1. US&R Medical Care and Safety for Victims

2. Basic Medical Considerations For Rescuers –Primary objective is to stabilize collapsed structures –Rescuers must protect themselves with proper gear For Victims –Establish victim collection areas –Use established triage procedures –Consider length of entrapment

3. Entrapment Survival 30 minutes = 91% survival 1 day = 81% 2 days = 36.7% 3 days = 33.7% 4 days = 19% 5 days = 7.4%

4. Injuries Associated with Structural Collapse High potential for rescuer injury Significant fall or crush potential Types of injury –Head, neck, back trauma –Broken bones and soft tissue injuries –Compartment and Crush Syndrome –Hypothermia –Hypovolemia –Dehydration –Inhalation injury

5. Compartment Syndrome Limbs trapped longer than 4 hours Tissue death begins Severe swelling of surrounding tissue that restricts blood flow

6. Crush Syndrome – “Grateful Dead” Pressure on body part for over 4 hours Tissue death begins Sudden release of pressure and toxins can cause heart dysrhythmias and kidney failure Can be alive one minute and then dead the next minute after releasing the victim from the collapse Treatment –Prior to releasing from the collapse –Oxygen, IVs, EKG, Meds –Requires ALS care

7. Victim Medical Care and Safety High flow oxygen C-spine immobilization EKG monitor ALS Medications Victim packaging for removal Maintain body temperature Possible head, eye and respiration protection Protect from rescue operations Caution during victim movement over debris piles

8. Basic Infectious Disease Safety Rescuer PPE for infectious precautions –Protects against cuts and abrasions –Protect eyes, respiratory and mucous membranes –Rubber gloves under leather work gloves –Tyvec type moisture barrier outer wear

9. General PPE Rules “If its warm and wet and not yours, get it off you as soon as possible” Wash with soap and water or mild disinfectant Wash hands and face prior to eating Remove and wash clothing, boots, gloves if contaminated Immunizations need to be current –Hepatitis, Tetanus