Chapter 36 EMS Operations Flashcards
CRITICAL DECISION MAKING
Although most of this text has discussed treating the patient at the scene, your response and vehicle placement is an important part of your responsibilities at a call. Proper vehicle placement ensures your safety and that of the vehicle and that its contents are available to you in a convenient location. For each of the following situations, explain where you would park the ambulance if you were first arriving:
You are called to a railroad car derailment.
Park uphill and upwind at potential chemical incidents. You must also be aware of the risk of explosion (e.g., a propane car) and park a significant distance away until the hazards are dealt with. Patients may be brought to you in a safe zone.
CRITICAL DECISION MAKING
Although most of this text has discussed treating the patient at the scene, your response and vehicle placement is an important part of your responsibilities at a call. Proper vehicle placement ensures your safety and that of the vehicle and that its contents are available to you in a convenient location. For each of the following situations, explain where you would park the ambulance if you were first arriving:
You are called to a collision on the interstate. An engine company and trooper are parked at the scene, blocking oncoming traffic.
Park past the collision. On an interstate scene, you should have a blocking vehicle (e.g., a fire engine or highway department barricade truck) between you and oncoming traffic. By parking past the scene, you will be able to load the patient with the safety of the blocking vehicles behind you.
CRITICAL DECISION MAKING
Although most of this text has discussed treating the patient at the scene, your response and vehicle placement is an important part of your responsibilities at a call. Proper vehicle placement ensures your safety and that of the vehicle and that its contents are available to you in a convenient location. For each of the following situations, explain where you would park the ambulance if you were first arriving:
You are called to a scene involving domestic violence. Police are not yet on the scene.
Stage out of sight from the residence and far enough away so any dangerous persons won’t come from the scene to you. Drive to the scene only when advised the police have secured it.
Short Answer
. List the five phases of an ambulance call.
- Preparing for the ambulance call.
- Receiving and responding to a call.
- Transferrin the patient to the ambulance.
- Transporting the patient to the hospital.
- Terminating the call.
Short Answer
List activities you perform at the beginning of each shift.
At the beginning of each shift, spend the time to be sure that you, your vehicle, and your equipment are ready to respond. Talk with the off-going crew, get a brief shift report, and learn about any issues that might have come up with the ambulance or equipment during their shift. Complete a thorough bumper-to-bumper inspection of the ambulance using a checklist provided by your service. Inspect the vehicle and the equipment.
Short Answer
List three ways to prevent collisions when driving an emergency vehicle.
There are a number of very effective ways to reduce your chances of having a collision when driving an emergency vehicle. Come to a complete stop at intersections against a red light, minimize lights-and-siren responses whenever possible, and become familiar with your response area so you know where you’re going when you receive an emergency dispatch. In addition, work to minimize all possible distractions when driving. Leave the radio communications, navigation, talking to the cell phone, or listening to music during an emergency response.
Short Answer
What types of stretcher straps are essential to restrain a patient and prevent him from becoming a projectile in a collision?
A patient-carrying device should have a minimum of three straps for holding the patient securely. The first strap is placed at chest level, the second strap is placed at hip or waist level, and the third strap is placed around the lower extremities. Sometimes there is a fourth strap if two are crossed at the chest. Newer stretchers have straps that act as a harness to restrain the upper body.
Short Answer
Describe the steps that should be followed when air rescue is required.
Using air rescue resources comes with some critical responsibilities for those responders on the scene. They must ensure a safe environment upon which the aircraft can land and relaunch. Prior to the arrival of the aircraft, set up a landing zone:
- The landing zone should be a minimum of 100 by 100 feet on a flat surface that is clear of wires, towers, vehicles, people, and loose objects that might fly up when the aircraft lands (responders often underestimate the power of the helicopter’s down force). Once a site has been chosen, place one flare in an upwind position to allow the pilot to judge wind direction. During night operations, keep emergency lights on and shine headlights onto the landing zone (never skyward toward the pilot).
- Once the helicopter has landed, approach the aircraft only when escorted by flight personnel, and allow the helicopter crew to direct the loading of the patient. It is critical that all personnel be aware of their positions compared to the tail rotor of the aircraft and avoid this area at all times. This important information varies from location to location. Your instructor will provide information on resources in your jurisdiction.
Critical Thinking Exercises
Organizing your equipment is a key part of your job as an EMT. The purpose of this exercise will be to consider how best to manage the equipment you will need at the emergency scene?
What equipment should you include in a kit that you carry to the scene?
Equipment that should be available to carry onto a scene includes:
- Two-way radio - Portable Oxygen - Oxygen administration equipment, BVM, airways, and masks - Pulse oximeter - Automatic External Defibrillator (AED) - Cervical collars, head immobilization device, backboards, and splints - Dressings, gauze, bandages, tape, cold packs, and burn sheets - Obstetric kit - Blood pressure cuff, stethoscope, shears, flashlight, blanket, towels, triage tags, bedpan, and urinal - Infection control equipment such as gloves, eye protection, face protection, gowns, shoe covers, and N-95 or N-100 masks - Protective helmet for highway operations, reflective outerwear, fire extinguisher, and hazmat guide.
Critical Thinking Exercises
Organizing your equipment is a key part of your job as an EMT. The purpose of this exercise will be to consider how best to manage the equipment you will need at the emergency scene?
How should the equipment be positioned so you can quickly reach urgently needed items?
Items that are retrieved regularly (such as the blood pressure cuff, stethoscope, and oxygen masks) for routine calls should be placed in a bag or “jump kit” in the vehicle near the rear or side door (or on top of the stretcher) so, upon arrival on the scene, your crew can exit the vehicle, retrieve the bag(s), and enter the scene quickly with the most essential equipment in hand. Equipment that is used infrequently (such as the obstetric kit, traction splint, and burn sheets) can be placed inside the vehicle in a more secure location where they can be retrieved under those special circumstances that require them.
Critical Thinking Exercises
Organizing your equipment is a key part of your job as an EMT. The purpose of this exercise will be to consider how best to manage the equipment you will need at the emergency scene?
What special items, if any, should be in the kit to meet local needs?
Special items that may be dictated by local requirements include:
- Advanced or alternative airways
- Glucose meter
- Specialized pediatric equipment such as a smaller blood pressure cuffs, stethoscopes, spinal immobilization equipment, and oxygen masks and airways
- Medications such as oral glucose, albuterol, nitroglycerin, and auto-injector EpiPens
- Specialty equipment related to specific interfacility transfer work
- Cellular telephone
