)
  • Disaster Response Technicians
  • Emergency Medicine Physicians

• Facility Roles:

  • Emergency Medicine Nurse Practitioners
  • Emergency Services Coordinators
  • Triage Nurses
  • Emergency Communication Specialists

• Note: Not all emergency medicine physicians work in the field; some nurse practitioners may work in the field.

Emergency Call and Scene Assessment

• Scenario: Arriving at a remote area with an approaching storm and a severely injured individual.
• Scene Size-Up Process:
  1. Control the Situation:
  • Stay calm, ensure safety of everyone present.
  1. Identify Hazards:
  • Determine potential dangers for the team, patient, and bystanders.
  1. Assess the Situation:
  • Gather information through observation and questions.
  1. Protect & Prioritize:
  • Use personal protective equipment (PPE) and prioritize care for the most critical patients.

Importance of Sensory Assessment

• Use senses:
  • Hearing: Listen for unusual sounds (e.g., approaching vehicles, collapsing structures).
  • Smelling: Detect hazardous odors (e.g., smoke, chemicals).
  • Visual Indicators: Observe environmental cues (e.g., animal movements, potential fall hazards).

Patient Assessment

• Approach Patient: Keep scanning for dangers.
• Primary Assessment Steps:
  1. General Impression: What has happened? Severity of the condition?
  2. Mechanism of Injury (MOI): Identify cause of trauma.
  3. Responsiveness: Is the patient alert, in pain, or unresponsive?
  4. Spine Stabilization: If spinal injury is suspected, immobilize to prevent further injury.
  5. Check ABCs:
  • Airway (A): Check for blockages.
  • Breathing (B): Assess quality of breaths.
  • Circulation (C): Monitor pulse, check for bleeding.

Patient Description & Condition

• Injuries observed:
  • Bleeding from upper arm and right knee, bruising, possible allergies.
  • Medical alert bracelet indicates allergies to tree nuts, bee stings, and latex.

Stabilization of Spine

• Critical to prevent additional injuries, especially cervical fractures.
• Cervical Fractures: Can cause severe implications, including paralysis or death.

Airway Management

• For non-spinal neck/head injuries, use the head tilt-chin lift maneuver to open the airway:
  1. Position near the patient's head.
  2. Press forehead down and lift chin forward.
• Patient assessment reveals noisy wheezing; initiate breathing support with a bag valve mask resuscitator.

Circulation Assessment

• Check pulse:
  • Health Findings:
  • Weak pulse at 106 beats per minute.
  • Pale, cool, moist skin.
  • Control bleeding: prioritize life-threatening injuries.

Secondary Assessment During Transport

• Steps:
  1. Rapid Physical Exam: Check head-to-toe for injuries.
  2. Vital Signs Measurement: Record pulse, blood pressure, and respiratory rate.
  3. Patient History: If unconscious, gather information from bystanders.
  4. Emergency Care: Manage airway, provide oxygen, stop bleeding, and administer medications if necessary.

Injuries and Findings During Secondary Assessment

• Patient shows multiple injuries: swollen face, broken arm, and lacerated knee.
• Pupillary Response Assessment: Check for neurological function; discrepancies may indicate brain or nerve damage.

Final Concerns and Emergency Procedures

• Warning signs for Anaphylactic Shock: low blood pressure, elevated heart rate, and constricted airway.
• Action Plan: Intubation for airway management and treatment for potential allergic reaction while taking measures to stop bleeding.
• Team Coordination: Ensure effective communication and teamwork for patient stability during transport.