Transcript Paramedic Care: Principles & Practice Volume 5 Special

Paramedic Care:
Principles & Practice
Volume 5
Special Considerations/
Operations
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Chapter 10
Rescue Awareness and
Operations
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Topics
Role of the Paramedic
Protective Equipment
Safety Procedures
Rescue Operations
Surface Water Rescues
Hazardous Atmosphere Rescues
Highway Operations and Vehicle Rescues
Hazardous Terrain Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Introduction
Rescue is the “act of delivering from danger
or imprisonment”
In EMS, rescue means extricating and/or
disentangling the victims who will become
your patients
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Role of the Paramedic
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Role of the Paramedic
Awareness training imparts knowledge
about rescue operations to EMS personnel
In any rescue situation, treatment begins at
the site of the incident
Paramedics should have the proper training
and personal protective equipment (PPE)
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Role of the Paramedic
Paramedics should
understand the
hazards associated
with various
environments
Recognize when it
is safe and unsafe
to access the
patient
© Jeff Forster
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Protective Equipment
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Protective Equipment
Rescuer
Protection
– Visible clothing
– Adapt PPE
– PPE may not
completely
prevent exposure
to infectious
disease
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescuer’s Protective
Equipment
Helmets
Eye protection
Hearing protection
Respiratory
protection
Gloves
Flame protection
Personal flotation
devices
Lighting
Hazmat suits
Wilderness
protection
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Protection
Helmet
Eye protection
Hearing and respiratory protection
Protective blankets
Protective shielding
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Safety Procedures
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Safety Procedures
Steps in curbing
“heroics” and
maintaining
optimum safety
include:
– Rescue SOPs
– Crew assignments
– Preplanning
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue Operations
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue Operations
Phase 1
Phase 5
– Arrival and size-up
Phase 2
– Disentanglement
Phase 6
– Hazard control
Phase 3
– Patient Packaging
Phase 7
– Patient access
– Removal/transport
Phase 4
– Medical treatment
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 1—Arrival and Size-Up
Establish medical
command
Conduct a rapid
scene size-up
Be careful not to
overestimate your
capability to handle
a rescue situation
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 2—Hazard Control
On-scene hazards must be identified with
speed and clarity
Control as many of the hazards as possible
Potential hazard
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 3—Patient Access
Begin by
formulating a plan
Use appropriate
safety equipment
and procedures
Formal briefing
should be held for
rescue personnel
prior to effort
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 4—Medical Treatment
Three responsibilities
– Initiation of patient
assessment and care
as soon as possible
– Maintenance of
patient care
procedures during
disentanglement
– Accompaniment of the
patient during removal
and transport
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 4—Medical Treatment
Identify and care for existing problems
Anticipate changing patient conditions and
determine in advance the assistance and
equipment needed
Continually evaluate risks to both rescuers
and the patient
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 5—Disentanglement
Responsibilities
– Personal and
professional
confidence in the
technical expertise
and gear
– Readiness to
provide prolonged
patient care
– Ability to call for
and/or use special
rescue resources
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 6 – Patient Packaging
Consider means of
egress
Factor time based
on the patient’s
medical conditions
Properly package
the patient to
prevent additional
injury
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Phase 7 – Removal/Transport
Requires the
coordinated effort
of all personnel
Coordinate
decisions regarding
transport early
Ongoing
assessment
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Surface Water Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Surface Water Rescues
Water rescues may involve many kinds of
water bodies
– Pools, rivers, streams, lakes, canals, flooded
gravel pits, or even the ocean
Paramedics participating in water rescues
are trained and equipped properly
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Surface Water Rescues
Always wear a PFD
whenever you are
around water or ice
Become familiar
with safe aquatic
practices
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Water Temperature
Factors contributing to hypothermia
–
–
–
–
Incapacitation and an inability to self-rescue
Inability to follow simple directions
Inability to grasp a line or flotation device
Laryngospasm
Heat Escape Lessening Position (HELP)
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Basic Rescue Techniques
PPE
– Include dry suits for
ice rescue
Water rescue
model is reach–
throw–row–go
Become proficient
with a water-throw
bag
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Moving Water
The most dangerous water rescues
involve water that is moving
Hydraulics of moving water
– Variables, including water depth, velocity,
obstructions to flow, changing tides, and
more
Four swift-water rescue scenarios
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Recirculating Currents
May create a
“drowning
machine”
Can look very
tame
Once caught, it
is very difficult
to escape
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Strainers
Water flows
through
obstructions
Currents force
a patient up
against a
strainer
Try and swim
over, if
possible
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Foot/Extremity Pins
It is unsafe to walk in fast-moving
water over knee depth
– Danger of entrapping a foot or extremity
To remove the foot or extremity, it
must be extracted the same way it
went in
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Dams/Hydroelectric Intakes
Often found along rivers
Height of the dam is no indication of the
degree of hazard
– Drowning machines
Intakes become strainers
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Self-Rescue Techniques
Use of PFD’s
HELP technique to maintain warmth
Other techniques
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Flat Water
A large
proportion of
drowning or
near-drowning
incidents take
place in flat or
slow-moving
water
Alcohol is a
factor in many
instances
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Factors Affecting Survival
Personal flotation devices
Cold-protective response
– Mammalian diving reflex
Parasympathetic response occurs
Location of submerged victims
Rescue vs. body recovery
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Factors Affecting Survival
In-Water spinal
immobilization
technique
Occurs in phases
– Phase 1
– Phase 2
– Phase 3
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous
Atmosphere Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous
Atmosphere Rescues
One of the most
serious threats of
confined space
rescue is an
oxygen-deficient
environment
60% of all fatalities
are people
attempting to
rescue a victim
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous
Atmosphere Rescues
Confined space
– Any space with
limited
access/egress
that is not
designed for
human occupancy
or habitation
Examples
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous
Atmosphere Rescues
Entering
confined spaces,
such as silos,
requires training,
equipment, and
experience
© Michal Heron
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Confined-Space Hazards
Oxygen-deficient atmospheres
Toxic or explosive chemicals
Engulfment
Machinery entrapment
Electricity
Structural concerns
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Confined-Space Protection
In the Workplace
Employers must provide a training program
for all employees who work in or around
confined spaces
Permit process
Types of emergencies
– Falls, medical emergencies (often hazmat
related), oxygen deficiencies or asphyxia,
explosions, and entrapment
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Cave-Ins and
Structural Collapses
Collapsed
trenches or caveins can occur in
almost any
community
– Most occur in
trenches less than
12 feet deep and
6 feet wide
© Michal Heron
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Reasons for Collapse
Contractors disregard safety regulations
The lip of one or both sides of the trench
caves in
The wall shears away or falls in entirely
“Spoil pile” is placed too close to the edge of
the trench
Water seepage, ground vibrations,
intersecting trenches, or previously
disturbed soil
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue from Trenches
A secondary collapse is likely
Secure the scene, establish command,
secure a perimeter, and immediately
summon a team specializing in trench
rescue
Proper shoring must be in place
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Highway Operations
and Vehicle Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Highway Operations
and Vehicle Rescues
Traffic flow is the largest single hazard
associated with EMS highway operations
Reducing traffic hazards
–
–
–
–
–
Staging
Positioning of apparatus
Emergency lighting
Redirection of traffic
High visibility
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Highway Operations
and Vehicle Rescues
Other Non-Traffic Hazards
Fire and fuel
Alternative fuel
systems
Sharp objects
Electric power
Energy-absorbing
bumpers
Air bags
Hazardous cargoes
Rolling vehicles
Unstable vehicles
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Auto Anatomy
Motor Vehicle Collisions (MVCs) present
EMS with the most common access and
extrication problems
You must know some basic information
about automobile construction or “anatomy”
Considerations include:
–
–
–
–
Frame/construction
Firewall/engine-compartment components
Types of glass
Doors
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue Strategies
Perform initial
scene size-up
Control hazards
Assess the degree
of entrapment
Establish circles of
operation
Treatment,
packaging, removal
© Joshua Menzies
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue Skills Practice
Practice and/or
observe the various
disentanglement or
extrication skills
commonly used
Become familiar
with the use of
heavy hydraulic
equipment
© Joshua Menzies
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Rescue Equipment
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hybrid Vehicles
HEVs contain both an
electric motor and an
internal combustion
motor
The high-voltage
component poses a
particular risk for
rescue personnel
– Easiest way to control
is turn off the vehicle
and remove the key
Both photos: © Ray Kemp/911 Imaging
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous Terrain Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Hazardous Terrain Rescues
Activities such as mountain climbing, rock
climbing, cross-country skiing,
snowboarding, and hiking have drawn more
people into rugged areas
You should know how to perform litter
evacuations without causing additional
injury to patients
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Types of
Hazardous Terrain
Steep slope or low-angle terrain
– Can be accessed by walking or scrambling
Vertical or high-angle terrain
– Usually involves a cliff, gorge, side of a building,
or terrain so steep that hands must be used
when scaling it
Flat terrain with obstructions
– Trails, paths, or creek beds
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Access in
Hazardous Terrain
High Angle Rescues
– Must have extensive
initial and ongoing
training
– Terms
Aid
Anchor
Belay
Rappel
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Access in
Hazardous Terrain
Low-Angle Rescue
– Rescue is
considered a lowangle rescue up to
40°
– Low-angle rescues
involve less
technical skill than
high-angle rescues
Initial and ongoing
training is essential
© Ken Kerr
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Packaging
The Stokes Basket
– The standard litter for rough terrain evacuation
– Most Stokes baskets are not equipped with
adequate restraints
Additional strapping necessary
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Utilization of the Stokes
Apply a harness to the patient
Apply leg stirrups
Secure the patient to a litter
Tie the tail of one litter line to the patient’s
harness
Use a helmet or litter shield
Administer fluids
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Utilization of the Stokes
Allow accessibility for taking BP,
performing suction, and assessing distal
perfusion
Ensure adequate padding
Consider use of a patient heating/cooling
system
Provide for an airway clearing system via
a gravity “tip line”
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Removal from
Hazardous Terrain
Flat, Rough Terrain
– Have enough litter carriers
2-3 teams of six carriers
– Devices exist to ease the difficulty of a litter
carry
Straps
Litter wheels
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Patient Removal from
Hazardous Terrain
Low-Angle/High-Angle Evacuation
– Require specialized knowledge and skills
Evacuation is a team effort
– Use of aerial apparatus such as tower-ladders
or bucket trucks
Utilizes Stokes basket
Litter belay
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Use of Helicopters
Helicopters can be useful in hazardous
terrain rescues
You must understand the capabilities of
helicopters along with their advantages and
disadvantages
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Use of Helicopters
Boarding and de-boarding practices
Restrictions on carrying non-crew members
Use of cable winches for rescues
Weight restrictions
Restrictions on hovering rescues
Use of short hauls or sling loads of
equipment and/or personnel
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Practicing Evacuation
Techniques
Familiarize yourself
with the specific
equipment
Practice the skills
required for lowangle and highangle rescues
Be familiar with
local resources
© Craig Jackson/In the Dark Photography
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Extended Care Assessment
Consider protocols addressing the following
areas:
–
–
–
–
Long-term hydration management
Repositioning of dislocations
Cleansing and care of wounds
Removal of impaled objects
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Extended Care Assessment
Environmental issues
–
–
–
–
Weather/temperature extremes
Limited patient access
Difficulty transporting street equipment
Cumbersome PPE
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Extended Care Assessment
Environmental issues (cont.)
–
–
–
–
Patient exposure
ALS care
Patient monitoring
Improvisation
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ
Summary
Role of the Paramedic
Protective Equipment
Safety Procedures
Rescue Operations
Surface Water Rescues
Hazardous Atmosphere Rescues
Highway Operations and Vehicle Rescues
Hazardous Terrain Rescues
Bledsoe et al., Paramedic Care: Principles & Practice, Volume 5: Special Considerations/Operations, 3rd. Ed.
© 2009 by Pearson Education, Inc. Upper Saddle River, NJ