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What are the goals of the Scene Management System?
- Protect Life
- Protect Environment
- Protect Property
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What are the actions of FIRST RESPONDERS in a disaster situation?
- Scene assessment: is it safe?
- Scene Size-Up: what type, how many, injuries?
- Send Info: for resources (hospitals, more help...)
- Scene set-up: triage, in and out of area, mortuary, etc...
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What is our role and purpose in a disaster?
Do the greatest good for the greatest number of people
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This triage category the victim is unlikely to survive given the severity of injuries, level of available care, or both
Expectant (black tag)
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This triage category the victim can be helped by immediate intervention and transport, requires medical attention within minutes (up to 60), includes compromises to ABC's.
Immediate (Red tag)
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This triage category the victim's transport can be delayed, includes serious and potentially life-threatening injuries, but status not expected to deteriorate significantly over several hours.
Delayed (Yellow tag)
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This triage category the victim with relatively minor injuries, status unlikely to deteriorate over days, may be able to assist in own care: walking wounded.
Minor (green tag) - these go to secondary triage
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If an ADULT OR CHILD is able to walk they are considered which triage category and where do they go next?
MINOR --> to secondary triage
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If an ADULT cannot walk to secondary, what is assessed next?
Are they spontaneously breathing? Open airway - if nothing they are tagged EXPECTANT
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If an ADULT cannot walk to secondary triage and they can breath, what is assessed next?
RR - if >30 they are IMMEDIATE
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If an ADULT is
Breathing AND
RR <30, what is next?
PERFUSION - if radial pulse absent or cap refill >2 sec then they are IMMEDIATE
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If an ADULT is
Breathing
RR<30
has a radial pulse or cap refill <2 seconds, what's next?
MENTAL STATUS - if they don't obey commands they are IMMEDIATE
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If an ADULT person is
Breathing
RR<30
has a radial pulse or cap refill <2 seconds,
Obeys commands
what's next?
DELAYED - they are not expected to deteriorate and can wait several hours
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If a CHILD is not breathing what is done next?
Position airway - if breathing - IMMEDIATE
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If a CHILD is not breathing and has no pulse what's next?
DECEASED
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If a CHILD is
not breathing
has a pulse
what's next?
Give 5 rescue breaths - if nothing - DECEASED
If breathing - IMMEDIATE
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If a CHILD cannot walk and is breathing, what is assessed next?
RR <15 OR >45 - IMMEDIATE
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If a CHILD
cannot walk
is breathing
RR between 15-45
what is next?
PALPABLE PULSE - if none - IMMEDIATE
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If a CHILD
cannot walk
is breathing
RR between 15-45
has a palpable pulse
what is next?
- AVPU (alert, verbal, painful, unresponsive)
- if inappropriate or posturing --> IMMEDIATE
if appropriate --> DELAYED
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What are the scene priorities in a Chemical (Nerve Gas) event?
- Leave area – get into open air
- Cover mouth with damp cloth
- Stay calm, shallow breaths
- Don’t lay down
- Get antidote - Atropine or pralidoxime
- Showered with soap and water, eyes flushed for 5 min each
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What type of CBRNE event would you suspect with a patient that presents with pinpoint pupils, seizing, frothing at the mouth?
Nerve agent (Sarin, Tabun, VX)
acetylcholine accumulation - runny nose, crying, drooling, defecating, urinating, vomiting
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What type of CBRNE event would you suspect with a patient that presents with SOB, hemoptysis (pulmonary issues)?
- pulmonary agents: phosgene, ammonia
- nerve agents may cause also
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What type of CBRNE event would you suspect with a patient that presents with skin or eye burning and blistering?
blistering agents: sulfur mustard, lewisite
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What type of CBRNE event would you suspect with a patient that presents with skin rash and GI symptoms?
Biologics: Anthrax
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What type of CBRNE event would you suspect with a patient that presents with GI bleeding?
- Biologic: Anthrax
- Environmental: Ebola
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What type of CBRNE event would you suspect with a patient that presents with a fever?
- Biologic: Anthrax
- Environmental: Ebola
- Radiologic/Nuclear
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