This document provides information on pre-hospital emergency care, including transport modes, ambulance equipment types, response times, patient assessment, trauma management principles, and mass casualty incident response. It discusses concepts like the golden hour and platinum 10 minutes for trauma patients, and outlines standards for scene size-up, patient packaging and sorting in multi-casualty events.
4. To bring the right patient,
via the right mode of transportation,
to the right center within
the right time
5. ď˝âŻ Land ambulances
âŚâŻ Examples: Type A1, A, B, FWD
âŚâŻ Private ambulances â for paying cases, often non-
emergencies
âŚâŻ Patients Transport Van
ď˝âŻ Water ambulances
ď˝âŻ Air Ambulances
ď˝âŻ Motorcycle Squads
6. TYPE B TYPE A
ď˝âŻ Immobilization
package
ď˝âŻ Trauma Kit
ď˝âŻ Triage Card
ď˝âŻ Stretcher
ď˝âŻ All Grade B Equipments
ď˝âŻ Transport Ventilator
ď˝âŻ Defibrillator
ď˝âŻ Monitor
âŚâŻ Note: Type A1: additional
specialized equipments â
incubator, mini intensive
care facilities
7. ď˝âŻ To reach persons in need as quickly as
possible with trained personnel
ď˝âŻ To stabilize the patientâs condition to
prevent further deterioration
ď˝âŻ To move the patient to a facility capable of
providing more extensive care or additional
services that will enhance patient outcome
ď˝âŻ To offer the level of care equal to the
receiving institution recognizing the limits
inherent in traveling.
8. ď˝âŻ Intra-hospital--transport of a patient from
one location to another within the hospital
ď˝âŻ Inter-hospital--transport of a patient
between hospitals
ď˝âŻ Scene run--transport of a patient from a
non-medical site to the nearest available or
designated hospital
23. ď˝âŻ Body substance isolation review
ď˝âŻ Scene safety
ď˝âŻ Total number of patients
ď˝âŻ Essential equipment and resources needed
on-scene
ď˝âŻ Mechanism of injury
30. Information to relay to when making an emergency call
ď˝âŻ E = Exact Location - The precise location of the incident
ď˝âŻ T = Type - The nature of the incident (trauma, non-trauma, heart
atack, motor-vehicle accident), including how many vehicles,
buildings etc. are involved
ď˝âŻ H = Hazards - Both present and potential (e.g., explosion, spillage of
combustible materials, highly volatile hydrocarbons, chemicals, etc)
ď˝âŻ A = Access - Best route for emergency services to access the site, or
obstructions and bottlenecks to avoid
ď˝âŻ N = Numbers - Numbers of Casualties, Dead and Uninjured on scene
ď˝âŻ E = Existing Emergency Services - Which services are already on
scene, and which others are required - s0 as not to duplicate
services, and for better utilization of services in other concurrently
emergency happenings.
31.
32. ď˝âŻ Sorting of patients according to:
âŚâŻ ABCDEs
âŚâŻ Available resources
ď˝âŻ Multiple casualties
ď˝âŻ Mass casualties
ď˝âŻ Stay and play versus Scoop and Run
33. Good Early Trauma Management
Impacts
100%
50%
0%
Immediate
Deaths
Early
Deaths
Late
Deaths
% of
Deaths
34. ď˝âŻ Time is a critical factor
for the patient with a
significant MOI
ď˝âŻ Barring the need for
extrication, the rule of
the âGolden hourâ and
the âPlatinum 10
minutesâ will apply
35. ď˝âŻ The environment (ie: bottom of stairs, out in the
cold, tripod position, pool of blood)
ď˝âŻ Patientâs MOI/NOI
ď˝âŻ Patientâs age and sex
ď˝âŻ Patientâs degree of distress
ď˝âŻ Listen for the chief complaint
ď˝âŻ Keep the priority of care in focus
37. ď˝âŻ Are they conscious or unconscious? (if
unconscious do CPR quick-check)
ď˝âŻ Introduce yourself
ď˝âŻ Whatâs your name? (oriented to person)
ď˝âŻ Do you know where you are? (oriented to
place)
ď˝âŻ What day of the week is it? (oriented to day)
ď˝âŻ How can I help you today? (chief complaint)
38. ď˝âŻ Alert â oriented to person, place, and day
(âbig threeâ)
ď˝âŻ Verbal â cannot answer the âbig threeâ
correctly
ď˝âŻ Painful â either appropriate, inappropriate, or
posturing (decorticate/decerebrate)
ď˝âŻ Unresponsive
39. ď˝âŻ S â signs and symptoms
ď˝âŻ A â allergies
ď˝âŻ M â medications
ď˝âŻ P â pertinent past medical history
ď˝âŻ L â last oral intake
ď˝âŻ E â events leading up to
40. ď˝âŻ D â deformity
ď˝âŻ C â contusions
ď˝âŻ A â abrasions
ď˝âŻ P â punctures/penetrations
ď˝âŻ B â burns
ď˝âŻ T â tenderness
ď˝âŻ L â lacerations
ď˝âŻ S â swelling
41. ď˝âŻ D = Deformity
ď˝âŻ O = Open Wound
ď˝âŻ T = Tenderness
ď˝âŻ S = Swelling
42.
43. ď˝âŻ Time is a critical factor
for the patient with a
significant MOI
ď˝âŻ Barring the need for
extrication, the rule of
the âGolden hourâ and
the âPlatinum 10
minutesâ will apply
44. ď˝âŻ The maximum time
EMS providers stay on
the scene for a critical
trauma patient