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Bomb Squad/E.M.S. Interface

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Presentation on theme: "Bomb Squad/E.M.S. Interface"— Presentation transcript:

1 Bomb Squad/E.M.S. Interface
2005 I.A.B.T.I. EMT Training Conference By Sergeant/Paramedic Marty Hietala Davis County Sheriff’s Office, Utah

2 Goals Understand levels of emergency medical care
Understand trauma centers and burn centers Understand the Incident Command System Articulate potential hazards for EMS and Fire personnel Articulate potential hazards and mechanisms of injury for the bomb technician Demonstrate emergency doffing of the bomb suit and chemical suit

3 Why? To ensure that emergency medical personnel and fire personnel will provide the highest level of medical care in the shortest amount of time The golden hour

4 The Golden Hour? After a traumatic event, a patient will have the best outcome if rapid stabilization and surgical intervention is made within an hour of sustaining the injury Transport must be expedient Transport to an appropriate facility

5 What EMS support is available in your jurisdiction?
Is this your ambulance? Will EMS need additional resources?

6 What type of Fire Dept. support is available in your jurisdiction?
Is this the local fire engine? Will the fire service need additional resources?

7 Levels of Emergency Medical Care
Basic life support Advanced life support Hospital emergency room Trauma center Burn center

8 Basic Life Support Bandaging Splinting Spinal precautions
Oxygen therapy Cardiopulmonary resuscitation Automatic external defibrillator Transportation

9 Advanced Life Support Basic life support Intravenous access
Advanced cardiac life support Advanced trauma life support Pharmacological intervention EKG interpretation Advanced airway placement Endotracheal Intubation

10 Advanced Life Support Advanced invasive procedures
Surgical cricothyrotomy Chest tube placement Central line insertion Intraosseous infusion External jugular vein cannulation Nasogastric tube placement

11 Trauma Centers A designation made for a hospital that meets stringent requirements for providing care to trauma patients Board certified emergency physicians In-house neurosurgeon In-house surgical staff In-house radiology staff

12 Burn Centers Positive pressure isolation Hydrotherapy
Hyperbaric therapy Surgical staff Debridement Skin harvesting Skin grafting

13 Incident Command System
A standardized system used by emergency services to manage incidents, regardless of size Initiated by first arriving assets and branches out based on primary duties Required by OSHA

14 Staging Where should the command post, EMS and fire assets stage?
Uphill Upwind Cold zone

15 Hazards to EMS/Fire personnel
What are the potential hazards that EMS and fire personnel may face at the incident? Secondary devices Fragmentation Chemical, biological, radiological exposure Exposure to residues Blast pressure

16 Pre-arrival considerations
Prior to arrival at the scene Notify medical control Notify trauma center Use standing orders Consider staging a medical helicopter

17 Pre-arrival considerations
Advise EMS/fire personnel what types of hazards the technician may encounter so they can prepare… R.F.I. Hazards Turn off radios Turn off cellular phones Turn off pagers

18 Medical history data Each technician should have information on scene for EMS providers Medical history Medications Allergies to medications Blood type Normal vital signs

19 Bomb Technician Hazards
Blast pressure Ear injury Lung damage Traumatic amputation Internal hemorrhaging

20 Bomb Technician Hazards
Fragmentation Possibility of fragments traveling in excess of 8900fps

21 Size Does Not Matter Effects of a Dry Ice Bomb Never underestimate the power of an explosive device by it’s size. Even small explosive devices can cause death or serious injury. This injury was caused by a dry ice bomb.

22 Explosive Injuries Blasting cap injury

23 Injuries Continued Effects of improvised fireworks

24 Explosive Force Pressure and Fragmentation effects of high explosives

25 Russian Bomb Technician attempting to disarm a backpack device

26 Blast Over Pressure Injuries

27 Blast Over Pressure Injuries

28 The results of trying to crimp a blasting cap with your teeth



31 Blast Over Pressure Blast Injuries 5 PSI over pressure
Slight chance of eardrum rupture (without hearing protection) 15 PSI over pressure 50% chance of eardrum rupture 30 to 40 PSI over pressure Slight chance of lunge damage

32 Blast Over Pressure Blast Injuries continued 80 PSI overpressure
Severe Lung damage 100 to 120 PSI overpressure Slight chance of death 130 to 180 PSI overpressure 50% chance of death 200 to 250 PSI overpressure Nearly 100% chance of death

33 Bomb Technician Hazards Blast Effects

34 Bomb Technician Hazards
Spinal injury EMS should know how the bomb suit ensemble is donned/doffed When the bomb technician’s safety is at risk, the suit may need to be cut

35 Bomb Technician Hazards
Burns Chemical or thermal burns Second or third degree burns greater than 10% of body surface area will require transport to a burn center Circumferential burns, burns to hands, face, groin or respiratory tract will require transport to a burn center

36 Bomb Technician Hazards
Heat stress Monitor vitals signs HR >100, diastolic BP>110 should rehab prior to donning PPE Monitor core temperature, 105F degrees can be life threatening

37 Bomb Technician Hazards
Heat stress injuries Cramps Heat exhaustion Heat stroke Heat stroke is life threatening

38 Bomb Technician Hazards
Heat stress prevention Hydration Cooling Shade Air conditioning Cooling systems

39 Fire Department Concerns
Utility locations Gas Power Sewer Water lines, hydrants

40 Fire Department Concerns
Hazardous chemicals Combustible gases Fire load Weather Decontamination

41 Fire Department Concerns
Staging location for a rapid intervention team (RIT) Protected location Hose lines connected Water supply ready PPE/SCBA donned

42 Summary Levels of EMS Trauma centers Hazards for EMS/fire personnel
Hazards for the bomb technician Importance of vital sign monitoring Donning/doffing of PPE

43 Questions? Comments? Sergeant/Paramedic Marty Hietala
Davis County Sheriff’s Office 800 West State Street Farmington, Utah 84025 Office Fax Cellular

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