First Responder EMS Curriculum for Training Centers in Eurasia

Complex access requires the use of special equipment to extricate the patient. Thissituation often involves the use of specialized equipment and often involves speciallytrained personnel.6. Air Medical TransportSpecial considerations apply when air medical transport is used. Most air medical sceneresponses involve rotor wing craft. Consider the use of air medical transport in situationswhere transport to a specialty center will be faster by air than by ground. Other reasons touse air medical transport are when patients are inaccessible by ground transport and whenthe patient needs a high level of care that the air ambulance crew but not the ground crewcan provide.Select a landing area clear of obstacles of at least 60 feet by 60 feet. Illuminate and markoff the area and remove personnel from the area. Inform the aeromedical crew of thelocation of both the patient and the landing zone. Keep the patient in a sheltered area anddo not bring the patient to the helicopter until instructed to do so by the helicopter crew.Do not approach the helicopter until instructed to do so. When approaching a helicopterfollow the directions of the crew. Approach the helicopter from the front when at allpossible, which allows the pilot to see you as you approach. Don’t approach the helicopterfrom the back because the tail rotor is extremely dangerous and is difficult to see when it ismoving.7. Hazardous MaterialsYour role as the First Responder at a hazardous material scene is to first protect yourself.Keep bystanders away from the scene to minimize the number of people exposed. Contactdispatch with available information so specially trained individuals can be mobilized intothe hazardous material area. All contaminated victims must remain in the hot orcontaminated zone until properly decontaminated by specially trained personnel. Once theyare decontaminated, you can initiate care of the patients. The first step in the care of thesepatients is decontamination. Approaching a contaminated patient without appropriatesafety equipment will mean you also will be contaminated and will no longer be able toperform your job.Set up a hot or contaminated area where the patients and hazardous material are located.Keep bystanders away from this area. Set up a cold zone for patient treatment afterdecontamination that is upwind and preferably uphill from the hot zone. A separatedecontamination zone must also be set up.When contacting dispatch to request specialized personnel, try to provide them with asmuch information as possible. This information includes scene location and the physicalmakeup of the scene; number of patients and their acuity; type of material; and whether thematerial is stable or if it is vaporizing, flaming, or blowing into the air. Also report weatherconditions and additional scene hazards.8. Mass Casualty IncidentsWhen the number of patients exceeds the capabilities of the providers, a system of triagemust be instituted to decide in what order to treat patients. The concept is to treat the mostcritical but still salvageable patients first. Patients are sorted into three different triagecategories. The highest priority is given to those patients with changed mental status,uncontrolled bleeding, or airway difficulties. Second priority is given to patients with burnsFirst Responder EMS Curriculum/AIHA, July 2002 227