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CERT Basic Training - (Final Review)

Terms in this set (119)

CERT GOAL
Do the greatest good for the greatest number
CERT's job in fire safety
extinguishing small fires, preventing additional fires
CERT Priorities
help in emergencies before pro-responders arrive, rescuer safety is #1. Work with a buddy and always wear safety equipment
Fire Triangle
fuel, heat, and oxygen - remove one side to stop fire
Class A Fire
ordinary combustibles
Class B Fire
flammable and combustible liquids
Class C Fire
energized electrical equipment
Class K Fire
combustible metals
Class E Fire
cooking oils
Reducing electrical hazards
avoid "electrical octopus," replace broken or frayed cords, maintain appliances
L.I.E.S.
Limit, Isolate, Eliminate, Separate
Know where the power shutoffs are for
appliances, circuit breakers, fuses
Install in your home
natural gas detector, carbon monoxide detector. Test batteries every six months
CERT Fire size-up
do we have the right equipment? Are there other hazards? Is the building structurally damaged? Can we escape? Can we fight the fire safely?
Fire extinguishers
water (type A fires), dry chemical, carbon dioxide, specialized fire extinguisher (type D or K fires) higher number on label = greater amt. of extinguishing agent
P.A.S.S.
Pull, Aim, Squeeze, Sweep
Fire suppression DON'Ts
don't get too close, fight alone, suppress large fires, or enter smoke filled areas
Hazardous Materials
corrode other materials, explode or are easily ignited, react strongly with water, are unstable when exposed to heat or shock, toxic to humans/animals/environment through absorption, inhalation, injection, or ingestion
All hazardous material placards are a ___ ___ for CERTs
Stop Sign
NFPA 704 Diamond
Red - flammability, BLUE - health hazard, YELLOW - reactivity, WHITE - reacts with water, oxidizing problems, special precautions (anything greater than "1" = stop
START
Simple Triage And Rapid Treatment (30 seconds)
Three Killers
airway, bleeding, shock
How to approach a victim
be sure victim can see you, identify yourself, your name and organization, request permission to treat if possible, respect
Open airway
head-tilt/chin-lift method
Arterial bleeding
artery spurts - controlled by direct pressure
Venous bleeding
vein flows - controlled by elevation
Capillary bleeding
capillaries ooze - controlled by pressure points
Shock
a result of ineffective blood circulation; could lead to death of cells, tissues, entire organs
Signs of shock
rapid & shallow breathing, capillary refill >2 seconds, failure to follow simple commands "squeeze my hand"
Responding to mass casualty event
have a plan, follow it, and document your actions throughout (follow the CERT size-up)
Triage
process for managing mass casualty events - victims are evaluated, sorted by urgency of treatment needed
Immediate (I)
RED - life-threatening injuries (i.e. airway obstruction, unconscious, bleeding, shock)
Delayed (D)
YELLOW - injuries don't jeopardize victims life (i.e. pregnancy, shoulder dislocation)
Minor (M)
GREEN - walking wounded, ambulatory
Dead (DEAD)
BLACK - no respirations after two attempts to open airway
Never say ____
"Dead"
Rescuer safety during triage
if hazmat or terrorist event is suspected, cert doesn't respond. Evacuate as safely as possible. Always wear PPE's (helmet, work gloves/non-latex exam gloves, N95 mask, goggles, protective shoes/work boots)
Triage Process
Step 1) Stop, look, listen and think; Step 2) conduct voice triage (x2); Step 3) start where you stand, follow systematic route; Step 4) Evaluate each victim and tag; Step 5) Treat "I" victims immediately; Step 6) Document triage results
Triage Evaluation
Check airway and breathing (<30 bpm is normal), check circulation and bleeding (type of bleeding, cap refill <2 seconds is normal), check mental status (questions)
R.P.M.
respirations, perfusion, mental status
Triage pitfalls
no team plan/organization/goal, indecisive leadership, too much focus on one injury, treatment instead of triage
Maintaining hygiene
wash hands or use hand sanitizer often, wear non-latex gloves, wear N95 mask and goggles, keep dressings sterile, don't touch bodily fluids
Maintaining sanitation
put waste products in plastic bags - tie off and mark as "medical waste", bury human waste, control the disposal of bacterial sources
Water sanitation methods
1) boil water for 1 minute, 2) use water purification tablets, 3) non-perfumed liquid bleach - 8 drops/gal of water, 16 drops/gal if water is cloudy, let stand for 30 minutes before use
Functions of disaster medical operations
triage, treatment, transport, morgue, supply
Establish a medical treatment area
select site and set up treatment area as soon as injured victims are confirmed, when determining best location(s) for treatment area, consider - most effective use of resources and safety of rescuers and victims
Treatment area selection
the site selected should be - in a safe area, free of hazards and debris; upwind, uphill, and upstream (if possible) from hazard zones; accessible by transportation vehicles; expandable
Treatment area layout
4 treatment areas within treatment area: "I" for immediate care, "D" for delayed care, "M" for minor injuries/walking wounded, and "DEAD" for the morgue
Treatment area organization
assign treatment leader for each treatment area, document thoroughly (available identifying information, description - age, sex, body build, estimated height - clothing, injuries, treatment, transfer location)
Objectives of head-to-toe assessment
Determine extent of injuries & types of treatment needed, document injuries
Conducting head-to-toe assessment
pay careful attention; look, listen, and feel; check own hands for patient bleeding; if you suspect a spinal injury in unconscious victims, treat accordingly, check PMS in all extremities, look for medical identification
Order of head-to-toe assessment
1) head, 2) neck, 3) shoulders, 4) chest, 5) arms, 6) abdomen, 7) pelvis, 8) legs
Closed-head, neck, spinal injuries
do no harm - minimize the movement of head and neck; keep spine in straight line; stabilize head
Treating burns
conduct thorough size-up, treat with first aid (cool burned area, cover with sterile cloth to reduce risk of infection)
Burn severity
factors that affect burn severity - amount/strength of burning agent, area of body affected, period of exposure, size of area burned, depth of burn
Burn classifications
1) superficial - epidermis, 2) partial thickness - dermis & epidermis, 3) full thickness - subcutaneous layer and all layers above (don't irrigate it)
Burn treatment DOs
cool skin or clothing if they are still hot, cover burn loosely with dry sterile dressings to keep air out, reduce pain, and prevent infection; elevate burned extremities
Burn treatment DON'Ts
use ice, apply antiseptics or ointments, remove shreds of tissue, break blisters, or remove adhered particles of clothing
Treatment for chemical burns
remove cause of burn and affected clothing/jewelry; if irritant is dry - gently brush away as much as possible (away from eyes, victim, and you); flush with lots of cool running water; apply cool, wet cloth, compress to relieve pain; cover wound loosely with dry, sterile, or clean dressing; treat for shock if appropriate
Inhalation burns; signs and symptoms
sudden loss of consciousness, evidence of respiratory distress or upper airway obstruction, soot around mouth or nose, singed facial hair, burns around face or neck
Wound care
control bleeding; clean by irrigating with clean, room temperature water (never use hydrogen peroxide, never scrub); apply dressing and bandage (dressing is applied directly to the wound, the bandage holds the dressing in place
Rules of dressing
if active bleeding - redress over existing dressing; if no active bleeding - remove bandage and dressing to flush wound, check for infection ever 4-6 hours; signs of possible infection - swelling around wound site, discoloration, discharge from wound, red striations from wound site
Amputations
control bleeding & treat for shock; if amputated body part is found - save it wrapped in clean material and placed in plastic bag, keep cool, but NOT directly on ice, keep it with the victim
Impaled objects
if foreign object is still impaled - DO NOT attempt to move or remove, try to control bleeding at entrance wound, clean and dress it, making sure to stabilize the impaled object
Fractures, dislocations, sprains, strains
immobilize above and below, if unsure of injury type, treat as a fracture
Treating open fractures
don't try to realign the bones, you idiot. Cover the wound with sterile, moist dressing, splint without disturbing the wound, place most dressing over the bone ends
Dislocations
(an injury to ligaments around a joint that permits the separation of bone from its normal position); immobilize - NOT relocate, check PMS before and after splinting/immobilization
Signs of a sprain
tenderness at site, swelling and bruising, restricted or loss of use
Splinting guidelines
1) support injured area above and below, 2) assess PMS in extremity, 3) splint in the position you found it, 4) don't try to realign bones or joints, 5) fill voids to stabilize and immobilize, 6) immobilize above and below, 7) after splinting, reassess PMS
Nasal injuries
(caused by - blunt force to nose, skull fracture, non-trauma conditions like sinus infections, high BP, or bleeding disorders); cautions - large blood loss from nose bleed can lead to shock, actual blood loss may not be evident because victim will swallow some blood. Yuck
Treatment of nasal injuries
pinch nostrils or put pressure on upper lip under nose, have victim sit with head forward, ensure that airway remains open, keep victim calm
Cold-related injuries
hypothermia (when body temp drops below normal) and frostbite (when extreme cold shuts down blood flow to extremities, causing tissue death)
Symptoms of hypothermia
body temp of 95 or lower, redness/blueness of skin, numbness and shivering, slurred speech, unpredictable behavior, listlessness
Hypothermia treatment
remove wet clothing, wrap victim in blanket, protect from weather, provide food and drink to conscious victims if they aren't nauseas, do not massage to warm body, place unconscious victim in recovery position, place in warm bath if available
Symptoms of frostbite
skin discoloration, burning or tingling sensation, partial or complete numbness
Frostbite treatment
immerse injured area in warm water (warm slowly), do not allow part to refreeze, do not massage, wrap body parts in dry, sterile dressing
Heat cramps
muscle spasms brought on my over-exertion in extreme heat
Heat exhaustion
when exercising or working in extreme heat results in loss of body fluids. Symptoms - cool, moist, pale, or flushed skin, heavy sweating, headache, nausea or vomiting, dizziness, exhaustion
Heat stroke
temperature control system shuts down, body temp rises so high that brain damage and death may result. Symptoms - hot, red skin, no sweating, changes in consciousness, rapid, weak pulse and rapid, shallow breathing
Treatment for heat-related injuries
remove from heat to cool environment, cool body slowly, have victim drink water slowly, NO food or drink if victim is vomiting, cramping, or losing consciousness, you may administer ice for heat exhaustion but not stroke
Treatment for bites/stings
remove stinger by scraping edge of credit card or something similar across stinger, wash site thoroughly with soap and water, place ice on site for 10 min/on and 10 min/off
Anaphylaxis
check airway and breathing, calm individual, remove constrictive clothing and jewelry, find and help administer victim's Epi-pen, watch for signs of shock and treat appropriately
CERT Size-Up 1) Gather Facts
time and day, construction type/terrain, occupancy, weather, hazards
CERT Size-Up 2) Assess and Communicate Damage
if damage is light (broken windows, superficial cracks or breaks in wall surface, minor damage to interior contents) - safe to enter and remain; if damage is moderate (visible signs of damage, decorative work damaged or fallen, many visible cracks or breaks in wall, major damage to interior contents, building still on foundation) - enter only to save lives; if damage is heavy (partial or total collapse, tilting, obvious structural instability, building off foundation) - DO NOT ENTER
CERT Size-Up 3) Consider Probabilities
how stable is the situation? What else could go wrong? What does it meant for the search and rescue?
CERT Size-Up 4) Assess Your Situation
is it safe to continue? What risks will rescuers face? What resources are needed? What resources are available? (Personnel like firefighters, police, nurses, M.D.s, contractors; tools like crowbars, autojacks, chainsaws; etc
CERT Size-Up 5) Establish Priorities
what should be done? In what order? How to rescue the greatest number in the shortest amount of time?
CERT Size-Up 6) Make Decisions
keep in mind - safety of CERT members, life safety for victims and others, protection of environment and property
CERT Size-Up 7) Develop Plan of Action
focus operation on established priorities and decisions, provide for documentation to give responding agencies, provide for documentation to become part of CERT records
CERT Size-Up 8) Take Action
based on plan developed during step 7
CERT Size-Up 9) Evaluate Progress
most critical step, monitor plan's effectiveness and safety, make rescuer safety primary concern (use buddy system), be alert for hazards, use safety equipment, rotate teams
Individual voids
pancake, lean-to, and "V". if you see collapsed floors get out. Victims could be hiding in bathtubs, underneath desks, inside cabinets, under/next to beds, inside closets
Documentation
upon entering search area, slash the door! Enter information: date, time in/out, areas searched, "L" and "D" victims, CERT I.D.
Search Methodology
call out to victims, ask responding victims for more information about the building/other victims, (victims may be shocked or confused), search bottom-up/top-down for a multi-story building, right wall/left wall for single floor, stop frequently and listen for tapping, movement, voices, patterns, triangulation allows rescuers to view a location from several perspectives, keep records of rescued victims and of those who remain trapped or are dead, report information to a section leader & emergency service personnel
Exterior search
grid search - set distance b/w searchers according to visibility and debris, overlap patterns for full coverage, search in as straight a line as possible, mark areas that have been searched
Rescue operations
remove objects and debris to free victims, create safe rescue environment, triage and remove victims, remove debris
Maintain rescuer safety
triage in lightly and moderately damaged buildings only, evacuate victims ASAP, know your limitations, follow safety procedures, remove debris by leveraging and cribbing, ilift properly, use self removal or assist with lifts and drags
Type of extrication methods depends on
number of rescuers available, strength and ability of rescuers, condition of victim
Principles of on-scene management
maintain the safety of disaster workers, provide clear leadership and organizational structure, improve effectiveness of rescue efforts, well-defined management structure, manageable span of control, common terminology, effective communication, consolidated action plans, comprehensive resources management, accountability - everyone is responsible for everyone
Objectives for on-scene management
1) identify scope of incident, 2) determine overall strategy, 3) deploy resources, 4) document actions and results
CERT Operations
Incident commander - section chief of operations, (search and rescue, triage/treatment/ transport/morgue); logistics (communications, food, med support to members, supplies, facilities), planning (resource status, prepares action plan, alternative strategies, documentation services, situation status); & finance/administration (contract negotiation and monitoring, time keeping, cost analysis, injury/damage comp)
Dealing with the Media
refer medial to incident command/team leader, do not let media inhibit CERT goals, be careful about info released
NIMS compliance
ability to work together
CERTs take care of ______,____ ________, ____ _______, and _____ _______.
themselves, their families, their homes, and their neighbors.
Rescuer safety is ____ ______
first priority
Heavy damage =
no rescue
Moderate damage =
locate, triage, evacuate
Light damage =
locate, triage, continue size-up, and document
Documentation
Command post documents situation status (incident locations, access routes, identifies hazards, support locations)
Terrorism
the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives
Terrorist goals
mass casualties, loss of critical resources, disruption of vital services, disruption of the economy, heightened fear
Terrorist targets
seats of government, key industries, bridges, subways, tunnels, key transportation facilities, water supplies and utilities
Terrorist weapons
CBRNE
Chemical weapons
blister, blood, choking, nerve, riot-control agents
Biological weapons
exposure through inhalation, absorption, ingestion
Radiological Weapons
considered a higher threat because components are easy to obtain
Nuclear weapons
derives destructive force from nuclear reaction, long-term effects make it difficult to monitor/track, affected are is larger as contamination spreads, potential for casualties extends beyond initial attack
High-Yield explosives
weapons of choice, grenades, mortars, surface-to-air missiles, improvised explosive devices (IEDs) - any device created to destroy disfigured, distract, or harass
Eight signs of terrorism
surveillance, elicitation, tests of security, funding, acquiring supplies, impersonation or suspicious people, rehearsals and dry runs, deployment
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