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EMS Response to Disaster PowerPoint Presentation

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Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "EMS Response to Disaster", to know about EMS Response to Disaster and Prehospital Considerations.

Tags : Emergency Medical Services, EMS, EMS Response, Disaster, Prehospital Considerations

Published on : Aug 10, 2021 | Views : 2359 | Downloads : 8

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Slide 1-

PDLS©: EMS Response to Disaster Prehospital Considerations Jorge D. Yarzebski, NREMTP
Slide 2-

Objectives To review EMS considerations in disaster situations and the unique needs of children What to expect from prehospital providers Review the Incident Command System (ICS) and Field Triage as it applies to prehospital providers
Slide 3-

Objectives Recognize and formally declare a MCI Communication Interagency Hospitals
Slide 4-

Emergency Medical Services Network of multiple services and agencies ‘coordinated’ to provide aid and medical care from 1º response to definitive care based on training First Responder Basic Intermediate Paramedic RN’s/MD’s
Slide 5-

Coordination Incident Command System Management system created to address concerns of interagency compatibility and interaction Direct Control Coordinate
Slide 6-

ICS (Incident Command System) Senior on scene: command assess need for further resources and direct incoming resources to where they are needed This starts with first to arrive Triage: initial fast assessment of every patient, sort for evacuation and first in line for care when additional resources arrive Responsibilites delegated through ICS
Slide 7-

ICS Scene control limit access for civilians media cameras maintain in/out routes for vehicles which do need entry Communications notify hospitals of rough numbers, kinds of injuries
Slide 8-

When YOU are the first to arrive… Declaring the Multiple Casualty Incident Recognize the major incident Available resources are insufficient to manage the number and nature of injuries and environment Possibilities More than two ambulances required (dependent on resources)
Slide 9-

When YOU are the first to arrive… HAZMAT Special resources: Fire, Police, rescue with specialized extrication equipment, SAR, Medivac Dispatch En route request for assistance, confirm upon arriving on scene or cancel request* *follow SOP for particular department
Slide 10-

EMS ICS Coordinates EMS activities – Activates MCI response plan Supervises TRIAGE, TAGGING, TREATMENT, TRANSPORTATION Assigns personnel Guides difficult medical decisions
Slide 11-

Need Help?
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First to Arrive Initial units assumes command Senior/most experience takes control Requests additional support Updates safety/mechanism/conditions Support
Slide 13-

Support
Slide 14-

Triage “to sort” or place in order Guides decisions about allocating scarce resources and limited time “greatest good for greatest number” Protocol helps make decisions ICS separates triage from treatment immediately: see everybody once briefly for focus
Slide 15-

START Most commonly used triage system across country Initial eval –not final Time limited (plan 1 min/patient) Categorize and move on
Slide 16-

START “If you can hear me and are able, walk over here” GREEN triage done – still need individual evaluation, but can await more staff, allows initial rescuers to focus on more severely injured people. Avg 80% of victims will be green, self extricate (may self transport – eases burden on field but hard on hospitals) *Not applicable for under 8 years old*
Slide 17-

Kids in triage Don’t follow commands May actually hide from rescuers in full gear (spaceman look) May be extricated by GREEN parents/ adults with delay in triage and treatment Need distraction and dedicated supervisor able to run after wandering toddlers
Slide 18-

JumpSTART (under 8) Kids more airway dependent – rescue breaths attempted if pulse present (unlike adults) Resp 15-40 instead of <30 Vascular system clamps down sooner, so cap refill less reliable Use peripheral pulse instead Mental status AV/PU instead of follow/not
Slide 19-

JumpSTART “If you can hear me and you are able, walk over here for help.” GREENs are done. Screen GREEN adults for RED/YELLOW kids carried out. Assess non-ambulatory patients as you find them using RPM.
Slide 20-

ICS Treatment: patients may outnumber transport, leading to time in field where treatment can be started. Sort patients by category (greens, yellow, red, black) and treat within areas. If greens self triaged, they need evaluation.
Slide 21-

Treatment Limited initial treatment – don’t delay evacuation if vehicle available Oxygen, dressings, splints Airway management? Remember, no intubations during triage, and no codes during mass casualty event, unless sufficient personnel and equipment that no other care is delayed
Slide 22-

Treatment Kids will be mixed in – do you have enough supplies in kid size (oxygen, IVs, splints)? Does your locality stock a “disaster truck”? Does it have kid size equipment and kid sized doses of Hazmat antidotes? Do you have Broselow tapes to guide dosing?
Slide 23-

Treatment - airway Non breathing child (with pulse): rescue breaths, then if no response, BLACK Non breathing child without pulse: BLACK Oxygen: how administered? Do you have octopus adaptors to set more than one NRBM off each nozzle? REDs first.
Slide 24-

Treatment IV fluids? Depends on numbers: does everyone need an IV? Are there enough IV kits to give everyone an IV? Use triage to guide => treat REDs first, then YELLOWs. Do GREENs need IV? BLACK/expectant: pain control (if drugs available) NO IV fluids, NO oxygen
Slide 25-

Treatment: Dressings – rinse gross dirt with sterile fluids or tap water if available, sterile cover to prevent further contamination Pressure dressing for active bleeding Recruit neighbor to help hold pressure during triage while awaiting transport/evacuation ARE KIDS CAPABLE OF THIS? IS IT APPROPRIATE PSYCHOLOGICALLY? Splint – extremity injuries
Slide 26-

Treatment Medications: pain control, specific antidotes with Hazmat event/team Monitoring: repeat assessment after triage, re-categorize if necessary (to worse, never better – even if they respond to treatment, they have the same underlying injury)
Slide 27-

ICS Transport: decides which patients leave scene first and where they’re going Remember that helpful bystanders and self transporters will fill nearest hospital first Includes decisions about longer transport times for specialty care ( e.g. out of town for burn unit straight from scene rather than to hospital for transfer) PEDIATRIC SPECIALTY CENTERS
Slide 28-

Communication Telephones Cellular Phones Pager System Radios Whistles Loudspeakers/Megaphones
Slide 29-

Your Pedi First in Bag Is your ambulance equipped to handle a Pediatric MCI? What is essential to your first in bag? Airway supplies Dressings Tags Do we include Broselow tapes to guide dosing?
Slide 30-

Ambulance / Disaster Preparedness Top to bottom BLS / ALS specific Pre-determined scope of practice rules Policy formulation Incident specific arrangements Sectioning shell - age specific
Slide 31-

Supplies: Oral pharyngeal airways Bag Valve Mask’s O2 / delivery devices Pulse oximeter P.O. ear probes CO2 monitors Trauma scissors Stethoscopes Blood pressure cuffs Cervical collars Portable suction Padded board splints Obstetrics kit Blankets Sheets
Slide 32-

Supplies Car seats Toys Airway rolls O2 multiplexer Naso-gastric tubes Chest tubes Nebulizers I.V. solutions Needles Sharps containers Glucometer I.O. needles Broselow Tape Adhesive tape Medications Clean water / cups
Slide 33-

Supplies Formula Purifier / preservative hand lights with batteries Light sticks Candles / waterproof matches Rain tarps/ poles Ground clothes Paper / waterproof pens Disaster Tags Disposable bags Chlorine bleach Soap / towels Hand tools
Slide 34-

Supplies Radio CB/am/fm Whistle Meals Ready to Eat Bandage Triangular bandage Kling Aluminum foil Vaseline gauze Trauma dressings Gauze Hydrogen peroxide Alcohol Cold / hot packs Gloves Instaglucose Sterile water / saline
Slide 35-

Supplies Backboards/ straps Optional / Monitors defibrillators AED / SAED Other regional specific adjuncts
Slide 36-

Supplies Expanded practice Special needs
Slide 37-

Thank you