Transcript SCENE SIZE UP - Dave EMS History Page

SCENE SIZE UP
DOT OBJECTIVES
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RECOGNIZE HAZARDS AND POTENTIAL HAZARDS
DESCRIBE COMMON HAZARDS AT THE SCENE
DETERMINE SCENE SAFETY
MECHANISMS OF INJURY/NATURE OF ILLNESS
IDENTIFY NUMBER OF PATIENTS
RATIONAL FOR EVALUATING SCENE SAFETY
SERVE AS A MODEL FOR OTHERS
DEFINITION
• AN ASSESSMENT OF THE SCENE AND
SURROUNDINGS TO ASSURE THE
SAFETY OF THE EMT AND TO
PROVIDE POTENTIALLY USEFUL
INFORMATION ABOUT THE PATIENT.
SCENE SAFETY
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PERSONAL PROTECTION - IS IT SAFE TO APPROACH THE PATIENT?
– LOOK AND LISTEN FOR OTHER EMERGENCY VEHICLES
– LOOK FOR DOWNED POWER LINES
– OBSERVE TRAFFIC FLOW
– WATCH FOR FIRE OR SMOKE
– LOOK FOR CLUES TO HAZARDOUS MATERIALS
– SNIFF FOR ODORS
SCENE SAFETY CONT’D.
• PATIENT SAFETY - CAN I WORK ON
MY PATIENT HERE OR MUST I MOVE
HIM TO A PLACE OF SAFETY
• BYSTANDER SAFETY
– WATCH FOR PEDESTRIANS ON THE
ROAD
– CURIOUS ONLOOKERS POSE MANY
DANGERS
SCENE SAFETY CONT’D.
• ESTABLISH A DANGER ZONE
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NO APPARENT HAZARDS - 50 FT IN ALL DIRECTIONS
SPILLED FUEL - 100 FT IN ALL DIRECTIONS
VEHICLE FIRE - 100 FT IN ALL DIRECTIONS
DOWNED WIRES - PARK ONE FULL SPAN OF POLES AWAY
HAZ MAT SPILL - CHECK THE NORTH AMERICAN EMERGENCY
RESPONSE GUIDEBOOK
SPECIAL CONSIDERATIONS
• CRIME SCENE WARNINGS
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FIGHTING OR LOUD VOICES
WEAPONS VISIBLE
SIGNS OF ALCOHOL/DRUG USE
UNUSUAL SILENCE
KNOWLEDGE OF PRIOR VIOLENCE
CONSIDER THIS
• ONE DANGER THAT IS PRESENT AT
MANY SCENES IS THE FAMILY DOG.
EVEN ONES THAT LOOK HARMLESS
COULD ATTACK IF THEY FEEL
THREATENED. BE CAREFUL.
NATURE OF THE CALL
• MECHANISM OF INJURY
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HEAD-ON-COLLISIONS
REAR-END COLLISIONS
SIDE-IMPACT COLLISIONS
ROTATIONAL IMPACT COLLISIONS
ROLLOVER COLLISIONS
HEAD ON COLLISIONS
• TWO PATTERNS OF INJURY SEEN
– UP AND OVER - PATIENT GOES UP AND
OVER THE STEERING WHEEL - HEAD
AND NECK INJURIES COMMON
– DOWN AND UNDER - PATIENT GOES
DOWN AND UNDER THE STEERING
WHEEL - KNEE, HIP AND LEG INJURIES.
REAR-END COLLISIONS
• HEAD AND NECK INJURIES COMMON
• BODY MOVES BUT HEAD REMAINS
STILL
• PROPERLY PLACED HEAD RESTS
HELP TO ELIMINATE THIS
SIDE IMPACT COLLISIONS
• BODY IS THROWN SIDEWAYS
• DIRECT BLUNT INJURY ANYWHERE
ON THE IMPACTED SIDE
• HEAD AND NECK INJURIES COMMON
ROLLOVER COLLISIONS
• POTENTIALLY THE MOST SERIOUS
• POSSIBILITY OF PATIENT EJECTION
FROM VEHICLE
• ALL TYPES OF INJURIES FOUND
ROTATIONAL IMPACT
COLLISIONS
• VEHICLE IS STRUCK AND THEN
SPINS
• OFTEN HAVE MULTIPLE IMPACTS
• SUSPECT ALL INJURY PATTERNS
LOOK AND LEARN
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DETERMINE WHERE THE PATIENT WAS SITTING
SEAT BELTS? AIR BAGS?
EJECTED?
STEERING WHEEL BENT?
WINDSHIELD DAMAGED? PEDALS BENT?
PENETRATING TRAUMA
• INJURY CAUSED BY AN OBJECT
PASSING THROUGH BODY TISSUE
– LOW VELOCITY - PROPELLED BY HAND
(KNIVES)
– MEDIUM VELOCITY - HANDGUNS AND
SHOTGUNS
– HIGH VELOCITY - HIGH POWERED OR
ASSAULT RIFLES
LOW VELOCITY INJURY
• INJURY LIMITED TO AREA OF THE
PENETRATION
• LOOK FOR MULTIPLE WOUNDS
• SUSPECT INJURY TO VITAL ORGANS
MEDIUM VELOCITY INJURY
• LOOK FOR ENTRANCE AND EXIT
WOUNDS
• SUSPECT INJURY TO VITAL ORGANS
• BULLETS CAN TRAVEL ANYWHERE
IN THE BODY
HIGH VELOCITY INJURY
• DAMAGE CAN BE ANYWHERE IN THE
BODY
– DAMAGE DIRECTLY FROM THE BULLET
– PRESSURE RELATED DAMAGE CAVITATION
NATURE OF ILLNESS
• FIND OUT MEDICAL INFO FROM:
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THE PATIENT
BYSTANDERS
FAMILY MEMBERS
THE SCENE
• LOOK FOR MEDICINES
• LOOK FOR OXYGEN DEVICES
RESOURCES NEEDED
• DO YOU HAVE THE RESOURCES TO
HANDLE THE SITUATION
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NUMBER OF PATIENTS
FIRE DEPARTMENT?
RESCUE SQUAD?
MORE AMBULANCES?
THE END
• PRESS ESC TO END THIS
PRESENTATION. I HOPE YOU
ENJOYED IT.