1. Slide 1 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Disasters and Hazardous Materials Chapter 33

2. Slide 2 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Case History You respond to a call for an overturned truck. You approach the scene from upwind and observe a flaming tanker approximately 200 yards in the distance. There are several cars involved in the incident. You respond to a call for an overturned truck. You approach the scene from upwind and observe a flaming tanker approximately 200 yards in the distance. There are several cars involved in the incident.

3. Slide 3 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Hazardous Materials (HAZMAT)  Definition: Any substance (solid, liquid, or gas) capable of creating harm to people, property, and the environment.  HAZMAT can contaminate or physically remain on or in a person, animal, the environment, or equipment, creating a continuing risk of injury or a risk of exposure to others.

4. Slide 4 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Hazardous Materials (HAZMAT)  EMT’s primary responsibility – provide medical care and maintain safety, preventing unnecessary contamination of themselves and others.

5. Slide 5 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Hazardous Materials (HAZMAT)  May be flammable, toxic, infectious, corrosive, radioactive, oxidizing, or reactive

6. Slide 6 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. OSHA Hazardous Waste Operations and Emergency Response Standard  First responder/awareness  First responder/operations  Hazardous materials technician  Hazardous materials specialist  On-site incident commander

7. Slide 7 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Safety  First and ongoing concern  Position vehicle and crew upwind and uphill from incident.  Ascertain information about incident from a safe distance.  Keep unnecessary people away from the affected area.

8. Slide 8 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Properties of Hazardous Materials  Routes by which hazardous materials can enter the body:  Inhalation  Absorption  Ingestion  Injection  Can be alone or in combination

9. Slide 9 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Control Zones

10. Slide 10 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Personal Protective Equipment  Those who enter a potentially contaminated area should have:  Special training  Specialized protective equipment Specifically compatible with the hazard Specifically compatible with the hazard  Breathing apparatus

11. Slide 11 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Decontamination  Dilution  Absorption  Chemical washes  Disposal and isolation

12. Slide 12 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. HAZMAT Warning Placards

13. Slide 13 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Incident Management System  Organized system of roles, responsibilities, and SOPs used to manage emergency operation  Central authority for incident  Three essential components  Command  Triage  Transportation

14. Slide 14 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Structure

15. Slide 15 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.Structure

16. Slide 16 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Role – Individuals  Individuals are assigned roles in one of the sectors.  EMT should report to the sector officer.  EMT should complete the task and report back to the sector officer.

17. Slide 17 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Safety  EMS command is responsible for scene safety.  Priorities of safety concerns:  Rescuer  Public  Victim  Do not add to the number of victims.

18. Slide 18 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Triage  Three stages  First No treatment No treatment Victims are tagged by category of injury. Victims are tagged by category of injury.  Second Begins after patients removed to safe area Begins after patients removed to safe area More thorough assessment More thorough assessment Treatment Treatment  Third Field hospital, if necessary Field hospital, if necessary

19. Slide 19 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Triage Priorities  Red – Highest priority  Patients with life threats who have greatest chance for survival  Require hospital care within 1 hour  Examples: Readily controllable bleeding Readily controllable bleeding Compound fractures Compound fractures Mechanical respiratory problems Mechanical respiratory problems

20. Slide 20 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Triage Priorities  Yellow – Second priority  Potential life threats who must be treated within a few hours  No systemic signs of shock  Examples Multiple or major fractures Multiple or major fractures

21. Slide 21 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Triage Priorities  Green – Lowest priority  No life-threatening injuries  Ambulatory  Black – Last priority  No signs of life  Obvious mortal injuries

22. Slide 22 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. START Triage System

23. Slide 23 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Special Considerations  Children should be kept with parents when possible.  Hysterical patients should be removed to another area.

24. Slide 24 Copyright © 2007, 2004, by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Transportation  Drivers should remain with their vehicles or leave keys with transport officer.  When ambulance leaves site with patients, transport office notifies receiving hospitals  To keep airwaves clear, EMS crew should not communicate with hospital.  Hospital selection – per local protocol