HAZMAT, MCI, Incident Management Flashcards
What Are Hazardous Materials?
• “Any substance or material in a form which poses an unreasonable risk to health, safety, and property when transported in commerce.”—U.S. Department of Transportation (DOT)
Levels of Training
- First Responder Awareness (no minimum)
- First Responder Operations (8 hours)
- Hazardous Materials Technician (24 hours)
- Hazardous Materials Specialist (24 additional hours)
Responsibilities of the EMT**
- Recognize hazmat incident
- Control scene
- Establish danger zone and safe zone
- Attempt to identify substance
Identify Hazardous Material**
• Signs, labels, placards – Binoculars from safe distance – NFPA 704 system placards – Diamond-shaped DOT labels • Other sources – MSDS, bill of lading, invoice, manifest – Interview workers
Identify Hazardous Material
• Get expert advice about next actions – Dispatcher – Hazardous materials expert – Emergency Response Guidebook • Get expert advice about next actions – CHEMTREC (800-424-9300) – CHEM-TEL (800-255-3924) – State/federal radiation control authorities – Regional poison control center
Control Zones**
• Hot zone – Area of contamination or danger • Warm zone – Area immediately adjacent to hot zone • Cold zone – Area immediately adjacent to warm zone – Where equipment and emergency rescuers are staged
Treatment Area*****
• Rehabilitation operations – Located in cold zone – Protected from weather – Large enough to accommodate multiplerescue crews – Easily accessible to EMS units
Treatment Area
• Care of injured and contaminated patients – Decontaminate in warm zone – Treat in cold zone • Phases of decontamination – Gross decontamination – Secondary decontamination
Treatment Area***
don’t see deodor
• Mechanisms for decontamination – Emulsification – Chemical reaction – Disinfection – Dilution – Absorption or adsorption – Removal – Disposal
Treatment Area
• Decontamination procedures
– Victims wearing PPE
– Victims not wearing PPE
Multiple-Casualty
Incident Operations
• Know local disaster plan – Written to address events conceivable for particular location – Well publicized – Realistic – Rehearsed
Incident Command System
• National Incident Management System (NIMS) Command -Operations -Planning -Logistics -Finance
Communications
- On arrival, give brief report and request necessary resources
- Incident commander only person to converse with communications center, disseminates information to others
- Have face-to-face conversations among command staff whenever possible
EMS Branch Functions
Under Command Structure
- Mobile command center
- Extrication
- Staging area
- Triage area
- Treatment area
- Transportation area
- Rehabilitation area
Triage****
• Goal: afford greatest number of people greatest chance of survival
• Prioritizing patients
– Priority 1: Treatable life-threatening illness or injury
– Priority 2: Serious but not life-threatening illness or injury
– Priority 3: Walking wounded
– Priority 4 (sometimes called Priority 0): Dead or fatally injured
START Triage**
• Simple Triage and Rapid Treatment • Foundation of system is speed, simplicity, consistency of application • Simple commands to patients • Patient evaluation based on RPM – Respiration – Pulse – Mental status
START Triage**
• Able to walk? – Yes: Priority 3 – No: Check respirations • Respirations present? – Yes and >30/minute: Priority 1 – Yes and <30/minute: Check pulse – No: Position airway; recheck respirations – Still no respirations: Priority 4 (or 0)
START Triage page 1028 flow**
• Good pulse?
– Unresponsive, not breathing, no pulse: Priority
4 (or 0)
– Breathing, no apparent pulse: Priority 1
– Breathing, pulse, good skin signs, capillary
refill: Check mental status
• Good mental status?
– Alert: Priority 2
– Altered mental status: Priority 1
Patient Identification*****
• Color code patients by priority – Priority 1: Red – Priority 2: Yellow – Priority 3: Green – Priority 4: Black
Transportation
and Staging Logistics
- Triaged and treated patients next transported using priority system
- Ambulances stage in designated area to await direction and patients
- Receiving facilities contacted early to determine capabilities and update on expected patient counts
Psychological
Aspects of MCIs
- Caring, honest demeanor can reassure patient
- Do not attempt to psychoanalyze person’s distress
- “Psychological first aid” may be necessary on the scene of MCI
Chapter Review
- Be suspicious. Many hazmat incidents start out as routine EMS calls.
- Remember the Hot Zone-Warm Zone-Cold Zone.
- Patients who have been decontaminated still have some contamination.
Chapter Review
• Use your MCI plan and procedure at small incidents and larger ones will be easier when they occur.
• Learn and practice START triage
essentials.
• Be alert for signs of stress and seek help as necessary.
Remember
• A hazardous materials response requires specialized training and resources.
Common responsibilities of initial
responders must be identification of the incident, scene control, and activation of appropriate resources.
Remember
- Scene safety is highest priority; when possible, use scene clues, product information, and specific resources to identify hazardous materials.
- Decontamination prevents the spread of a hazardous material. EMTs are commonly involved in various levels of this process.
Remember
• Multiple-casualty incident overwhelms resources of responding units. When this
occurs, organization is the most important priority.
• NIMS and its incident command system provide organization resources and structure to improve management of large-scale incidents.
• Triage allows EMTs to prioritize care and transport of patients when resources are
limited.
What are hazardous materials
….
levels of training
don’t worry about testing hours
Responsibilities of the EMT**
1 hazmat team in tampa…
rely on EMS to give some info
vehicle should have placard on all 4 sides
NFPA system - fixed placards 39-3
MSDS sheets on all materials in a facility
.
sometimes it is best to do nothing at all
.
Emergency Response Guidebook
list the hazard - and generally what to do about it
hot zone / red zone
don’t set up rehab here
where the stuff is
set up rehab in the cold zone
well away
only people in the hot zone are the HAZMAT people
warm zone
decon area
slow process takes a while to get the stuff in place
people intensive
suits are very hot
vitals and keg done before they go in and out
cold zone
tx and rehab is in the cold zone
deodorization**
not a decon method on the test
ICS
Fire Fighters out in California
was the start of NIMS
EMS will be in the operations area
arrive on scene
paint a picture and tell them what resources you need
Triage
french word that means to sort for the greatest # of people for the greatest good
Priority 1**
treatable life threat
Priority 2**
Serious but not life threat
Priority 3****
Walking wounded
Priority 4*****
dean or will be
START***
Simple Triage and Rapid Tx
Pt Eval*****
Resp, Pulse, Mental Status
If good on all three and can’t walk
open airway with a had tilt - only time
study this***** pg 1028
if walked on the test remember is at
.
priority 1 transported first
.
first vehicle that gets there what should you do
call paint a picture
