EMERGENCY MEDICAL CARE State of Georgia BASIC FIRE FIGHTER TRAINING COURSE

Emergency Medical Care 2 INFECTIOUS DISEASE CONTROL Universal Precautions  Assume all patients are infectious  Treat all body fluids as infectious  Use precautions when using sharps  Wash immediately if contaminated with blood/body fluids  Clean, disinfect, & sterilize equipment properly

Emergency Medical Care 3 INFECTIOUS DISEASE CONTROL Program Components  Written infection control policy  Annual training  Infection control officer  Health maintenance program: hep B, TB  Medical Personal Protective Equipment (Med PPE) readily available  FD facility Cleaning & decontamination areas

Emergency Medical Care 4 INFECTIOUS DISEASE CONTROL Medical Personal Protective Equipment  Always wear latex gloves  Wear masks & eye protection  Wear protective clothing  Use airway equipment during artificial respiration efforts  Avoid putting your hands around your face  Clean & dispose of equipment using universal precautions

Emergency Medical Care 5 INFECTIOUS DISEASE CONTROL Procedures  Clean, disinfect, & sterilize equipment properly  Hand protection and washing is done before and after handling equipment

Emergency Medical Care 6 INFECTIOUS DISEASE CONTROL Equipment  Example: stethoscope, BP Cuff, splints  Process: Clean off visible material Clean with 1/4 cup chlorine bleach mixed with one gallon of tap water  Use an EPA approved disinfectant

Emergency Medical Care 7 INFECTIOUS DISEASE CONTROL Routine Housekeeping No Blood  Cleaning apparatus seats and floors  Use any cleaner or disinfecting agent which is intended for environmental use

Emergency Medical Care 8 INFECTIOUS DISEASE CONTROL Cleaning & Decontaminating Blood Spills  Wear gloves  Wear eye protection  Remove visible material using disposable towels  Clean with 1/4 cup of chlorine bleach per gallon or water  Clean, decontaminate, or dispose of soiled equipment

Emergency Medical Care 9 INFECTIOUS DISEASE CONTROL Laundry  LINENS: Place soiled linens in plastic, leak-proof bags to remove from site Launder as normal per manufacture’s instructions

Emergency Medical Care 10 INFECTIOUS DISEASE CONTROL Laundry  Uniforms & Protective Clothing Place contaminated clothing in plastic bags to remove from site Launder as normal per manufacturer’s instructions Brush/scrub boots & leather goods with warm soapy water

Emergency Medical Care 11 INFECTIOUS DISEASE CONTROL Infected Waste Disposal  Follow local regulations  Normally, incinerate or decontaminate before disposal in landfill  Pour fluids/liquids down a drain connected to sanitary sewer  Place sharps in puncture-proof container  Place blood-contaminated items in leak-proof plastic bags

Emergency Medical Care 12 SCENE ASSESSMENT

Emergency Medical Care 13 SCENE SIZE-UP Begins While En-route  Form a mental picture of what to expect based on the particular location  Think of what to expect based on the nature of the call  Mentally review treatment procedures

Emergency Medical Care 14 SCENE SIZE-UP Upon Arrival  Try to get the “big picture” of the emergency scene  Determine if additional personnel and/or equipment are needed  Call for additional help if needed

Emergency Medical Care 15 DETERMINE SCENE SAFETY  Remember your own safety first: wear Med-PPE  Be aware of environmental hazards electrical & gas hazards hazardous materials traffic hazards  Be aware of potential violence patients people at the scene

Emergency Medical Care 16 DETERMINE SCENE SAFETY  Be aware of unstable scenes buildings vehicles  Be aware of & use necessary precautions for infectious diseases

Emergency Medical Care 17 GETTING INFORMATION  Bystanders  Patient  Mechanism of Injury  Items around victim: drug bottles other drug materials

Emergency Medical Care 18 PRIMARY SURVEY A systematic assessment of victims to find and correct life threatening injuries

Emergency Medical Care 19 PRIMARY SURVEY  Use all appropriate Med-PPE  Survey must follow sequential order  Alert patients able to answer questions have “ABC’s”  Assume all unconscious and trauma victims to have spinal injury Do NOT move cervical spine [neck]  Determine responsiveness before survey

Emergency Medical Care 20  A irway: Open airway (with C-spine control)  B reathing: Look, listen & feel  C irculation: Check Carotid pulse Check for severe bleeding PRIMARY SURVEY ABC & Check

Emergency Medical Care 21 SOFT TISSUE INJURIES Injuries to the skin or the underlying tissue which may result in external or internal bleeding and can lead to shock or death  Lacerations  Burns

Emergency Medical Care 22 TYPES OF EXTERNAL BLEEDING  ARTERIAL BLEEDING  VENOUS BLEEDING  CAPILLARY BLEEDING

Emergency Medical Care 23 CONTROLLING EXTERNAL BLEEDING u Direct pressure u Elevation u Pressure Point

Emergency Medical Care 24  TOURNIQUETS? Used only in very rare cases May cause more damage The victim may lose the entire limb CONTROLLING EXTERNAL BLEEDING

Emergency Medical Care 25 BURNS Skin  Largest organ  Layers of skin: Epidermis - outer layer Dermis - middle layer Subcutaneous layers

Emergency Medical Care 26 BURNS Classification  First Degree Surface  Second Degree Partial Thickness  Third Degree Full Thickness

Emergency Medical Care 27 BURNS General Treatment  Primary Survey  Stop burning process  Cool the burn  Treat for shock  Prevent infection Never apply ointments, creams or butter  Arrange for transport

Emergency Medical Care 28 BURNS Thermal  Cool water  Do not remove stuck clothing

Emergency Medical Care 29 BURNS Chemical  Wash away chemical at least 15 minutes  Remove contaminated clothing  Cover burned area

Emergency Medical Care 30  Provide special treatment based upon the chemical involved Dry Lime Phenol (carbolic acid) Sodium metals Sulfuric acid BURNS Chemical

Emergency Medical Care 31 BURNS Chemical Burns to the Eyes  Flush contaminated eye Contact lenses should be removed  Arrange for transport to medical facility

Emergency Medical Care 32 SHOCK A failure of the circulatory system to provide sufficient blood supply to all parts of the body resulting in body cells receiving insufficient oxygen. This causes a depression in body functions & eventually death if not controlled

Emergency Medical Care 33 SHOCK Types  Hypovolemic shock  Psychogenic shock Fainting (syncope)  Anaphylactic Shock

Emergency Medical Care 34 SHOCK Signs & Symptoms  Restlessness or anxiety  Extreme thirst  Nausea or vomiting  Dull, vacant-looking eyes  Dilated pupils  Cold, clammy skin  Pale or cyanotic face  Rapid, shallow breathing possibly labored, irregular or gasping  Weak, rapid pulse  Falling blood pressure

Emergency Medical Care 35 Shock Treatment  Primary Survey  Administer oxygen  Treat the cause  Lay patient down Gently elevate the feet and legs  Maintain body temperature  Monitor pulse respirations level of consciousness  Transport to medical facility

Emergency Medical Care 36 INGESTED POISONS Any substance that can cause illness or death when consumed (ingested) or absorbed by the body

Emergency Medical Care 37 INGESTED POISONS Signs & Symptoms  Nausea / vomiting  Cramps or severe abdominal pain  Diarrhea  Excessive salivation or foaming at the mouth  Burns or stains around the mouth  Unusual odors on the clothes or breath

Emergency Medical Care 38 INGESTED POISONS Signs & Symptoms  Sweating  Abnormal breathing  Abnormal or irregular pulse  Dilated or constricted pupils  Drowsiness or unconsciousness  Convulsions

Emergency Medical Care 39  Primary Survey  Try to determine what was ingested container bystanders / family  Time of ingestion  Amount ingested  Age/Weight INGESTED POISONS Treatment

Emergency Medical Care 40 INGESTED POISONS Treatment  Never give anything by mouth to anyone who is unconscious, convulsing, or having difficulty swallowing  If substance is NOT intended for ingestion, give victim one or two glasses of milk or water to dilute the poison. Contact Poison Control Center  Arrange for medical transport

Emergency Medical Care 41 DRUG OVERDOSE  NARCOTICS Alter the perception of pain Cause a depressed mental status Slows or stops respirations

Emergency Medical Care 42 DRUG OVERDOSE  SIGNS and SYMPTOMS of NARCOTIC OVERDOSE Shallow or absent respiration Cool clammy skin Constricted pupils Cyanosis Decreased heart rate & blood pressure Seizures

Emergency Medical Care 43  DEPRESSANTS Lowers the body functions Decreases nervous system activity Decreases the possibility of seizures DRUG OVERDOSE

Emergency Medical Care 44 DRUG OVERDOSE  SIGNS and SYMPTOMS of Depressant Overdose Cool clammy skin DILATED pupils Shallow or absent respirations Weak, rapid pulse Coma

Emergency Medical Care 45 DRUG OVERDOSE  STIMULANTS Increases the body energy levels

Emergency Medical Care 46  SIGNS and SYMPTOMS of Stimulant Overdose Combativeness Increase in body temperature Hallucinations Increased heart rate and blood pressure Seizures DRUG OVERDOSE

Emergency Medical Care 47 DRUG OVERDOSE  Hallucinogen or Cannabis Hallucinogens create a false perceptions not based on reality Cannabis drugs produce a euphoric effect when ingested or smoked.

Emergency Medical Care 48 DRUG OVERDOSE  SIGNS and SYMPTOMS of Hallucinogen or Cannabis Overdose Longer, more intense trip Possible violent behavior Psychosis Increased heart rate Increased blood pressure Seizures

Emergency Medical Care 49 DRUG OVERDOSE Emergency Treatment  Law enforcement  Primary survey  Never give anything orally to anyone who is unconscious, convulsing, or having difficulty swallowing  Try to keep patient calm

Emergency Medical Care 50 DRUG OVERDOSE Emergency Treatment  Try to determine what was taken, how much was taken, & whether anything else was taken Interview victim, family, and bystanders Search the area (in front of witnesses)  Contact Poison Control Center  Arrange for medical transport