Scene Size up Flashcards
scene management challenges
- crowd control
- resources
- biohazards, radiological and toxic
preparedness
- mitigation
- when on the scene of an incident, you must rely on training and reference sources
- know how and when to access specific toxicologic information
- understand how a hazardous materials scene is organized and where you fit in
- know where to find the emergency response plan in your facility
general considerations
- emergency operations must be conducted in a structured, consistent manner
- strong emphasis is placed on standard operating procedures (SOPs)
- it is critical to ensure your own safety
- it may not be possible to identify what hazards are present
- warning signs include:
- signs and symptoms from patients
- placards and labels
if you suspect an attack:
- ensure scene safety and personal safety
- notify dispatch and/or supervisor
- request additional specialized resources
- establish or coordinate with command
- initiate mass casualty incident procedures
general consideration steps
- approach scene with caution and UPWIND
- carry out scene assessment
- establish incident command (each responding agency)
- recognize signs and indicators of CBRN incidents
- determine whether CBRN or hazardous material incident
- estimate the number of causalities/victims
- estimate resource requirements (certain hospitals dont take certain trauma patients -> OB)
- carr out primary triage, decontamination, secondary triage, medical care, and transport
- consider specialist advice/resource requirements
scene safety
- do not enter the scene if there is any doubt that it is not safe
- the best location for staging is upwind and uphill
- wait for assistance from trained personnel
pre-arrival information
- pre-arrival information
- size up begins with dispatch
- the name, location, and nature of the incident help the first responders anticipate what might be happening at the scene
scene size up
- sizing up the incident
- size up is a systematic process of gathering and processing information to evaluate a situation
- the end result is an incident action plan
- an experienced provider will adjust the plan as more information becomes available
Lloyd Layman’s 5 step size up process
-facts
-probabilities
-situation
-decision
-plan of operation
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scene size up: facts
- things that are known about the incident
- time of day- you have less resources at night -> be prepared
- weather
- resources
- location of incident
scene size up: probabilities
- things that are likely to happen or can be anticipated
- what other bad things can happen
scene size up: situation
- the situation assessment involves 3 considerations:
- are the resources on scene and en route sufficient to handle the incident
- what are the specific capabilities and limitations of responding resources (equipment) in relation to the problem
- what are the specific capabilities and limitations of the personnel based on training and experience
scene size up: decisions
- make a judgement call
- be decisive
- plan is dynamic -> change plan if you need to
- gather the facts before your decision
- are there enough resources responding to and on the scene to mitigate the situation
- are there sufficient resources available and do conditions allow for an interior attack
- what is the most effective assignment of on scene resources
- what is the most effective assignment of responding resources
scene size up: plan of operation
-develop the actual plan that will be used to mitigate the incident
plan of operation: goal
- life safety
- incident control/stabilization
- environmental protection
- systems/infrastructure protection
- property protection
- mode of operation
operation actions
- make immediate contact with incident commander for coordination
- isolate the area upwind and uphill initially
- > then in specified directions as per the incident commander or hazmat team
- identify a safe staging location for incoming units
- give access and egress to these units if necessary
- mobilization points for resources may be set up away from the scene and resources deployed as necessary
utilize available resources for
- identification- of hazards
- evacuation
- emergency medical care- what kind
assess initial isolation/standoff distances
- green section of ERG
- specific to chemical
hot zone
- initiate public protection actions
- restrict unnecessary personnel from entering the hot zone
- primary triage in the hot zone
green zone
- secondary triage
- wait for additional resources
when to use control zones
- mitigate damage and increase safety
- explosive devices
- chemical or biological contamination or dispersion devices
- potential radioactive contamination
perimeter control factors
- amount of available resources
- self protection capabilities
- size and configuration of the incident
- incident stability
- use evaluation to guide in stablishing perimeters
access and egress routes
- establish
- maintain
- do not block other vehicles in
- drop off and pick up
- keep equipment away that restricts other people
crowd control
- people run, push
- survival mode
- police is good for crowd control
staging
- initial emergency responders
- uphill and upwind
- avoid bottleneck- you need to get in and out
- additional resources
- establish staging area
- location
- size
decontamination
- emergency decontamination
- yellow zone
- need to happen immediately
- routine post exposure decontamination- this is for first responders after the fact
special awareness of responders as targets
- there can be traps
- be aware of surroundings
- secondary bombs
- creating panic
- people seeing the people helping getting hurt -> panic -> who is going to help them?
secondary devices
- be alert for, and warn on scene personnel of, secondary devices
- be aware
- it is extremely important that first responders not become victims
- command and control will quickly disintegrate
crime scene considerations
- be aware
- protect urself
- your items on you can become evidence
- remember what you saw, and where you went -> this is not primary concern
- saving lives in primary concern
medical sector
- size up
- strategy
- tactics
mass casualty incident
- not enough resources to mitigate
- any incident that exceeds medical care facilities resources within a specific geographic area
- doesnt matter if you can handle it or not via skill -> you do not have enough resources
- exact numbers of patients required to exceed this capability may vary
- may vary within a specific area dependent on a number of factors
- ex. if three people get shot and you only have 2 tourniquets -> MCI
medical sector
- largest component of the incident command system (ICS)
- incident command and victim care
initial actions
- supervisor
- request dedicated EMS staging officer
- determine need for medical staff PPE
- request safety officer for medical sector
triage area
- triage in hot zone
- triage in warm zone (decon)
- triage area considerations
treatment area
- may need to establish treatment zones
- requires the most medical personnel
- established prior to 1st arriving victims
- not hot zone preferably
transportation area
- determines victim transport needs
- determines initial assessment of area hospital medical care capability
- determines the need to activate NDMS
treatment support
- provides medical supply support to teams
- provides pharmaceutical support to teams
hospital coordinator
- determines the need to activate NDMS (national disaster medical system)
- NDMS- assist hospitals in incidents
- coordinate patient allocation
- hospital coordinator decides to deploy or not
summary
- PPE in place upon arrival
- know specific SOPs now: triage, treatment, and transport are crucial components
- establish support for these zones- early hospital assessment is crucial for control and NDMS
Standard Operating Procedure (SOP)
-treatment
-transportation
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