Gaining Access. Lesson Goal. Lesson Objectives 9/10/2012. Explain basics of emergency rescue operations. Additional training recommended

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1 Gaining Access Lesson Goal Explain basics of emergency rescue operations Additional training recommended Lesson Objectives Discuss role of EMT in rescue operations List 7 rescue specialties and discuss differences in required safety equipment Identify basic components of rescue operation 1

2 Lesson Objectives Discuss steps to protect patient during rescue operation Describe different ways of gaining access to patient Discuss differences between simple and complex rescues Introduction Trauma often occurs in situations requiring specialized rescue resources This lesson provides an awareness of rescue operations, but does not provide training needed to engage in rescue operations Technical Rescue 7 NFPA areas of technical rescue Structural collapse Rope rescue Confined space rescue Trench rescue & excavation Vehicle & machinery rescue Water rescue Wilderness rescue 2

3 Technical Rescue Rescue operations involve risk: Accessing patient is a risk to rescuers Techniques and tools used in rescue operations also pose hazards Would-be rescuers with little, no, or improper training can be injured or killed Technical Rescue Occupational hazard Regulated by OSHA Minimum standards for rescue operations training EMS personnel should be trained, at a minimum, to Awareness Level Technical Rescue EMS personnel must be familiar with: Personnel accountability system used by rescue agency Principles of incident management and ICS Local evacuation routes Appropriate PPE for various rescue situations 3

4 Technical Rescue First-arriving EMS personnel play critical role in initiating proper rescue response Scene-size up Type & scope of incident Scene is dynamic; hazards may change & evolve Number & location of victims Technical Rescue Familiarity with NIMS Working in ICS Command Safety Rescue Medical Control zones Structural Collapse Causes of collapse Earthquakes Severe weather Explosions Fire Substandard construction Transportation accidents Age-related weakening of structures 4

5 Structural Collapse Response considerations Occupancy Structural type Collapse mechanism Information from others at the scene Search & rescue resources Stability of structure Structural Collapse Phases of response 1. I: Initial rescue attempts by civilians 2. II: Response of community resources 3. III: Void space rescue teams 4. IV: Technical experts, such as USAR teams Rope Rescue High angle Vertical Low angle Slope 5

6 Rope Rescue Rope Rescue Hazards Falling Tripping Uneven or wet ground Entanglement Fall objects Active utilities Atmospheric conditions Weather Untrained responders Hostile bystanders & victims Location-specific hazards Confined Space Rescue Extremely hazardous Majority of fatalities are bystanders & rescuers not trained in confined space rescue Many fatalities due to inhalation hazards 6

7 Confined Space Rescue Non-permit required entry Larger spaces Fewer risks Permit-required entry Hazardous atmospheres Material that may engulf the rescuer Risk of rescuer entrapment EMTs should never attempt to enter a confined space unless they have the proper training, resources, and authority to do so Trench Rescue & Excavation A trench is narrower than it is deep <15 ft wide OSHA regs apply to trenches: >5 ft deep <5 ft deep if special hazards Trench Rescue & Excavation Initial collapse Secondary collapse Most lethal Types of trench collapse Slough in Side wall in Shear in Spoil in 7

8 Trench Rescue & Excavation Typical weight of soil from collapse: 3000 lb Basic methods for creating a protected trench: Shoring Shielding Sloping Trench Rescue & Excavation Typical injuries Fractures Crush syndrome Hypothermia Head injuries Chest injuries Spinal injuries Hypoxia Vehicle & Machinery Rescue Special considerations Traffic control Stabilization of machinery or vehicle Hazardous materials Electricity Fire Crowd control Work zones Octal survey 8

9 Vehicle & Machinery Rescue Mechanism of injury Vehicle & Machinery Rescue Special considerations Fuel, oil, battery acid, hydraulic fluid, & other spills Stored energy systems Airbags Sharp edges Rescue tools Water Rescue PFD required Hazards include: Drowning Hypothermia Currents Animals, insects, plants Infectious agents & contamination 9

10 Water Rescue Water rescue situations Dive rescue Ice rescue Surf rescue Swift water rescue Water Rescue Dive rescue hazards Barotrauma Decompression sickness Nitrogen narcosis O 2 toxicity Air embolism Drowning Becoming lost, disoriented, or trapped Loss of air supply Water Rescue Ice rescue Multiple victims possible Cold water may prolong patient viability 10

11 Water Rescue Surf rescue Hazards Undertow Tidal surge Riptides Currents Surf rescue Injuries Head/spinal trauma Fractures Contusions Lacerations Water Rescue Swift water rescue Flooding Rivers Low head dams Wilderness Rescue Manpower intensive 3 types of tactics I: Hasty teams II: Open grid III: Closed grid 11

12 Wilderness Rescue 4 basic elements Locate victim Reach victim Stabilize victim Evacuate victim Hazards to rescuers Blisters, scratches, falls Dehydration Bites, stings, weather Terrain hazards Summary Injury and the need for rescue often go hand-in-hand The mechanism entrapping victim is a hazard to rescuers Rescue operations require specialized training Summary EMS personnel must be aware of: Types of rescue & their associated concerns Rescue resources Incident management/ics 12

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