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Presentation on theme: "Emergency Services, LLC / Copyright 2007 / Volume 07-81 TRAINING Click anywhere on page to view show in its entirety Click anywhere on page to view show."— Presentation transcript:

1 Emergency Services, LLC / Copyright 2007 / Volume 07-81 TRAINING Click anywhere on page to view show in its entirety Click anywhere on page to view show in its entirety FIRE MEDICS PHTLS Training 4: Musculoskeletal Trauma, Pt. 1PHTLS Training 4: Musculoskeletal Trauma, Pt. 1 Quiz EVOLUTIONS 2000 Kramer vs. Kramer Program Quiz Answers FIRELINE Rural House Fire Mercury Spill Discussion Questions HANDS-ON Interoperability Box Quiz Rescue Search Dogs, Pt. 1 Quiz Working Fire Training 07-8 Training Materials

2 Emergency Services, LLC / Copyright 2007 / Volume 07-82 TRAINING Click anywhere on page to view show in its entirety Click anywhere on page to view show in its entirety Working Fire Training 07-8 Training Materials All training methods and procedures presented in this Working Fire Training (WFT) video program and training materials are based on IFSTA, NFPA, NIOSH, OSHA and all other relevant industry regulations and standards and are presented as a part of generally accepted and acknowledged practices in the U.S. Fire Service. WFT should be used under the supervision of certified trainers in conjunction with national, state, and local training standards and protocols, and the standard operating guides and procedures of the Subscriber. WFT is intended to be an ancillary source of training information and should not be used as the sole source of training for any emergency service organization. WFT accepts no responsibility for how the Subscriber implements or integrates this program into the Subscriber’s own training program, nor does the use of this program by the Subscriber imply that WFT approves or endorses any specific training methods presented by the Subscriber to its own organization. WFT accepts no responsibility for the correct understanding or application of its training methods and procedures by emergency service personnel who view this program; nor for any performance or lack of performance by emergency service personnel who may view this program and use or apply these training methods and procedures incorrectly; nor does it accept any liability for injuries or deaths of emergency service personnel who may view this program and use or apply such training methods and procedures incorrectly. By presenting this program for viewing to its organization’s members, the Subscriber, and by viewing or reading materials presented by WFT, the members and students of the Subscriber, agree to hold harmless WFT, the University of Cincinnati, VFIS, and any persons or organizations who participate in the creation and/or presentation of this training material from any legal action which might result from any line-of-duty injuries or deaths of the Subscriber’s members or any other emergency service personnel who view this program and who may use or apply such training methods and procedures incorrectly. LEGAL DISCLAIMER

3 Emergency Services, LLC / Copyright 2007 / Volume 07-83 DISPATCH/SIZE-UP Residence was a wood frame structure with a wood foundation and OSC siding. –Its insulation was not fireproof. Upon arrival, the fire was through the roof of the garage and starting on the roof of the house. –Response time was approximately ten minutes. Did a hose lay on the fly and had water flowing in less than a minute. Fireline Incident: Rural House Fire 07-8 Training Materials

4 Emergency Services, LLC / Copyright 2007 / Volume 07-84 INCIDENT COMMAND/INCIDENT ACTION PLAN Set up a tanker shuttling operation with five tankers to cover the six-mile distance to the water supply. Attack crews entered the house in areas where the fire hadn’t spread to in an attempt to head it off. Since the fire couldn’t be turned back, firefighters exited the building and the incident went defensive. 07-8 Training Materials Fireline Incident: Rural House Fire

5 Emergency Services, LLC / Copyright 2007 / Volume 07-85 STRATEGY/TACTICS A tanker shuttle was set up with a portable pen. –The tankers could barely keep up with the demand for water. Fire crews entered the house with one 1-¼-inch line. Three other 1-¼-inch lines and a 2-1/2-inch were all in service outside. 07-8 Training Materials Fireline Incident: Rural House Fire

6 Emergency Services, LLC / Copyright 2007 / Volume 07-86 EVENTS Initial truck arrived on scene, laid hose, and got water on the fire in less than a minute. An interior fire attack was turned back by the advancing flames. There was gun ammunition in the garage that was on the fire when firefighters arrived. –Popping was heard; no one was hurt. 07-8 Training Materials Fireline Incident: Rural House Fire

7 Emergency Services, LLC / Copyright 2007 / Volume 07-87 EVENTS The homeowner had a number of animals in pens and dogs that were running loose. –The Humane Society was called to handle the dogs. When the back wall collapsed, IC decided to go defensive. 07-8 Training Materials Fireline Incident: Rural House Fire

8 Emergency Services, LLC / Copyright 2007 / Volume 07-88 REMARKS The Humane Society was called to round up a number of dogs that were loose on the property. This is an important issue for firefighter safety. Soft gravel roads presented difficulties for tankers. 07-8 Training Materials Fireline Incident: Rural House Fire

9 Emergency Services, LLC / Copyright 2007 / Volume 07-89 REMARKS Motorists would not give right-of-way to tankers on narrow roads, in spite of lights and sirens in operation. 07-8 Training Materials Fireline Incident: Rural House Fire

10 Emergency Services, LLC / Copyright 2007 / Volume 07-810 LESSONS LEARNED Apparatus placement could have been better. Sometimes when trucks arrive later, rather than all at the same time, optimum placement can’t be achieved. –This prevented a second portable pen from being set up which would have facilitated water delivery to the fire. Older houses with wood foundations can present extinguishment problems. –Pay attention to which structures in your jurisdiction might have them. 07-8 Training Materials Fireline Incident: Rural House Fire

11 Emergency Services, LLC / Copyright 2007 / Volume 07-811 DISPATCH/SIZE-UP (by Haz-Mat division late on scene) Weather was cold. Dispatch came from the Department of Environmental Protection, originating with the State Police. A Keyspan Gas Company truck carrying a cylinder of mercury hit a bump. The container came off the truck and was run over by a following motorist. The container blew out a tire and spilled about 3 ounces of mercury on the roadway. Fireline Incident: Mercury Spill 07-8 Training Materials

12 Emergency Services, LLC / Copyright 2007 / Volume 07-812 DISPATCH/SIZE-UP (by Haz-Mat division late on scene) About 200-300 feet of roadway was affected. Due to the cold weather that day, the mercury rolled down the street like bee-bees. The driver made the proper notifications. –A local fire company responded but apparently the Keyspan people called Clean Harbors, a clean-up/mitigation service, before the Haz-Mat Division was alerted. –Keyspan didn’t realize there was another vehicle involved. –Haz-Mat specialists didn’t arrive until an hour later. Fireline Incident: Mercury Spill 07-8 Training Materials

13 Emergency Services, LLC / Copyright 2007 / Volume 07-813 INCIDENT COMMAND/INCIDENT ACTION PLAN District Chief took command. The scene had to be properly secured and operations coordinated among responding agencies. –Traffic in the area had to be controlled and brought down to one lane. 07-8 Training Materials Fireline Incident: Mercury Spill

14 Emergency Services, LLC / Copyright 2007 / Volume 07-814 INCIDENT COMMAND/INCIDENT ACTION PLAN The IAP had two areas of concentration: –Mitigation of residual mercury on the roadway. –Decontamination of pedestrians, vehicles, and responders Vacuums were used 07-8 Training Materials Fireline Incident: Mercury Spill

15 Emergency Services, LLC / Copyright 2007 / Volume 07-815 STRATEGY/TACTICS Jerome Mercury Vapor Analyzers were used to monitor the environment. –Jerome meters use a gold film sensor to determine mercury sources, the extent of mercury contamination, and to verify that no residual mercury remains after clean-up. 07-8 Training Materials Fireline Incident: Mercury Spill

16 Emergency Services, LLC / Copyright 2007 / Volume 07-816 STRATEGY/TACTICS Specialists wearing proper PPE and breathing apparatus used vacuums to mitigate the roadway and the vehicles involved. 07-8 Training Materials Fireline Incident: Mercury Spill

17 Emergency Services, LLC / Copyright 2007 / Volume 07-817 EVENTS A truck dropped a container of mercury which was then run over by a following vehicle, spreading the mercury. The driver made the proper notifications. –A local fire company responded but apparently the Keyspan people called Clean Harbors, a clean- up/mitigation service, before the Haz-Mat Division was alerted. –Haz-Mat specialists didn’t arrive until an hour later. 07-8 Training Materials Fireline Incident: Mercury Spill

18 Emergency Services, LLC / Copyright 2007 / Volume 07-818 EVENTS This was a Level 2 Haz-Mat response. –Vehicles and the roadway were mitigated. –Pedestrians had to be deconned. The truck that dropped the mercury returned to the scene and ran over the mercury again. The road was shut down for a total of three hours. 07-8 Training Materials Fireline Incident: Mercury Spill

19 Emergency Services, LLC / Copyright 2007 / Volume 07-819 REMARKS Initially, the driver that dropped the mercury didn’t know he had, but later returned to the scene once he did. The scene was not taped off and secured properly. –Some pedestrians who walked through the mercury had to be deconned. A Veterans Hospital and a skating rink were on opposite sides of the street at the point where the spilled occurred. –It was important that no mercury were tracked into either place. 07-8 Training Materials Fireline Incident: Mercury Spill

20 Emergency Services, LLC / Copyright 2007 / Volume 07-820 LESSONS LEARNED Proper scene identification and marking of such must be done correctly. Earlier notification would have been better, so resources and personnel can get on scene quicker and in the appropriate numbers. –This makes for a more accurate and efficient size-up and a determination of what exactly are affected. 07-8 Training Materials Fireline Incident: Mercury Spill

21 Emergency Services, LLC / Copyright 2007 / Volume 07-821 LESSONS LEARNED Training with private mitigation companies is an excellent idea. –As they often respond jointly with the Haz-Mat division, they function the same way as mutual aid companies. Consequently, co-training gets all responders on the same page. 07-8 Training Materials Fireline Incident: Mercury Spill

22 Emergency Services, LLC / Copyright 2007 / Volume 07-822 Fireline Incident Discussion The departments involved in this month’s training and WFT pose some discussion questions that you can use as discussion-starters in your own department’s training sessions. How will your department handle these scenarios? 07-8 Training Materials

23 Emergency Services, LLC / Copyright 2007 / Volume 07-823 Rural House Fire / Donohue, IA Fire Chief Pat McBride, Donahue (IA) Fire Dept. For any department, but particularly departments with rural jurisdictions, response time is crucial. The quicker you get there, the more impact you can have on the incident. Nobody wants to just watch it burn. We have some structures with wooden foundation which are very hard to extinguish since they’re below ground. Be prepared to use plenty of water on them and extend your fire watch. Even in rural areas, motorists often don’t respect warning lights and sirens or give right away. Work with your local media to get stories written or broadcast about it. Let TV news ride along sometime and get a few offenders on the air. Fireline Incident Discussion 07-8 Training Materials

24 Emergency Services, LLC / Copyright 2007 / Volume 07-824 Mercury Spill / Boston, MA Haz-Mat Specialist Fred Ellis, Jr, Haz-Mat Division, Special Ops. Command, Boston (MA) Fire Dept. Early notification of specialty response squads is always important. Just like mutual aid, if we aren’t needed, we can go back to the station. But get us rolling early if you think we might be needed. That’s important, because in this case, a mitigation company arrived on scene before we did. Get to know your local mitigation departments and encourage them to call you if they get called. Always monitor the scene for atmospheric content and wear proper PPE and SCBA or PAPRs, if necessary. Always expect that civilians will be involved and may have to be deconned. Remember, they may be very frightened! Fireline Incident Discussion 07-8 Training Materials

25 Emergency Services, LLC / Copyright 2007 / Volume 07-825 OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: the concept of telecommunications interoperability how to connect different radios and communication devices together and make them communicate effectively. CODES, STANDARDS & REGULATIONS NFPA 1221 Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems Hands-On: Interoperability Box 07-8 Training Materials

26 Emergency Services, LLC / Copyright 2007 / Volume 07-826 DISCLAIMER From time to time, Working Fire Training likes to make subscribers aware of new or innovative equipment that are available. New technologies or techniques should be important news to departments and as they ultimately has an impact on training and responder safety. This month we are featuring the concept of an interoperability communications unit which facilitates the integration of diverse communications systems. Our demo product is the ACU-1000 JPS Interoperability Box by the JPS Division of Raytheon Corporation. 07-8 Training Materials Hands-On: Interoperability Box

27 Emergency Services, LLC / Copyright 2007 / Volume 07-827 DISCLAIMER Working Fire Training receives no compensation from JPS/Raytheon Corporation who manufactured the ACU-1000, the product featured in this segment. In fact, WFT has identified over 80 products from manufacturers such as Cisco IP, Sharp, CoCo Communications, Drakontas LLC. Working Fire Training urges all departments to do due diligence to arrive at a solution that best fits the individual department’s or mutual aid group’s needs. Such decisions may depend upon the involvement of neighboring departments. Download a Communications Interoperability Guide (.PDF) from the 07-8 Training Materials, for more information on strategies and products.Communications Interoperability Guide (.PDF) 07-8 Training Materials Hands-On: Interoperability Box

28 Emergency Services, LLC / Copyright 2007 / Volume 07-828 CONCEPT Interoperability systems are designed to integrate various and numerous communications methods and technologies that may show up at a response scene. In this way responders and/or civilians may communicate with any other responder, regardless of the system each is using. 07-8 Training Materials Hands-On: Interoperability Box

29 Emergency Services, LLC / Copyright 2007 / Volume 07-829 DEMONSTRATION PRODUCT The product used for demonstration is the ACU-1000 JPS Interoperability Box made by the JPS Division of Raytheon and was demonstrated at the Clayton Fire department in Clayton, Missouri. As noted above, there are many other systems available that responder departments and agencies may investigate including a newer version available from Raytheon, the ACU-2000 which has IP control capability. This is a demonstration of the basic functions of the ACU-1000. 07-8 Training Materials Hands-On: Interoperability Box

30 Emergency Services, LLC / Copyright 2007 / Volume 07-830 EXAMPLES OF POSSIBLE INTEROPERABILITY Here are some examples of devices which may communicate with each other using the Interoperability Box as an interface. –A VHF system may talk to a UHF system –Different signaling formats may be integrated: A P-25 communication system may talk to a conventional system or a trunking communication system –A Nextel two-way radio unit may talk to a standard VHF radio –Someone remote from the scene may call in on a standard phone line and talk with a radio user. 07-8 Training Materials Hands-On: Interoperability Box

31 Emergency Services, LLC / Copyright 2007 / Volume 07-831 INTERFACE This system is capable of five inputs, one reserved for telephone and the other four for any type of radio user. To hook up to the box, you need the radio for each communications system that you want to integrate and a connecting cable for that particular radio. –Only use approved cables to connect devices! 07-8 Training Materials Hands-On: Interoperability Box

32 Emergency Services, LLC / Copyright 2007 / Volume 07-832 INTERFACE Each cable is unique to each make and model of radio. –A manufacturer may make a UHF and a VHF radio with the same style and model number with a cable that will work with both. 07-8 Training Materials Hands-On: Interoperability Box

33 Emergency Services, LLC / Copyright 2007 / Volume 07-833 USERS Users can be very diverse and firefighters are a typical users group. –At a fire scene you will have many departments and diverse jurisdictional agencies show up with different means of communication. The Interoperability Box will allow members of different agencies or specialties to speak with members of other agencies without intermediaries. 07-8 Training Materials Hands-On: Interoperability Box

34 Emergency Services, LLC / Copyright 2007 / Volume 07-834 USERS Local or mutual aid departments, police, military – any participant in a unified command scenario can now have communications access to other participants as if they are on the same radio system. You can also set up sub-networks so that different conversations can go on at the same time. –Permissions can be set up so that some agencies may be able to listen and talk to each other while other agencies can only listen or be listened to. 07-8 Training Materials Hands-On: Interoperability Box

35 Emergency Services, LLC / Copyright 2007 / Volume 07-835 CONFIGURATIONS The Interoperability Box comes in essentially three configurations: –The ruggedized portable unit –A rack-mounted unit with more inputs and outputs and designed to be in a more fixed position, such as in a mobile command vehicle or trailer –A smaller desktop unit. It’s not as durable as the other units but it’s designed for quick and easy connection, perhaps from a management team such as an LEPC or at a SEMA/ FEMA level. 07-8 Training Materials Hands-On: Interoperability Box

36 Emergency Services, LLC / Copyright 2007 / Volume 07-836 SYSTEM OVERVIEW Though appearing imposing at first, the Box can be set up quickly, easily, and be operational with just a few button pushes. The JPS system consists of a(n): –keypad –handset for direct talking –interface cable between the Box and a radio that would plug into it. 07-8 Training Materials Hands-On: Interoperability Box

37 Emergency Services, LLC / Copyright 2007 / Volume 07-837 SYSTEM CONTROL The unit can be controlled three ways: –By a keypad –By a computer interface to a computer –Over the air using a DTMF (touch-tone) pad on a radio. 07-8 Training Materials Hands-On: Interoperability Box

38 Emergency Services, LLC / Copyright 2007 / Volume 07-838 HOOKING UP A VHF to UHF RADIO CONNECTION Here’s how to hook up a Motorola HT1250, a VHF radio using a frequency commonly used by many fire departments to a UHF radio. –Hook up the radio to the HT1250 port on the Box using the interface cable. In this case Port #3 was selected. –This unit is now the dedicated unit for VHF communications to the Box and it cannot be removed while in service. 07-8 Training Materials Hands-On: Interoperability Box

39 Emergency Services, LLC / Copyright 2007 / Volume 07-839 HOOKING UP A VHF to UHF RADIO CONNECTION –On the keypad, enter * 03 to enable the connection through Port #3. A voice confirms the connection and the port light becomes lit. –Hook up a UHF radio to Port #2. On the keypad, enter *02 to enable the connection through Port #2. A voice confirms the connection. We now have connectivity between the two radios, as well as the handset connected to the Box. 07-8 Training Materials Hands-On: Interoperability Box

40 Emergency Services, LLC / Copyright 2007 / Volume 07-840 HOOKING UP A VHF to UHF RADIO CONNECTION The monitor speaker on the Box may be muted if so desired. 07-8 Training Materials Hands-On: Interoperability Box

41 Emergency Services, LLC / Copyright 2007 / Volume 07-841 HOOKING UP A NEXTEL WALKIE-TALKIE HANDSET Here’s how to interface a Nextel handset. –Connect the Nextel interoperability connecting cable to the ear/microphone jack of the Nextel unit. –Connect the cable to Port #4 and enter *04 on the keypad. A voice confirms the connection and the port light becomes lit. –In the scroll list of the Nextel unit, scroll to the Nextel unit we’ve configured, and push to talk. 07-8 Training Materials Hands-On: Interoperability Box

42 Emergency Services, LLC / Copyright 2007 / Volume 07-842 HOOKING UP A NEXTEL WALKIE-TALKIE HANDSET The Nextel unit is now communicating with the VHF and UHF radios and the handset on the Box. 07-8 Training Materials Hands-On: Interoperability Box

43 Emergency Services, LLC / Copyright 2007 / Volume 07-843 TO DISCONNECT A UNIT The standard disconnect code is *33. –So, to disconnect Port #4, on the keypad enter *3304. –A voice command confirms the disconnection and the port light goes out. 07-8 Training Materials Hands-On: Interoperability Box

44 Emergency Services, LLC / Copyright 2007 / Volume 07-844 REAL-WORLD SET UP The initial installation of the unit for the Clayton (MO) Fire Department that uses the ACU-1000 was handled by professional technicians who trained the fire department in its use. Clayton Fire surveyed its mutual aid partners and responding agencies and created a list of what communications devices might arrive on scene at an incident. –Clayton then purchased the appropriate connecting cables to fit those units. 07-8 Training Materials Hands-On: Interoperability Box

45 Emergency Services, LLC / Copyright 2007 / Volume 07-845 REAL-WORLD SET UP When units respond, they provide a radio unit to be connected to the box. Clayton was hesitant at first regarding the proper usage of the Interoperability Box but uses the provided training video for review monthly or bimonthly so that its operations remain fresh in mind. Responsibility for its operation will fall to the chief officers, captains, and medical officers. 07-8 Training Materials Hands-On: Interoperability Box

46 Emergency Services, LLC / Copyright 2007 / Volume 07-846 REAL-WORLD SET UP Another reason for the selection of such a device has eliminated the need for a person to relay communications between non-compatible radio/communications units. Now, agencies such as the FBI or Secret Service may communicate along with important civilians such as the Mayor or City Managers who can be hooked into the communications network from their Nextel or land-line telephones. 07-8 Training Materials Hands-On: Interoperability Box

47 Emergency Services, LLC / Copyright 2007 / Volume 07-847 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ 1. True or False: To hook a radio to the Interoperability Box, any interconnection cable may be used. 2. True or False: With this Box, even the President could talk to local responders. 3. True or False: The unit can be controlled three ways: by a keypad, by a computer hard drive, or over the air using a DTMF (touch-tone) pad on a radio. 07-8 Training Materials Quiz: Interoperability Box

48 Emergency Services, LLC / Copyright 2007 / Volume 07-848 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which procedure order is correct? a. Hook up a radio to the box – punch *03 to connect to port #3 -- Hook up another radio to Port #2 by punching *02 – Handset is hooked in to the two radios. b. Hook up a radio to the box – punch *02 to connect to port #2 -- Hook up another radio to Port #3 by punching *03 – Handset is hooked in to the two radios. c. Hook a handset to two radios – punch *03 to a radio connect to port #3 -- Hook up another radio to Port #2 by punching *02 – The radios are hooked up. d. None of the above e. Two of the above 07-8 Training Materials Quiz: Interoperability Box

49 Emergency Services, LLC / Copyright 2007 / Volume 07-849 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which code is used to disconnect Port 3? a. *04 b. *03 c. *3303 d. *33XX depending upon the Port e. 3303 (Answers on Slide 106) Printable quizzes following answers on slide 108 on.PDF version 07-8 Training Materials Quiz: Interoperability Box

50 Emergency Services, LLC / Copyright 2007 / Volume 07-850 OBJECTIVES/OUTCOMES After watching this segment, the student shall learn about: the origins and training of search dogs what’s involved with training a search dog procedures for a dog and handler rappelling from an aerial ladder. CODES, STANDARDS & REGULATIONS NFPA 1670: Standard on Operations and Training for Technical Search and Rescue Incidents Hands-On: Rescue Dogs, Pt. 1 07-8 Training Materials

51 Emergency Services, LLC / Copyright 2007 / Volume 07-851 INTRODUCTION This training is to demonstrate the importance in using rescue dogs for live searches and cadaver recoveries and as a backup to law enforcement and fire personnel. Members of rescue dog teams are members of fire departments or law enforcement. The group in this training is also a member of and responds with the Heavy Rescue Strike Force Team in the St. Louis metropolitan area. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

52 Emergency Services, LLC / Copyright 2007 / Volume 07-852 TRAINING Dogs start out when they are around 12 weeks old with formal training beginning when they are about six months old. It takes about two years for a dog to become fully certified in both live-find and cadaver work. A dog will continue to work until she’s around 10 years old. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

53 Emergency Services, LLC / Copyright 2007 / Volume 07-853 SEARCH DOG BREEDS Many dogs come from the Czech Republic which is known for breeding and training search and rescue dogs. Most dogs on the team are German Shepherds, but this team has also had Labrador Retrievers, Blue Healers and others. Nearly any dog can be trained but working dog breeds are particularly well-suited. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

54 Emergency Services, LLC / Copyright 2007 / Volume 07-854 COMMAND LANGUAGE Many trainers talk to their talks in German or Czech, so that not just anyone can take control of the dog. This is an added safety feature. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

55 Emergency Services, LLC / Copyright 2007 / Volume 07-855 SAFETY NOTE All search dog team members are fire department members and receive regular high-angle and confined space training. –Consequently, all are knowledgeable in these skills and can back each other up -- another safety point. Safety is a primary concern for team members, their dogs, and their victims. All riggings are checked before they are stressed. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

56 Emergency Services, LLC / Copyright 2007 / Volume 07-856 AERIAL LADDER LIFT When is an aerial lift used? –A building is burned out or collapsed and the upper stories need to be searched. –Access from the ground is unsafe or not possible. –In such cases, dogs must be trained to ride under an aerial ladder bucket. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

57 Emergency Services, LLC / Copyright 2007 / Volume 07-857 AERIAL LADDER LIFT Obedience & Fear –While the handler prepares the rigging, the dog obediently waits for his command to come. –Obedience is important because knowing where the dog is at all times leads to safer incidents. –An obedient dog will stay where he is told to stay. Fear of heights –Dogs have a fear of heights just as people do. –Handlers will often carry their dogs over their shoulders like a sack of wheat to help the dogs overcome their fear. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

58 Emergency Services, LLC / Copyright 2007 / Volume 07-858 AERIAL LADDER LIFT Dog Harness Rigging –The lifting harness for the dog is specially designed for canine use –It’s padded at the contact points (knee and elbow joints). –Two straps hold the harness on the dog until rigging is complete. –The harness is weight-rated just like all firefighter gear; absolute weight rating for a 100 lb. dog, shock-loading, appropriate hardware for the weight, etc. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

59 Emergency Services, LLC / Copyright 2007 / Volume 07-859 AERIAL LADDER LIFT Dog Harness Rigging (cont.) –Carabiners are used to secure all straps giving the harness eight points of contact. –Four straps in the rear and four in the front are brought together with two separate carabiners to form a front and rear lifting point. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

60 Emergency Services, LLC / Copyright 2007 / Volume 07-860 AERIAL LADDER LIFT Dog Harness Rigging (cont.) –This spreads the weight more evenly than bringing all eight straps together with one carabiner. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

61 Emergency Services, LLC / Copyright 2007 / Volume 07-861 AERIAL LADDER LIFT Aerial Bucket Rigging –Two separate systems are rigged underneath the bucket: a primary and a secondary anchor. Good fire service procedure calls for backing up the primary anchor in case the first one is lost. Additionally, a back-up safety or belay line is rigged from the top of the bucket during training or a demonstration to add an additional safety margin. –In most cases, the dog teams arrive after the fire departments and specialty teams, so much of this rigging is already set up and ready to go. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

62 Emergency Services, LLC / Copyright 2007 / Volume 07-862 AERIAL LADDER LIFT Handler Rigging –The dog’s harness is locked into the handler’s harness. This gives him complete control over the dog as the dog rides below the handler, between his legs. The handler’s harness supports the dog in his harness. The handler is then free to maneuver without the dog interfering with his movements. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

63 Emergency Services, LLC / Copyright 2007 / Volume 07-863 AERIAL LADDER LIFT Handler Rigging (cont.) –The dog’s harness is locked into the handler’s harness. As the dog is positioned between the handler’s knees, he is able to direct the dog’s movement. The handler uses a brake rack to assist in the rappel which will come later. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

64 Emergency Services, LLC / Copyright 2007 / Volume 07-864 COMMUNICATIONS Radio communications are maintained between the handler and the bucket operator. The truck operator can also communicate with the bucket operator. The handler will be directing the bucket operator as far as where the handler and dog need to go: higher or lower and in which direction. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

65 Emergency Services, LLC / Copyright 2007 / Volume 07-865 EVOLUTION – SET-UP In this evolution, the handler and dog will be lifted up and over the roof line and then rappel to the training tower’s roof surface. This is to simulate getting a dog and a handler over a downed building, debris pile, swift water current, or some impassible object where traversing would not be possible. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

66 Emergency Services, LLC / Copyright 2007 / Volume 07-866 EVOLUTION – IN OPERATION As the slack on the bucket haul line is taken out, the handler weighs down or loads the system before he and the dog are lifted off the ground, to insure that the rigging is safe and holding. The dog, once accustomed to the height, enjoys the airborne lift. The backup belay line from the top of the bucket is controlled by the bucket operator. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

67 Emergency Services, LLC / Copyright 2007 / Volume 07-867 EVOLUTION – IN OPERATION The operator provides sufficient slack so the handler can maneuver at his own pace, but the line would come into play should the main line fail. The truck or turntable operator radios to the bucket operator to let him know when the handler and dog are off line, so he can release the slack on the safety line. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

68 Emergency Services, LLC / Copyright 2007 / Volume 07-868 EVOLUTION – IN OPERATION Once secured on the roof, the dog is ready to work. The turntable operator of the aerial controls the raising and lowering of the bucket. –He is at a disadvantage when raising the handler and dog to a higher position, such as a roof top, as he cannot see them. –So he relies heavily on the bucket operator who can see, to provide direction. –Once the handler and dog clear the roof line on removal, he can see them. 07-8 Training Materials Hands-On: Rescue Dogs, Pt. 1

69 Emergency Services, LLC / Copyright 2007 / Volume 07-869 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: Rescue dogs are often commanded in other languages. 2. True or False: A rescue dog just starts getting proficient at ten years of age. 3. True or False: A dog can be afraid of heights. 07-8 Training Materials Quiz: Rescue Dogs, Pt. 1

70 Emergency Services, LLC / Copyright 2007 / Volume 07-870 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which of the following do NOT belong in a dog harness rigging? a. Eight points of contact b. Ropes weighted and shock-rated for a dog c. Four carabiners from the front and the back are combined to hook into two carabiners, one in front and one in back. d. Swivels e. None of the above 07-8 Training Materials Quiz: Rescue Dogs, Pt. 1

71 Emergency Services, LLC / Copyright 2007 / Volume 07-871 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which of the following are NOT part of the Aerial Bucket Lift? a. Communications between operators b. Loading of the system by the handler c. Prusik wraps d. Primary and secondary anchors e. None of the above (Answers on Slide 106) Printable quizzes following answers on slide 108 on.PDF version 07-8 Training Materials Quiz: Rescue Dogs, Pt. 1

72 Emergency Services, LLC / Copyright 2007 / Volume 07-872 OBJECTIVES/OUTCOMES After watching this segment, the student shall understand: the pathophysiology of musculoskeletal (MS) trauma management of MS trauma in: – multisystem trauma – isolated extremity trauma CODES, STANDARDS & REGULATIONS Pre-hospital Trauma Life Support Training, National Association of Emergency Medical Technicians and the American College of Surgeons. Fire Medics: PHTLS Training 4: Musculoskeletal Trauma 07-8 Training Materials

73 Emergency Services, LLC / Copyright 2007 / Volume 07-873 INJURY STATISTICS 23.8 million musculoskeletal injuries occur annually (CDC, 2003). That’s 83 per 1000 population so these injuries are very common: sprain, strain, fracture, bleeding, etc. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

74 Emergency Services, LLC / Copyright 2007 / Volume 07-874 MS TRAUMA Management depends on the situation Multisystem trauma (even a potential one) vs. simple isolated injury is the issue. The problem is, one can complicate the other. For example, a simple isolated fracture or injury could be a distracting injury from a more severe, multisystem problem you find out about later. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

75 Emergency Services, LLC / Copyright 2007 / Volume 07-875 MS TRAUMA You have to look at the kinematics of the situation, the mechanism of injury, and the patient’s overall status using the primary survey and the secondary survey to help you decide between the two. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

76 Emergency Services, LLC / Copyright 2007 / Volume 07-876 SCENARIOS Patient #1 –An intoxicated male has cut his arm on window glass –Upon arrival you see a lot of blood and glass by the front door –A 40 year-old male, sitting in a chair, presents with heavy bleeding from the upper arm. –Upon examination, you see a laceration of the antecubital fossa with copious bright red bleeding. –What are your first thoughts? 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

77 Emergency Services, LLC / Copyright 2007 / Volume 07-877 SCENARIOS Patient #1 (cont.) –Possible conditions Arterial bleeding Shock Hypovolemia –Are there any life-threatening injuries? Absolutely! –We may find them even by doing our primary survey ABCs (airway-breathing-circulation). In the circulation phase, we check the pulse, condition of the skin, and major, arterial bleeding, so this patient might have life-threatening injuries. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

78 Emergency Services, LLC / Copyright 2007 / Volume 07-878 SCENARIOS Patient #1 (cont.) –What are examples of life-threatening MS injuries? Life-threatening hemorrhage or bleeding – for example, with Patient #1 Multiple, large-bone fractures –What ways exist to control the bleeding? Use the “Depth” pneumonic acronym –Direct pressure –Elevation –Pressure –Tourniquet –Help 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

79 Emergency Services, LLC / Copyright 2007 / Volume 07-879 SCENARIOS Patient #1 (cont.) –Does this injury require rapid packaging and transport? –Is this a “load and go” patient? Absolutely! 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

80 Emergency Services, LLC / Copyright 2007 / Volume 07-880 SCENARIOS Patient #2 –A 24 year-old female has fallen while skiing. –She was brought to the lodge by the Ski Patrol –She complains of severe right thigh pain. –What are your first thoughts? A femur fracture is possible. Alone, this would be an isolated injury. But a broken femur could easily distract from a multisystem injury, perhaps an abdominal injury. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

81 Emergency Services, LLC / Copyright 2007 / Volume 07-881 SCENARIOS Patient #2 (cont.) –Primary Survey A – Patent airway B – Normal breathing C – No external hemorrhage, normal pulse rate, skin is warm and dry D – GCS score: 15 –Conclusions based on these findings: Her injury seems isolated since her primary survey looks okay. Could she develop something like compensatory shock, later on? Possibly. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

82 Emergency Services, LLC / Copyright 2007 / Volume 07-882 SCENARIOS Patient #2 (cont.) –Secondary Survey –A swollen right thigh –How much blood could a patient lose from this type of injury? The patient could lose 1-2 liters internally. It doesn’t have to be an external wound to lose that quantity of blood. –Is this enough to cause shock? Absolutely. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

83 Emergency Services, LLC / Copyright 2007 / Volume 07-883 SCENARIOS Patient #2 (cont.) –Management Priorities Transport and start an IV en route. Even though this is a likely isolated extremity injury, we are still going to do a rapid transport. Start O 2. Oxygen should be initiated to keep O 2 saturation levels above 95%. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

84 Emergency Services, LLC / Copyright 2007 / Volume 07-884 SCENARIOS Patient #3 –A 45 year-old male pedestrian was struck by an SUV. –He smells of alcohol. –What are your first thoughts? Look for pelvis, chest injuries. This patient has a lot of potential for multisystem trauma. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

85 Emergency Services, LLC / Copyright 2007 / Volume 07-885 SCENARIOS Patient #3 (cont.) –Primary Survey A – Patent airway B – VR rapid and shallow, clear BS C – Blood oozing from multiple soft tissue injuries, weak and rapid radial pulse D – GCS score: 13 (E-3, V-4, M-5) –When you gently stress his pelvis, crepitus is noted and the patient screams in pain. –What is the potential blood loss for a patient with an injured pelvis? It could be extremely high. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

86 Emergency Services, LLC / Copyright 2007 / Volume 07-886 SCENARIOS Patient #3 (cont.) –Conclusions based on these findings: The patient could very quickly be going into compensated or decompensated shock. –Management Priorities On scene, package for transport. –If the patient has a pelvic fracture: Consider using a P.A.S.G. (Pneumatic Anti-Shock Garment) Inflate all the compartments all at once until the Velcro crackles. Immobilize on a backboard/longboard Rapid transport Start an IV and O 2 en route. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

87 Emergency Services, LLC / Copyright 2007 / Volume 07-887 SCENARIOS Patient #4 –A 22 year-old male crashed while riding a mountain bike. –Because of the remote location, you reach the patient 1.5 hours after the injury occurred. –What are your first thoughts? Without question, the Golden Hour has passed. This patient may have potential for multisystem trauma. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

88 Emergency Services, LLC / Copyright 2007 / Volume 07-888 SCENARIOS Patient #4 (cont.) –Primary Survey A – Patent airway B – VR slightly increased C – No external hemorrhage, rapid and weak radial pulse D – GCS score: 15 E – Deformities noted to left upper arm and to both lower legs –Conclusions based on these findings: We have multiple, isolated fractures which combine to become a multisystem event. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

89 Emergency Services, LLC / Copyright 2007 / Volume 07-889 SCENARIOS Patient #4 (cont.) –Secondary Survey VR 24 Pulse 122 BP 104/72 There is no abdominal or pelvic tenderness –Management Priorities Shock is almost a certainty O 2 application C-Spine immobilization Packaged on a backboard/longboard –Only splint injuries if there is time during transport Consider a different kind of transport Access to helicopter or quicker mode of transport 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

90 Emergency Services, LLC / Copyright 2007 / Volume 07-890 SCENARIOS Patient #4 (cont.) –Estimated Blood Loss (mL) Rib 125 Radius or Ulna 250 – 500 Humerus 500 – 750 Tibia or Fibula 500 – 1000 Femur1000 – 2000 Pelvis1000 – massive –If you think the patient has a broken pelvis, treat the patient as if he will be in shock if he isn’t already. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

91 Emergency Services, LLC / Copyright 2007 / Volume 07-891 SCENARIOS Patient #4 (cont.) –There are lots of vascular structures and vessels in the pelvis. –With a broken pelvis, if it’s angulated or bones are in positions where they shouldn’t be, blood vessels could easily be ruptured, resulting in major blood loss 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

92 Emergency Services, LLC / Copyright 2007 / Volume 07-892 SCENARIOS Patient #5 –A 70 year-old woman slipped on ice and fell down a staircase. –Upon your arrival, she is complaining of pain in her left wrist and left ankle. –On examination, deformities are founding both extremities. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

93 Emergency Services, LLC / Copyright 2007 / Volume 07-893 SCENARIOS Patient #5 (cont.) –What are your first thoughts? If the flight of steps is maybe twelve steps, we should be looking for a mechanism of trauma. If it’s only two or three steps, trauma should be considerably less. Depending on how far the fall, we’re probably looking at two isolated extremity injuries unless there appears to be shock in evidence. Deformities in both extremities might mean problems with pulses and profusion in both extremities. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

94 Emergency Services, LLC / Copyright 2007 / Volume 07-894 SCENARIOS Patient #5 (cont.) –Primary Survey A – Patent airway B – VR slightly fast C – Moderate hemorrhage from oozing and open ankle, irregular pulse D – GCS score: 15 VR 22 Pulse 105 BP 110/70 Complains of pain at fracture sites. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

95 Emergency Services, LLC / Copyright 2007 / Volume 07-895 SCENARIOS Patient #5 (cont.) –Any other possible contributing medical factors? Based on her age, atrial fibrillation, irregular heart rate? A secondary survey should be done to check further for other contributing factors. Is there a potential for shock? Absolutely. –Are there life-threatening injuries present? The fractures are not. –Conclusions based on these findings: We have multiple isolated fractures which combine to become a multisystem event. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

96 Emergency Services, LLC / Copyright 2007 / Volume 07-896 SCENARIOS Patient #5 (cont.) –Management Priorities Preparation for transport O 2 application Immobilization techniques Consider using extra padding when immobilizing Consider splinting possible fractures to decrease pain and keep her from moving more Start an IV Manage her pain; consider giving her a narcotic 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

97 Emergency Services, LLC / Copyright 2007 / Volume 07-897 SUMMARY Although MS injuries can be dramatic, always begin with the primary survey. This would entail: –checking the airway. –checking for signs of circulation problems. –checking the heart rate. –looking at the skin for signs of shock. –making sure there is no life-threatening hemorrhaging; arterial bleeding, etc. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

98 Emergency Services, LLC / Copyright 2007 / Volume 07-898 SUMMARY Multisystem trauma patient –Focus on primary threats to life revealed by primary survey Airway Breathing Circulation –Most MS trauma is splinted with spinal immobilization; if done correctly, additional splinting should not be necessary in most cases. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

99 Emergency Services, LLC / Copyright 2007 / Volume 07-899 SUMMARY Isolated MS injury –Splint as appropriate, assuming the injury is isolated and you’re not worried about shock Rigid Splints (be sure and use padding with this type) Traction Splints Hard Splints Using the other side of the body as a splint –If no P.A.S.G is available, use a sheet or blanket wrapped around and pulled as tight as possible. A KED (Kendrick Extrication Device) may also be used for a pelvic fracture. If you are not familiar with this device, go here: http://en.wikipedia.org/wiki/Kendrick_Extrication_Device http://en.wikipedia.org/wiki/Kendrick_Extrication_Device 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

100 Emergency Services, LLC / Copyright 2007 / Volume 07-8100 SUMMARY Isolated MS injury (cont.) –If you think the patient has possible shock or hypovolemia due to blood loss, it could be a problem to take the time to do all the immobilization. You might have just to load and go. –If you have multisystem trauma, respect and honor the Platinum 10 Minutes! 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

101 Emergency Services, LLC / Copyright 2007 / Volume 07-8101 SUMMARY Consider pain management –On any isolated injury or injuries where shock isn’t an issue, pain management should be provided if the patient is in pain. –Be careful, of course, if either compensated or decompensated shock is present, but pain management should be considered. –That means start an IV during transport. –If your protocols won’t allow you to start pain meds, contact your incoming hospital or trauma center and see if they can’t get you started with some pain management. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

102 Emergency Services, LLC / Copyright 2007 / Volume 07-8102 SUMMARY Consider pain management (cont.) –Later on, patients may not remember the isolated injury they had, but they will remember whether they were in pain or not. –Pain could be viewed as a vital sign that can be responded to. –You owe it to your patient to give consideration toward treatment of the pain as well as the injury. 07-8 Training Materials Fire Medics: PHTLS Training 4: Musculoskeletal Trauma

103 Emergency Services, LLC / Copyright 2007 / Volume 07-8103 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: A broken leg is far away from the heart; it could never be life-threatening. 2. True or False: A decent primary survey could be proved wrong when a secondary survey is conducted. 3. True or False: Based on this primary survey… A – Patent airway; B – Normal breathing; C – No external hemorrhage, normal pulse rate, skin is warm and dry; D – GCS score: 15 …this patient is in no immediate danger. 07-8 Training Materials Quiz: PHTLS Training 4: Musculoskeletal Trauma

104 Emergency Services, LLC / Copyright 2007 / Volume 07-8104 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Considering the “D.E.P.T.H.” pneumonic acronym, which item is correct? a. Deviation b. Elevation c. Profusion d. Tamponade e. Hemoglobin 07-8 Training Materials Quiz: PHTLS Training 4: Musculoskeletal Trauma

105 Emergency Services, LLC / Copyright 2007 / Volume 07-8105 Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. When packaging a broken pelvis for transport, which of the following is NOT correct? a. Consider using a P.A.S.G. (Pneumatic Anti-Shock Garment) b. Inflate all the compartments all at once. c. Immobilize on a backboard/longboard d. Transport normally e. Start an IV and O 2 en route. (Answers on Slide 108) 07-8 Training Materials Quiz: PHTLS Training 4: Musculoskeletal Trauma Printable quizzes following answers on slide 108 on.PDF version

106 Emergency Services, LLC / Copyright 2007 / Volume 07-8106 Kramer vs. Kramer Essay Questions Telecommunications Interoperability 1. What are the advantages of having total interoperability in telecommunications among responders at major emergency incidents? 2. What are the drawbacks of having total interoperability in telecommunications among responders at major emergency incidents? 3. Describe efforts, or lack thereof, of telecommunications interoperability in your area. What suggestions do you have for improvement? If you’re enrolled in the Open Learning Fire Science Program at the University of Cincinnati, complete written responses to the following three essay questions to earn one college credit hour for watching Working Fire Training. 07-6 Training Materials Evolutions 2000 – Continuing Education

107 Emergency Services, LLC / Copyright 2007 / Volume 07-8107 ENROLLMENT INFORMATION: For more information on enrolling in the Open Learning program to gain college credit, call Working Fire Training at 800-516-3473 for a brochure or, to register directly, call the University of Cincinnati at 513- 556-6583. Associates and Bachelors programs are available. Call to have your transcripts evaluated. Send your responses to: Professor Bill Kramer University of Cincinnati College of Applied Science 2220 Victory Parkway, ML #103 Cincinnati, Ohio 45206 07-8 Training Materials Evolutions 2000 – Continuing Education

108 Emergency Services, LLC / Copyright 2007 / Volume 07-8108 Thanks so much for viewing Working Fire Training! See you next month – stay safe! Answers: Hands-On – Interoperability Box: Quiz on Slides 47-49: 1. False 2. True 3. False 4. e 5. c Rescue/Search Dogs, Pt. 1: Quiz on Slides 69-71; 1. True 2. False 3. True 4. d 5. c Fire Medics – PHTLS Training 4: Quiz on Slides 103-105: 1. False 2. True 3. True 4. b 5. d TRAINING Working Fire Training 07-8 Training Materials


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