1. Essentials of Fire Fighting
6th Edition
Firefighter I
Chapter 22 — Emergency Medical Care for Fire Department First Responders

2. Learning Objective 1
Describe the roles the fire service may take in providing emergency medical care.

3. DISCUSSION QUESTION
Why are firefighters often cross-trained as emergency medical technicians (EMTs) or Paramedics?

4. The fire service is a key participant in providing emergency medical service.
EMS
Treatment on scene
Transport to definitive healthcare facility
If no ambulance unit
Respond as first responder
Treat until ambulance arrives

5. Ambulance services are provided in several ways.
Fire-based EMS
Third service EMS
Hospital-based EMS

6. Reasons firefighters are requested to respond
Fire departments provide on scene medical care at various service levels.
Reasons firefighters are requested to respond
Can respond faster than EMS
Areas have multiple stations, few ambulances
May have more medical calls than ambulances
Service provided by
Personnel with limited EMS training
Paramedics with same resources as on ambulance

7. REVIEW QUESTION
What are the roles the fire service may take in providing emergency medical care?

8. Learning Objective 2
Summarize patient confidentiality requirements.

9. DISCUSSION QUESTION
What information is included in the protected medical information (PMI) of a patient?

10. Patient confidentiality centers around protected medical information (PMI).
Personal data
Medical history
Condition

11. Medical information privacy is covered by applicable laws.
Health Insurance Portability and Accountability Act (HIPPA)
Greater regulations on use, distribution, storage
Requires designated privacy officer, compliance training

12. Release to others only with patient consent
Good professional practice is to be as discreet as possible with all PMI.
Disclose only if legitimate need
Law enforcement
EMS
Hospital staff
Release to others only with patient consent

13. REVIEW QUESTION
What does the Health Information Portability and Accountability Act (HIPPA) of 1996 require regarding patient confidentiality?

14. Learning Objective 3
Distinguish among commonly encountered communicable diseases.

15. Learning Objective 4
Summarize immunization considerations for first responders.

16. Infection control measures can be used to reduce the risk of infection.
Ability to identify signs and symptoms
Use proper body substance isolation (BSI)

17. There are several commonly encountered communicable diseases.
Hepatitis
Tuberculosis
HIV/AIDS
(Cont.)

18. CAUTION
Medical equipment and surfaces should be decontaminated immediately following soiling to prevent the possible spread of infectious diseases to responders and other patients.

19. There are several commonly encountered communicable diseases.
Multi drug-resistant organisms
Others
Outbreaks
H1N1 flu
Avian flu

20. Immunizations may be required by your jurisdiction.
Various types may be required or recommended
Test for tuberculosis may be administered

21. REVIEW QUESTION
What are the communicable diseases commonly encountered by firefighters?
What types of immunizations may first responders be required to have?

22. Learning Objective 5
Explain the importance of body substance isolation (BSI).

23. Pathogens to protect against are both bloodborne and airborne.
Numerous routes of exposure
Open wounds, cuts, sores
Contact with eyes, nose, mouth
Any break in skin

24. Proper body substance isolation (BSI) is the best way to protect yourself.
Hand washing
Proper use of personal protective equipment (PPE)
Proper disposal/ cleaning of soiled items

25. Hand washing is one part of maintaining proper BSI.
Reduces transmission
Should be frequent
Wash in methodical manner
Use alcohol based solution as alternative

26. BSI also requires the proper use of different types of PPE.
Gloves
Eye protection
Masks
Gowns
Spare uniforms

27. Cleaning and disposal of contaminated items is another part of proper BSI.
Clean with disinfectant
Follow NFPA® 1581 and local SOPs

28. REVIEW QUESTION
What are some basic ways first responders can practice body substance isolation (BSI)?

29. Learning Objective 6
Explain actions taken for basic patient assessment.

30. Patient assessment must be completed before treatment can begin.
Airway B
Breathing C
Circulation/Compressions

31. The airway is an assessment of the passage where air travels when breathing.

32. Look, listen, and feel to determine breathing assessment.

33. Circulation/compressions are easily determined by feeling for a pulse.

34. REVIEW QUESTION
What actions are taken to assess a patient’s condition?

35. Learning Objective 7
Compare and contrast CPR techniques for adults, children, and infants.

36. Learning Objective 8
Explain when to administer and when to discontinue CPR.

37. Clinical death, known as cardiac arrest, may require defibrillation.
Heart not beating, no longer breathing
Can lead to biological death
Caused by heart failure
Defibrillation may be required to resume heart

38. Cardiopulmonary resuscitation (CPR) may be required for several reasons.
Heart’s condition may not warrant defibrillation
Defibrillation may not be successful
Outside intervention is needed to slow cellular death

39. Chest compressions, the main component of CPR, are performed differently depending on patient age.
Compress heart to circulate blood
Don appropriate PPE, determine patient condition
Do not administer if obvious signs of death
(Cont.)

40. Chest compressions, the main component of CPR, are performed differently depending on patient age.
(Cont.)
For adults

41. Chest compressions, the main component of CPR, are performed differently depending on patient age.
(Cont.)
For children

42. Chest compressions, the main component of CPR, are performed differently depending on patient age.
For infants

43. REVIEW QUESTION
How do CPR techniques for adults, children, and infants differ from one another?

44. Once begun, CPR should only be discontinued in specific circumstances.
Patient regains consciousness or begins to move
Patient has pulse
You are unable to continue due to exhaustion
You hand over care to higher trained rescuer
You are instructed to stop by medical control physician

45. You should understand the emotional nature of cardiac events.
You may be subject to anger when deciding to begin, end CPR
Speak calmly, keep in mind feelings when discussing with other responders

46. REVIEW QUESTION
When should a first responder administer and discontinue CPR?

47. Learning Objective 9
Describe basic types of external bleeding.

48. Learning Objective 10
Explain the use of direct pressure and elevation to control external bleeding.

49. Bleeding control is an extremely important aspect of medical treatment.
Typical causes of external bleeding

50. Arterial Venous Capillary
You should recognize the signs of the three types of external bleeding.
Arterial
Venous
Capillary

51. REVIEW QUESTION
What are the basic types of external bleeding?

52. Methods used to control external bleeding depend on the type.
May use one or more methods
Follow department medical protocols
Use proper PPE

53. The direct pressure method is the first and most commonly used method.

54. The elevation method is used to raise an extremity above a patient’s heart.

55. REVIEW QUESTION
How can direct pressure and elevation control external bleeding?

56. Learning Objective 11
Describe the signs and symptoms of internal bleeding.

57. Internal bleeding, not seen externally, still shows several signs or symptoms.
Significant bruising
Bleeding from openings in body
Bloody stool, urine
Painful, swollen, rigid abdomen
Vomiting substance that looks like coffee grounds
Cool, pale, clammy skin

58. Internal bleeding has several causes and is a true medical emergency.
Traumatic
Medical
Actions
Treat for shock
Immediately transport by ambulance to hospital

59. Learning Objective 12
Describe the role that recognizing the types, signs, and symptoms of shock plays in shock management.

60. Shock occurs when the body is unable to keep vital organs functioning.
Hypovolemic
Cardiogenic
Neurogenic
Others
Anaphylactic
Septic

61. You should know the signs and symptoms of the two stages of shock.
Compensated
Only slight changes
No visible changes
Decompensated
Pale, cool, and/or clammy skin
Confusion
Nausea and/or vomiting
Changes to vital signs
Others such as dizziness, dilated pupils, and loss of consciousness

62. Patients exhibiting signs of shock should be treated and prepared for transport immediately.
Do not delay transport
Control any bleeding noticed
Cover patient with blanket

63. REVIEW QUESTION
Why is it important that a first responder recognize the types, signs, and symptoms of shock?

64. Summary
Providing Emergency Medical Services is a critical function of the fire service, especially as aging populations create an increased demand.
Properly trained firefighters are needed because they can often make the difference between life and death, not only for victims but for other firefighters as well.