Leadership
Fire safety: define each letter
R
A
C
E
Rescue clients
Alarm
Confine fire
Extinguish
Who is ALWAYS first on the scene?
Teach them to do what before emergency services arrive?
Bystanders.
STOP THE BLLED. (apply pressure, dressing and press, apply tourniquet)
What is dehydration from heavy perspiration and inadequate fluid and electrolyte intake during heat exposure over hours to days?
How do we treat this?
HEAT EXHAUSTION
tx: STOP physical activity, transfer to cool place, cooling measures, rehydration therapy
Acute mountain sickness (AMS)
S/S
anorexia, nausea, vomiting
feels hungover (thanks ben)
Fire safety: define each letter
P
A
S
S
Pull the pin
Aim at the base of the fire
Squeeze the handle
Sweep the extinguisher from side to side
Mass Casualty triage
initial triage guidelines say no more than how long PER ASSESSMENT/PATIENT?
RR>?= what tag?
RR<?=what tag?
NO LONGER THAN 30 SECONDS
RR>30=RED TAG
RR<30= YELLOW TAG
What is...?
-Body temp exceeding 104
-High mortality rate without treatment
Exertional vs. non-exertional
HEAT STROKE
exertional: sudden onset; from strenuous physical activity in hot humid conditions
non-exertional: occurs over period of time from chronic exposure to hot, humid environment
HACE (high altitude cerebral edema)
Apathy, ataxia, mental status changes
Who is at the highest risk for falls, physical, cognitive, and sensory changes?
How can we prevent falls?
Older adults
Remove items that can cause them to trip, provide assistive devices, and ensure adequate lighting
RED TAG means?
YELLOW TAG means?
GREEN TAG means?
BLACK TAG means?
RED= emergent, needs immediate attention (class 1)
YELLOW=Can wait short time for care (class 2)
GREEN= non urgent/ "walking wounded" (class 3)
BLACK= expected to die or are dead (class 4)
TREATMENT FOR HEAT STROKE???
-o2
-iv lines
-foley
-cont' cooling
-benzos FOR SHIVERS
-monitor for multi-system organ dysfunction, electrolyte imbalances
HAPE (high altitude pulmonary edema)
S/S
persistent dry cough, lip and nail bed cyanosis, pink frothy sputum
How quick should we report an incident?
ASAP. WITHIN 24 HRS.
The joint commission mandates that hospitals have an _______________? that is actively tested at LEAST how many times a year?
Emergency preparedness plan actively tested 2x a year
First priority for snakebites?
What should we encourage the patient to do? why?
Immobilize extremity where?
PRIORITY: move patient to safety! (try to take picture of snake)
Encourage rest and breathing exercise. Try to calm the patient down to decrease hr. This decreases circulation of venom
Immobilize extremity @ level of heart
what med do we give when we respond to acute mountain sickness
Acetazolamine
The doctor orders restraints for a patient getting physical with staff. what should the order include?
When must the order be renewed?
Where do you secure restraints?
Order should include: clinical justification, type of restraint, duration, date and time of physician signature.
Must be renewed every 24 hours
Secure restraints to moveable part of the bedframe
HOSPITAL INCIDENT COMMAND SYSTEM
define the roles of each
-Hospital incident commander
-Medical command physician
-Triage officer
Hospital incident commander: responsible for public information, safety and security. Controls available personnel or resources. Takes a global view of entire situation and facilitates movement
Medical command physician: focuses on the number, acuity, and medical resources needs for victims arriving. In charge of calling specialty providers
Triage officer: generally a physician who is helped by triage nurses.
Mild,Moderate,Severe hypothermia
what are the temperature ranges for each?
Can't defib until greater than what temp?
MILD: 90-95
MODERATE: 82.4-90
SEVERE: below 82.4
CANT DEFIB UNTIL GREATER THAN 86 DEGREES