Class 3 (Scene Size-Up with Safety, BSI & HazMat) Ch8 (Partial), Ch2 (Partial), & Ch37 (Partial)Patient Assessment RoadmapScene Size-upBody Substance IsolationScene Safety: Potential HazardsScene SafetyMechanism of InjuryNature of IllnessThe Importance of MOI/NOINumber of PatientsAdditional ResourcesSpinal ImmobilizationScene Safety and Personal ProtectionCommunicable DiseasesOccupational Safety & Health AdministrationOSHA Required Protective EquipmentUniversal PrecautionsRoutes of TransmissionBody Substance Isolation (BSI)Hand WashingGloves & Eye ProtectionSkill Drill 2-1Skill Drill 2-1:Glove Removal TechniqueGowns & MasksSharpsReducing Risk of InfectionImmunizationsDuty to ActDiseases of Special Concern (1 of 4)Diseases of Special Concern (2 of 4)Diseases of Special Concern (3 of 4)Diseases of Special Concern (4 of 4)Other Diseases Causing Concern (1 of 2)Other Diseases Causing Concern (2 of 2)General Postexposure ManagementEstablishing an Infection Control RoutineScene HazardsIntroduction to Hazardous MaterialsHazardous Materials SituationsRecognition of Hazardous Materials (2 of 2)Recognition of Hazardous Materials (1 of 2)HazMat PlacardsHazardous Materials Safety PlacardsFirst ArrivalIdentifying Hazardous MaterialsApproach a hazardous incident cautiously from upwind.HazMat Scene OperationsDecontamination AreaClassification of Hazardous Materials—Toxicity LevelsCaring for Patients at a HazMat IncidentSpecial CareResourcesPersonal Protective Equipment LevelsFour Levels of ProtectionElectricityFireProtective Clothing (1 of 3)Protective Clothing (2 of 3)Protective Clothing (3 of 3)Violent SituationsSafetyBehavioral EmergenciesClass 3 (Scene Size-Up with Safety, BSI & HazMat)Ch8 (Partial), Ch2 (Partial), & Ch37 (Partial)Patient Assessment Roadmap•Scene size-up•Initial assessment•Focused history and physical exam–Examination•Rapid•Focused–History–Vital signs•Detailed physical exam•Ongoing assessmentScene Size-up•Dispatch information•Inspection of scene•Scene hazards•Safety concerns•Mechanism of injury•Nature of illness/chief complaint•Number of patients•Additional resources needed•Consider Spinal PrecautionsBody Substance Isolation•Assumes all body fluids present a possible risk for infection•Protective equipment–Latex or vinyl gloves should always be worn–Eye protection–Mask –Gown –Turnout gearScene Safety: Potential Hazards•Oncoming traffic•Unstable surfaces•Leaking gasoline•Downed electrical lines•Potential for violence•Fire or smoke•Hazardous materials•Other dangers at crash or rescue scenes•Crime scenesScene Safety •Park in a safe area.•Speak with law enforcement first if present.•The safety of you and your partner comes first!•Next concern is the safety of patient(s) and bystanders.•Request additional resources if needed to make scene safe.Mechanism of Injury•Helps determine the possible extent of injuries on trauma patients •Evaluate:–Amount of force applied to body–Length of time force was applied–Area of the body involvedNature of Illness•Search for clues to determine the nature of illness.•Often described by the patient’s chief complaint•Gather information from the patient and people on scene.•Observe the scene.The Importance of MOI/NOI•Guides preparation for care to patient•Suggests equipment that will be needed•Prepares for further assessment•Fundamentals of assessment are same whether emergency appears to be related to trauma or medical cause.Number of Patients•Determine the number of patients and their condition.•Assess what additional resources will be needed.•Triage to identify severity of each patient’s condition.Additional Resources•Determined by:–Mechanism of injury–Nature of illness–Number of patients•Medical resources–Additional units–Advanced life support–Air Ambulances•Nonmedical resources–Fire suppression–Rescue–Law enforcementSpinal Immobilization•Consider early during assessment.–Affects airway management•Do not move without immobilization.•Err on the side of caution.•Manual stabilization initially–Full immobilization secured with device after examination–Term C-Spine immobilization improper as it implies only cervical protection takenScene Safety and Personal Protection •Prepare yourself when dispatched. •Wear seat belts and shoulder harnesses. •Ensure scene is well marked. •Check vehicle stability.Communicable Diseases•A disease transmitted from one person to another•Minimize risk of contracting disease with proper protectionOccupational Safety & HealthAdministration•Develops workplace risk reduction guidelines•Provides enforcement•Requires all EMTs to be trained in–Bloodborne pathogens–Treating communicable or infected patients–Airborne precautions–Contamination precautionsOSHA Required Protective Equipment•Vinyl and latex gloves•Heavy-duty gloves•Protective eyewear•Masks including HEPA•Cover gowns•Respiratory assistance devices–Pocket mask–Bag Valve mask•Exposure control plan–Table 2-6 pg 49Universal Precautions•Developed by CDC•Prevents direct contact with germs•Universal means “used for all patients”•Defines exposure–Contact with blood, body fluids, tissues or airborne droplets•Assumes only blood and certain other fluids pose riskRoutes of Transmission•Direct–Being sneezed on•Vehicle (indirect) –Touching contaminated linen•Vector-borne–Bitten by a tick•Airborne–Inhaling contaminated dropletsBody Substance Isolation (BSI)•Infection control concept•Assumes all body fluids are infectious•Provides protection from several routes–Blood or fluid splash–Surface contamination–Needle stick exposure–Oral contaminationHand Washing•Effective disease control method•Before & after contact•Prevents you from spreading germs•No water use waterless system•Procedure–Soap & warm water–Rub for 10-15 seconds–Rinse & dry–Use paper towel to turn off faucetGloves & Eye Protection•Minimum standard•Gloves–Vinyl or latex–Double glove–Change with patient–Heavy duty for cleaning•Eye protection–Side Shields–GogglesSkill Drill 2-1InstructorGive each student a pair of glovesbefore proceedingStudentsDon gloves and note which sizeSkill Drill 2-1:Glove Removal TechniqueGowns & Masks•Provides protection from large fluid amounts•Gowns–Childbirth–Major trauma–Spare uniform•Masks–Fluid