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. Land ambulances
◦ Examples: Type A1, A, B, FWD
◦ Private ambulances – for paying cases, often non-
emergencies
◦ Patients Transport Van
Water ambulances
Air Ambulances
Motorcycle Squads
6. TYPE B TYPE A
Immobilization
package
Trauma Kit
Triage Card
Stretcher
All Grade B Equipments
Transport Ventilator
Defibrillator
Monitor
◦ Note: Type A1: additional
specialized equipments –
incubator, mini intensive
care facilities
7. To reach persons in need as quickly as
possible with trained personnel
To stabilize the patient’s condition to
prevent further deterioration
To move the patient to a facility capable of
providing more extensive care or additional
services that will enhance patient outcome
To offer the level of care equal to the
receiving institution recognizing the limits
inherent in traveling.
8. Intra-hospital--transport of a patient from
one location to another within the hospital
Inter-hospital--transport of a patient
between hospitals
Scene run--transport of a patient from a
non-medical site to the nearest available or
designated hospital
9. • Advantages
– Door‐to‐door service/no
addi4onal transport
vehicle
– No landing zone required
– Ease of personnel training
– Few weather restric4ons
– Affordable and generally
reimbursable
– Family member rides too
• Disadvantages
– Mo4on sickness
– Limited pa4ent access,
light and electrical power
– Traffic delays
– Transport 4me
– Vibra4on/noise (69‐75 dB)
– Need to carry addi4onal
baReries/AC converters
23. Body substance isolation review
Scene safety
Total number of patients
Essential equipment and resources needed
on-scene
Mechanism of injury
30. Information to relay to when making an emergency call
E = Exact Location - The precise location of the incident
T = Type - The nature of the incident (trauma, non-trauma, heart
atack, motor-vehicle accident), including how many vehicles,
buildings etc. are involved
H = Hazards - Both present and potential (e.g., explosion, spillage of
combustible materials, highly volatile hydrocarbons, chemicals, etc)
A = Access - Best route for emergency services to access the site, or
obstructions and bottlenecks to avoid
N = Numbers - Numbers of Casualties, Dead and Uninjured on scene
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. Sorting of patients according to:
◦ ABCDEs
◦ Available resources
Multiple casualties
Mass casualties
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. Time is a critical factor
for the patient with a
significant MOI
Barring the need for
extrication, the rule of
the “Golden hour” and
the “Platinum 10
minutes” will apply
35. The environment (ie: bottom of stairs, out in the
cold, tripod position, pool of blood)
Patient’s MOI/NOI
Patient’s age and sex
Patient’s degree of distress
Listen for the chief complaint
Keep the priority of care in focus
37. Are they conscious or unconscious? (if
unconscious do CPR quick-check)
Introduce yourself
What’s your name? (oriented to person)
Do you know where you are? (oriented to
place)
What day of the week is it? (oriented to day)
How can I help you today? (chief complaint)
38. Alert – oriented to person, place, and day
(“big three”)
Verbal – cannot answer the “big three”
correctly
Painful – either appropriate, inappropriate, or
posturing (decorticate/decerebrate)
Unresponsive
39. S – signs and symptoms
A – allergies
M – medications
P – pertinent past medical history
L – last oral intake
E – events leading up to
40. D – deformity
C – contusions
A – abrasions
P – punctures/penetrations
B – burns
T – tenderness
L – lacerations
S – swelling
41. D = Deformity
O = Open Wound
T = Tenderness
S = Swelling
42.
43. Time is a critical factor
for the patient with a
significant MOI
Barring the need for
extrication, the rule of
the “Golden hour” and
the “Platinum 10
minutes” will apply
44. The maximum time
EMS providers stay on
the scene for a critical
trauma patient