Chapter 7- Scene Size Up
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Created by:
JLewis122171 on February 4, 2011
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Terms | Definitions |
|---|---|
 What makes up the scene sizeup? | evaluate the scene for safety hazards take the necessary Standard Precautions Determine the mechanism of injury versus the nature of illness number of patients need for additional resources |
| how do you evalute for scene safety? | yourself crew patient(s) bystander(s) |
| what do you determine during scene sizeup? | mechanism of injury vs. nature of illness number of patients need for additional resources |
| what is scene safety | an assessment to assure the well-being of the EMT |
| what are the elements of scene safety? | protect bystanders (prevent them from becomming patients) never enter an unsafe scene make scene safe or call for someone who call |
| what is a danger zone? | minimum of 50 feet around scene further if fuel spill, fire, hazardous material, downed powerline |
| Danger areas | Crash or rescue scenes toxic substances or hazmat unstable surfaces: slopes, ice and water |
| what scene clues should you use in scene violence? | fighting loud voices alcohol/drug use unusal silence prior experience |
| what 3 things do you need to remember about standard precautions? | anticipate the need for standard precautions always have standard precautions equipment available use appropriate equipment to prevent exposure |
| give examples of 3 types of standard precautions | gloves mask and eye protection gown |
| define mechanism of injury | the physical event that caused an injury (for example a fall, motor vehicle accident,etc.) |
| who can provide information for you to determine the mechanism of injury? | patient family bystander observation of scene |
| what are the types of motor vehicle collisions? | head on rear impact roll over side impact rotational |
| what are the mechanisms of injury in a motor vehicle collission? | ejection deformed windshield, steering wheel amount of vehicle deformity seatbelt use |
| where can you find clues about the mechanism of injury in a motor vehicle collission? | vehicle interior |
| what are the types of motorized vehicles | motorcycles all-terrain vehicles snowmobiles jet-ski |
| what do you look at when you are examining a situation where the mechanism of injury is a fall? | distance patient fell part of body that struck surface type of surface patient landed on did anything break the fall? |
| what are the components of the mechanism of injury known as the penetrating trauma? | velocity body region penetrated exit wounds |
| what are the 3 types of velocity | low velocity-knife medium velocity- handgun, shotgun high velocity-rifle |
| what is a blunt force trauma | Injury caused by force from a blunt object (such objects may include hands and feet). Includes abrasions, bruises and contusions, and lacerations |
| what is a penetrating trauma | injury incurred when an object (as a knife or bullet or shrapnel) penetrates into the body |
| what are the sources of information for nature of illness for a medical patient | scene patient family bystanders SPFB |
| how do you determine adequacy of resources? | number of patients hazardous materials fire or rescue unusual situations |
| what do you do once you determine that you need more resources (adequacy of resources) | call for assistance before beginning care use triage procedures if necessary |
| what is a blunt-force trauma? | injury caused by blow that does not penetrate through the skin or body tissue |
| what CHEMTREC | agency that provides advice on hazardous materials via a hotline |
| what is a danger zone | area around the wreckage of a vehicle collission or other incident within which special safety precuations should be taken |
| what is domestic violence | violence in home |
| what is a high index of suspicsion | keen awareness that a person may have injuries |
| what is the law of inertia | principle that a body in motion will remain in motion unless acted on by an outside force |
| what is a mechanism of injury | force or forces that may have caused injury |
| what is the North American Emergency Response Guidebook | material available for rescuers to obtain quick information about hazardous materials |
| what is a penetrating trauma | injury caused by an object that passes through the skin and other body tissues |
| what is scene size up | steps taken by an ems crew when approaching, arriving, and attending at the scene of an emergency call to ensure the safety of the crew, the patient and bystanders |
| what is your top priority | personal safety is your top priority. determine dangers to yourself or other EMS providers from sources such as unstable vehicles, machinery, toxic exposure or violence. if you or other crew members are not safe, you will be unable to continue with other steps in the scene size up |
| when does scene size up end | scene size up is an ongoing process throughout the call. emergencies are dynamic: events may change without warning. For example, family members who were docile when you first arrived could turn hostile; structures that were stable could become unstable. Keep alert at all times. |
| should you rely on another person's scene sizeup | always conduct your own scene sizeup, no matter how many rescue vehicles or personnel are at the scene when you arrive. never assume a scene is safe because others may have taken care of hazards. |
| where should you park your car | always try to park your vehicle uphill from a collision scene this way your ambulance will be out of the path of dense smoke if fuel ignites. the other actions listed are appropriate and necessary actions to take as you near a collission scene |
| what should you do when you are in sight of the collission | when you are in sight of the collission, you should watch for the signals of police officers and other emergency service personnel because they may have information about hazards or the location of the injured persons. who is in charge depends on the type of incident. the police are not the medical care experts in most communities. |
| how far does the danger zone extend if there are no apparent hazards | when there are no apparent hazards, consider the danger zone to extend 50 feet in all directions from the wreckage |
| how far does the danger zone extend if the vehicle is on fire | when a colission vehicle is on fire, consider the danger zone to extend at least 100 feet in all directions, even if the fire appears small and limited to the engine compartment |
| what should a good scene sizeup identify | a good scene size-up should identify the potential for a violent situation. the name and amount of toxic substances would difficult to determine during the scene size-up. the number of patients should be identified but diagnosis is not the responsibility of the EMT |
| is an oxygen mask considered a piece of equipment used for standard precautions | no. the emt's bsi equipment during the scene size-up may include eye protection, disposable gloves, and a mask |
| what is the key element of body substance isolation | the key element of body substance isolation is to always have the personal protective equipment readily available. you only need to take standard precuations when you might actually be exposed. standard precautions equipment is not placed on the patient. it is not practicable for the EMT to try to determine which body fluids are a danger. |
| what are injuries to bones and joints associated with? | injuries to bones and joints are usually associated with falls and vehicle colissions. fights usually produce blunt injuries and drug usage often results in overdoses. Fires and explosion produce burns. Bullet wounds can cause damage to anything in their paths. |
| what does knowing the mechanism of injury do to help the EMT | knowing the mechanism of injury assists the EMT in predicting various injury patterns. while it does not assist you in immobilzing the spine, it can tell you when immoblization may be needed. an emt should always take standard precautions. |
| what does the law of inertia state? | the law of inertia states that a body in motion will remain in motion unless acted on by an outside force. centrigual force is a force that explains why the faster you enter a turn the more your vehicle will be pulled straight. the formula for kinetic energy states that the mass or weight of an object is the least important contributor to the injury |
| what injuries will an unrestrained driver involved a head on, up and over collision sustain? | an unrestrained driver involved in an head-on, up and over collision may injure his skull as well as the neck. injuries to the fibula, knees and femure are seen in the down and under pattern |
| which is the least likely to be the mechanism of injury in an up and over down and under colission? | the brake pedal is least likely to be a mechanism injury in and up and over and down and under collissions. in the up and over pattern, the patient commonly strikes his head on the windshield and may additional strike his chest and abdomen on the steering wheel. in the down and under pattern, the patient typically strikes his knees on the dash |
| when are knee, leg and hip injuries common | knee, leg, and hip injuries are common in head-on ,down and under collission since the patient strikes the knees and force is project to the hips. the head on up and over collission produces head, neck, chest and abdominal injuries. |
| which type of collission is the most serious | the rollover collision is potentially the most serious because of the potential for multiple impacts. rollover collissions frequently cause ejection of anyone who is not wearing a seat belt. expect any type of serious injury pattern |
| what are examples of mechanism of injury | a patient who fell three times his height, a spiderweb crack in the windshield, and a broken steering column are examples of mechanism of injury. a flat tire is not a mechanism of injury |
| what is a severe fall | a severe fall for an adult is over 15 feet or three times the patient's height because a fall from this height will most likely involve a spinal injury. falls from great heights are not always fatal because patients often strike objects that break their falls, such as a canopy |
| what is a low velocity injury | a penetrating injury that is usually limited to the penetrated area |
| how are medium and high velocity injuries different from low velocity injuries | the medium and high velocity injuries have larger zones of damage due to cavitation in the tract of the projectile |
| what is cavitation | the pressure wave around the bullet's tract through the body is called cavitation |
| what is exsanguination | exsanguination is when a patient rapidly bleeds to death. |
| when can gas penitration occur | with air rifles |
| how often does pressure damage occur | pressure damage occurs only occasionally |
| what is a blunt force trauma | an inury caused by a blow that strikes the body but does not penetrate the skin is a blunt force trauma |
| is there a term such as inertia trauma | no such term |
| what are the 4 parts of scene sizeup | scene safety mechanism of injury or nature of illness number of patients additional resources |
| five signs of danger from violence that you may observe when you approach the scene | fighting or loud voices weapons visible or in use signs of alcohol or other drug use unusual silence knowledge of prior violence |
| five types of motor vehicle collisions include | head-on rear-end side impact roll over rotational impact |
| three sources of information about the nature of illness include | patient family by stander scene |
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