200s EMS Incidents Flashcards by Luke Russo

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)

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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

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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)

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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

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When should triage tags be used?

1: 3 or more Immediates
2: More than 10 total patients

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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

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What should be considered if there is a complex hazard?

Remove victims rather than stabilize hazard and perform triage at the entry to treatment

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How should you request more resources for a EMS call?

Use the next alarm level 2n1 1st alarm etc

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The first 2n1 goes directly to the scene, what do the next arriving companies do?

Level 1 staging, consider level 2 staging early.

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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

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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

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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

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What sector should be established on a 3rd alarm or greater med?

Medical Supply

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What would Medical Branch be responsible for on mass casualty incidents?

1: Triage
2: Extrication
3: Treatment

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Where may some FD personnel need to be allocated for disaster incidents?

Hospitals

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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

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Who should triage be handled by?

10 or less patients first arriving company

More than ten assign the next unit

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What is a reasonable guideline for how many companies should be assigned to extrication?

One company per 4 patients

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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

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What can be special ordered to assist extrication?

Wreckers, cranes, cutting torches etc

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If there is a risk of fire what does extrication need?

Hose line coverage

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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

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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