Unit 2-Lesson 5.pdf

Unit 2 Respond to a Medical Emergency Lesson 5 Providing Care While Under Threat Lesson Goal At the end of this lesson, you will be able to provide care when under direct and indirect threat situations. You will also learn how to evacuate a scene and learn techniques for mov- ing patients...

Unit 2 Respond to a Medical Emergency Lesson 5 Providing Care While Under Threat Lesson Goal At the end of this lesson, you will be able to provide care when under direct and indirect threat situations. You will also learn how to evacuate a scene and learn techniques for mov- ing patients while under fire. When you are responding to an active threat/shooter incident, you may need to provide care for another officer who has been wounded. While the methods described below can be used with any patient, the section on providing care under different threat levels is primarily for providing care to fellow responding officers at a scene. For this reason, the term “officer” is used instead of “patient.” ✅ HL225.1. Differentiate between direct threat care, indirect threat care, and evacuation care environments Direct Threat Care Direct threat care/hot zone/care under fire environment describes a scene that can include an active threat, multiple active threats, or any imminent danger. Your primary concern in direct threat care is to stop or neutralize the threat if possible. As threats are changing, continuously conduct a threat assessment until the threat no longer exists or involved parties are in an area of relative safety. Instruct a wounded officer to move out of the visual field of the threat or away from the source of imminent danger to an area of cover or relative safety. If the officer is alert and capable, direct them to stay engaged. In general, prioritize only the most life-threatening injuries that can be quickly addressed, such as massive hemorrhage. If the officer is bleeding from an extremity like a leg or arm, control the bleeding by applying a tourniquet while behind cover or something that can block bullets. If you become injured, the primary focus should be applying your own tourniquet and providing self-care (the lesson on bleeding and soft-tissue injuries covers tourniquet application in greater detail). Instruct the officer to render their own self-aid if possible, including the self-application of a tourni- quet. If the officer is unresponsive or unable to render self-aid or move to safety, conduct a remote assessment to develop a rescue plan to maximize scene safety. Indirect Threat Care Indirect threat care/warm zone/tactical field care environment describes a scene in which the officer is out of imminent danger but not yet in a safer zone. A hot zone can change to a warm zone Chapter 2 First Aid for Criminal Justice Officers / 85 once the officer is in a place of relative safety or an area of cover becomes cleared but not secured. This is an area where there is less of chance of you or other officers sustaining injuries. However, a warm zone can become a hot zone again simply by the return of the threat. Your level of care includes following the assessment and treatment priorities outlined in MARCH. Address any life-threatening bleeding first by applying direct pressure to a wound, wound pack- ing, and using sterile dressings or seals in addition to tourniquets. Except for placing the patient in the recovery position, do not initiate any airway care, like CPR, until you and the patient are in the warm zone. Evacuation Care Evacuation care/cold zone/tactical evacuation care environment describes a scene in which you are moving towards transporting an injured officer to a medical treatment facility. A cold zone can also refer to an area that has been cleared of threats and may include triage areas and incident command posts. The best medical care for an injured officer and other trauma patients is typically evacuation and hand-off to a higher and more skilled practitioner, but it is good practice to re-evaluate the injured person and all interventions so you can communicate the information to EMS. The only time that you should consider delaying evacuation is to address immediately life-threatening conditions, such as a massive hemorrhage and airway compromise. Any additional interventions during this phase of first aid can occur while on the way to higher care or when performed by EMS operations. Moving Patients While Under Threat During active threat/shooter incidents you might not have time to stop to provide care (aside from direct threat care) and will need to be prepared to move injured officers and patients from a hot or warm zone to a cold zone, such as a collection point for EMS. The following techniques for moving patients to safety are important to keep in mind as you deal with evacuation care and possible on-going threats. Vehicle Dump ✅ HL225.2. Describe how to load a patient into a vehicle Perform a two-officer vehicle dump using the lifts previously discussed to transport a patient to higher care if there is delayed access to EMS or to meet EMS at a designated location. Ideally, perform a vehicle dump using two officers; however, under extreme circumstances, you may need to perform a one-officer vehicle dump. In a one-officer vehicle dump, immediately life threating conditions (e.g. tourniquet for massive extremity bleeding) should be addressed before leaving the patient to operate the vehicle. A two- officer vehicle dump can become a three-officer vehicle dump when you need someone to open the vehicle door or you need someone to maintain security in an active threat/shooter situation. 86 / Florida Basic Recruit Training Program (HL): Volume 2 Vehicle Dump – Two Officers 1. Officers 1 and 2 perform a two-officer extremity lift of the patient and walks them to the truck bed or space in the vehicle that will accommodate a patient. 2. Officer 2 places the feet of the patient in the vehicle and moves to assist Officer 1. 3. Officer 1 lifts the patient’s torso into the vehicle. 4. Both officers adjust the patient into a position of comfort that maintains an open airway and secures the patient in the vehicle. Figure 2-13 Vehicle dump Chapter 2 First Aid for Criminal Justice Officers / 87 Figure 2-14 Vehicle load – feet first 88 / Florida Basic Recruit Training Program (HL): Volume 2 Vehicle Load – Feet First 1. Officers 1 and 2 performs a two-officer extremity lift of the patient and walks them to the vehicle that will accommodate a patient. 2. Officer 2 is leading the carry toward the vehicle. 3. Officer 2 places the patient’s feet and lower legs on the seat and moves to the opposite side of the vehicle while Officer 1 holds the patient’s torso. 4. Officer 2 grasps the patient’s ankles and pulls the patient towards them while Officer 1 pushes the patient into the vehicle. 5. Both officers adjust the patient into a position of comfort that maintains an open airway and secures the patient in the vehicle. 6. The officer in the vehicle should be positioned to render additional first aid as required. Vehicle Load – Head First 1. Officers 1 and 2 performs a two-officer extremity lift of the patient and walks them to the vehicle that will accommodate a patient. 2. Officer 1 positions themselves near the outside edge of the open door to allow enough space to turn toward the vehicle. 3. Officer 2 places the patient’s legs on the ground and moves to the opposite side of the vehicle. 4. While Officer 2 is getting into position, Officer 1 turns and steps toward the vehicle, plac- ing the patient’s torso on the seat. 5. Officer 2 grasps the patient’s wrists and pulls the patient towards them while Officer 1 pushes the patient’s legs into the vehicle. 6. Both officers adjust the patient into a position of comfort that maintains an open airway and secures the patient in the vehicle. 7. The officer in the vehicle should be positioned to render additional first aid as required. Chapter 2 First Aid for Criminal Justice Officers / 89 Figure 2-15 Vehicle load – head first 90 / Florida Basic Recruit Training Program (HL): Volume 2 Officer Vest Drag Perform this drag as a last option and only on an injured officer who is wearing a tactical vest either inside or outside their shirt. Dragging the injured officer for long distances can result in choking. Use this drag for short distances only. When the officer is wearing a concealed vest, do not use the shoulder straps as they may not hold the weight of the officer. 1. If the officer is unconscious, secure their firearm. 2. Stand behind the officer’s head and squat by bending your knees. 3. If the officer is wearing an outer carrier vest, grasp the shoulders of the officer’s outer carrier vest. 4. If the officer is wearing a concealed vest, grasp both the shoulders of the vest and the shirt. 5. Pull the officer up and toward you. 6. Stand up, lean back, and walk backwards. 7. Drag the officer to safety. Figure 2-16 Officer vest drag and close up Chapter 2 First Aid for Criminal Justice Officers / 91