EM Study Guide PDF

Notes From Packet: 1. Medical Support Model a. Verify Safety of Protectee i. Utilize Hazardous conditions protocol and/or Unknown substance protocol as needed ii. If there is an injure reference tactical emergency casualty care protocol iii...

Notes From Packet: 1. Medical Support Model a. Verify Safety of Protectee i. Utilize Hazardous conditions protocol and/or Unknown substance protocol as needed ii. If there is an injure reference tactical emergency casualty care protocol iii. Assist EMT's and other medical response teams as needed b. Manage patient per TECC iv. Control hemorrhage v. Maintain airway vi. Give oxygen with non-rebreather (15 liters per minute vii. Support respirations viii. Obtain vitals, heartrate and breathing ix. Request additional EMS support c. Problem Management x. Determine the problem and use the appropriate protocol d. Initiate shock management xi. Blood xii. Breathing xiii. Temperature e. Response verification xiv. Have you called EMS? Are they coming? How soon? f. Evac Decision xv. Is patient being transported? How? g. Patient transfer xvi. LER works with EMS to facilitate timely transfer of patient to the closest appropriate medical facility 2. Hazardous Conditions protocol h. Remove patient from hazard and avoid self- contamination xvii. Preform general patient care xviii. Ensure breathing xix. Ensure circulation i. Spot vs Gross Decontamination xx. Spot- Open RSDL found in the Nerve Agent Response Pack and use sponge to thoroughly clean affected area xxi. Gross- Fully wash patient using soap and sponge, redress or cover them, rapidly evacuate to medical care 3. Unknown substance treatment j. Assess xxii. Check mental status xxiii. Consciousness xxiv. Vitals k. Manage xxv. Monitor patient for any changes and be prepared to repaidly evacuate for medical if they start to lose consciousness or vitals drop 4. Nerve agent Response l. Recognize a nerve agent with SLUDGE xxvi. Salivation xxvii. Lacrimation (tears) xxviii. Urination xxix. Defecation (ew) xxx. Gastrointestinal upset (half the class after PHO) xxxi. Emesis (vomit) m. If hit by a nerve agent xxxii. Obtain Nerve Agent Response Pack xxxiii. Administer 3 DuoDotes to lateral thigh xxxiv. Seek immediate medical attention 5. Tactical Emergency Casualty Care (TECC) n. Basic Management xxxv. Return Fire xxxvi. Tell casualty to get to cover xxxvii. Stop life threating external bleed if tactically possible o. Priorities of treatment (MARCH) xxxviii. Massive hemorrhage xxxix. Airway xl. Respiration xli. Circulation xlii. Head injury/ Hypothermia 6. The 5 Rights- must all be met p. Right person q. Right Medication r. Right dose s. Right route t. Right time 7. General Patient care u. Control hemorrhage (bleeding) v. Open/maintain airway w. Give oxygen through non-rebreather (15 LMP) x. Support respirations, if below 8 breaths per minute provide rescue breathes y. Obtain baseline set of vitals (heartrate and respiratory) z. Request additional EMS support as needed I will not be including notes on every possible medical situation which can be found from page 23-56 of the packet, everyone does start with general patient care. 1. Patient Assessment a. Scene size up b. Primary assessment i. Objective: Detect and treat life threats 1. Form a general impression I.E- sick or not sick 2. Check ABC's (Airway, Breathing, Circulation) c. History taking and Physical exam ii. OPQRST 3. Onset, palliation/ provocation 4. Quality 5. radiation 6. Severity 7. Timing/ triggers iii. SAMPLE 8. Symptoms 9. Allergies 10. Medicine taken 11. Past history of similar events 12. Last oral intake 13. Events leading to injury or illness d. Secondary assessment iv. Once full assessment is done consider possible injuries or illnesses and consider most life threating ones first e. Reassessment v. Recheck vitals to ensure they are stable or improving 2. Triage f. Patients are categorized based on recognition of 4 parameters vi. Airway vii. Respiration viii. Perfusion (more or less circulation but not exactly? I looked it up and got confused so probably just ask Bobby or Blake) ix. Mental status g. Triage Categories x. Immediate (red) xi. Delayed (yellow) xii. Walking wounded/ minor (green) xiii. Deceased/ expectant (black) What follows are the notes I took from class, much more concise for quick studying: **Emergency Services Law Enforcement Responder** 1. Medical Support Model a. Verify safety of protectee i. Remove protectee from hazard and decontaminate as necessary. b. Manage patient per TECC Guidelines, including; ii. Control hemorrhage, maintain airway, give oxygen, etc c. Problem management d. Initiate shock management iii. Bleeding, oxygen, temperature? e. Response verification iv. Have you called EMS? Are they coming? f. Evacuation decision g. Patient transfer v. LEO works with EMS to transfer the patient to EMS. h. Request local EMS resources. 2. Hospitals i. Level 1,2,3,4 (Civilian 1 is the highest, Military 4 is highest) 3. If exposure occurs j. Clean area k. Activate departments infectious control plan. 4. Supine is the sit-up position (Laying on you back) 5. Prone (on stomach) 6. When referring to side of injury, always go from patients POV (their left or right) 7. The heart l. Four chamber muscle (2 sides) m. Own blood supply n. Own electrical impulse o. Surrounded by pericardium **Emergency Service Initial Response** 1. When do we move people? a. When there is a direct threat, or we cannot help them 2. Active threat protocol b. Scene survey c. Consider threats d. Insure protectee considerations e. Consider direct threat/ care under fire f. Is the scene safe? i. PPE? ii. Determine mechanism of injury iii. Determine number of patients 3. Hazardous conditions protocol g. Address threat h. Remove patient from hazardous environment i. Wash patient iv. Soap and water is best 4. Nerve agent antidote kit (NAAK) j. 1 kit for a minor k. 3 kits for major exposure 5. Types of drags l. Clothes m. Blanket n. Fire fighter o. Arm to arm elevated 6. Types of carries p. Cradle in arms q. Pack strap r. Fire fighters (don't do it) s. Extremity carry (2 person) t. Seat carry u. Chair carry v. Supporting carry 7. Reeves stretcher w. Flexible stretcher 8. LER patient assessment stages x. Scene size up v. Nature of illness vi. Machinist of injury y. Primary assessment vii. One (Red)- immediate life threat viii. Two (yellow)- Delayed or urgent ix. Three (green)- delayed care or walking wounded x. Four (Black)-dead z. History taking a. Secondary assessment b. Reassessment c. Handoff report 9. Triage d. Sorting e. Classifying f. Mass casualty incident 10. Determine mental status g. Alert h. Verbal stimulus i. Painful stimulus j. Unresponsive 11. History taking k. **S**igns (see it)/ symptoms (told it) l. **A**llergies m. **M**edications n. **P**ertinent medical history o. **L**ast oral intake p. **E**vents (what happened) 12. OPQRST q. Onset r. Provocation/ palliation (pain worse or better) s. Quality (What does it feel like) t. Radiation (pain move anywhere) u. Severity (pain level 1-10) v. Time (when did it start, is the pain changing over time) **Trauma** 1. Mechanisms of injury are very important a. Gunshot b. Falls c. Motor vehicle d. Stabbing/ cutting 2. Trauma=MARCH e. Major bleeding i. Direct pressure ii. Tourniquet iii. Pressure points/ dressings f. Airway g. Respiration/ breathing h. Circulation i. Head/hypo