EMS Support and Operations

You Are the Emergency Medical Responder Lesson 42: EMS Support and Operations You Are the Emergency Medical Responder You are an EMR approaching the scene of a two-car collision at a busy intersection. It is rush hour and traffic is heavy. One of the involved cars is situated on the median strip, and the other is off the road on the shoulder, just past the intersection. There are multiple occupants in each vehicle.

Roles of the EMR in the EMS System Traditional EMR Functions within the 9-1-1 system Affiliated with a servce: fire, ambulance, law enforcement, search and rescue Non-traditional EMR Has same training as traditional EMR Works in less traditional settings Athletic trainers Health and human performance

Nine Phases of EMS Response Preparation for an emergency call Dispatch En-route to the scene Arrival at the scene and patient contact Transferring the patient to the ambulance En-route to the receiving facility Arrival at the receiving facility Clear medical facility Available for next emergency call

General Criteria for Requesting Air Medical Transport Vehicle rollover with an unrestrained passenger(s) Motorcycle accident with driver thrown at a speed >20 mph Multiple injured or ill people Pedestrian struck with vehicle travelling at >10 mph Fall from a height >15 feet Critical stroke and cardiac patients if ground transport >45 minutes Critical trauma patient if ground transport >30 minutes

Air Medical Transport Considerations Types: Rotorcrafts: used for areas not accessible to any other type of rescue craft Fixed-wing crafts: used for transport over long distances Considerations Weather Space and weights

Landing Zone Considerations (LZ) A minimum area of 10,000 square feet (100 feet by 100 feet) Flat, firm land An area clear of any obstacles, such as trees or utility poles An area clear of any type of vehicular traffic or pedestrians An area that is well lit that can easily be seen by the pilot

Emergency Vehicle Safety Vehicle preparedness Equipment preparedness – includes PPE Use of lights and sirens Responding with due regard Obey traffic laws Weather and road conditions

High-Risk Situations Intersections and highway access Fatigue Speeding Driving distractions Inclement weather Aggressive driver Unpaved roadways Responding alone/first on the scene Fatigue Downed electrical lines Leaking fuel or fluids Smoke or fires Broken glass Trapped or ejected patients

Activity You are the first to arrive at the scene involving a tree that has fallen onto a house after a violent thunderstorm. The house is located in a rural section of the town. The wind is blowing hard and rain continues to fall, somewhat heavy at times. The tree has hit the second story of the house, damaging the roof and several windows. Tree branches, window shards and pieces of the roof litter the ground. The utility pole in front of the house is leaning toward the house. The family members, who were on the second floor when the tree hit, are outside sitting on the grass. They are dazed and have numerous cuts and lacerations that are oozing blood. Fire and utility crews have been notified but have yet to arrive.

Safety and Patient Care in the Ambulance All personnel seated and secured Patient properly secured with all straps Keep three of the five essential body parts (two hands, feet and backside) “hugging” the ambulance at all times during patient care All moveable equipment secured

Jump Kit PPE and hand sanitizer Oral airways Suction equipment Artificial ventilation devices Basic wound supplies Other items, such as— PPE and hand sanitizer Scissors, blood pressure cuff, stethoscope and flashlight Maps, notepad and pen

You Are the Emergency Medical Responder Additional fire rescue, police and EMS units arrive. You see that one of the occupants of the vehicle that is on the shoulder of the road apparently was not wearing a seat belt, was ejected from the vehicle and is not moving. The driver of the car on the median strip is conscious, but because of traffic you cannot get to that vehicle.

Enrichment Operational Safety and Security Begin each shift with an in-person briefing or review of written notes about any issues Never leave an ambulance or rescue vehicle running or unattended with the key in the ignition Monitor all vehicles, in and out of service Track all vehicle use