200s EMS Incidents Flashcards
What are the 3 sizes of EMS calls when there is more than 1 patient?
1: Multi Patient (Fewer than 25)
2: Mass Casualty (25-100)
3: Disaster (Greater than 100)
The first arriving officer of an EMS call with more than 1 unit responding shall establish command, what are the general tactical objectives?
1: Remove endangered and treat the injured
2: Stabilize and provide for life safety
3: Ensure triage extrication treatment transport established
4: Safety Accountability Welfare
5: Conserve property
What are the benchmarks for an EMS multi unit response?
1: Triage report completed
2: All Immediates transported (Transportation sector)
3: All other patients treated and transported (Transportation)
What is the basic approach to multi unit EMS calls?
1: Take Command size up
2: Triage
3: Hazard assessment create safe zone
4: Traffic
5: Hazard protection (hose line, cones)
6: Resources
7: Radio triage report to alarm (ASAP)
8: Stabilize hazards remove patients to treatment
9: Assignments and sectors
10: Patient assessment and treatment
11: Transport
When should triage tags be used?
1: 3 or more Immediates
2: More than 10 total patients
What are considerations for treatment sector?
1: Treat in place for smaller
2: Establish treatment area for larger (preferred)
3: Multiple treatment areas for spread out
4: Colored salvage covers
What should be considered if there is a complex hazard?
Remove victims rather than stabilize hazard and perform triage at the entry to treatment
How should you request more resources for a EMS call?
Use the next alarm level 2n1 1st alarm etc
The first 2n1 goes directly to the scene, what do the next arriving companies do?
Level 1 staging, consider level 2 staging early.
What is the responsibility of triage sector?
1: Obtain location number condition of patients START
2: Coordinate with extrication
3: Decide Triage before or after extrication
4: Provide command with triage report (Benchmark)
5: Manage tracking slips
What is the responsibility of extrication sector?
1: Move patients to treatment area
2: Work with triage
3: Extricate and deliver patients to CCP or Tx sector
4: They are responsible for all patients until delivered to treatment
What are the responsibilities of transportation?
1: Obtain modes of transportation (air ground)
2: Loading areas and LZ location
3: Hospital availability
4: Notify hospitals
5: Account for patients
6: Manage tracking slips
7: Notify all immediates transported
8: Aggressively supervise movement of patients from treatment to ambo
9: Maintain close coordination with treatment sector
What sector should be established on a 3rd alarm or greater med?
Medical Supply
What would Medical Branch be responsible for on mass casualty incidents?
1: Triage
2: Extrication
3: Treatment
Where may some FD personnel need to be allocated for disaster incidents?
Hospitals
What other branches may be needed?
1: Transportation (Divide into a trans sector for each tx area)
2: Logistics (supply and morgue)
3: Multiple Medical branches for disaster (west medical)
4: Air for disaster
Who should triage be handled by?
10 or less patients first arriving company
More than ten assign the next unit
What is a reasonable guideline for how many companies should be assigned to extrication?
One company per 4 patients
What order should patients be extricated?
Immediate
Delayed (may go first if extensive immediate extrication)
Minor may assemble in an area and walked to treatment later by extrication if needed
What can be special ordered to assist extrication?
Wreckers, cranes, cutting torches etc
If there is a risk of fire what does extrication need?
Hose line coverage
What is the objective of treatment sector?
1: Rapid treatment and transport
2: Set up treatment area and mark for others to see (think big)
3: Advise command when ready to receive patients
4: Direct litter bearers arriving at treatment
If deciding to treat in place how should companies be directed to patients by treatment sector officer?
To a specific patient or location (you have the patient in the red sedan)
What is the GOAL for patient to crew ratio?
One ALS or BLS company and an ambo for each patient
What is the INITIAL standard for the number of crews in treatment for major incidents?
one crew for 4 patients
Still one ambo per patient
As new patients arrive in treatment and triage is adjusted what should the treatment sector officer provide to command?
Triage Update
Triage members can be reassigned to treatment for this purpose
Were are vitals injuries and treatments documented?
Triage tag
Non department medical personnel should be monitored closely by the treatment officer, who has full authority over these individuals?
Command staff, branch directors, and sector officers
Once all immediate patients have been treated where does the attention go?
Reevaluate delayed patients and upgrade accordingly
What must be done when patient care has been transferred to an air ambulance
Notify command
The focus of the treatment sector officer is for rapid treatment and transportation. The officer must maintain an awareness of which patients are ready for transport, when is the only time extended treatment should be administered?
When transport is not immediately available. Transport if available always takes priority.
Which hospitals should air ambulances transport to?
More distant, leave closer ones for ground ambos
How should ambo loading areas be set up?
Separate entry and exit points, toward hospitals if possible
As ambos are staged how should they be brought to transportation?
No more than 2 at a time
How can Minor patients be transported if lots of patients?
By city buses to more distant hospitals
Transportation determines hospital destination, what factors into this?
1: Injury and Priority (immediates first)
2: Hospital capacity
3: Hospital specialty
What does treatment do with triage tags?
1: Remove tags from patient
2: Write transport unit and destination
3: Use to maintain record of all patients leaving the scene
What does transportation notify command and alarm with when an ambo leaves?
1: Unit
2: ETA
3: Pt status (immediate)
Who manages patches and CNs?
Treatment
When more than one transportation area is needed what should be created?
Transportation branch
Where is transportation branch director located?
Near command post with sector officers at each transportation sector with at least one full company
If there is a transportation branch they should have their own radio channel. Who communicates with alarm command and staging?
Transportation branch director
What isi a mass casualty incident?
When the first 2n1 EMS services and resources (personnel and equipment) are overwhelmed by patients
What are the company officer/command responsibilities of an MCI
1: Take command and size up
2: Focus on rapid triage and transport of immediates (START)
3: Request appropriate alarm (Hazmat if needed)
4: Set up staging
5: Establish unified command with PD
6: Set up RTF if needed
7: Direct walking wounded
8: THREAT
9: Assign sectors
10: WMD? request chempak if needed
11: Ensure security
12: Post incident review
What the rules of thumb for alarm level request based off of 1/3 of the patients being immediate
1: 5-10 patients 1st
2: 11-20 2nd
3: 21-100 3rd 4th Consider EOC activation
4: 100+ Disaster response
5: If unsure and not code 4 request 1st alarm and wait for a count
When an incident goes to disaster level state and federal resources are required, what does this included
1: MMRS
2: EOC
3: State Hazmat
4: DMAT
5: National guard
6: DPS
7: Notify hospitals (advise if hazmat is involved for contamination concern
Each unit should have an MCI bag, what items are recommended inside?
1: 2 triage packs which have the following
2: Gloves
3: Ped face piece
4: Color ribbons
5: 2 Tourniquets
6: 2 Hemostatic dressing
7: 2 chest seals
8: 50 triage tags
9: Writing utensils
When is the medical support unit dispatched?
2nd alarm or greater
When does the patient compartment of a Medic unit need to be inspected, and what must be done after each patient?
1: Every morning
2: After each patient
3: Non disposable equipment and interior disinfected
4: If communicable disease entire rescue disinfected
5: If equipment cant be decontaminated tag it and hazard clearly listed
Can food be stored in the patient compartment of a medic unit?
No, only water
How do we decon vehicles?
1: PPE
2: Absorb large fluid and place material in red bag
3: If heavily contaminated rinse with soap and hot water
4: Wet equipment with disinfectant or 9 to 1 bleach and allow to dry for 10 minutes
5: Disinfect mops and things with bleach solution
6: Use approved disinfectant to wipe interior
7: Place PPE and wipes in garbage
8: leave in uv light for 15 minutes and air dry
9: Wash hands
Who responds on a CM Behavioral?
Licensed Behavioral Clinician
Behavioral Health Tech
Employed by CPR
What algorithm is used for behavioral CM patients?
Behavioral Health Patient Management
What types of calls can CM Behavioral handle?
1: Suicidal
2: SMI
3: intoxicated
4: Potentially Combative
5: Others where safety is concern
What is Assertive Community Treatment (ACT)?
Highest level of outpatient support for SMI patients
How can we call CMB?
Must be on scene first and assess the need
After transfer of care to CMB who has medical authority?
The Licensed Behavioral professional
