If not be careful of activation during extrication

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If not, be careful of activation during extrication Broken Glass in or around vehicle Potentially dangerous to patient and crew September 2014 JI 17
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Scene Hazards Fluids Flammable fluids may ignite Flames, Smoke, Sparks Request FDNY, DONOT attempt to put out fires Loaded Bumpers Compression pistons located in the bumper to resume normal shape “Exploding” Bolts When HURST tool is used; possibility of bolts flying out due to increase pressure September 2014 JI 18
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September 2014 JI 19 Scene Suggestions Wear extrication gloves Heavy or “Work gloves” for broken glass or sharp metal Try doors before windows Ask patient to unlock door Cover patients with blankets To protect from glass, etc. Notify everyone of any safety concerns (window, sparks, etc.) Use the bottom corner of window if using “punch”
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September 2014 JI 20 Mass Casualty Incidents - MCI Any incident beyond the capability that a single unit should handle Usually more than one agency and would require Incident Common System ( ICS ) Defined by number of patients and type of incident Bus accident, down plane, big fire, etc. EMS is required to do (on-line assignment): IS 100b, IS 200b, IS 700a, IS800b, IS 5a (Hazwoper)
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September 2014 JI 21 Incident Command System (ICS) A pre-planned system to coordinate of all emergency response units in a clear concise, manner Incident Command and Communications Sectors Extrication Triage Treatment Transportation Staging Supply Morgue (PRN)
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September 2014 JI 22 Triage The rapid assessment, treatment, and transport of patients based upon priority and survivability From French meaning “ to sort Primary triage Done on site to categorize for treatment Care not provided except airway positioning and major bleeding control Secondary triage Performed at treatment area to assign care priorities
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September 2014 JI 23 Triage S.T.A.R.T. Simple Triage And Rapid Transport 60 second rapid assessment to determine priority Ability to walk: “walking wounded” . If unable to proceed Airway: Open airway to assist in chest rise = Expectant Respiratory Rate: <10 or >30 = Immediate Pulse Rate: No Carotid = Expectant . No 2 Radial = Immediate Mental Status : Ask patient to do two simple tasks, if both done correctly Delayed . If either tasks fails Immediate “30, 2, Can Do”
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September 2014 JI 24 Triage - START Walking Wounded Green Minor soft tissue injuries Minor fractures Delayed Yellow Burns w/out airway involvement Major / multiple musculoskeletal injuries Neurological injuries Intermediate Orange Medical Only Immediate Red Airway / breathing problems Severe /uncontrollable bleeding Decompensated shock Severe burns Expectant - Black Cardiac or Respiratory Arrest Or non-survivable injury
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September 2014 JI 25 Triage Tags Includes: Patient’s Name Vital signs Transport location Removable corners for tracking “Tear Off” to indicate priority No Transport High Priority Secondary Priority Lowest Priority
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  • Fall '14
  • NYC, Ji, triage

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