Preparing for PHEM Flashcards
Category of dispatch priorities
Colour, Type, Response, Target, 90th percentile
Category 1
Category 2
Category 3
Category 4
Category 1:
Purple
Life threatening- cardiac arrest
Immediate dispatch
7 mins (90th centile 15)
Category 2:
Red
Time critical emergencies (stroke)
Resources dispatched but may be diverted to a cat 1
18 mins (90th centile 40)
Category 3:
Amber
Urgent (eg abdominal pains)
Some treatment by resources in own home. Some will interrogate further.
No target. 60-120 mins
Category 4:
Green
Less urgent (vomiting, back pain)
Some will be given advice over the phone or referred to another service
No target. 180 mins.
Immediate Dispatch Criteria LAA
7 answers
- Fall from height >2 floors (>20 feet)
- Fall or jumped in front of train
- Ejected from vehicle
- Death of a same vehicle occupant
- Amputation above wrist or ankle
- Trapped under vehicle (not motorbike)
- Request from other emergency service
13
Incident Categories for interrogation for LAA
- Shooting
- Stabbing
- Amputations
- Industrial Accidents/ incidents
- Building site accidents
- Impalements
- Hangings
- Explosions
- Burns
- Drowning
- Entrapments
- Falls from < 2 floors
- RTC
Daily Vehicle Check
Fuel
oil levels
Water coolant
Screen wash
Electrics
lights
Tyres (tread, depth, inflation, damage)
Restrained medical equipment
Lockable box for drugs
Needs to have:
- visual and audible warning devices
- high visibility markings
Parking on scene
Dictated by the police
Fend off position - wheels turned in safe direction
Keys in ignition & engine running
at least 50m back from incident
Use rear visual devices and reflective high visibility markings
Land vs Air
Land:
Not restricted by weather
Not restricted by daylight
Good for urban areas (dont need a landing site)
Similar transit time for short distances
Air:
Good for remote and rural regions
Allows bypass of local hospitals
Can help with congestion
Provides a birds eye view- helpful for complexity and risks
Can fly at night if night vision imaging system
Restricted by weather- high wind, low cloud, freezing temperatures
Restricted by landing site
Flight Regulations
Regulated by the European Aviation Safety Agency
HEMs flight defined as a ‘flight by helicopter’
operating under HEMS approval
to facilitate emergency medical assistance
where immediate and rapid transportation is essential by carrying
1- medical personnel
2- Medical supplies
3- ill or injured persons and other persons directly involved
Exemptions from:
- normal weather
- flying and landing in congested areas and special sites
- eg nuclear power, prisons, restricted airspace
Incidents that don’t meet this definition are classified as air ambulance missions and don’t have the same exceptions.
Helicopter Safety
During start up and shut down, rotor blades are suceptible to sail
Wait for a thumbs up to approach
use safe direction of approach avoiding the main hazards
Always exit downhill and avoid walking uphill
Sterile cockpit for take off and landing
Landing sites should be 2x diameter of rotor blades, flat, free of debris, clear of people and animals
Need to consider access and egress for crew and personnel.
Blue light Rules & Exemptions
2 regulations
5 exemptions
Authority given by police & Ambulance
Road Traffic Regulation Act 1984
Section 87 and the Traffic Signs Regulations 2002
- Treating a red light as a give way sign (section 5b(36b))
- Passing to the wrong side of a keep left bollard (section 3(15)(2))
- Stopping on zig zag lines (section 4(27(3c)))
- Driving on a motorway hard shoulder. Can be in wrong direction under police instruction.
- Disobeying the speed limit
Blue Light Driving- NOT allowed
Do not:
- ignore a no entry sign
- Ignore a STOP or give way
- Drive the wrong way down a one way street
- Ignore flashing signs at a level crossing or fire station
- Cross a solid white line down the middle of the road (except for the same circumstances as other road users to overtake a stationary vehicle or slow moving cyclist)
Blue Light Driving- Use of lights
Blue lights can only be used:
1. At the scene of an emergency
2. Responding to an emergency tasked by the ambulance service
3. Wanting to let people know the responder is there
4. Wanting to let people know that there is a hazard on the road +/- protecting the scene if the responder comes across an incident
Arrival on Scene
First on scene- Fend off position (40 degree angle, wheels towards a safe direction of travel)
Obey the direction of the Police or Fire Service
Don’t obstruct access or egress
Leave visible warning lights on
Leave engine running
Secure vehicle
Wear appropriate PPE
Confirm arrival & update control
Collect equipment required
Move carefully to the scene
Read the scene
If EMS already on scene
- park beyond incident
- Turn off warning lights
- Identify selves to commanders
- Respond to taskings
Rail Incidents
Need training from network rail
Many electrified
Undergroud has a 4 rail system charged to 630-660 volts
Needs to be isolated
Contact BTP
PPE
High Visibility Jacket- conforming to the british standard EN 471
ID labels
Overalls- fire retardant)
Knee pad protection
Safety helmet and visor
Safety Glasses
Ear defenders
Rubble/ chemical gloves
Safety boots- steel toe caps/ acid resistant
waterproof trousers
Types of Ambulances
Type A-
Road ambulance, for patient transport of non-emergencies.
A1- 1 patient, doesn’t have lights or sirens
A2- >1 patient on stretchers or chairs, may have lights and sirens
Type B
Transport, basic treatment and monitoring, and has lights and sirens
Type C
Mobile intensive care unit road ambulance adapted for advanced treatment
