1. EMS Support and Operations

2. You Are the Emergency Medical Responder
Lesson 42: EMS Support and Operations
You Are the Emergency Medical Responder
You are an EMR approaching the scene of a two-car collision at a busy intersection. It is rush hour and traffic is heavy. One of the involved cars is situated on the median strip, and the other is off the road on the shoulder, just past the intersection. There are multiple occupants in each vehicle.

3. Roles of the EMR in the EMS System
Traditional EMR
Functions within the system
Affiliated with a servce: fire, ambulance, law enforcement, search and rescue
Non-traditional EMR
Has same training as traditional EMR
Works in less traditional settings
Athletic trainers
Health and human performance

4. Nine Phases of EMS Response
Preparation for an emergency call
Dispatch
En-route to the scene
Arrival at the scene and patient contact
Transferring the patient to the ambulance
En-route to the receiving facility
Arrival at the receiving facility
Clear medical facility
Available for next emergency call

5. General Criteria for Requesting Air Medical Transport
Vehicle rollover with an unrestrained passenger(s)
Motorcycle accident with driver thrown at a
speed >20 mph
Multiple injured or ill people
Pedestrian struck with vehicle travelling at >10 mph
Fall from a height >15 feet
Critical stroke and cardiac patients if ground
transport >45 minutes
Critical trauma patient if ground transport >30 minutes

6. Air Medical Transport Considerations
Types:
Rotorcrafts: used for areas not accessible to any other type of rescue craft
Fixed-wing crafts: used for transport over long distances
Considerations
Weather
Space and weights

7. Landing Zone Considerations (LZ)
A minimum area of 10,000 square feet (100 feet by 100 feet)
Flat, firm land
An area clear of any obstacles, such as trees or utility poles
An area clear of any type of vehicular traffic or pedestrians
An area that is well lit that can easily be seen by the pilot

8. Emergency Vehicle Safety
Vehicle preparedness
Equipment preparedness – includes PPE
Use of lights and sirens
Responding with due regard
Obey traffic laws
Weather and road conditions

9. High-Risk Situations Intersections and highway access Fatigue
Speeding
Driving distractions
Inclement weather
Aggressive driver
Unpaved roadways
Responding alone/first on the scene
Fatigue
Downed electrical lines
Leaking fuel or fluids
Smoke or fires
Broken glass
Trapped or ejected patients

10. Activity
You are the first to arrive at the scene involving a tree that has fallen onto a house after a violent thunderstorm. The house is located in a rural section of the town. The wind is blowing hard and rain continues to fall, somewhat heavy at times. The tree has hit the second story of the house, damaging the roof and several windows. Tree branches, window shards and pieces of the roof litter the ground. The utility pole in front of the house is leaning toward the house. The family members, who were on the second floor when the tree hit, are outside sitting on the grass. They are dazed and have numerous cuts and lacerations that are oozing blood. Fire and utility crews have been notified but have yet to arrive.

11. Safety and Patient Care in the Ambulance
All personnel seated and secured
Patient properly secured with all straps
Keep three of the five essential body parts (two hands, feet and backside) “hugging” the ambulance at all times during patient care
All moveable equipment secured

12. Jump Kit PPE and hand sanitizer
Oral airways
Suction equipment
Artificial ventilation devices
Basic wound supplies
Other items, such as—
PPE and hand sanitizer
Scissors, blood pressure cuff, stethoscope and flashlight
Maps, notepad and pen

13. You Are the Emergency Medical Responder
Additional fire rescue, police and EMS units arrive. You see that one of the occupants of the vehicle that is on the shoulder of the road apparently was not wearing a seat belt, was ejected from the vehicle and is not moving. The driver of the car on the median strip is conscious, but because of traffic you cannot get to that vehicle.

14. Enrichment Operational Safety and Security
Begin each shift with an in-person briefing or review of written notes about any issues
Never leave an ambulance or rescue vehicle running or unattended with the key in the ignition
Monitor all vehicles, in and out of service
Track all vehicle use