Fundamentals of Fire Fighter Skills, Third Edition
Chapter 25: Emergency Medical Care
Chief Concepts
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Because fire fighters encounter ill or injured victims on the job, a basic knowledge of
emergency medical care skills is important.
Assume that all victims are potentially infected with bloodborne pathogens. To avoid
exposure to infectious diseases such as HIV, hepatitis B, or hepatitis C, always follow
standard precautions, such as wearing gloves and washing your hands.
To prevent exposure to airborne pathogens such as TB, wear a face mask or HEPA
respirator if you encounter a victim with a cough.
The victim’s airway is the pipeline that transports life-giving oxygen from the air to the
lungs and transports the waste product, carbon dioxide, from the lungs to the air.
An injured or seriously ill person may not be able to protect the airway, such that this
passageway may become blocked. You must take certain steps to check the victim’s
airway and correct the problem to keep the victim alive.
The first step in checking the victim’s airway is checking the victim’s level of
responsiveness. If the victim does not answer your initial question, gently shake the
victim by the shoulder. If the victim does not respond, call 911.
If the victim is unresponsive, try to open the airway with the head tilt–chin lift or jawthrust maneuver.
If the victim does not begin to breathe, look in the victim’s mouth to see if anything is
blocking the airway. Foreign matter may be cleared by using finger sweeps, suctioning,
or placing the victim in the recovery position.
If the victim is breathing adequately, you can maintain the open airway by placing the
victim in the recovery position and also inserting an oral or nasal airway.
After you have checked and corrected the victim’s airway, next check and correct the
victim’s breathing.
You must breathe for any victim who is not breathing through rescue breathing.
To perform rescue breathing, you may perform mouth-to- mask rescue breathing, mouthto-barrier rescue breathing, or utilize a bag-mask device.
To relieve a foreign body obstruction, perform abdominal thrusts in a conscious victim
and chest thrusts in an unconscious victim.
Not all fire fighters know how to administer oxygen; by learning this skill, you will be
able to assist other members of the EMS team.
Circulation depends upon the heart: When it stops, circulation of blood and oxygen
stops—a condition known as cardiac arrest.
The technique of CPR requires three types of skills: the A (airway) skills, the B
(breathing) skills, and the C (circulation) skills.
As a fire fighter, you can help a victim by providing early CPR and making sure that the
EMS system has been activated.
If you suspect that the victim has experienced cardiac arrest, first check and correct the
airway, then check and correct the breathing, and finally check for a pulse. If there is no
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pulse, begin CPR by performing external chest compressions. Perform 100 chest
compressions per minute.
If only one rescuer is present, give two rescue breaths (1 second each) after every 30
chest compressions. If two rescuers are present, give two rescue breaths (1 second each)
after every 15 chest compressions. Continue the cycle until an AED arrives or the victim
starts to move.
Complications of CPR include broken ribs, gastric distention, and regurgitation. These
complications can be minimized with the use of proper technique.
Increasing numbers of fire departments are equipping fire fighters with AEDs. This
equipment allows fire fighters to combine effective CPR with early defibrillation.
Shock is a failure of the circulatory system. The three primary causes are pump failure
(heart failure), pipe failure (falling blood pressure), and fluid loss (bleeding).
As a fire fighter, you can keep shock from getting worse by positioning the victim
correctly, maintaining the victim’s ABCs, treating the cause of shock (if possible),
maintaining the victim’s body temperature, and forbidding the victim to eat or drink.
Blood loss can occur through external or internal bleeding.
To control external blood loss, apply direct pressure on the wound, elevate the injured
part, and apply a tourniquet if one is available and permitted under your local protocols.
Wounds may be closed or open. The skin remains intact in a closed wound, whereas it is
disrupted in an open wound.
Stop any external bleeding as quickly as possible using the cleanest dressing available.
There are three classifications of burns based on the depth of the injury: superficial,
partial-thickness, and full-thickness burns.
The rule of nines is a method used to determine what percentage of the body has been
burned.
The various types of burns include thermal burns, respiratory burns, chemical burns, and
electrical burns.
Suspected spinal cord injury requires manual stabilization of the victim’s cervical spine.
Mass-casualty incidents require triage to provide the best care to the greatest number of
victims.
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© 2014 Jones & Bartlett Learning