Presentation on theme: "Patient Transport and Packaging"— Presentation transcript:
0Lamorinda CERT Patient Transport and Packaging Lamorinda CERT - Patient Transport & Packaging with Perishable Skills4/1/2017Lamorinda CERT Patient Transport and PackagingReleased: 4 September 2013September 2013
1Patient Transport and Packaging Why do we need to transport victims?How do we transport them?What problems are inherent in moving victims?How do we mitigate those problems?
2Need to Transport Victims need to be moved for a few reasons: Victim is immediate dangerCurrent location is unstableBuilding unstableFireWaterOther hazards – gas, electrical, explosives, etc.Victim needs more care than can be given at current locationVictim is blocking access to other victims
3How to transport Several ways to transport Method depends on situation and victim conditionWalking AssistsCrawls and DragsCarriesCarried directly by rescuersCarried on equipment by rescuersMay require immobilization
5Walking Assist1. Stand at the victim’s side and drape the victim’s arm across your shoulders. 2. Support the victim by placing your arm around his or her waist. 3. Using your body as a crutch, support the victim’s weight as you both walk.
25Patient Packaging What Is It? Patient packing is the process in which a patient is prepared for transport, while providing for comfort and immobilization. This process should not interfere with the patient’s ability to continue with normal bodily function and yet should allow the transporting personnel the ability to maintain an accurate account of the patient’s vital signs, continue with the treatment of any and all illness and injury and provide the appropriate medical care.This process must be able to be provided in a rapid and easy manner so as to not compromise scene time, the safety of the patient and rescue personnel, and not become a physical burden in its application.
26Patient Packaging Why Is It Important? Moving a “loose” victim is likely to cause further injury.A properly packaged patient can be moved easily and transferred from one set of transporters to another seamlessly.Packaging can be done for the type of movement needed, flat, low-angle, high-angle, vertical lift or descent.
27Patient Packaging What Kinds of Packaging may a CERT Need To Do? Cervical Spine immobilization.Longboard (backboard)ChairStretcher or Sling
28Spinal Motion Restriction Mechanism of InjuryAnything to suggest spinal injury?They say “my neck hurts” or “my back hurts”Altered mental StatusHead Injury?Which came first…Findings on AssessmentPain, tenderness, swelling, or deformity in spineMuscle SpasmNeurological deficit
29Need for a C-Collar A Cervical Collar provides: Temporary support to the head of a sitting or standing patient until the patient can be placed in a supine position.Frees the hands of rescuers while the patient is being moved & splinted to a Full spine board.Reduces compression of the cervical spine caused by the head.Minimizing axial loading / unloading of the spine that takes place during transport.
30Limitations of a C-Collar The Cervical Collar: Is NOT designed to immobilize the cervical spine, let alone the rest of the spine.Restriction of movement of the head with a rigid collar is at best 50% of normal movement.Is NOT designed to provide any traction to the head, but is only designed to support the weight of the head.Only prevents 50% of cervical spine movement.Provides no thoracic / lumbar spinal support.Has not been shown in any study to adequately immobilize the cervical spine.
31Hazards of a C-CollarA number of dangers may be associated with application of a Cervical Collar:If the jaw support of the collar clamps the teeth together, airway compromise may result if the patient vomits.Cervical Collars that place pressure on the neck (either via collar design or too small a Cervical Collar being applied), may cause an increase in intracranial pressure.
32Cervical Spine Motion Restriction The techniqueShould be simultaneous with assessment.Place collar, if needed, prior to any patient movementDon’t use force.More than one manufacturer of collarsOne collar does not fit all!Towel or Blanket rolls alternatives
33Typical C-Collars Many manufacturers and many styles Inexpensive ($6-15 each) These were $7.50 eachDirections are normally printed on package
34Backboards Backboards come in many styles Longboards are full length rigid backboards in either adult or pediatric sizes.Shortboards are used for extrication and go from waist to head.
35Issues with Backboards Now…a word about paddingSkin breakdown can begin to occur in as little as 1 hourGet victim off backboard as soon as possibleRedistribute the weight off of the shoulder blades, buttocks and heelsPadding (not a lot) makes a huge differenceBending knees flattens the back, flattens the feet to redistribute the weight
36Backboard Use Tips Pad the board prior to placing the patient on it Leave the appropriate arm/arms accessible to allow therapies and monitoringCover over the top of the straps rather than under themMake sure that the patient will not move side to side if tippedUse specialty securing devices for little people if they are available
37Backboard Special Circumstances Severe closed head injuriesTilt head of backboard upPenetrating back injuriesMay need to place victim on sideMay need to hold direct pressureImpaled objectsMay need to get creativePregnant womenLeft side down-pad between knees
38SledsRescue / Evacuation stretchers are rolled plastic sleds that, once unrolled and turned up on the edges, provides a rigid sled that can be dragged, lowered or hoisted.Longboards can be used inside sleds.
39LittersLitters are baskets, like the ‘Stokes Litter’ that enable rescuers to easily carry, hoist or lower a victim.
40Pole StretchersPole stretchers have rigid poles, folding poles or breakdown poles.Flexible webbing allows compact storage
41Flexible Stretchers Low-cost flexible stretchers and chairs Does not immobilize the spine
43Lamorinda CERT - Patient Transport & Packaging with Perishable Skills 4/1/2017BleedingArterial…spurtingVenous…flowingCapillary…oozingLosing one liter can be life threateningSeptember 2013
44Lamorinda CERT - Patient Transport & Packaging with Perishable Skills 4/1/2017Bleeding ControlDirect pressureElevationPressure pointsNo tourniquets!September 2013
45Wound Care Objective of wound care: Control bleeding Prevent secondary infectionTreatment of wounds:Clean wounds – don’t scrubApply dressing to woundApply bandage to hold dressing in placeNo tourniquetsNo Hydrogen Peroxide
46Rules of DressingIn the absence of active bleeding, remove dressing and flush, check wound at least every 4-6 hours, redress as necessaryIf there is active bleeding, redress over existing dressing and maintain pressure and elevation
47Hemorrhagic ShockHypovolemic shock is the most common type of shock and is caused by insufficient circulating volume. Its primary cause is hemorrhage (internal and/or external), or loss of fluid from the circulation. Vomiting and diarrhea are the most common cause in children.Hemorrhagic shock, a type of hypovolemic shock, is defined as a failure of adequate tissue perfusion resulting from a loss of circulating blood volume.Cardiogenic shock results from heart damage.Vasogenic shock results from blood vessel dilation, often from toxins like anaphylaxis.Neurogenic shock results from head or spine injury.
48External Hemorrhagic Blood Control New protocols allow use of tourniquets. If you use a tourniquet, the limb below the tourniquet is to be considered forfeited.Blood clotting agents are available to stop hemorrhagic blood loss.Hemostatic granules like Celox ~ $14Hemostatic gauze like Celox Rapid ~ $41Hemostatic sponge like QuikClot ~ $24Always tape empty package to victim
49External Hemorrhagic Blood Control New dressing materials staunch blood flow from traumatic hemorrhage wounds in pre-hospital emergency situations. Includes dressing and bandage with pressure applicator device.Israeli Bandage Battle Dressing4” width ~ $6.506” Width ~ $7.0012” Abdominal with 12x12 pad ~ $12.00
50Guidelines for Splinting All fracture & suspected fractures require splintingSupport the injured areaAssess color, warmth and sensationSplint injury in the position that you find itDon’t try to realign bonesImmobilize above and below the injuryAfter splinting, recheck for color, warmth, and sensation below the injury siteSAM splints are light, can be cut to shape and are well padded ~ $12