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Your Safety First !!!
You Have Already Responded to at Least One Problem. If You Get Hurt You Have Now Compounded the Original Problem.
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Topic Overview
- Learn to Recognize Hazards
- Determine if the Scene is Safe
- Know the Limitations of Your Resources
- Know How to Acquire Additional Resources
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Affective Objectives
- Don’t Have Tunnel Vision
- Look Around, Up, Down, Left, Right, Over, Under, Behind, In Front
- Be Observant
- Leave Yourself an Out
- Put 2 and 2 Together
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Determining any threats to your own safety or to the safety of your patients or bystanders, to determine the nature of the call, and to decide if you will need additional help
Scene Safety
An assessment to assure the well-being of the EMT–Basic
YOU ARE NUMBER ONE !!!
- Protect bystanders (prevent them from becoming patients).
- Never enter an unsafe scene.
- Make scene safe or call for someone who can.
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- Body Substance Isolation (BSI)
- Gloves
- Eye Protection
- Mask
- Gown
Danger Zone
Minimum 50’ around scene, further if:
- Fuel spill
- Fire
- Hazardous materials
- Downed power lines
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- Crash & Rescue Scene
- R U Safe
- Hazards
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- How Many Vehicles Involved
- Where R U Going to Park
- EMS Units
- Fire / Rescue Units
- What Type of Accident
- Head-On, Rear-End, T-Bone, Roll-Over
- How Many Patients
- Any One Entrapped
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- Have Your Limitations Been Taxed ?
- Do You Need Help ?
- Additional EMS, Rescue, FD, PD, Haz-Mat
- ALS ASSIST !!!
- WHO’S IN CHARGE ?
- Holy Crap - You Haven’t Started Treatment Yet
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- Toxic Substances
- Haz-Mat
- WMD
- Carbon Monoxide
- Low Oxygen for Any Reason
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- Are You To Close ?
- Are You Trained to Deal With Problem ?
- Do You Have Personal Protective Gear ?
- Situation Specific
- R U Safe ?
- Establish Safe Zone
- Don’t Compound the Problem
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- Crime Scene / Violence
- Police First / Secure
- Leave an Out
- Equipment Between You and the Problem
- Retreat
Scene Violence
Use scene clues:
- Fighting
- Loud voices
- Alcohol/drug use
- Unusual silence
- Prior experience
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- Beyond Scene Size-Up of Crime Scene
- Do Not Disturb if You Don’t Need To
- Note Everything
- Document Everything
- You Are Now a Witness for the State
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- Beware of the Warm Fuzzy Pets
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- Unstable Surface
- Ice / Snow
- Water
- Mud
- Rock
- Hill / Cliff
- What 2 Do / Need Help ?
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- Patient Protection
- Protection From Elements
- Protection During Rescue Ops
- Glass
- Tools
- Car Parts During Displacement / Removal
- Special Considerations
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- By-Stander Protection
- Establish Safe Zones
- Curiosity Kills The Cat & By-Standers Too
- Watch for Secondary Accidents
- Everybody Is In a Hurry
- Watch Out For That AS#@!$LE
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Quick Simple Summary
- If The Scene Is Unsafe
- Make It Safe. Otherwise
- DO NOT ENTER !!!
MECHANISM OF INJURY or NATURE OF ILLNESS
- Assessment of the Scene That May Provide Valuable Information About the Patient to the EMT.
NATURE OF ILLNESS
- Nature of Illness
- Medical
- Why Was EMS Called
- Patient, Family, Friends, By-Standers
- How Many Patients
- Enough Resources ?
- ALS ASSIST !!!
Mechanism of Injury
The physical event that caused an injury (fall, motor vehicle accident, etc.)
Index of Suspicion
A Keen Awareness That There May Be Injuries.
Inertia (Newton’s First Law)
A Body In Motion Tends to Stay In Motion Unless Acted Upon By An Outside Force.
or
A Body At Rest Tends To Stay At Rest Unless Acted Upon By An Outside Force.
MECHANISM OF INJURY / NATURE OF ILLNESS
- Mechanism of Injury
- Trauma
- What Hit Who Where ?
- Kinetic Energy
- Car Hits Tree, Head Hits Glass, Brain Hits Frontal Skull, Then Sloshes Back
- How Many Patients
- Enough Resources
- ALS ASSIST !!!
Mechanism of Injury:
Motor Vehicle Collision
- Ejection
- Roll-Over
- Deformed windshield, steering wheel, etc.
- Amount of vehicle deformity
- Seat belt use
Mechanism of Injury:
Motor Vehicle Collision–Motorized Vehicle
- Motorcycles
- All-terrain vehicles
- Snowmobiles
- Jet-Ski
Mechanism of Injury:
Falls
- Distance patient fell
- Part of body that struck surface
- Type of surface landed on
- Did anything break the fall?
Mechanism of Injury:
Penetrating Trauma
- Body region penetrated
- Exit wounds
- Cavitation
Adequacy of Resources
- DON’T BECOME A CASULTY
- Patient Count - Initially Estimate
- Get Help Before Any Patient Care
- Establish Command
- Initiate Mass Casualty Plan
- Triage, Treatment, Transport, Staging
Adequacy of Resources
- Rescue
- Fire
- Police
- Haz-Mat
- Animal Control
- Utilities
- Electric, Gas, Water
Adequacy of Resources
- Example
- How Many EMT’s Are Needed to Treat a Patient Complaining of Back Pain That Needs to be Immobilized On a Spine Board ?
Adequacy of Resources
- Example (cont.)
- The Patient Is On the Third Floor.
Adequacy of Resources
- Example (cont.)
- The Patient Weighs 400 Pounds.
- Now, How Many EMT’s Are Needed ???