EMS Flashcards
Basic EMS Services (EMS)
The objective of basic EMS response:
- establish and maintain command and control
- ensure that resources are utilized that provide best pt care
- provide scene safety
- efficient communications between crews
Medical Evacuation Helicopter
The decision to request or cancel an auto launch helicopter should be based on:
Best interest of the patient
Criticality of the Patient
Number of patients
Availability of transport resources
Time and distance to appropriate medical facility
Visibility of LZ
Direction of the paramedic once at scene and having completed patient assessment
Medevac helicopter
On scene criteria
IC shall confirm radio assignment for communication with the helicopter a sign ground contact and designate an LZ
100 signs radio frequency STAC-D (in PFAs jurisdiction)
PVH north, LCSO fire net, or a fern ( outside)
Consider law enforcement for blocking LZ. May ask 100 to provide a radio patch
Med evac heli
Ground contact responsibilities. Shall
Be designated by the incident name
Clear the intended LZ of all personnel and equipment
Relay to the pilot the following: intended LZ location,
wind direction and speed, overhead barriers and ground obstructions (watch outs), patient update if possible
Notify 100 when heli has left the incident
Med evac heli
LZ requirements
- 100 ft away from incident and secured
- free of debris and on hard surface
- free of overhead barriers
- have at least 2 miles of visibility
LZ Safety
All personnel on scene SHALL adhere to the following:
- ground contact is in charge of LZ and safety
- stay out of LZ during landing and take off
- wear eye pro and secure loose articles
- do not approach heli unless signaled by the pilot
- approach from the front of aircraft
- approached in a crouched position
- do not raise anything overhead
- move and load the patient only under the direction of the flight crew
MCI
What is it:
- classified 5 or more Pts
- emphasis on triage, transport, and efficient prioritizing of Pts and assignments to transport units
- level 1-3, based on NCRETAC (northeast regional EMS/trauma advisor council) Operations plan
MCI Level 1
- 1st alarm
5-15 patients
- at least 5 critical
- 5 critical patients, 5 PFA units, 5 ambulances, 1 heli, SO, BC, EMS 1 & 2
MCI Level 2
- 2nd alarm
- 16-50 patients
- at least 10 critical
- 10 critical Pts, 7 PFA units, 10 ambulances, 2 Helis, SO, BC, EMS 1 & 2
MCI Level 3
- 3rd alarm
- more than 50 patient
- at least 20 critical
- 20 critical, 10 PFA units, 20 ambulance, 3 Helis, SO, BC, EMS 1 & 2
MCI
1st arriving IC SHALL:
- conduct a size up
- establish and announce location of command
- communicate the IAP
- ensure orders and assignments are understood
MCI
SCENE SIZE UP
- nature, type, and scope of incident - initial designation of MCI response
- approximate number of victims - severity of injuries: all Pts need to be accounted for, Pts injured, Pts contacted, ID life safety hazards (fire, hazmat, etc)
- routes of Ingress and egress
MCI
STRATEGIC CONSIDERATIONS
- gain control of the scene early
- determine triage strategy (triage in place, triage funnel
- determine resources needed
- determine MCI level
- first 2 critical unit leaders: triage and transport
- ensure rapid triage, treatment, transport
- if multi-agency response, request tactical radio frequency from dispatch
- designate ground contact officer
- consider PIO
MCI
TACTICAL CONSIDERATIONS
- develop a traffic flow path. Command will direct incoming transport units to stage in single file line
MCI
Benchmarks
- 360 compete or not complete
- declare appropriate MCI level
- ID ingress/egress points/routes
- all Pts triaged
- all Pts transported and or accounted for
- scene stabilization
MCI
MEDICAL GROUP SUP
- implemented at 2nd alarm level
- coordinates triage, treatment, and transport
- appointing unit leaders and assign support staff
- coordinating all medical ops
- account for all personnel to this group
- requesting additional resources and supplies
MCI
Triage unit leader
- quickly locating and triaging every victim (RPM & triage tags)
- ID extrication needs, coordinate with rescue group
- communicate priority of Pts to transport
- developing pt care on priority basis
- formulating strategy (in-place or triage funnel)
- requesting and assigning shuttle teams
- directs movement of victims to transport units
- designating pt treatment area and requesting a treatment unit leader
MCI
Transport unit leader (EMS sup)
Responsible for:
- coordinate transport of Pts and notify appropriate hospital - emsystems (real time info)
- establish and employing patient transport strategy
- coordinate with triage
- request own transport channel
- request resources (1 red 1 yellow per unit)
- ingress egress
- assign of patient to transport unit
- maintain transport form
- assign hospital destination
- responsible for Patients, crew, ambulance, hospital assignments
MCI
Treatment unit leader
- maintain a secure treatment area
- coordinate delivery of Patient care
- ID need for additional personnel and supplies
- re assessment of victims
- directing movement of reclassified patients
- assign priority o patient transport
Trauma team activation
Operations
- 1st IC should contact MCR with an initial advisory of full trauma team activation (FTTA)
- IC should ensure the responding for contacting the destination ED
- limited trauma team - transporting crew responsibility
- IC needs to ensure FTTAs are not duplicated
Trauma team activation
Considerations
- FTTA Pts should be transported to an appropriate trauma center in consult with on-line medical control
- deviation of destination must be cleared through base physician
- air medical transport considered >20 minute extrication or time saving of approximately 15 minutes
- full trauma arrest - nearest facility
