EMS POINTS TO PONDER
The EMS operations in these photographs offer a number of points to ponder. We’ll give you a few, in no particular order of importance. Write to us with your own operational considerations of the scenarios depicted, and we’ll publish them in a future issue.
- For all patients with possible spinal injuries, administer high-concentration oxygen. Underoxygenation is a serious problem in head and spinal injuries.
- Secure the patient’s body to the spine board first; secure the head last.
- Use only rigid cervical extrication collars to immobilize the neck in combination with securing the head to the backboard. It is critical to select the proper size collar for the patient
- The manually triggered demand-valve resuscitator c highest delivered oxygen concentrations of any posil but application tends to cause gastric distention due in airway pressure. The patient’s abdomen should avoid vomiting secondary to excessive pressure with
- Proper head positioning to maintain an open airway when using a resuscitator. Oropharyngeal or nasoph aryngeal airways. designed to lift the base of the tongue forward and a the throat, can assist in airway management and car easier.
- Because CPR is only 25 to 33 percent as effective a action in circulating blood, the proper techniques sue tioning and compression delivery are critical factors in the resuscitation effort.
(Photo by Keith Cullom.)
(Photo by Bob Pressler.)
(Photo by Ron Jeffers.)
- Firefighters are particularly susceptible to heatrelated disorders brought on by high ambient temperatures and humidity, heavy protective clothing, and intense heat radiating from burning structures.
- Unless fluids are replaced during strenuous fire suppression operations, the health of a dehydrated firefighter can be endangered.
- Every firefighter should drink at least a quart of water for every hour he/she is actively engaged in fire suppression operations. This amount is not predicated on thirst.
- Evidence shows that when a firefighter perceives thirst, he/she is already two percent dehydrated. A firefighter who becomes five percent dehydrated almost is unable to function.
(Photo by Roger Courtney.)
- Sometimes scene control is as easy as recognizing a bad situation. Your response to “load and go” may be the best way to control it.
- Priapism, a painful erection of the penis, can be associated with spinal cord interruption. Follow such a finding with complete spinal immobilization and assessment.
- While quite a bit of controversy surrounds the use of the pneumatic antishock garment, there are benefits to its application in the field. They include an increase in blood pressure; increased blood flow to the heart, brain, and lungs; control of bleeding; and stabilization of fractures of the lower limbs and pelvis.
(Photos by Sieve Spak.)
- One of the greatest contributing factors to ambulances becoming involved in accidents during an emergency run is erroneous assumptions made by the ambulance driver— assumptions that the other driver will see the emergency lights, hear the siren, understand the intended path of the ambulance, know what to do, and do what is required.
- Drivers of emergency vehicles must recognize the limitations of their audible warning devices. Studies have shown that other drivers judge the direction of the source correctly only 25 percent of the time. In addition, the warning effectiveness most typically is 125 feet or less, a distance often inadequate to take appropriate evasive action.
If you would like to submit photos for Rescue or EMS Points to Ponder, send them with a short description of the incident to: Points to Ponder, Fire Engineering, Park 80 West, Plaza 11, 7th Floor, Saddle Brook, NJ 07662.
