ask a doctor

Hazardous materials

  • Wear the appropriate protective gear.
  • Requires Hazmat team or special training.
  • Know the warning placards.
  • MSDS (material safety data sheets) provide information on a hazardous chemical.
  • Establish safety zones
    • Hot zone: where contamination is present. Protective gear required. No bystanders allowed.
    • Warm zone: area surrounding the hot zone. Protective gear required. Used to control and prevent the spread of contamination.
    • Cold zone: safe zone where normal triage, stabilization and treatment is performed. No contaminated gears allowed in this zone.

Multiple casualty incidents

  • A multiple-casualty incident (also called mass-casualty incident) is any event that places excessive demands on the EMS system.
  • Incident command system
    • Command.
    • Finance/administration.
    • Logistics.
    • Operations.
      • Triage: sorts patients by criticality and assigns priorities for emergency care and transport.
      • Treatment: provides emergency care.
      • Transport: moves patients to medical facilities.
      • Staging: holds and manages ambulances, helicopters, and additional equipment.
      • Morgue: handles the dead.
    • Planning.
    Triage codes
    • Red: priority 1, immediate care and transport. Patient unable to walk and unstable.
    • Yellow: priority 2, delayed care and transport. Patient unable to walk, but otherwise stable.
    • Green: priority 3, minor injuries, patients can walk.
    • Black: priority 4, dead.
  • START triage system: simple triage and rapid transport system.
    • Ability to get up and walk (ambulatory): if patient can get up and walk, they're tagged green. If not, check respirations.
    • Respiratory status: if respiratory rate is greater than 30, tag patient red. If less than 30, check perfusion. If patient not breathing, open the airway. If still no breathing, tag black (in MCIs you don't have time to do CPR).
    • Perfusion status: Tag red if cap refill takes greater than 2 seconds or radial pulse is absent. Otherwise, check mental status.
    • Mental status: if patient can obey commands, tag yellow. If patient can not obey commands or is unresponsive, tag red.
  • JumpSTART pediatric triage system: triage system for infants and children. Similar to the ordinary triage system but with the following differences:
    • If patient is not breathing, but have a pulse, give 5 rescue breaths.
    • When assessing respiratory status, a respiratory rate of <15 or >45 warrants a red tag.