EMS Operations

•As a first responder, you need the proper equipment on an emergency call, including the medical equipment in your life support kit, your personal safety equipment, and equipment to safeguard the accident scene.
•The five phases of an emergency call include dispatch, response to the scene, arrival at the scene, transferring care of the patient to other EMS personnel, and postrun activities.
•You should be able to perform the first four steps in the extrication process and assist other rescuers with steps five through seven.
•Because you may be the first trained person on the scene of an incident involving hazardous materials, you must be able to identify the potential problem and respond appropriately. During a hazardous materials incident, your top priority is to protect yourself and bystanders from exposure and contamination.
•You should understand the role of a first responder during the first few minutes of a multiple-casualty incident. The START system is a simple triage system that you can use at multiple-casualty incidents.
•The National Incident Management System (NIMS) is designed to provide a unified approach to emergency incidents of any size that involve multiple agencies anywhere in the United States.

Patient Assessment

•A complete patient assessment consists of five steps: perform a scene size-up, perform an initial patient assessment, perform a physical examination, obtain a patient's medical history, and provide an ongoing assessment.
•The scene size-up is a general overview of the incident and its surroundings. Based on this information, you can make decisions about the safety of the scene, what type of incident is present, any mechanism of injury, and the need for additional resources.
•During the initial patient assessment, determine and correct any life-threatening conditions. The steps of initial patient assessment are: form a general impression of the patient, assess responsiveness, check the patient's airway, check the patient's breathing, check the patient's circulation, acknowledge the patient's chief complaint, and update responding EMS units.
•The physical examination of the patient from head to toe is done to assess non–life-threatening conditions after completing the initial assessment and after stabilizing any life-threatening conditions. This exam helps you locate and begin initial management of the signs and symptoms of illness or injury. After completing the physical examination, review any positive signs and symptoms of illness or injury.
•The purpose of obtaining a medical history is to gather a systematic account of the patient's past medical conditions, illnesses, and injuries to determine the signs and symptoms of the current condition. The SAMPLE history provides a framework to ask needed questions of the patient.
•It is essential that you watch all patients carefully for changes in status. If the patient is stable, monitor vital signs every 10 minutes. If the patient is unstable, monitor vital signs every 5 minutes. If the patient's condition changes, repeat the physical examination.
•Provide a concise and accurate hand-off report to emergency medical personnel.
•Patients can generally be divided into two main categories: medical and trauma. When examining trauma patients, follow the patient assessment sequence:
1. Size up the scene.
2. Perform an initial patient assessment:
a. Form a general impression of the patient.
b. Assess the patient's responsiveness and stabilize the spine if necessary.
c. Assess the airway.
d. Assess breathing.
e. Assess circulation and stabilize if necessary.
f. Update responding EMS units.
3. Examine the patient from head to toe.
4. Obtain the patient's medical history using the SAMPLE format.
5. Provide ongoing assessment.

Communications and Documentation

• Communications systems allow you to relay information from one location to another when it is impossible to communicate face to face. Excellent communication skills are crucial during every phase of a call.
•You must be familiar with two-way radio communications and have a working knowledge of mobile and hand-held portable radios. You must know when to use them and what type of information you can transmit.
•Throughout the different phases of an EMS call, communication systems are used for different functions. The phases of an EMS call include dispatch, response to the scene, arrival at the scene, updating the responding EMS units, transferring care of the patient to other personnel, and postrun activities.
•The protocols for communicating with others during each phase of an EMS call may vary from one system to another. It is important that you learn and follow the standard procedures and protocols of your department.
•In addition to radio and oral communications, first responders must have excellent person-to-person communication skills. You should be able to interact with the patient and any family members, friends, or bystanders.
•It is important for you to remember that people who are sick or injured may not understand what you are doing or saying. Therefore, your body language and attitude are very important in gaining the trust of both the patient and family. You must also take special care of individuals such as children, geriatric patients, hearing-impaired and visually impaired patients, non–English-speaking patients, developmentally disabled patients, and persons displaying disruptive behavior.
•Along with your radio report and oral report, you must also complete a formal hand-off report to other EMS professionals at the scene. Documentation provides a legal record for the actions you took and provides a basis to evaluate the quality of care given. Remember that the call is not over until the paperwork is completed.

A first responder needs a set of skills that includes
controlling airway, breathing and circulation.
treating wounds and shock.
spinting injuries to stabilize extremities.

When EMTs or paramedics arrive, the first responder should
assist the EMTs or paramedics. Do not figure or assume your finished you can assist EMTs if needed

UNDER CONTRUCTION

FIREFIGHTERS ONLY