Chapter 38-41 Flashcards
What do you do at the start of a shift?
Check equiment and supllies at start of shift by readiness. Talk to previous shift of oproblems. Check car head to toe when ambulance is on loo k for lights, brakes, or windsheilf wipers, check heat and air condition. If major thing isnt working have ambulance be out of service. Make sure doors work, doors lock, AED fully charged make you have four sets of some things expiration dates, make sure to have extra batteries for stretcher. document what you do, in house oxygen is full and how much is in it
What is the job of the EMD?
answer questions a ssign priority, mrfical instructions and coordinate, location nmber, problem, how old, sex conscious and breathing staying on line if hot or nonbreathing fast with lights
What do you do when driving?
tolerant of other drivers and mentally ready inn nonemergency siuations follow laws. Can park vehicle anywhere wont hurt or damage proerty orr person slowing only at stop signs pass other vehicles in no passing zones and go improper directions on streets . Can speed if wont hurt unders with limmits. Use sirens in only emergency when there is possible loss of life or limb of only when using driver exemptions and horns use similarly. Headlights on day or night use all lights when emergency approach intersectiond with caution no fast turns signal lane changes and turns be careful driving in grpup people cut off. Slow when approaching school don pass when lights flaashing. Have maps in ambulance
How do you respond to a crash?
keep people parked off highway, dont do u-turns, if first unit- blocks incident by parking upstreatm block traffic by using vehicle as barrier best use of this is fire truck and ambulances are best downstreatm. If extrication where vest helmet and wear gear. Place cones and flares upstreatm to warn and direct traffic reduce emergency lights, dont drive over debris and skid marks keep ambulance on same side as road avoid backin g up
What is packaging?
getting patient and the patient carrying device in one unit to be secured and transport. Apcakage so condition isnt aggravated caring for wounds, stabilize impaled objects, check all dressings and splints before placed on devicrr with it secured and covered. Always cover patient to protect and keep private and place plastic over when wet. Carryind device needs a minimum of three straps, chest, hip, and lower extremities. Lock stretcher in ambulance,
What do you do if a patient needs to bring someone else along?
If friend must come along try to have them use some other transportation if not have them travel in the operator’s compartment if child bring car seat and put in truck fill forms if bringing personal effects. Dont drive hot unless necessary.
What do you do once the patient is at the ED?
May have to wait in ambulance or with patient if ED is busy and continue care until they transfer care never put in bed and leave without transferring care. Help staff give verbal and PCR and transfer effects, then get release from hospital
What do you do after you drop off the patient?
Clena up ambulance getting rid of body fluids and splash sites putting towels in red bag, sweep away dirt, bag for laundry, deodorize. Clean and disinfect respirtory equipment. Replace expendable items masks gauze, splint and spine boards. Stretcher raise to high-level position making it easier flat with side rails lowered and unfastened straps, remove unsoiled stuff placing on clean and soiled stuff to designated, clean mattress (if blood use bleach) turn mattress, put sheet and disposable mat on center of mattress, open blanket fully, top sheet on top tuck everything under beat
What do you do if the patient is unconscious with no spinal injury?
or a patient with an altered mental status onto their side. If patient may go in cardiac arrest put board under him just in case. Loosen clothing.
What do you do after leaving the hospital?
Let EMD know u are on your way back and serviceable or not, and notify is you stop and leave for any reaosn, open windows on way back if had airborn disease or ventilating system not recirculation to air out, filll up ambulance. Clean patient care equipment anywhere it touched, clean and sanitize respiratory equpment (soak in germicidal solution), clean interior wash ahnds, replace extendable, replace oxygen, replace patient care equipment, maintain ambulance, clean exterior, report for service, complete unfinished report
What are the different kinds of disinfectants and what do you use them for?
Low-level disinfetant clean and kill germs on abmbulance floor and walls, intermediate-level disinfectant mixture of 1:100 bleach to water used to clean and kil germs on equipment surface, high level disinfectant cidex plus destory all forms of microbial life except high numbers of spores, sterilization of invasive equipment.
How do you prepare yourself for the next call?
Clean hands under fingernails change clothes with communicable disease blood or body fluid-soiled clothes cant be taken home to wash
When do you use air rescue?
speedy transport to distant trauma station, extrication of high-priority patient is prolonged or rescued from remote location. Clinical: in shock, glasgow coma scale 10 or less, head injury with altered mental status, chest truamama dn respiratory distress, penetrating injuries to body cavity, ampuation proximal to hand aor foot, extensive burns, serious mechanism of injury post-cardiac arrest with a pulse. Catheterization or surgery, stroke patients and hyperbaric oxygen (carbon monoxide) transfer from one hospital to another cardiac arrest if hypothermic. Name, call-back number, agency name, nature of situation, exact location crossraods and major landmarks and exact location of safe landing or gps coordinats. 100by 100 feet. Dont approach helicopter unless escorted by flight personnel direct loading of patient stay clear or tail rotars dont smoke within
What are the different kinds of specialty training?
vehicle rescue, water rescue, ice rescue, high-angle rescue, hazardous material response, trench rescue, dive rescue, backcountry or wilderness rescue, farm rescue, and confined-space rescue.
when u first arrive to a highway scene what do you do?
First person that arrives blocks scene to protect area, fire is best for this. Limited access highways first-due units go to seen backup wait outside until requested rescue trucks downstream of initial blocking vehicle park in same direction as traffic and stay in single file only turn when it won’t obstruct the flow of traffic. Have it block one and a half to two lanes of traffic workings toward work zone to protect crew wheels away from incident.
Where does EMS park in a highway scene?
EMS downstream and should be in between fire and crash only exit in safe zone and be in class 2 traffic safety vests and helmet cones and flares at angle across road and around site leave red/amber warning lights on ambulance.
What are the steps of vehicle extrication?
preparing for rescue, sizing up the situation, recognizing and managing hazards, stabilizing vehicle prior to entering, gaining access to patient, providing primary patient assessment and rapid trauma assessment, disentangling patient, immobilizing and extricating patient from vehicle, providing assessment care and transport, terminating rescue
What are the PPE EMTs where?
For gloces wear firefighters gloves but if u need more dexterity use intermediate-weight leather gloves. Turnout coat and everything that is brgithly colored wear stuff without rear brimand everything bright wearing safety glasses with side shields and lenses are vital.
How do you protect the patient?
aluminized rescue blanket protects form bad weather and flying particles, lightweight vinyl-coated paper tarpaulin from bad weather, wool blanket with aluminized blanket- when cold, short and long spine board, hard hats goggles hearing protectors disposable dust masks and thermal masks, emotional support.
When do you use flares?
avoid spilled fuel, dry vegetation, and other combustiles, dont throw flares out of moving vehicle position few at edge of dangers zone as soon as it is parked walk with flares toward oncoming traffic every ten feet dont turn back held away from body when igniting never use as traffic wand.
What do you do with airbags?
Smoke when airbag goes off wear protective and eye equipment can hurt patitne look at dash weheel and air bag to see if damaged. Must disconnect battery to make sure it doesnt go off 2-3 minutes. Dont step in front of bumper as it is spring loaded. Keep crowd control may have to ask bystander to help but will be liable if they were hurt
What is the danger zone?
zone where controling hazard for electrical
What is the safe zone?
nothing could harm keep yourself and others away form anything somewhat electrical. Keep people in cars or in wreckage wood handles can also conduct. Ground can be energized, if feel tingling means on energized ground. If feel tingling hop to safe place on one foot, shuffle away from danger area with both feet no break in contact between two feet and ground to incomplete circuit
What do you do when confronting a fire?
put on full protective gear, if hood open back to wind across base of fire with short bursts direct it in any direction toward engine if hood closed leave it be and get patients out. Fire in dash or upholstery apply directly but sparingly if in trunk leave. If people inside and fire is under vehicle try sweeping keeping source away. Never stand directly in front of a truck wheel approach from 45 degree angle.
How do you cut the battery when do you cut it?
Dont cut battey unless for airbag or gasoline under vehicle only negative cable.
What do you assume about vehicles post-crash?
Assume all vehicles are unstable place a chock under car or stabilizing on side with cribbing or struts. If don’t have equipment stand by until rescue unit stabilizes
How do you secure the vehicle?
Make sure keys out, in park, engine off, keys are removed and parking brake on, deflate tired and place stop chocks to keep from rolling. Stabilize in the position it is found to not injury people,
What do you do to try to get to the patient?
Once stable ask if they can open door or window, laminated glass- break into small pieces in passenger car side and rear windows
Flathead axe- used for windshield, place tarps over patietn crawl in through window and do primary assessment.
Just take the roof and doors off for easy access or cut front end of car off after everything has been turned off and stay away from deplyoying things
What is terrorism?
the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives. Have to pay attention to rime scene and further destruction
What is domestic terrorism?
terrorism directed against one’s own government or population without foreign direction. Is no longer organized but is becoming fragmented and leaderless
What is international terrorism?
terrorism that is purely foreign-based or directed outside the targeted country or whose acitivites cross national boundaries
What are weapons of mass destruction?
weapons, device, or agents intended to cause widespread harm and/or fear among a population usually CBRNE agents (chemical, biological, radiological, nuclear, and explosive)
What are multiple devices?
destructive devices, such as bombs, including both those used in the initial attack and those placed to be activated after an initial attack and timed to ijur emergency responders and others who rush in to help care for those targeted by an initial attack
What are secondary devices?
destructive devices, such as bombs, placed to be activated after an initial attack and timed to injure emergency responders and others who rush in to help care for those targeted by an initial attack
What is OTTO?
(occupancy or location, type of event, timing of event, on-scene warning signs). O- place or business that terrorists might target, type perhaps with large ground, timing holiday or anniversary, on-scene clues chemical containers or out of place items.
What are the targets of terrorists?
symbolic and historical targets (some organization or even particularly effensive such as government buildings, statue of libery, liberty bell, wall street, world traid center). Public buildings or assembly areas (shopping malls, convention centers, entertainment venues, sporting arenas, and tourist destinations), controversial businesses (familt planning, nuclear faciilites, animal research, car dealerships, large commercial developments), infrastructures systems (bridges, power plants, phone companies, water-tereatment plants, mass transit,a nd hospitals.
What are some events that raise awareness of terrorism?
explosions/incendiaries, incident with firearms (aniper attack or hostages), nontrauma mass casualty. Also dates and holudays and times-rush-jour
What is exposure?
dose or concentration of an agent multiplied by the time, or duration substance taken in. . Pay attention to unusual lab or weird containers
What is TRACEM-P?
thermal harm extreme heat from burning liquids, metals, extreme cold from cryogenic with heat melting protective clothing secondary harm; radiological harm; secondary harm-asphyxiation argon carbon dioxide or chemcial vapors in dusty spaces; primary- chemical harm (toxic or corrosive materials); etiological harm (causes of disease); secondary- mechanical harm (gunshot wounds, slip trip and fall injuries, and injury from bomb fragments or shrapnel; seconadary- psychological harm (violent or traumatic event creating fear, invoke panic, reduce faith in government).
What is a biological incident?
Protect yourself first- respiratory proteciton prioriry skin face hands feet head and body. Potential use as infectivity (small number of virsuses), virulence (severity of disease), toxicity (incapacitation), incubation period, transmissibility (person to person), lethality, and stability.
What are bacteria?
ingle-celled organism grow in variety of environments from growing in body or grow outside producing toxins treated with antibiotics look for fever, nausea, vomiting, and diarrhea with sudden onset multiple patients in same area. No cure to viruses which rely on cell.
What are things associated with bacteria?
Fever, chills cough: Anthrax (1-6 days no Human to human H-H), cholera (1-5 days rare H-H incapaciting not deadly with death from dehydration and and electrolyte imbalance), bubonic plague (2-10 days high H-H), pneumonic plague (high H-H2-3 days), Q fever 2-10 days rare H-H, tularemia (2-10 days no H-H)
What are toxins?
posionous chemical produced by living organism ricin (24-72 hours no H-H dangerous via inhalation with supportive treatment), mycotoxin (minutes to hours H-H can go through skin weight loss, vomitng, diarrhea, weakness, dizzines,s, hypotension, and shock death within 12 hours use soap and water ), staphylococcola enterotoxin (4-6 hours no H-H fever 103-106 general weakness and nonspecific respiratory sumptoms chest baina nd pulmonary edema mostly incapacitating), botulin (deadliest toxins in planet 24 hours to several days no H-H).
What are viruses?
smallpox (10-12 days high H-H citizens do not have immunity to it acute onset fever, weakness, headache, backache, and vomiting 2-3 days rash and blisters around mouth throat and face spreading to extremities 30% mortality droplet transfer), VEE encephalitis (2-6 days low H-H only transfered via animals causing swelling of brainfever profoudn CNS effects headache phtophobia and altered consciousness incapacitating), Viral Hemmorhagic Fevers VHF-ebola, dengue fever, marburg, lassa fever (3-21 days moderate H-H clotting characteristics of blood and permeability of capillaries with systemic hemorrhage and liquefaction of solid organs highly ocntagiousa nd lethal rapid onset of fever, weakeness easy brusing and bleeding, sclera of eyes with bleeding and leaking of capillaries respiratory portal)
What are chemical doses?
Chemical doses milligrams per kilogram of body, biological doses fractions of micrograms per kilogram of body weight concentration in parts per million limiting dose concentration or time near agent you will reduce exposure. Based on 150 poind man in good health.
What are the results of a biological incident?
Results in chemical harm (secondary), etiological harm (primary), mechanical harm (secondary), and psychological harm (secondary).
What are some routes of entry?
pathways into the body, generally by absorption, ingestion, injection (vector (disease carrying organism), jagged glass or metal, syringe, high-oressure devices) , and inhalation. Injury to skin allows entryway, skin temp/blow flow, higher concentration more exposure, more hair more exposure, length of exposure, type og agent .
What is contamination/
contact with or presence of a material (contaminant) that is present something cloing where it does not belong and that is somehow harmful to persons, animals, to the environment. Contaminating hard and soft surfaces, skin and hair, and clothing.
What is permeation?
the movement of a substance through a surface or, on a molecular level, through intact materials; penetration, or spreading
What are dirty bombs?
medical waste or low-lvelevl radioactive sources
What are the radiological/nuclear incident?
thermal harm (primary- nuclear explosion), radiological harm (primary) more dangerous to children pregnant woman and the elderly with signs of nausea vomtiing and diarrhea, chemical harm (secondary), mechanical (primary explosion), psychological harm (secondary). Radiological detection, search all patients at scene may be bomber. Can be activated by lighht, pressure, ovment or radio transmission dont attempt to handle or neutralize.
What is a high order explosive?
defining supersonic overpressuizaiton shock ex. Nitroglucerin dynamite and ammonium nitrate
What is a low order explosive?
subsonic explosion adn lack overpersssurization ppe bombs gunpowder petroleum based
What is dissemination/
spreading usually through respiratory system. Nerve agents- sarin, smona or tabin can penetrate skin causing systemic efforts. Things with delayed incubation including smallpox, pneumonic plague, and viral hemmorhagic fevers
