EMS OPERATIONS: We've got a lot riding on us!
At a hazardous materials incident, approach cautiously from these directions to reduce exposure.
Upwind, Uphill, and Upstream
A patient awakens with stroke symptoms. Establish this historical time rather than assuming symptoms began upon awakening.
Last Known Well
A sexual assault survivor agrees to preserve removed clothing. Use this type of bag.
Paper Bag
A toddler develops a barking cough, hoarseness, and inspiratory stridor after cold symptoms. Suspect this upper airway illness.
Croup
After blunt chest trauma, a chest wall segment moves inward during inspiration and outward during expiration. Identify this injury.
Flail Chest
Arriving ambulances awaiting assignments report to this designated incident location.
Staging Area
Chest pressure persists despite an initially nondiagnostic ECG. Repeat this assessment to identify evolving ischemia.
12-Lead EKG
Lower abdominal pain, fever, and abnormal vaginal discharge suggest this infection of the upper reproductive tract.
Pelvic Inflammatory Disease (PID)
An infant with diarrhea has fewer wet diapers, dry mucous membranes, and a sunken fontanelle. These findings suggest this condition.
Dehydration
Exposed abdominal organs require this initial protective covering before an outer occlusive layer.
Sterile, Saline-Moistened Dressing
During adult START triage, a nonambulatory patient breathing 36 times per minute receives this priority designation.
Immediate or Red
Several household members have headaches near a malfunctioning furnace despite normal pulse oximetry. Suspect this poisoning.
Carbon Monoxide Poisoning
Sudden, severe unilateral pelvic pain with vomiting and a known ovarian cyst raises concern for this time-sensitive emergency.
Ovarian Torsion
A febrile child drools, cannot swallow, and sits leaning forward without a barking cough. Suspect this airway emergency.
Epiglottitis
Following facial burns, progressive hoarseness and stridor indicate threatened airway patency. Prepare early for this definitive airway intervention.
Endotracheal Intubation
Two supervisors give a paramedic conflicting assignments. Reporting to only one designated supervisor follows this ICS principle.
Unity of Command
During sepsis fluid resuscitation, new crackles and worsening dyspnea develop. Take this immediate action.
Pausing fluids and reassessing
High fever, diffuse sunburn-like rash, and hypotension follow prolonged tampon retention. Suspect this systemic emergency.
Toxic Shock Syndrome
An infant has episodic severe abdominal pain, pallor, vomiting, and lethargy between episodes. Suspect this bowel emergency despite absent bloody stools.
Intussusception
After a tibial fracture, worsening disproportionate pain and pain with passive stretching occur despite palpable distal pulses. Suspect this complication.
Compartment Syndrome
Agencies sharing jurisdiction establish common incident objectives while retaining individual authority through this command structure.
Unified Command
An enclosed-space fire victim has profound hypotension, confusion, and markedly elevated lactate. Suspected cyanide toxicity warrants this antidote.
Hydroxocobalamin
A patient with missed menses develops unilateral pelvic pain, shoulder pain, syncope, and hypotension despite scant vaginal bleeding.
Ruptured Ectopic Pregnancy
An infant with tetralogy of Fallot becomes profoundly cyanotic while crying. This positioning maneuver increases systemic vascular resistance.
Knee-to-Chest Positioning
Following a precordial stab wound, hypotension, distended neck veins, and muffled heart sounds suggest this cause of obstructive shock.
Cardiac Tamponade