PARAMEDICS Speak about your profession briefly: What are some things that you see? How many years at school? College? University? What do you enjoy the most about your job?

Let’s Talk About Paramedics role during a trauma Recovery position & Good Samaritan Act Opioids and the naloxone kit awareness

The Golden Hour To reduce the time of injury... To the time of surgery Speak to the importance of first responders to arrive at a scene and to get the patient the right level of care or depending on how serious the incident is to a trauma center ASAP Not all patients who are involved in a trauma require a trauma centre – responders are skilled in making that determination Different situations require different facilities – such as MCI events, Paediatric, micro surgery, pregnant patients Pain management during extrication Complications

of patient out of vehicle Extrication of patient out of vehicle Speak about how before we even get to extrication, we have the actual response to the call and the various factors that play into that (rural vs. urban, traffic, distance, vehicles not pulling over, etc.) Talk about the partnership between allied services (Police and Fire) and everyone's roles on calls Police there for scene containment and safety Fire to perform majority of actual extrication with specialized tools Talk about how even though the extrication is on-going, we will try to assess and treat the patient as best as possible during the extrication process vary (weather, geographical, electrical hazards, unsafe scenes etc.) Safety concerns that arise for the patient, the public and the responders

of patients out of vehicle Extrication of patients out of vehicle PLAY VIDEO Car Extrication Video As they can see, lots is being done simultaneously and that it is extremely important to have excellent lines of communication so that everyone is on the same page. There are courses available to us to have some of the basic extrication training, however it is usually the fire department that handles it. There are some locations where the paramedics have basic extrication equipment, due to the local fire department being so far away.

Rapid Assessment Many incidents involve multi-system trauma. Includes rapidly determining the major life threats and stabilizing them prior to transport to hospital After initial stabilization attempts (airways, CPR, medications etc), we continuously monitor for changes in condition on the way to the hospital Becomes far more complex depending on the increased number of people involved and the severity of individuals injuries

Rapid Transport Paramedics face several challenges in transporting our patients to the trauma centers. Distance to the trauma facility, inclement weather and the severity of the patient all play factors in delaying arrival at a trauma facility; Mention how in Toronto we're lucky to have three, however some areas don't have any. Speak to students of what to do when an emergency vehicle approaches you Safety of paramedics often dealing with sharps and other dangerous situations during transport Paramedics use lights and sirens to expedite transport but must ensure that the safety of everyone is the top priority Speak about ORNGE and what they do as air transport. Explain that ORNGE may go directly to the scene or to a location close to it (local airport or heliport). Sometimes even to the local hospital.

used to stabilize patients Equipment used to stabilize patients   Mention how we have numerous types of trauma equipment, from bandages to military dressings and tourniquets, as well as different splints and the backboards (however trying to move away from them). Paramedics have a wide variety interventions, skills and medications that can be used to assist a trauma patient.This can include things like: airway manoeuvers airway adjuncts such as: NPAs, OPA, ETT, Cricothyrotomy, Medications intravenous fluids and defibrillation to name a few.

911 and Recovery Position Scenario 4 students Scenario: read by teacher (script) Teacher will prompt the group What are they celebrating From where? Student (script)

Opioids Medications usually used to treat pain. Includes: Tylenol #3, heroin, fentanyl, morphine, methadone, codeine, oxycodone and many others. DANGEROUS! – even small amounts could cause an overdose or even death. Opioids are a class of medications that can be very effective for treating pain, but they come with serious risks. This class of medications can include drugs like Tylenol #3, heroin, fentanyl, morphine, methadone, codeine and oxycodone, among others. These drugs are highly addictive and dangerous. Even small amounts could lead to an overdose and even death.

Signs of Opioid Overdose Breathing slow or not breathing at all Blue lips and nails Person is not moving Gurgling or choking sounds or snoring Person cannot be woken up Dizziness or confusion Skin feels cold and clammy Pupils are tiny If you or someone you know uses drugs (prescription or illegal), its important to be aware of the signs of an overdose. *Ask the students if they know any of the signs of an opioid overdose before showing the signs. A person who has overdosed from an opioid: May be breathing slow, or not breathing at all May have blue lips or nails May not be moving May be choking May make gurgling or snoring sounds May be unable to be woken up May feel cold or clammy to the touch Or may have very tiny pupils like a pinpoint Source: http://www.fraserhealth.ca/health-info/health-topics/harm-reduction/overdose-prevention-and-response/recognizing-an-overdose/

Naloxone Kit Naloxone is a safe medication. Temporarily reverses the signs of opioid overdose by blocking the effects of opioids in the brain. In Canada naloxone is available in the intramuscular (injectable) and intranasal (nasal spray) formulations. Let’s talk about Naloxone Kits. The kits contain a medication called Naloxone. Naloxone is safe, it will not cause harm even if the person has not had an overdose. If given in an overdose situation, it temporarily reverses the effects of opioids for about 30 minutes. It could save someone’s life. In Canada, Naloxone comes in 2 different forms – an injectable form and a nasal spray form. The injectable form is the more common form. The kits have a few different items: gloves, alcohol swabs, 2 doses of the medication and safety syringes. This all might sound a bit scary, but you will get training from the pharmacist when you pick up a kit. Source: https://www.ontario.ca/page/get-naloxone-kits-free

If you suspect an overdose call 9-1-1 PLAY VIDEO If you think that someone you are with has overdosed, call 911 immediately! Do not let legal fears stop you! If you are worried about getting in trouble with the law, you will have some protection in these situations. The Good Samaritan Drug Overdose Act applies to anyone seeking emergency support during an overdose. This includes the person experiencing the overdose and anyone else who is at the scene when help arrives. Source: https://www.canada.ca/en/health-canada/services/video/good-samaritan-law.html

Questions This is an opportunity to share more about your profession and strategies that you use to help cope with the stresses of the job Feel free to share your experience, ideas that keep you hopeful, resilient while on the job.