Units 3_4_7 Oct 2013 Instructor Timimg
TIME
TOPIC
8:30 am Welcome, Introductions, Agenda, Housekeeping
MINUTES
10
 Welcome participants. Today we’re covering
disaster medical and disaster psychology.
 Introduce instructors.
 Welcome/introduce anyone new to this class.
 Restrooms, exits.
 Breaks, lunch.
Q&A from Day 1
 Answer any questions from day 1.
 Quick Recap of Day 1: o.k., you have a
hurricane to respond to. There are 5 on your
team who make their way after the storm
passes to your team assembly area. You’ve
got your three team boxes [HANDOUT], so
now what do you do? Team Quick Start
Checklist…
 Pose some review questions from day 1, key
concepts.
8:50 am UNIT 3: Introduction to Disaster Medical
Operations Part I
5
 More victims than rescuers
 EMS response may be delayed
 3 phases of Death
o Several minutes, death catastrophic
vital organs
o Several hours, excessive bleeding
o Several days/weeks, infection,
complications
 CERTs Role & SAFETY, treat life
threatening conditions, hold the fort until…,
hazardous environment/conditions, most
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good for most people
 Simple Triage and Rapid Treatment
(START)
 Unit Objectives (slide)
8:55 am Treating Life Threatening Conditions
9:00 am
 3 Killers
 Approaching the victim
 1st priority
o Open the airway
o Control bleeding
o Treat for shock
 Opening Airway:
o Anatomy (slide)
o Most common obstruction
o 7 steps to Open Airway using HeadTilt, Chin Lift Method. DO TWICE!!!
 DEMO W/GLOVES (head, neck, spine
injuries) (Recovery position)
5
10
9:10 am PAIRS EXERCISE
 Explain that in real situations you would
always have protective gloves, mask.
 Pair off, practice twice each.
 Maintaining the airway
15
9:25 am Controlling Bleeding
 Types: Arterial, Venous, Capillary
 3 methods to control: Direct P, Elevation,
Pressure Points (brachial arm, femoral leg)
 DEMONSTRATE EACH
15
9:40 am BREAK
10
9:50 am EXERCISE: Controlling Bleeding
30
 Explain gloving, and tips
 Instructions for Pairs Practice at their seats
 Tips on bandaging
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o Direction to unroll roller gauze
o How to tie off the end, stuff unused
roll under edge, etc.
 PAIRS PRACTICE. Arm.
 Explain how to properly remove gloves
o Shave cream per person…
 Disinfecting gloves. Latex gloves under
work gloves.Debrief the exercise
 Discuss tourniquets
10:20 am SHOCK
 SHOCK: Ineffective blood circulation. Death
of cells, tissues, organs
o Signs: Rapid shallow breathing
o Capillary refill greater 2 seconds
o Can’t follow simple commands,
squeeze my hand
 Assessment (30-2-Can Do)
o Two volunteers seated at front of
class, one breathe normally, one over
30 per minute as class observes the
difference.
 Treatment: On back, Elevate legs, maintain
body temp, control bleeding, gentle handling
15
10:35 am TRIAGE:
25
Mass casualty. Helicopters arriving with wounded.
Sorted…
 More victims than rescuers, limited
resources, time is critical
 Prioritize into 3 Categories (slide)
o Immediate: life-threatening Airway,
bleeding or shock. Time is critical
o Delayed: Not life threatening, but may
require professional care. Treatment
can be delayed.
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
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1.
2.
3.
4.
5.
6.

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11:00 am
o Dead: No respiration after two
attempts to open airway. NO CPR.
Protective gloves, mask and goggles. Crosscontamination.
Procedure
Size-Up: Stop, look, listen.
Voice Triage: “Emergency Response Team.
If you can walk, come to the sound of my
voice.”
Start where you stand. Systematic route.
Closest and work outward.
Evaluate and tag
Treat “I” immediately for airway, bleeding
and shock.
Document casualties
Participant Manual p 3-15 table Triage
Procedures
Participant Manual p 3-17 Triage Decision
Flowchart

 Triage Pitfalls (slide)
 Triage versus treatment
 Documenting results: Search & Rescue
Forms
11:15 am TRIAGE EXERCISE
12:15 am LUNCH
1:00 pm UNIT 4 Introduction, Disaster Medical
Operations Part 2




1:10 pm
Unit 3 Review: The Killers (slide)
Triage (slide)
Unit 4 Intro (slide)
Unit 4 Objectives (slide)
 Public health considerations
5
5
5
 Avoid medical waste
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 Water purification
1:15 pm DISASTER MEDICAL OPERATIONS
 We don’t operate at night, but what about the
injured you are in the midst of caring for?
20
 Where to treat versus what’s in your
workbook: We’re adapting it to our structure
and a changing scenario. Adapt and
improvise. If it lasts past 8 hours…
 Principles involved in treatment area layout,
treatment area organization.
 Documenting the victims [HANDOUT]
1:35 pm HEAD-TO-TOE ASSESSMENTS
 Indicators of Injury (slide)
 Conducting Victim Assessment (slide)
o Done for all victims
o Verbal, if possible
10
o Hands-on
 When to do it. Where to do it. How to do it.
Sequence.
 Head-to-Toe Assessment (slide): DCAPBTLS.
 P. 4-11 Spinal injuries signs & symptoms
 DEMONSTRATE creative in-line
stabilization (field expedients)
 DEMO Head-to-Toe assessment

1:45 pm DEMO Head-to-Toe assessment
5
1:50 pm PAIRS EXERCISE
10
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2:00 pm BURNS
 Heat, chemicals, electric current, radiation
 Temp of agent, duration exposed, part of
body affected, area affected, depth
10
 Burn Classifications (slide)
 P. 4-14 (slide) Guidelines for Treating Burns
2:10 pm WOUND CARE
 Dressing on wound, bandage holds dressing
in place
15
 DEMONSTRATE
 Rules for dressings (slide)
 Amputations
 Impaled objects
2:25 pm BREAK
10
2:35 pm TREATING FRACTURES
 P. 4-17 Closed vs. Open Fractures
 Treating open fracture (slide) (slide)
10
 P. 4-18 Displaced vs. non-displaced fractures
 Dislocations
 Sprains and strains
 Signs of Sprain (slide)
 P. 4-20, 4-21Soft vs. hard splint materials
 Guidelines (slide)
 Cervical/spinal
o Do not move, unless safety issue.
Keep spine in line. Drag. Etc.
o Backboards are issued 1 per team but
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their use is under review.
2:45 pm DEMONSTRATION no pairs exercise? Have
them work with SAM Splints
15
3:00 pm OTHER CONSIDERATIONS
10
 Nasal injuries
 Heat Cramps
 Heat Exhaustion
 Heat Stroke
READ the rest in the workbook (cold injuries,
stings and bites)
3:10 pm DISASTER PSYCHOLOGY
 Impact on victims
 Impact on rescuers
20
 How to triage (DISCUSS Red Cross
Psychological First Aid triage tag)
[HANDOUT]
 CERT response
o TLC for yellow and green
o Family, neighbors assistance and care
o EMS for RED/Immediate. Do not
leave unattended.
 READ the rest in the workbook
3:30 pm Q&A
NEXT Class day, time, place
READING (if any)
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