Gaining Access and Rescue

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Gaining Access and Rescue

  1. 1. Chapter Gaining Access and Rescue Twenty-Seven
  2. 2. <ul><li>Extrication: 10 fundamental phases </li></ul><ul><li>Role of the EMT-B at an extrication </li></ul><ul><li>How to size-up and recognize potential hazards at rescue scene </li></ul><ul><li>What personal protective equipment should be worn at the rescue scene </li></ul><ul><li>How to determine the need for extrication </li></ul>CORE CONCEPTS Chapter Twenty-Seven (Continued)
  3. 3. <ul><li>Importance of safety equipment at rescue scene </li></ul><ul><li>How to stabilize vehicle and gain access to patient </li></ul><ul><li>Typical disentanglement action plans used at a vehicle rescue </li></ul>CORE CONCEPTS Chapter Twenty-Seven
  4. 4. Fundamental Phases of Extrication <ul><li>Prepare for the rescue. </li></ul><ul><li>Size up the situation. </li></ul><ul><li>Recognize and manage hazards. </li></ul><ul><li>Stabilize the vehicle or structure prior to entering. </li></ul><ul><li>Gain access to the patient. </li></ul><ul><li>Perform an initial patient assessment and a focused trauma exam. </li></ul>(Continued)
  5. 5. <ul><li>Disentangle the patient. </li></ul><ul><li>Immobilize and extricate the patient. </li></ul><ul><li>Provide ongoing assessment, triage, treatment, and transport. </li></ul><ul><li>Terminate the rescue. </li></ul>Fundamental Phases of Extrication
  6. 6. <ul><li>Provide patient care before </li></ul>without further injury. <ul><li>Ensure that patient is removed </li></ul>extrication. endangers patient or rescuer. <ul><li>Extricate first only if delay </li></ul>(Continued) Role of Nonrescue EMT-B
  7. 7. <ul><li>Work with others: </li></ul><ul><li>Cooperate with non-EMS personnel. </li></ul><ul><li>Prevent any of their activities from </li></ul>injuring patient. Role of Nonrescue EMT-B
  8. 8. <ul><li>Follow chain of command. </li></ul><ul><li>Ensure patient care before </li></ul>extrication unless delay endangers patient/rescuer. <ul><li>Remove patient without </li></ul>inflicting further injury. Role of Rescue EMT-B
  9. 9. <ul><li>Top priority for EMS workers. </li></ul><ul><li>Wear appropriate protective </li></ul><ul><li>Headgear </li></ul><ul><li>Eye protection </li></ul><ul><li>Hand protection </li></ul><ul><li>Body protection </li></ul>clothing: Personal Safety Equipment
  10. 10. Protective Clothing for Extrication
  11. 11. Remind new EMT-Bs that traffic and spectators can become hazards if not controlled. A number of EMT-Bs have been killed at the scene of collisions by drivers who were watching the collision rather than the EMT-B crossing the street. P RECEPTOR P EARL
  12. 12. Patient Safety <ul><li>Next priority for EMS providers. </li></ul><ul><li>Keep patient informed of </li></ul>activities and what to expect. <ul><li>Protect patient from glass, sharp </li></ul>metal, other hazards.
  13. 13. <ul><li>Unstable collision vehicles pose a hazard to rescue workers. </li></ul><ul><li>Tires can be deflated by pulling valve stems. </li></ul>Vehicle Stabilization <ul><li>Make sure engine is turned off. </li></ul><ul><li>Step chocks (cribbing) are often used. </li></ul>
  14. 14. Tell new EMT-Bs that when placing cribbing, they should never kneel. They should always squat, staying on both feet so they can quickly move away from the vehicle if necessary. P RECEPTOR P EARL
  15. 15. <ul><li>Try opening each door. </li></ul><ul><li>Roll down windows. </li></ul><ul><li>Have patient unlock doors. </li></ul>Simple Access (No Equipment Needed)
  16. 16. <ul><li>Beyond scope of EMT-B course. </li></ul><ul><li>Courses are available for </li></ul>interested EMT-Bs: <ul><li>Trench rescue </li></ul><ul><li>High-angle rescue </li></ul><ul><li>Basic vehicle rescue </li></ul>Complex Access (Special Equipment Needed)
  17. 17. <ul><li>Maintain cervical </li></ul>spine stabilization. <ul><li>Complete initial assessment. </li></ul><ul><li>Provide critical interventions. </li></ul>(Continued) Removing the Patient
  18. 18. <ul><li>Immobilize spine securely: </li></ul><ul><li>Short spine board </li></ul><ul><li>Rapid extrication </li></ul><ul><li>Lift and move patient , not short </li></ul>spine board . (Continued) Removing the Patient
  19. 19. <ul><li>Use sufficient personnel to lift </li></ul>and move patient. <ul><li>Choose path of least resistance. </li></ul><ul><li>Continue to protect patient </li></ul>from hazards. Removing the Patient
  20. 20. 1. Name the 10 phases of the extrication process. 2. What is the role of the nonrescue EMT-B at a rescue scene? R EVIEW QUESTIONS 4. Describe the complex access plan. 3. Describe the simple access plan.

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