# Introduction to Medical Operations and Safety Considerations

Carol Eiben:

Hello, welcome to another edition of Classroom Connection. I'm Carol
Eiben. Today's topic is disaster and medical operations. Our instructor
for today is John Maede, who is a firefighter paramedic from Los
Angeles. This course is part of a weeklong offering at the Emergency
Management Institute Community Emergency Response Training. Lets join
John now.

John:

In this first session we divided it up again because what we wanted to
try to do was teach folks how to take care of a patient on a one-to-one
basis. You get hurt this is how I take care of you. That's in the first
part. What were going to do in the second part is, were going to expand
that a little bit. Disasters tend to cause large numbers of casualties,
so what we'll do is apply the same things we just talked about dealing
with the single patients and put it on a multi-patient situation. Our
objectives during this program is first of all we want to identify what
we call the killers, the things that will kill people long before
anything else. Remember I told you earlier in the program that one of
the first things you have to do is you have to sort out what people need
to know versus what is nice to know. And we felt that what we'd do is
direct this training program towards those killers. The killers are the
airway, bleeding and shock problems. Our second objective is once we
recognize those is to treat them so, were going to talk about
recognizing airway problems how to open airway, how to treat for
bleeding and treat for shock. And our third objective will apply that
into a mass causality situation and we'll talk about triage. After we
talk a little bit about each one like airway, bleeding and shock we'll
do a lot of demonstration and a lot of hands on. Everything were going
to do in this first part has this very time sensitive situation to it.
Disaster events are not everyday operations, but the medical training
that you're getting can be applied in various settings, for example, kid
falls out of a tree and breaks a leg or grandma is found in the kitchen,
she's not breathing or is in a position where she can't breath, those
things can be used everyday, we know that educating the population will
help increase the survivability rate.

Safety, Safety, Safety, will be hammered home in every component of this
training program, whether it's personal safety, whether it's safety
equipment or even something as simple as working in the buddy system.
The buddy system has been around ever since day one, you never go
swimming by yourself, you never go diving by yourself, you never go
hiking by yourself, the idea is that if you get into trouble at the very
least you can send somebody out to go get help. The buddy system has
been around for a long time and we will keep that buddy system alive in
every portion of this program. In fact you can help me remember that
because every time I'm going to do something, sorry, every time we're
going to do something, it's going to be me and my buddy. Say it with me,
me and my buddy. We will always work together, so that we will maintain
our safety, we will make sure that were wearing the right kind of
protective clothing and what the safety equipment will do for you is it
will reduce you casualty. It will reduce the amount of injury. Everybody
who gets hurt adds to our problems. We as emergency response personnel
need to make sure that we don't let people get hurt cause there adding
to our workload. So prevent that things like gloves, goggles, masks,
helmets, boots, go a long way towards preventing problems later on. The
other thing that were going to always try to do is were going to back up
a little bit and me and my buddy will always do a good size up. Size up
is a term that probably comes mostly from the fire service and more than
anything it's an evaluation of the process of what's going on. I was
once told by a battalion chief and I thought it was a good definition is
that size up is what you have, where it going, and what do you need to
stop it. And the simple way I always thought that was a very good idea,
but imagine that me and my buddy were approaching into a room and this
recognizance that we do this size up shows there are problems, there are
holes, this size up where we stop and we take a look to make sure
there's nothing there that can hurt us. That size up will hopefully
prevent us from just waltzing into an area and then getting ourselves
hurt. If it is a bad situation should we go in there? Me and my buddy?
Maybe we should not go in there. When is size up done? Say again? Ok,
not only initially cause me and my buddy do a good size up , but if
we're working should we be doing the size up at the same time? Ongoing,
why? Because conditions can change and if the little voice tells you to
get out...me and my buddy. All right, but the size up and the buddy
system is designed from the very get go.

In the medical side of the house are their things that we need to pay
attention to in the form of dangers? Sure, if your out their and you're
touching bloody areas or you got some pus on your hands do you think
that you can get sick can you take sickness home? Right, size up has to
include also what you're getting into and protect yourself all the time.
And the reason why you want to train people over and over about safety
equipment? Things like

Students: Mask, gloves helmet, boots

John:

Because, rescuers are notorious for having tunnel vision? And what they
will do is they will be working at the scene and for example our patient
here has been trapped under rubble, what they will do is they will focus
in on the problems and they will dig and they will dig, and they will do
all the stuff that their suppose to do and dig, dig, dig, and then when
they come to the patient, what will be the first thing they do? They'll
take off their gloves. Equipment will help prevent those. You can get so
many different things. In the ambulance what we carry is, we carry these
heavy duty double layered gloves. You can use just about anything. Do
you remember those Playtex gloves? The ones that you can pick up a dime
with. Those work very nice, cost ninety-nine cents at the ninety-nine
cent store. You can go get those and those work very well, these are
similar these are the corner gloves. The idea is you encourage people to
wear these underneath their work gloves. So if and when they are working
and working and they get to a spot and they take their work gloves off
automatically and start touching somebody, there is some level of
protection or some barrier of protection for them. You have to maintain
that barrier of protection. When you're up close or your inside a
confined space and a patient starts coughing or spiting or doing
something like that, maybe you should prevent those droplets from
getting in your eyes and you can prevent those droplets from getting
inside your mouth. Safety is also important when you start first
approaching patients perhaps I could have my guest...