Five keys to Emergency Scene Management
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From Officers and Managers to the Grunts on the street, we all have the potential to be First Due / On-Scene, arriving at calls that have the potential to quickly get away from us. While many books, acronyms and mnemonics are available, few focus on the core principles of emergency management in such a way that you can carry them with you to use on each and every call. This program presents the 5 fundamental keys that every responder should have with them at 3 AM by the side of the road on a dark and stormy night. Teaching Formats: -Lecture -Interactive Role Play -Question and Answer Learning Objectives: Students will learn: -The difference between a “Through the windshield” and an “On the ground” scene size-up. -Establish Command and Control with minimum resources in the face of overwhelming needs. -Methods of rapidly “securing the scene” in the face of large groups. -When to use and when to avoid different channels of communication. -Liaison between local, state and federal fire, EMS, law and other agencies. Find more at www.romduckworth.com
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Five keys to Emergency Scene Management
- 1. The Five Keys To Managing any Emergency Incident
- 3. SITUATIONAL AWARENESS Defined as • “Knowing what is going on so you can figure out what to do." And • "What you need to know to not be surprised."
- 4. SITUATIONAL AWARENESS You can perceive many cues in the environment and still miss CRITICAL ones. You can perceive CRITICAL CUES and still not be able to make SENSE of them.
- 5. SITUATIONAL AWARENESS Situational Awareness / Attention Management is the prioritization of applying brain resources to: Visiting Nurse is ConcernedTrouble Breathing Allergic to Peanuts!!! PERCEPTION – 1 Distress, Dyspnea,Recent Antibiotic Prescription IdentifyingInhalers Cues Sister has medical Power of Attorney Wheezing, Old Tachypnea, st Had a lovely time at the flower show on Wednesday!Pulse 118 bpm ECG = Sinus Rhythm w/ PVCs Respirations– PROCESSING 32/min. BP 180 / 100 Sensemaking Asthma 2nd SpO2 88% Weak !!!!!!! Leg Pain Diaphoretic Anxiety EtCO2 28% Surgery in 2004 for cysts. Urine has been “green-ish” Pale!! Elderly PREDICTING Problem Nebulizer Solving 3rd Petechiae Now
- 6. THE OODA LOOP • Col. Boyd • Observe F-86 Sabre • Orient • Decide • Act • Loop MiG 15
- 8. 5 Keys: Stay Keen CODE - EASY
- 9. CODE - Easy • Cognition: We need more brains! • Crew Resource Management Tip
- 10. CODE - Easy • Observation: Sense and Perception • Systematic (not robotic) • Crew Resource Management • Concise, systematic Hand-Off Reports
- 11. CODE - Easy • Distractors: The Medic needs quiet time! • Assessment Prioritization • Checklists • Good Scene Management
- 12. CODE - Easy Tip
- 13. CODE - Easy • Experience: Knowing is half the battle! • Education • Simulation • Visualization • Practice • Mentorship
- 14. CODE - Easy • Easy: A Lazy Medic is a good Medic • Field Guides / Apps • Checklists / Tactical Boards • Streamlined Protocols and Algorithms
- 15. CODE - Easy Cognition Observation Distractors Experience Easy
- 17. Your Job! • Incident Commander • Liaison • Healer • Technician • Consultant • Driver • Radio operator • Equipment Specialist
- 18. The Five Keys • Size Up • Call for Help • Secure the Scene • Identify Objectives • Complete the “Next Task”
- 19. SIZE UP •Through the Windshield • Address / Area / Access • Command location • Actions • Number of patients • Dangers • Operational Needs
- 20. The Five Keys • Size Up • Call for Help • Secure the Scene • Identify Objectives • Complete the “Next Task”
- 21. WHAT CAN Reports One patient pinned Planning to roll up Manpower Conditions Actions Needs under dash dash Send FD to assist Difficulty with lower Removing glass extremities from windshield Dispatch helicopter Stable vital signs Establishing I.V. on patient
- 22. HOW • Mobile / Vehicle • Portable • Walkie-Talkie • Face to Face • In person • Runner • Bullhorn
- 23. WHO • NIMS • Own Agency • Local • County / Region • State • Federal
- 24. The Five Keys • Size Up • Call for Help • Secure the Scene • Identify Objectives • Complete the “Next Task”
- 25. SECURE THE SCENE • Isolate and Deny Entry • Me, Us, You, Them • Hot, Warm, and Cold • Triage, Treatment, and Transport
- 26. The Five Keys • Size Up • Call for Help • Secure the Scene • Identify Objectives • Complete the “Next Task”
- 27. IDENTIFY OBJECTIVES • Command & Control • Identify • Objectives • Resources • Delegate • Tasks • Authority
- 28. The Five Keys • Size Up • Call for Help • Secure the Scene • Identify Objectives • Complete the “Next Task”
- 29. NEXT TASK • Identify • Priorities • “Next Task” • Make it so • Say • Do
- 32. STAY KEEN Cognition Observation Distractors Experience Easy
- 33. ON SCENE Size Up Call for Help Secure the Scene Identify Objectives Complete the “Next Task”
- 35. Thank You! EMS,
Editor's Notes
- DEFINITION
- Are we looking INTO these items (implications) or simply AT them (past them).
- Baloon frame example.
- Col. John Boyd in VietnamF-86 Sabre vs MiG 15
- “Solutions” - Because we’re the fire service and I’m here to help.
- Automatic Mutual Aid, Etc.
- Because this is the fire service and we’re here to help.
- The purpose of this presentation was to help make you confident that you were not falling prey to common cognitive illusions so that you could make better, faster decisions with more confidence.