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Emergency Medical Services (EMS) for Rural Farms: A Comprehensive Overview

This chapter provides an essential overview of emergency medical services (EMS) in rural American farming areas, highlighting the unique challenges and rescue principles related to farm emergencies. It discusses the prevalence of injuries during summer, particularly among vulnerable populations such as women, children, and the elderly. Key rescue principles, scene safety, and appropriate PPE when dealing with livestock are emphasized. Specific technical rescue scenarios are covered, including tractor accidents, silos, and farm chemicals, providing essential guidelines for ensuring safety and effective emergency response.

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Emergency Medical Services (EMS) for Rural Farms: A Comprehensive Overview

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  1. Chapter 47 EMS in Rural America

  2. Overview • Farm Emergencies • Basic Farm Rescue Principles • Technical Rescue

  3. Farm Emergencies • 90% of farms are privately owned • The majority of the injuries on farms occur in the summer months • Women, children, and the elderly are among the victims of farm related accidents

  4. Basic Farm Rescue Principles • A preplan is very important • Scene size up and safety are critical • Know when to call for backup when specially trained personnel are needed • Know how to mitigate threats while waiting for backup

  5. Basic Farm Rescue Principles • Livestock • React unpredictably when sensing danger • Consider appropriate PPE when encountering animals • Remove the animal from the scene • Become familiar with species-specific behaviors

  6. Basic Farm Rescue Principles • Pigs • Color-blind • Lack depth perception • Cows • Color-blind • Lack depth perception • Hindquarters are a blind spot • Startle at loud sounds

  7. Basic Farm Rescue Principles • Horses • Keen sense of hearing • Approach from the left shoulder • Use a lead and not the halter to lead • Stay parallel to the horse

  8. Basic Farm Rescue Principles • Mechanism of injury • Lacerations • Avulsions • Punctures • Crush injuries

  9. Stop and Review • Name the common mechanisms of injury on a farm. • Name hazards related to livestock. • Name hazards related to machinery.

  10. Technical Rescue • Establish scene safety and a perimeter • Develop a rescue plan • Request necessary special equipment or trained personnel • Consider time factors • Plan for transport

  11. Technical Rescue • Tractor accidents • Collisions with other vehicles on the roads • Rollovers are common • Entanglement in power takeoff gears is also common

  12. Technical Rescue • Tractor rollovers • Establish scene safety • Turn off the tractor • Lift the tractor off the patient or dig the patient out • MOI is usually a crushed pelvis, chest trauma, or burns

  13. Technical Rescue • Entanglement in PTO • Secure the scene • Turn off the tractor • Block the wheels • Disassemble or cut the PTO • Injuries include lacerations, fractures, avulsions

  14. Technical Rescue • Silos • Oxygen poor environments • Produce gases: nitrogen dioxide • Treated as confined space rescues • MOI is oxygen deprivation or entrapment

  15. Technical Rescue • Grain bins • Entrapment can occur due to movement of the grain • Do not open gravity gates • Encourage the patient to self-rescue

  16. Technical Rescue • Manure storage • Can be above or below ground • Gases are produced from the breakdown of bacteria • Gases include methane, hydrogen sulfide, ammonia, carbon dioxide • Dangers to the farmer are asphyxiation and explosion

  17. Technical Rescue • Farm chemicals • Pesticides, herbicides, fertilizers • Treated as a hazardous materials response • Common chemicals are anhydrous ammonia, organophosphates • Symptom patterns for exposure follow SLUDGEM

  18. Stop and Review • Discuss the dangers associated with: • PTOs • Silos • Manure storage facilities • Chemicals found on the farm

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