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SCENE SIZE UP

SCENE SIZE UP. DOT OBJECTIVES. RECOGNIZE HAZARDS AND POTENTIAL HAZARDS DESCRIBE COMMON HAZARDS AT THE SCENE DETERMINE SCENE SAFETY MECHANISMS OF INJURY/NATURE OF ILLNESS IDENTIFY NUMBER OF PATIENTS RATIONAL FOR EVALUATING SCENE SAFETY SERVE AS A MODEL FOR OTHERS. DEFINITION.

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SCENE SIZE UP

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  1. SCENE SIZE UP

  2. DOT OBJECTIVES • RECOGNIZE HAZARDS AND POTENTIAL HAZARDS • DESCRIBE COMMON HAZARDS AT THE SCENE • DETERMINE SCENE SAFETY • MECHANISMS OF INJURY/NATURE OF ILLNESS • IDENTIFY NUMBER OF PATIENTS • RATIONAL FOR EVALUATING SCENE SAFETY • SERVE AS A MODEL FOR OTHERS

  3. DEFINITION • AN ASSESSMENT OF THE SCENE AND SURROUNDINGS TO ASSURE THE SAFETY OF THE EMT AND TO PROVIDE POTENTIALLY USEFUL INFORMATION ABOUT THE PATIENT.

  4. SCENE SAFETY • PERSONAL PROTECTION - IS IT SAFE TO APPROACH THE PATIENT? • LOOK AND LISTEN FOR OTHER EMERGENCY VEHICLES • LOOK FOR DOWNED POWER LINES • OBSERVE TRAFFIC FLOW • WATCH FOR FIRE OR SMOKE • LOOK FOR CLUES TO HAZARDOUS MATERIALS • SNIFF FOR ODORS

  5. SCENE SAFETY CONT’D. • PATIENT SAFETY - CAN I WORK ON MY PATIENT HERE OR MUST I MOVE HIM TO A PLACE OF SAFETY • BYSTANDER SAFETY • WATCH FOR PEDESTRIANS ON THE ROAD • CURIOUS ONLOOKERS POSE MANY DANGERS

  6. SCENE SAFETY CONT’D. • ESTABLISH A DANGER ZONE • NO APPARENT HAZARDS - 50 FT IN ALL DIRECTIONS • SPILLED FUEL - 100 FT IN ALL DIRECTIONS • VEHICLE FIRE - 100 FT IN ALL DIRECTIONS • DOWNED WIRES - PARK ONE FULL SPAN OF POLES AWAY • HAZ MAT SPILL - CHECK THE NORTH AMERICAN EMERGENCY RESPONSE GUIDEBOOK

  7. SPECIAL CONSIDERATIONS • CRIME SCENE WARNINGS • FIGHTING OR LOUD VOICES • WEAPONS VISIBLE • SIGNS OF ALCOHOL/DRUG USE • UNUSUAL SILENCE • KNOWLEDGE OF PRIOR VIOLENCE

  8. CONSIDER THIS • ONE DANGER THAT IS PRESENT AT MANY SCENES IS THE FAMILY DOG. EVEN ONES THAT LOOK HARMLESS COULD ATTACK IF THEY FEEL THREATENED. BE CAREFUL.

  9. NATURE OF THE CALL • MECHANISM OF INJURY • HEAD-ON-COLLISIONS • REAR-END COLLISIONS • SIDE-IMPACT COLLISIONS • ROTATIONAL IMPACT COLLISIONS • ROLLOVER COLLISIONS

  10. HEAD ON COLLISIONS • TWO PATTERNS OF INJURY SEEN • UP AND OVER - PATIENT GOES UP AND OVER THE STEERING WHEEL - HEAD AND NECK INJURIES COMMON • DOWN AND UNDER - PATIENT GOES DOWN AND UNDER THE STEERING WHEEL - KNEE, HIP AND LEG INJURIES.

  11. REAR-END COLLISIONS • HEAD AND NECK INJURIES COMMON • BODY MOVES BUT HEAD REMAINS STILL • PROPERLY PLACED HEAD RESTS HELP TO ELIMINATE THIS

  12. SIDE IMPACT COLLISIONS • BODY IS THROWN SIDEWAYS • DIRECT BLUNT INJURY ANYWHERE ON THE IMPACTED SIDE • HEAD AND NECK INJURIES COMMON

  13. ROLLOVER COLLISIONS • POTENTIALLY THE MOST SERIOUS • POSSIBILITY OF PATIENT EJECTION FROM VEHICLE • ALL TYPES OF INJURIES FOUND

  14. ROTATIONAL IMPACT COLLISIONS • VEHICLE IS STRUCK AND THEN SPINS • OFTEN HAVE MULTIPLE IMPACTS • SUSPECT ALL INJURY PATTERNS

  15. LOOK AND LEARN • DETERMINE WHERE THE PATIENT WAS SITTING • SEAT BELTS? AIR BAGS? • EJECTED? • STEERING WHEEL BENT? • WINDSHIELD DAMAGED? PEDALS BENT?

  16. PENETRATING TRAUMA • INJURY CAUSED BY AN OBJECT PASSING THROUGH BODY TISSUE • LOW VELOCITY - PROPELLED BY HAND (KNIVES) • MEDIUM VELOCITY - HANDGUNS AND SHOTGUNS • HIGH VELOCITY - HIGH POWERED OR ASSAULT RIFLES

  17. LOW VELOCITY INJURY • INJURY LIMITED TO AREA OF THE PENETRATION • LOOK FOR MULTIPLE WOUNDS • SUSPECT INJURY TO VITAL ORGANS

  18. MEDIUM VELOCITY INJURY • LOOK FOR ENTRANCE AND EXIT WOUNDS • SUSPECT INJURY TO VITAL ORGANS • BULLETS CAN TRAVEL ANYWHERE IN THE BODY

  19. HIGH VELOCITY INJURY • DAMAGE CAN BE ANYWHERE IN THE BODY • DAMAGE DIRECTLY FROM THE BULLET • PRESSURE RELATED DAMAGE - CAVITATION

  20. NATURE OF ILLNESS • FIND OUT MEDICAL INFO FROM: • THE PATIENT • BYSTANDERS • FAMILY MEMBERS • THE SCENE • LOOK FOR MEDICINES • LOOK FOR OXYGEN DEVICES

  21. RESOURCES NEEDED • DO YOU HAVE THE RESOURCES TO HANDLE THE SITUATION • NUMBER OF PATIENTS • FIRE DEPARTMENT? • RESCUE SQUAD? • MORE AMBULANCES?

  22. THE END • PRESS ESC TO END THIS PRESENTATION. I HOPE YOU ENJOYED IT.

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