1 / 34

Contra Costa County CERT Program Unit 3 – Emergency Medical Operations Part 1

Contra Costa County CERT Program Unit 3 – Emergency Medical Operations Part 1. Released: 6 September 2011. Community Emergency Response Team. Personal safety is ALWAYS the number one priority Work as a team Wear personal protective equipment…gloves, helmet, goggles, N95 mask and boots

blade
Download Presentation

Contra Costa County CERT Program Unit 3 – Emergency Medical Operations Part 1

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Contra Costa County CERT ProgramUnit 3 – Emergency Medical Operations Part 1 Released: 6 September 2011

  2. Community Emergency Response Team • Personal safety is ALWAYS the number one priority • Work as a team • Wear personal protective equipment…gloves, helmet, goggles, N95 mask and boots • The CERT goal is to do the Greatest Good for the Greatest Number • Hope for the best but plan for the worst

  3. Unit Objectives • Identify the “killers” • Apply techniques for opening airways, controlling bleeding, and treating for shock • Conduct triage under simulated emergency conditions

  4. Death from Trauma • Overwhelming and irreversible damage to vital organs, death within minutes • Excessive bleeding, death within minutes • Infection or multiple organ failure, death in several days or weeks 40% could be saved! 90% of disaster victims are rescued by other victims!

  5. Life-Threatening Conditions The “Killers”: • Airway obstruction • Excessive bleeding • Shock Life-threatening conditions must receive immediate treatment!

  6. How to Approach a Victim • Size-up: Check scene for safety • Be sure victim can see you • Identify yourself • Your name, training and name of your organization • Request permission to evaluate and treat • Respect cultural differences

  7. Checking For Breathing • Tap and shout • Open airway…palm on forehead, 2 fingers under chin and tilt the jaw upward while tilting the head backwards slightly • Ear over victims mouth while looking at the chest • look - for chest rise • listen - for air exchange • feel – abdominal movement • Evaluate and repeat if necessary once more

  8. Opening The Airway

  9. Opening The Airway Head Tilt/Chin Lift

  10. Arterial…spurting Venous…flowing Capillary…oozing Bleeding Losing one liter can be life threatening

  11. Bleeding Control • Direct pressure • Elevation • Pressure points No tourniquets!

  12. Shock • Result of ineffective circulation of blood • Remaining in shock will lead to death of: • Cells • Tissues • Entire organs

  13. Shock - Signs • Weak, restless or irritable • Rapid and weak pulse • Rapid shallow breathing • Pale, cool, moist skin • Blue lips or fingernails • Nausea and vomiting • Dizzy, drowsy or unconscious • Very low blood pressure Treat anyone unconscious for SHOCK

  14. Shock - Treatment • Control major bleeding • Place in Recovery Position • Maintain body temperature • Loosen restrictive clothing Recovery Position

  15. Multi-Casualty Incident Definition A Multi-Casualty Incident (MCI) is any situation that overwhelms the normal emergency response capability An MCI is also known as a Mass Casualty Incident or a Mass Casualty Event

  16. Typical Multi-Casualty Incidents • Earthquakes • Urban Wild Lands Fires • Motor Vehicle Accidents • Floods • Tornados • Hurricanes • Explosions • Train derailments • Hazmat

  17. CERT Size-up • Gather Facts • Assess Damage • Consider Probabilities • Assess Your Situation • Establish Priorities • Make Decisions • Develop Plan of Action • Take Action • Evaluate Progress

  18. Triage TRIAGE – French term meaning “to sort ” • During triage, victims are evaluated and prioritized according to the urgency of treatment needed • Spending a lot of time trying to save one life may prevent a number of other patients from receiving the treatment they need • Triage is a Perishable Skill and must be practiced regularly

  19. Triage Steps • Size-up • Conduct voice triage • Follow a systematic route • Start where you stand • Evaluate each victim and tag them • Document Triage results “Immediates”…airway, bleeding, recovery position Transfer “Immediates” to medical group immediately!

  20. The START Triage System SimpleTriageAndRapidTreatment

  21. START Video

  22. Triage Pitfalls • No team plan, organization, or goal • Indecisive leadership • Too much focus on one injury • Treatment (rather than triage) performed

  23. Patient Assessment…RPM Three things to check… • Respirations • Perfusion • Mental Status Anyone who is unconscious is an “Immediate” by definition!

  24. RPM…Respirations Range…Adults under 30 breaths a minute Children to 12 years: 15-45 breaths/min • No breathing • Position airway, if still not breathing try it again • If still no breathing tag as DECEASED and move on to next person • Out of range for breaths per minute • Tag as IMMEDIATE and move on to next person • Within range for breaths per minute • Go to the next step…Perfusion

  25. RPM…Perfusion…Blanch Test Goal…perfusion in under 2 seconds • More than 2 seconds • Tag asIMMEDIATEand move on to next person • Less than 2 seconds • Go to next step… Mental Status

  26. RPM…Mental Status Goal…follow simple command • Can not follow directions • Tag asIMMEDIATEand move on to next person • Can follow directions • Tag asDELAYEDand move on to next person

  27. S.T.A.R.T. Categories • MINOR • IMMEDIATE • DELAYED • DECEASED

  28. “ MINOR ” • Walking wounded • Do not require immediate care • “Screamers” • Use as helpers to care for others

  29. “ IMMEDIATE ” • Life Threatening Injury • Victim needs immediate care • Fails R – P – M check Adult >30 respirations per minute • Child outside 15-45 respirations/m • Breathing normal, no radial pulse • Capillary refill > 2 seconds • Mental check

  30. “ DELAYED ” • Serious Non Life Threatening Injury • Did not walk out of scene • R-P-M within in acceptable limits • May have broken bones • May be extrication problem • May have chest pain, etc.

  31. “ DECEASED ” • New term: MORGUE • Considered Non-Salvageable • Obviously dead • Pulseless • Non-breathers who fail to breathe after airway has been cleared • Mortal injuries

  32. Triage Operations Review • Size Up … What’s happening? • Check the scene • Stop, look, listen and think • Assess your situation … What could happen? • Develop a plan of action … What will we do? • Conduct voice triage, get walking wounded out • Start where you stand • Follow a systematic route • Use RPM to evaluate and tag each victim • Transfer“Immediates”to medical group immediately! • Document Triage results Help or Document and Report

  33. Triage Exercises • Head Tilt / Chin Lift • Bleeding Control • Triage Exercise RPM

  34. Unit Summary • The Killers • Approaching a Victim • Open Airway • Control Bleeding • Treat Shock • Size-up and Triage • RPM

More Related