Farm Emergency Operations Unit 55 Farm Emergency Operations

Overview Farm emergencies Farm rescue principles Tractor accidents Silos, grain bins, manure storage Farm chemicals

Introduction Farmers are and self-reliant When EMS gets a call to respond to a farm, assume true emergency exists Special circumstances that are unique to rural EMS may exist on scene

Farm Emergencies 100,000 children injured on farms annually Most farm emergencies are Usual mechanisms of injury Machinery, tractor collisions, electrocutions, falling objects, and livestock Drowning Second leading cause of death on farm for children under five

Farm Rescue serves as excellent preparation for future emergencies on farm Include in preplan: Detailed maps of farm outlining building location Preplanned staging areas for heavy or special rescue Material safety data sheets (MSDS) for chemicals used or stored on farm

Basic Rescue Principles EMT should approach every scene cautiously and look for threats When encountering unique situations, EMT should call for rescue personnel immediately EMT should consider using emergency move to safely extricate accessible patient

Livestock When scared, livestock can kick, pin, bite, or gore a person in their path of escape EMT should never attempt rescue by getting between animal and patient Patient, who is down in livestock area, should not be approached until animal has been secured

Livestock (cont’d.) Animals harbor many diseases that are “cross-species” communicable Use appropriate personal equipment If trained to do so, move animal away from patient or remove patient EMT should always have escape route planned in case animal charges

Farm Vehicle Heavy Rescue Many obstacles are faced when managing farm rescue: Remote areas with poor road conditions Trouble turning off diesel engines or stabilizing heavy equipment Avoiding sharp cutting knives, rollers, and flails Dealing with spilled fuel and battery acid

Farm Vehicle Heavy Rescue (cont’d.) EMT must consider how to evacuate patient Air medic may not be available Ambulances may have difficult time traversing rough terrain Combination of these factors can change patient rescue into body recovery

Mechanism of Injury Typical mechanism of on farm: Entanglement in exposed screw, belt drive, or power takeoff (PTO) drive shaft Being struck by spinning crank handles Being crushed by shifting loads Injuries typically seen: Severe lacerations, puncture wounds, crushed injury

Farm Rescue Principles Ensure scene and establish perimeter Form plan and back-up plan for rescue Request special equipment for rescue In rare cases, field amputation by physician may be necessary

Tractor Accidents Tractor operation represents dual hazard to farmer Tractors tend to have motor vehicle collisions when on highway Tractors tend to rollover and pin operator Figure 55.3 Slow-moving farm machinery is no match for high-performance engines in modern cars

Tractor Rollovers Single largest contributor to mortality on farm is rollover Rollovers pin operators under weight of tractor and literally crush them Rollover protective structure (ROPS) Protective bar preventing driver from being crushed under weight of tractor Tractors prior to 1976 have no ROPS

Figure 55.4 The tractor operator has a great deal more protection with a rollover protective structure (ROPS) Figure 55.5 Operators of older tractors without ROPS, such as the one pictured here, are at risk for being entrapped and crushed

Tractor Rollovers (cont’d.) Rescue First, be prepared to suppress fire Next, turn off tractor Finally, turn attention to patient Lift tractor off patient or dig patient out Crushed pelvis highly likely; use pelvic sling or pneumatic anti-shock garment Trauma to chest may cause collapsed lung (pneumothorax) and contusions

Power Takeoff Power PTO) Spinning shaft that permits tractor to be used as portable power supply Accidents occur when piece of clothing or hair becomes entangled in PTO Resulting injury is severe lacerations Disentangling patient may require specialized tools and trained personnel

Figure 55.6 An unshielded power takeoff (PTO), spinning as fast as 1,000 rpm, can tear a limb off

Silos Structures that store (chopped corn, alfalfa, chopped grass) Silo gases created during process of fermentation and lactic acid production Chief among these silo gases is nitrogen dioxide (NO2) NO2 tends to displace oxygen and will cause suffocation

Figure 55.9 Brown stains on a silo can indicate the presence of nitrogen dioxide (NO2)

Silos (cont’d.) Rescue First use ventilation fans to clear dangerous silo gases If victim is visible, drop rope or reach victim with pike pole Never enter silo without safety/recovery system in place May be necessary to cut silo to free victim

Grain Bins Farmer can be submerged in of feed grain in as little as 10 seconds Rescue procedures First, talk to victim to help locate victim Do not open gravity gates If victim completely submerged, pairs of rescuers with safety harnesses may enter grain bin to attempt rescue EMT should never enter grain bin

Manure Storage Manure (storage structures) can be particularly dangerous Unsuspecting person may walk on cap, crumbling it, and person may drown Manure gases can either asphyxiate farmer or represent explosion hazard Maintain safe distance

Toxic Manure Gas Danger for from manure gas is from methane Other manure gases displace oxygen and asphyxiate victim Early symptoms of hypoxia include headache, nausea, and dizziness Key to survival is early recognition of these symptoms

Farm Chemicals Farmers use large number of , herbicides, and fertilizers Exposure to these chemicals should be treated as hazardous material exposure EMT must wear personal protective equipment when confronted with farm chemical exposure

Conclusion Farming can be one of most dangerous occupations in United States Majority of EMS calls to farm can be managed with training and skills of average EMT Some instances will require assistance of specially trained rescuers