Transcript 4 of 4 - Images

4
Search
Operations
and Victim
Management
4
Objectives (1 of 4)
• Discuss the use of search tactics during
search and rescue operations.
• Describe emergency medical response
system levels of service.
• List general hazards that may be present
during victim management at a technical
rescue event.
4
Objectives (2 of 4)
• Describe victim access considerations and
procedures.
• Describe victim stabilization.
• Identify the need for triage at a technical
rescue incident.
4
Objectives (3 of 4)
• List common victim injury patterns related
to technical rescue events.
• Describe types of patient packaging
devices and their use.
• Explain the safety procedures for working
around helicopters.
4
Objectives (4 of 4)
• Describe response planning and incident
management requirements related to
victim management at a technical rescue
event.
4
Victim Management (1 of 2)
• Identifying hazards to which a victim may
be exposed
• Accessing victim or victims
• Performing triage for multiple patients
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Victim Management (2 of 2)
• Assessing and stabilizing patient injuries
• Interacting with victims
• Moving and transferring victims requiring
technical rescue assistance
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Awareness Level Responders
• Identify the location of rescue victims upon
first arrival.
• Gain access to the victims’ location.
• Assist more qualified rescuers with patient
movement and transfer.
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Search Phase (1 of 2)
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Time during which patients are located
Location may be clear or unknown
Entrapment makes more complex
Can be prolonged and require many
resources depending on situation
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Search Phase (2 of 2)
• Search operations involve combination of:
– Detective work
– Analysis work
– Speculation
– Use of search tools, equipment, tactics
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Search Environment Determines
• Difficulty of search operations
• Amount of required resources
• Tactics utilized
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Examples of Environments
• Water
• Wilderness
• Structural collapse
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Search Tactics
• Methods depend on type of rescue, drives
decisions regarding tools or techniques
• Reconnaissance to gather information
regarding type, size, complexity of
situation
• Witness interviews to obtain information
– Includes victim’s last known location
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Factors That Determine Urgency
• Time elapsed
• Victim profile, including experience and
available survival equipment
• Environmental conditions
• Terrain/hazards
• History of incidents in area/site
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Search Plan Based On
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Urgency of search
Available resources
Existing hazards to responders
Known information about victim or victims
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Define Search Area
• Search grid:
– Identifies, prioritizes, documents search area
– Starts search in specific area
• Segmentation:
– Allows for search of large area
– Establishes specific search area boundaries
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Primary and Secondary
Searches
• Primary search:
– “Hasty” search
– Deployment of resources to initiate rapid
search of area thought to contain survivors
• Secondary search:
– Slower, methodical search to ensure no
victims overlooked
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Search Resources (1 of 2)
• Determined by type, complexity of problem
• Might include specialized personnel
resources, such as:
– Incident management personnel
– Trained or specialized searchers
– EMS
– Search dog handlers
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Search Resources (2 of 2)
• Specialized vehicles, such as:
– Helicopters
– Off-road vehicles
– Horses
– Watercraft
• Require plan ahead of time
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Basic Life Support (BLS)
(1 of 2)
• Medical first responders or EMT-Basics
• Limited set of emergency medical skills
• Can perform cardiac defibrillation using
AED
• Cannot administer medications beyond:
– Assisting patient with prescription medications
– Administration of IV fluids
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Basic Life Support (BLS) (2 of 2)
Courtesy of Yellowstone National Park/NPS
4
Advanced Life Support (ALS) (1 of 3)
• Extensive training required; greater
investment in equipment and personnel
training than BLS
• Operate as extension of physician, using
standing orders, protocols, radio direction
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Advanced Life Support (ALS) (2 of 3)
• May require more personnel at emergency
• Training levels include:
– EMT-Paramedics
– EMT-Intermediate includes limited ALS skills
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Advanced Life Support (ALS) (3 of 3)
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Primary Hazard
• May be larger event, such as a natural
disaster
• Specific type of technical rescue may be
secondary factor or cascade event created
by larger event
• Can create other hazards for rescuers,
such as flooding, electrical wires, debris
• Rescuers may also create hazards at
rescue site.
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Hazard and Risk Assessment
Identifies
• Hazards rescuers will be exposed to
• Hazards victims must be protected from
• Level of personal protection equipment
(PPE) required
• Necessary safety procedures
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Hazard and Risk Assessment
© Dennis Wetherhold, Jr.
4
Vehicle Accident Hazards
Include
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Fuel spills
Jagged metal, broken glass
Uncontrolled traffic flow
Unstable vehicles
Air bag systems and hydraulic systems
Possibly hazardous cargo
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Trench Collapse Hazards Include
• Potential for secondary collapse that may
entrap rescuers
• Atmospheric hazards
• Exposure to broken utility lines
4
Confined-Space Hazards Include
• Exposure to oxygen-deficient, explosive,
toxic atmospheres
• Engulfment potential from flowing products
• Uncontrolled energy sources
• Reduced visibility
• Slippery surfaces
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Needs Identified by Hazard and
Risk Assessment
• Special technical rescue protective gear
• Placing and staffing of protective hose
lines for fire hazard
• Controlling broken utilities or uncontrolled
energy sources
• Obtaining flotation device
• Additional or specialized resources
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Perform Hazard Evaluation
Before Initiating Patient Care
• Critical to rescue
• Patient care shifts focus away from
environmental hazards.
• Hazards may worsen, especially in
dynamic situations.
• One crew member should be
disconnected from patient care,
continuously evaluating the environment.
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Victim Access (1 of 3)
• Complexity varies depending on the
entrapment type.
• Type of technical rescue determines
difficulty.
• Victim location precipitated during the
search phase.
• Requires control or reduction of hazards
that may affect rescuer
4
Victim Access (2 of 3)
• Procedures, access equipment, and
access techniques vary widely.
• Rescuers should continuously look for new
hazards.
• Major goal to secure, stabilize victim and
protect from further harm
• Rescuers must identify escape route prior
to entry.
4
Victim Access (3 of 3)
Courtesy of Robert Rhea
4
Victim Assessment (1 of 2)
• First priority following assessment
• Identifies patient injuries and adverse
medical conditions
• Determines resources to extricate,
package, transport patients
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Victim Assessment (2 of 2)
• Based on medical protocols established by
AHJ and applicable local, state, federal
laws:
– Ensure protection from bloodborne via PPE
– Adherence to written protocols related to BSI
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Victim Stabilization per BLS
• Establishing and maintaining adequate
airway
• Providing respiratory ventilation to
maintain air flow
• Controlling severe bleeding
• Maintaining circulatory system
• Spinal immobilization or shock treatment,
if necessary
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Triage (1 of 2)
• Sorts patients based on severity of injuries
or medical conditions
• Essential in mass-casualty incidents
where increased number of patients
strains resources
• Review mass-casualty triage process.
• Follow local medical protocols to
determine patients with highest priority.
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Triage (2 of 2)
© Scott Downs/Dreamstime.com
4
Common Injury Patterns
• Rescuers should be familiar with common
injury patterns related to specific rescue
scenarios.
• Review injury patterns for:
– Vehicle accident entrapment
– Confined-space
– Trench and structural collapse
– Wilderness
– Water
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Victim Packaging, Movement,
and Transfer (1 of 4)
• Performed after victim access,
assessment, initial treatment
• Often uses long spine board or similar
device
• Rescuers choose the appropriate
packaging device for the environment.
• Goal is completing process safely,
efficiently, limiting further injury
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Victim Packaging, Movement,
and Transfer (2 of 4)
• Special equipment may be necessary.
• Ends with patient transfer, or handing-off
patient to EMS responders for transport to
medical facility
4
Victim Packaging, Movement,
and Transfer (3 of 4)
4
Victim Packaging, Movement,
and Transfer (4 of 4)
Courtesy of Junkin Safety
Courtesy of Ferno
Washington, Inc.
Courtesy of Ferno
Washington, Inc.
Courtesy of Ferno
Washington, Inc.
4
Resource Requirements
• Emergency medical services resources:
– Can be significant, depending on situation and
environment
• Specialized victim packaging and transfer
equipment:
– May need to fit in small, space-limited areas
– Must allow for proper victim management,
stabilization, movement
– Multiple patients requires multiple patient packaging
devices
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Transport Vehicle Options (1 of 3)
• Ambulances
• Mass-care vehicle, like a medical bus
used for numerous patients
• Commercial or school buses
• Aircraft for serious injuries
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Transport Vehicle Options (2 of 3)
4
Transport Vehicle Options (3 of 3)
Courtesy of the Prince George’s County Fire/EMS Department
4
Helicopter Usage (1 of 2)
• Initial reconnaissance and large-area
search operations
• Transport rescue teams over long
distances and in isolated areas that are
difficult to access by ground
• Flood and swiftwater rescue
• Serious medical emergencies
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Helicopter Usage (2 of 2)
© Fred L. Isom/ShutterStock, Inc.
4
Helicopter Resources
• Agency supplying helicopter determines
helicopter needed for particular rescue
• Identify locations and response times of
helicopter resources during response
planning.
• Rescue response agencies should have
SOGs related to helicopter assistance.
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Helicopter Safety and Landing
Zone Management (1 of 2)
• Be aware of hazards directly related to
approach, landing, and takeoff.
• Be aware of procedures for identifying,
procuring, and securing landing zones.
• Be aware of safety guidelines for working
around a helicopter.
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Helicopter Safety and Landing
Zone Management (2 of 2)
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Incident Management
Requirements
• Use ICS to achieve strategic objectives.
• ICS staffing and positions are determined
by scope of event.
• ICS management personnel are
responsible for strategic and tactical
management.
4
Response Planning (1 of 2)
• Perform regular needs assessments to
determine vulnerability to various technical
rescue events.
• Identify capability of agency personnel in
advance, including level of performance at
which agency personnel are trained.
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Response Planning (2 of 2)
• Understand location, capabilities, and
response times for regional, state, federal
search and rescue teams and medical
teams.
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Summary (1 of 2)
• Victim management includes identifying
hazards, accessing victims, performing
triage, assessing patient injuries,
stabilizing victim injuries, interacting with
victims, and moving and transferring
victims.
• Resource requirements vary, depending
on entrapment problem and number of
victims.
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Summary (2 of 2)
• Effective planning incorporates risk
assessment, resource assessment, and
development of written procedures.
• Rescuers must understand types of
common injury patterns.
• ICS may be necessary to control the
emergency.