Bomb Squad/E.M.S. Interface 2005 I.A.B.T.I. 2005 I.A.B.T.I. EMT Training Conference EMT Training Conference By By Sergeant/Paramedic Marty Sergeant/Paramedic Marty Hietala Hietala Davis County Sheriff’s Davis County Sheriff’s Office, Utah Office, Utah
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Bomb Squad/E.M.S. Interface 2005 I.A.B.T.I. EMT Training Conference By Sergeant/Paramedic Marty Hietala Davis County Sheriffs Office, Utah.
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Davis County Sheriff’s Office, UtahDavis County Sheriff’s Office, Utah
Goals
Understand levels of emergency medical care
Understand trauma centers and burn centers
Understand the Incident Command System
Articulate potential hazards for EMS and Fire personnel
Articulate potential hazards and mechanisms of injury for the bomb technician
Demonstrate emergency doffing of the bomb suit and chemical suit
Why?
To ensure that emergency medical To ensure that emergency medical personnel and fire personnel will provide personnel and fire personnel will provide the highest level of medical care in the the highest level of medical care in the shortest amount of timeshortest amount of time
The golden hourThe golden hour
The Golden Hour?
After a traumatic event, a patient will have After a traumatic event, a patient will have the best outcome if rapid stabilization and the best outcome if rapid stabilization and surgical intervention is made within an hour surgical intervention is made within an hour of sustaining the injuryof sustaining the injury
Transport must be expedientTransport must be expedient Transport to an Transport to an appropriateappropriate facility facility
What EMS support is available in your jurisdiction?
Is this your Is this your ambulance?ambulance?
Will EMS need Will EMS need additional additional resources?resources?
What type of Fire Dept. support is available in your jurisdiction?
Is this the local fire Is this the local fire engine?engine?
Will the fire service Will the fire service need additional need additional resources?resources?
Levels of Emergency Medical Care
Basic life support Basic life support Advanced life supportAdvanced life support Hospital emergency roomHospital emergency room Trauma centerTrauma center Burn centerBurn center
Basic life supportBasic life support Intravenous accessIntravenous access Advanced cardiac life supportAdvanced cardiac life support Advanced trauma life supportAdvanced trauma life support Pharmacological interventionPharmacological intervention EKG interpretationEKG interpretation Advanced airway placementAdvanced airway placement
A designation made for a hospital that A designation made for a hospital that meets stringent requirements for providing meets stringent requirements for providing care to trauma patientscare to trauma patients
A standardized system used by emergency A standardized system used by emergency services to manage incidents, regardless of services to manage incidents, regardless of sizesize
Initiated by first arriving assets and Initiated by first arriving assets and branches out based on primary dutiesbranches out based on primary duties
Required by OSHARequired by OSHA
Staging
Where should the command post, EMS and Where should the command post, EMS and fire assets stage?fire assets stage? UphillUphill UpwindUpwind Cold zoneCold zone
Hazards to EMS/Fire personnel
What are the potential hazards that EMS What are the potential hazards that EMS and fire personnel may face at the incident?and fire personnel may face at the incident? Secondary devicesSecondary devices FragmentationFragmentation Chemical, biological, radiological Chemical, biological, radiological
exposureexposure Exposure to residuesExposure to residues Blast pressureBlast pressure
Pre-arrival considerations
Prior to arrival at the scenePrior to arrival at the scene Notify medical controlNotify medical control Notify trauma centerNotify trauma center Use standing ordersUse standing orders Consider staging a medical helicopterConsider staging a medical helicopter
Pre-arrival considerations
Advise EMS/fire personnel what types of Advise EMS/fire personnel what types of hazards the technician may encounter so hazards the technician may encounter so they can prepare…they can prepare… R.F.I. HazardsR.F.I. Hazards
Turn off radiosTurn off radiosTurn off cellular phonesTurn off cellular phonesTurn off pagersTurn off pagers
Medical history data
Each technician should have information on Each technician should have information on scene for EMS providersscene for EMS providers Medical historyMedical history MedicationsMedications Allergies to medicationsAllergies to medications Blood typeBlood type Normal vital signsNormal vital signs
100 to 120 PSI overpressure 100 to 120 PSI overpressure Slight chance of death Slight chance of death
130 to 180 PSI overpressure 130 to 180 PSI overpressure 50% chance of death 50% chance of death
200 to 250 PSI overpressure 200 to 250 PSI overpressure Nearly 100% chance of death Nearly 100% chance of death
Bomb Technician HazardsBlast Effects
Bomb Technician Hazards
Spinal injurySpinal injury EMS should know how the bomb suit EMS should know how the bomb suit
ensemble is donned/doffedensemble is donned/doffed When the bomb technician’s safety is at When the bomb technician’s safety is at
risk, the suit may need to be cutrisk, the suit may need to be cut
Bomb Technician Hazards BurnsBurns
Chemical or thermal burnsChemical or thermal burnsSecond or third degree burns greater Second or third degree burns greater
than 10% of body surface area will than 10% of body surface area will require transport to a burn centerrequire transport to a burn center
Circumferential burns, burns to hands, Circumferential burns, burns to hands, face, groin or respiratory tract will face, groin or respiratory tract will require transport to a burn centerrequire transport to a burn center
Staging location for a rapid intervention Staging location for a rapid intervention team (RIT)team (RIT) Protected locationProtected location Hose lines connectedHose lines connected Water supply readyWater supply ready PPE/SCBA donnedPPE/SCBA donned
Summary
Levels of EMSLevels of EMS Trauma centersTrauma centers Hazards for EMS/fire personnelHazards for EMS/fire personnel Hazards for the bomb technicianHazards for the bomb technician Importance of vital sign monitoringImportance of vital sign monitoring Donning/doffing of PPEDonning/doffing of PPE