Disaster Medical Operations — Part 1 CERT Basic Training Unit 3 Assumptions ● Need for CERT members to learn disaster medical operations is based on two assumptions: . Number of victims could exceed local capacity for treatment . Survivors will assist others ‒ They will do whatever they know how to do ‒ They need to know lifesaving first aid or post- disaster survival techniques 90% of disaster victims are rescued by other victims! CERT Basic Training 3-1 Unit 3: Disaster Medical Operations — Part 1 Importance of Quick Action ● Phase 1: Death within minutes, result of severe trauma ● Phase 2: Death within several hours, result of excessive bleeding ● Phase 3: Death in several days or weeks, result of infection CERT Basic Training 3-2 Unit 3: Disaster Medical Operations — Part 1 CERT Training ● Treatment for life-threatening conditions . Airway obstruction, bleeding, shock ● Treatment for other, less urgent conditions Provide greatest good for greatest number by conducting simple triage and rapid treatment CERT Basic Training 3-3 Unit 3: Disaster Medical Operations — Part 1 Unit Objectives ● Identify “killers” ● Apply techniques for opening airway, controlling bleeding, and treating for shock ● Learn how to conduct triage under simulated disaster conditions CERT Basic Training 3-4 Unit 3: Disaster Medical Operations — Part 1 Unit Topics ● Treating life threatening injuries ● Triage CERT Basic Training 3-5 Unit 3: Disaster Medical Operations — Part 1 Three “Killers” ● Emergency medicine “killers” . Airway obstruction . Bleeding . Shock ● First priority of medical operations: . Open airway . Control excessive bleeding . Treat for shock CERT Basic Training 3-6 Unit 3: Disaster Medical Operations — Part 1 Remember your ABC’s ● A – Airway ● B – Breathing ● C – Circulation – in this case – Bleeding which if not controlled can lead to Shock In mass casualty situations We do not give 2 breaths we do not begin CPR CERT Basic Training 3-7 Unit 3: Disaster Medical Operations — Part 1 How to Approach a Conscious Victim ● Be sure victim can see you ● Identify yourself . Your name and name of your organization ● Request permission to treat, if possible ● Respect cultural differences CERT Basic Training 3-8 Unit 3: Disaster Medical Operations — Part 1 If the Victim is Unconscious ● Tap and Shout – “Are you OK?” ● If no response – . Consent is implied when a person is unconscious. Open airway…palm on forehead, 2 fingers under chin and tilt the jaw upward while tilting the head backwards slightly . Look, Listen, Feel for breathing . Evaluate – Repeat once if necessary CERT Basic Training 3-9 Unit 3: Disaster Medical Operations — Part 1 Open the Airway CERT Basic Training 3-10 Unit 3: Disaster Medical Operations — Part 1 Open vs. Obstructed Airway CERT Basic Training 3-11 Unit 3: Disaster Medical Operations — Part 1 Head-Tilt/Chin-Lift Method CERT Basic Training 3-12 Unit 3: Disaster Medical Operations — Part 1 Practice Airway Management ● Manikin Demonstration ● Conscious Victim ● Unconscious Victim ● Scenarios CERT Basic Training 3-13 Unit 3: Disaster Medical Operations — Part 1 Personal Protective Equipment (PPE ● Personal protective equipment, commonly referred to as "PPE", is equipment worn to minimize exposure to serious workplace injuries and illnesses. Goggles Masks CERT Basic Training 3-14 Unit 3: Disaster Medical Operations — Part 1 Personal Protective Equipment (PPE) ● How to put on and take off Non-Latex Gloves . For this exercise you’ll need ‒ 1 pair of gloves ‒ Chocolate syrup Gloves CERT Basic Training 3-15 Unit 3: Disaster Medical Operations — Part 1 Personal Protective Equipment (PPE) CERT Basic Training 3-16 Unit 3: Disaster Medical Operations — Part 1 Personal Protective Equipment (PPE IF IT’S WET AND NOT YOURS DON’T TOUCH IT! CERT Basic Training 3-17 Unit 3: Disaster Medical Operations — Part 1 Types of Bleeding ● Arterial bleeding . Bleeding from artery spurts . ● Venous bleeding . Bleeding from vein flows . ● Capillary bleeding . Bleeding from capillaries oozes CERT Basic Training 3-18 Unit 3: Disaster Medical Operations — Part 1 Control Bleeding ● 3 main methods for controlling bleeding: . Direct pressure . Elevation . Pressure points CERT Basic Training 3-19 Unit 3: Disaster Medical Operations — Part 1 Pressure Points CERT Basic Training 3-20 Unit 3: Disaster Medical Operations — Part 1 Practice Controlling Bleeding ● Find pressure points ● Direct Pressure – you need gloves and gauze ● If bleeding comes through – practice elevating the limb CERT Basic Training 3-21 Unit 3: Disaster Medical Operations — Part 1 Take 10 CERT Basic Training 3-22 Unit 3 Disaster Medical Operations — Part 1 Shock ● Result of ineffective circulation of blood ● Remaining in shock will lead to death of: . Cells . Tissues . Entire organs CERT Basic Training 3-23 Unit 3: Disaster Medical Operations — Part 1 Here’s What Shock looks like CERT Basic Training 3-24 Unit 3: Disaster Medical Operations — Part 1 Here’s What Shock Looks Like CERT Basic Training 3-25 Unit 3: Disaster Medical Operations — Part 1 Recognizing Shock ● Main signs of shock . Rapid and shallow breathing . Capillary refill of greater than 2 seconds . Failure to follow simple commands, such as “Squeeze my hand” ● Symptoms of shock are easily missed… pay careful attention to your patient! CERT Basic Training 3-26 Unit 3 Disaster Medical Operations — Part 1 Shock The Domino Effect CERT Basic Training 3-27 Unit 3: Disaster Medical Operations — Part 1 Signs and Symptoms of Shock ● Anxiety or agitation ● Cool, clammy skin ● Confusion ● Decreased or no urine output ● General weakness ● Pale skin color (pallor) ● Rapid breathing ● Sweating, moist skin CERT Basic Training 3-28 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock Caring for shock involves the following simple steps: ● Have the victim lie down. This is often the most comfortable position. Helping the victim rest comfortably is important because pain can intensify the body's stress and accelerate the progression of shock. Helping the victim rest in a more comfortable position may minimize any pain. CERT Basic Training 3-29 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock ● Call 9-1-1 or the local emergency number immediately. Shock cannot be managed effectively by first aid alone. A victim of shock requires emergency medical care as soon as possible. CERT Basic Training 3-30 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock ● Control any external bleeding. Remember the 3 main methods for controlling bleeding: . Direct pressure . Elevation . Pressure points CERT Basic Training 3-31 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock ● Elevate the legs about 12 inches unless you suspect head, neck or back injuries or possible broken bones involving the hips or legs. If you are unsure of the victim's condition, leave him or her lying flat. CERT Basic Training 3-32 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock If you have to leave the victim, see if there is someone that can stay. If not, put the victim in the recovery position. CERT Basic Training 3-33 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock ● Help the victim maintain normal body temperature. If the victim is cool, try to cover him or her to avoid chilling. CERT Basic Training 3-34 Unit 3 Disaster Medical Operations — Part 1 Treatment of Shock ● Do not give the victim anything to eat or drink, even though he or she is likely to be thirsty. ● Reassure the victim. CERT Basic Training 3-35 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 1 Check for dangers before approaching the victim. Tap and shout to the individual to see if they are responsive. If there is no response, THEY NEED HELP. CERT Basic Training 3-36 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 2 Check for breathing. Look for chest rise Feel the breath on your cheek Listen for sounds of breathing. If the person is breathing, then place him/her in the recovery position as follows. CERT Basic Training 3-37 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 3 Put the arm that's closest to you at a right angle to their body, with the palm facing upwards. CERT Basic Training 3-38 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 4 Put the palm of their other hand against their chest. CERT Basic Training 3-39 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 5 Lift the knee that's furthest from you so that their leg is bent and their foot is flat on the floor. Pull the bent knee towards you, and the person's body should roll onto their side. CERT Basic Training 3-40 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 6 Put the free hand under the head, so that the palm is on the floor, and the person's cheek is on the back of the hand. Point the mouth towards the floor so that any vomit or blood can drain from the victim. Push the chin (away from the chest, not away from the floor) to keep the epiglottis opened.[1] CERT Basic Training 3-41 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 7 Keep the knee bent so that the leg is at a right angle to their body. CERT Basic Training 3-42 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 8 Make sure the patient stays lateral, airway clear and draining. He/she can be easily rolled back to a supine position, but will not roll back him/herself. The recovery position is stable and safe, once a C Spine injury has been excluded CERT Basic Training 3-43 Unit 3 Disaster Medical Operations — Part 1 Recovery Position – No Head/Neck Injury STEP 9 Check again for breathing.