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Home My WebLink AboutDocumentation_Miscellaneous_Tab 03_06/10/1991 �oard of County Commissioners � Fire-Rescue Administration � Karen T. Marcus, Chair Chief Herman W. Brice Carole Phillips, Vice Chair Carol A. Roberts Carol J. Elmquist Marv McCarty � B� ken Foster i�laude Ford Lee Q �C� � a x �� O L7 N � April 23, 1991 Carl R. Roderick Chief of Police Village of Tequesta 357 Tequesta Drive Tequesta, FL 33469-0273 Dear Chief Roderick: As we have previously discussed, Palm Beach County Fire-Rescue is happy to provide the Tequesta Police Department with "First Responder" medical training. Attached is an outline for 30-hour "First Responder" Course. This course of study covers ten (10) major topics. At the conclusion of the course, the student will have a working knowledge of each of these topics. Those successfully completing the class will receive a Certificate of Completion from Palm Beach County Fire-Rescue. I wish to point out that the topics covered in the "First Responder" course are sanctioned by Dr. Jeff Davis, Medical Director for Palm Beach County Fire-Reseue. In fact, with the exception of EOA Management, this course duplicates the skills needed for compliance to the Palm Beach County Fire-Rescue Protocol for Basic Life Support Engine Cam,pany Response. Palm Beach County Fire-Rescue understands the scheduling needs of the Tequesta Police Degartment. I look forward to meeting with you to work out the final scheduling details. I feel confident that the twice per week/seven week total schedule we have discussed will work out fine. The resources necessary to provide this course are immediately available. SO South Military Trail, Suite 101 . West Palm Beach, FL 3341 S.(407) 683-0010 '� printed on �ecyc%d paper April 23, 1991 Chief of Police - Tequesta Page Two Please feel free to contact me should you have additional questions. Very truly yours, � � Thomas F. Murphy, Bat li Chief PALM BEACH COUN'1'Y F1RE=RESCUE ATTACHI�iENT PALM BEACH COUN'fY FIRE RESCUE TRAINING DIVISIUN "Eacetlence through Education" FIRST RESPONDER COUKSE The First Responder is likely to be the first medically trained person to arrive at an emergency scene and thus plays a pivotat role in providing care and in reducing nr preveating further harm Go the victim of trauma or sudden illness. At the coactusiQn af this course the FirstRespoader will have aworking knuwledge of the follaa�ing cate�ories. Yedica! Legal This section contains information pertaining to the liabilities and legal respunsibilities for the First Respunder: Cardiopnlmanary Resu�cilation A review of, certification in , or recertificatian in CPR. Eqoipment Fsmiliarization "Hands on" training with medical equipmenl currently on a PBCFR Eagine and Rescue Truck. Aastamy of the Hvman Body Basic approach la unders�anding body structures, loca�ions anci functions. Patient Asse�,sment � Recognitian and identaficalion of personal safety consideratians, patienl iliness or injvey, and sequential appraach to proper treatment. Pstieat �anagement Appropriate management of the patient presenting signs and symptoms of the following medica! emergencies. Respirstory E�ergeaciea Respiratory Distress/Airway Management Csrdisc Emergencies Trauma and Medical Child �irth Normat ur Gampiicated £nviron�ental Emer�encies Heat, Cold, and �later Related Upan svccessful completian of this course the First Responder will receive a �riificate of Gompletion fram Palm B�ach County Fire Rescu�. 1 � �� "FR014�i0TI�iG EZGELLENCE THROUGH EDU�ATION' F[RST RESPONDEB The First Responder is li�;ely ta be the first trained person at an ernergency scen� anc� t�ius piays a givotal role in pro�iding care and in r��ucir�� a�� prav�ntil�� furth�r harm #�;� t1�e victim of trauma or sudden illness. The actions ;�f t11� First R�sgonder rnay w�111�e life saving. First Pespot�d�r c�an sustsin life unt�l ot,her emergencp medical help arrives. Froies�ior�alism and Err�otional response to a crisis 1_ Take �hargP �f ttle �iGuataon Z_��p �:alrr� wYiila wc�rking un�ar pr�ssur� 3. Organiz� �thers t� d� li�ewise By t�Ying charge you also ta�e r�sponsibility BESFON�I�I LITY MEANS LIABI LITY 1�riiEDICAL LEGAL Bytitan�er is un�er no ��tigati�n t� assis� a stranger in distress - NO DUT�' TO ACT �ll�� t0 �Ct 1. A pers�n txained as a First R�span�lpr and belon��ng t.� � u�it charged with EMS 2_ i[ a�ssistin� in a��y emergency is the stat�d policy of the �rgar�izati�n �r �iepartment tA ww�i�h �n� bel�n�s N��lig�nce Aieglig�nce is th� failure to ex�rcis� the �am� due c�re that an�ther p�rs�n t��ith the same l�vel �f training and under the sam� �ircumsta:nces �ould exercise. II a persUn h�s a duty and abuses it ttlereby harming anoth�r ir�{�ivi�ual, tha First R�spon�er can be su�ci fc�r ne�li��n�e. � • Consent - requireci �fvre treatment 1_ Actuai ��n�nt - inforrric� �ons�nt - C�n:�at fdr each in�ividual"trratxnant 2_ Irnpiied consent - unconsciou$ pa�ient 3. �onsent far Minors - p�rents or leg�l guardian� Trr� to gain cons�ent f��m thasa legally responsik�le I n serious cases consent is impliec� , REMEMBER - never withhold lifesaving care �_ IVIlIl(�-�I�I'2C� �.�1@I1tS - simila� Go minors Tty � gain ��n5ent from th�se legaiiy respc�nsible Abandonment Once c� h�y been initi�ted, y4u must nat cea�e ren�ering that eare until a person at l�ast equally ccmp�tent assum�s respan�ibility or as sp�cif ied in t2�e Disast�r 1�ltanagement text of this d�cumen�. GQOD S�iMAH i Tt1N LA W � A p�rs�n going t� the aid �f another pers�n �.nd niakir�g a reas�nable effort t� help should not be liable for ordinary neglige�4e. H�we�•er - th� la�T does not protect pou from being sued for f�ilure to gain car�sent - ar failure t�a render proger care - or if you render car� outside of ;�our scape of training. CPR REGERTIFIGATI4ft F�illuw AHA St�.r��ar�s EQUIPMENT FAI��II LIARIZATI4R Res�ue an� Engine ( also impro�ise on scene) - ANATOI�iY 4F THE HU1�AN BODY Basic body stru�tures and l�tions 1. S�eleton a. Cranium - protects brain b. SFine - pretects spinal c�rd c. Upper Extremities � d. Ribs - pratect h�art and lungs �vita! argans� e. Pelvis - prc�t�cts abdominal and genitourinary organs f. L��r Extxemiti�� . A�ius4l�s - attach t�.� bone allo�ring mobilit� . ' • J � 3. Skin - larg�t orga�l vI t�le body Prut�;t� t�i� bc>dy by a�i�ting in t�m�ratur�e cantrol, by warding �,ff micronrganisms and virus�s that cause disease, �nd pro�ides a pii�ble loc�tion for n�rve endings. �_ Body Cavitie� a. Cranial (head} b. Thoracic �chest) ` c_ Abdominai �st�omach) d_ Pelvic ilower atxlQminal) �. B�y �rgans - l�cati4n and function a_ Brain -�ranial Caeitp - Controliing organ of the body b. Hea�rt - Thoraei� Ca�ity - Twa-sided purnp providing farce �.n� dir�cti�n to the biood in the circulatorY s�stem. The blood then carries �xygen and nutrients t� the body in exchange for Ct�2 and wa�t� �roducGs. c_ Lungs - Tharacic [:avitg - Provide the mechanism for t,�e �xct�ange of CO2 for Gxygen. d_ �i�nays - B�hin� Abdaminal Ga�ity - Rid th� �dy of t�xiti �4rast� produ4ts and control its balance of �rrat�er �n�i s��t. e. Liver - Right Upp�r Quadrant (RUQ} .�bdominal Cavity As �art af the digestive sys�em, i�. staores sugar for immer_iiate use b� the taody as �il a� prcxlucing many ai the fact�ars that aid in the pro�r regulation ai irnmune responses. f. Gaii�iiad�er - RUQ belo� Li�rer - Res�rvbir for bil� produced in the Liver. Bile is used t� digest fat. g_ Pa.ncreas - LUQ - Praduces pancre�tic juic�s which aid in digestion as w�eil as insulin v�iich regulates the amount, of sugar in the bloocl. h. Spleen - LUQ - Froduces anc� destroys biood cPlls: i. Int�stine$ - Abdominal Cavity - For final digestion and excretion of remairung bygroducts. j_�anitaurinary �rgans - Peivic Cavity - Th�se include Urinary Biadder, Ut�erus, and Ovaries. Used for urina�ion and reprc�duction. 6. C l�fechani�m of Injury PrQper Treatment � 4 � PATIENT ASSESSMENT I nitial assessm�nt ar�� em�rgency treatment of tt�� patient must be �rried on simultan�usly �eeping treatment �riorities in mind. Arrivai at scene 1. Scene acces� and control �personal safet�� 2. t�ain Iniormati�n tobs�rve) a_ The scene - is it �ie and �r�e �i h�zards Dves �tie pataent have t� �e maved, i.e. Fire, toxic fum�s, �t�.. b. Th� pa�i�nt - is he conscious, talking, moving c_ E y�t�.nders -�hat did they see or hear? V�That can they t�ell p�u? d. MQChanism of Injury -�hat �urrounding fact�ors may h�ve caus�d the in�ury? e_ Signs - a physicai ii�ding that can be vi��ved b� the First R�s�nder; such as an� deformities, cut�, burns, or bla�ding. f. ��mpt•:,ms - tiompl�ints v�iced bp the pataent; such as p�in, fear, or diffieulty with functions as swallowing, breathing or urinating. Conscious Fatient Identiiv y�urseli and gain c4nsent. 1. Pfimarp Surv�y a_ Resgirations - ass�ss for absence ar presence including the r�t�, depth a�d symmetr� of chest movement and d�ument these findings. U. Pulse - a-ss�ss for �bsen�e or pr�sence inGluding t1�e rate and reg;u.larity and document these findings. c. Blcrd�i Pressure -��termine th� systaiic and �iast�lic readings. The pati�nt is hpp�rt�nsive if the pressure is great�r tYian 2 00/ 134 mmHg. The pati�nt m�y be hppotensive if the spstolic pressure is le�s than 1�C� mmHg. If unable �o aus�ultate the bloc�d pressure, �ttempt t� palp�:t� s�stnlie pr�ss�.�re a�t t1�e ��racnial4r radiai art�ry and document these iindings. •- 5 � d. Patient's Mental Status - d�ument as... 1 } C�n�idus and alert 2 � ��ns4�ious but disorientaed 3} S�mi-conscious �� Unconscious 2. Secondary Snrvep a_ Head to Toe Alt�er the Primary Survey has 1�n complebed, �valuate th� patient f�r oth�r ��ounds ar illness that may n�t b� �b�ious at fi�st. All presenting signs and symptoma must be r�corded. T2�e Secandary Survep shouid start at the patient's head and progre,� tAward the toes. b. Skin Color - c�ocument as... t ) Narmal 2 ) Faie 3) Fiush�d 4) Ashen 5} Cy�notic c. Skin Temperature - Document a�... 1) Hc�t and Pry - or - Hot and Moist 2��arm and Dry - or -`1�l�rm and l�ioist 3� i.00i and Dry - or - i.00l and Moist � d _ lUiedic Alert Ai�rays ch�ck the pati�nt's n�ck, �v�rists, anki�s, � and �rall�t for a Medic A1ert tag or ca�d. These infarmative tags ma� provide y�ou with info�mati�n that m�y otherwise be unabtainable from a disoriet�te�l or unconscious �atient. Me�iic Alert may �over diabet�s or epiieps�, bload type, allergies, frequentiy used medications, special canditio�s, ar pr�edures to fallow in case of inedical emergency. 3. Relevant Iniarmati8n a. Fatient's chief camplaint, pertinent medical hist�ory, allergies, current medication, �.nd pri�ate m�dical doctor b_ �dame, age, sex, �ace and appropriat�e � �ei�ht af the gatient c. Pertanent physical e�minar.ion � d_ l�ri�chanism oi injury, ii �ound , v � � Unconsciaus P�tient 1. Primary Survey (A,B,C's) a_ Est�blish unresponsiceness (if no response cali for help) b. Assess far respirations �r breathing c_ �irGUlataon - palpat� c�rotid �rt�ry 2_ Secondary Survey 4Head t,o T�} RESPIR�iT4RY EMERGENCIES Respiratorg Distress t+�ith4ut oxyg�n, cell� c�nnot produce energy and there�or� die. If tt�e respiratArv systern iaiis ta place axygen in the bload, or if the �ii culat�ory system fails to c�rry ogygen �o the celis, then ceiis, tissue, �r�atls, and finaily tri� syst�m 4tt�e patient� dies. 1. Signs and S�mptoms a_ Nasal flarin� b_ Tr�cheal tugging �Adams aFple pulle� upward during lnhaiation� c. Retraction oi intercostal muscles d. Use of abdomina.I muscles during e�alation � _ Cyan�sis - biuish mu�ous m�mbran�s 2. Causes a_ Medical - i} Asthma - restriction of tha air con�lucting tubes causing wheezing on exp�rati�n . 2 ) Bronchitis - �hranic, pro�luetive cough �rith wheezing 4n in�alation and e�halataon 3) Emph�rsema - This chroni� abst�uctive con�itian continues t,� �vorsen until the pataent can no longer ��hang� sufficient air bo support life. �� Hype�v�ntilati�n - �apid breathing c�using tinoling around mauth and nose and tir�gling of hands anc� arms. � 5� Allergic reaetian - due t�o bee stings, ant bibes, vr ingestion of shellfish can cause anaph�lactic stiock, �vYii�h �ar�duces swelling of th� t�ongue and m�uth, which clUses the airway. . f � � b. Traur�ia - C�ntusion, penetrating injury, inhalatian of g�s�s or superh�at�ed air i.�e.. smoke inhalati�n AIRWAY MANAGEMEN? 1 _ �atient Airway a_ Maintain an open airway in all �atients. Thi� may be pe�iorrned �p the head tilt - chin lift methad ar, in �ases af su�pect�ed cerviGal spine injury, the modified ja�,v thrusG man�uv�r. Suspect a possibl� c�raical spine injury �n any trauma patient or unconsciousness of unYnawn causes. All unconscious pa�ients should ha�•e an oroph�ryn�eal airwag insertaed to aid in maintaining a gatent airway with suction ready. b_ Dc�ument respiratory rat� and d��th 2. Resgiratory distress A�minist,�r oxyg�n if t,Yi� pataent appe�rs to b� in re��irat�ory �istress as demanstrat�d t�y complaints of shortxiess of bre�th, use af accessdr�• muscles in tareathing, or abnarmal breath sounds. NOTE: Hioh flow 02 for any trauma gatient whether pediatri� ar adult. �. COPD patients - 2 to 41pm via nasal �annula b_ Ivlild distress - 4 tQ 61pm via nasal cannula t. ��re distress -$ t�a 12 1pm via non- rebreatY�er mask 3. Qbstructed air�ay a_ Conscious - administQr 6 t� 10 abd�minal thrusts (adult) o� chest thfusts (inia�t) depen�ling c�n patiet�t situataon untii the obstruetian is reli��ed or the patient taecornes unconscious. b_ Uncons�i�ns - Attempt t�o ventilat,s the patient. If succ�ssful, continue t� assess patients respirations. If . un�uccessful then admi�ister 6 t�o 10 abd�minal thrusts {�dult} or chest thrusts �infant) depenc�ing on pataent situation. p�rform finger �weep if necessary. NOTE_ Attempt v�ntilatrons after e�ch maneuver. Cantinue this sequence until t�he patient re�ains � consc�iousness or further qualified heip arrives. .- 8 � �. Respiratary arrest �r'antilaGe th� patient once every 5 seconds far an adult, once every 4 seconds for a chiid, and once every 3 secands for an infant utiilizin� an appropriately sized bag-valve ma$k with reservoir. �Yhen using the t�ag- value mask cannect the supply tubing to the oxygen tank at a iic�w r�.te of 15 lpm with the reser�oir bag attached. CARDIAC AHREST i_ Frimary Survey - a�vise advanced life support unit of cardiac arrest. Request ALS unit if nGt aireadp dispat�ched Z_ Perfarm adequat�e one ma�n or two man CPR a�carding to the current .�merican Heart .��saciatian St.�ndards. CARDIAC EI!�iEB�ENCIES Myocardiai infarction A coronary artery bECames occluded and the area of the heart supplied by that �Tessei di�s. 1. Sigas and Symptoms Uncamf4rtable pressure, squeezing fullness �ightness, or dull pain in the cent�er oi the chest lasting langer than two minut�s �radiating� Ai�, �ifficulty breathing, paipitati�ins, nausea and e�miting, c41d sv�eat, palencss, �eakness, and anxiet�. 2. Caases a. Gardiac embolism b . �ngina c. i.HF d_ �ttierosclerosis �. Spasms of arteries CARDIAC 14�AI�AGEMEI�iT 1_ Perfarm �ataent ��sessment and document findings. 2. Have �atient r�em�in quiet in a position of corrifort. 3_ If the ��tipnt cornplains of cl�est �ain administer 4xygen at 4 t,� o!pm via nasai c�nnula. ,. 9 � T�AUMA EMERGENCIES A priysi�al injury c�r �und c�us�� b� external fdree ar violen�e. General Assessment and Tr�atment 1. St,�bilize the neck and open the �irwap �rith a jaw thrust 2. Assess breathing and circulation while maintaining both manual c�rvical immob�lizatian and jaw t.hrust. 3- Proce�d �nrith appro�riate cardiopuimanary support as n�eded. Trauma p�tients i.e. contusion, laceration, p�netrating injury, blunt injury, avuisidn, ar amputatidn, shauid receiv� high flo�v o�ygen c� - 12 lpm via n�n-rebreather mask. 4. Replace manual cervical immobiliz�tion v��ith appropriats cer�ical imm��ailization deviee fC-C411ar, Ferno CID, and Rackl��ard i. 5- Control Blee�ding a_ Direct pressure b. Elevatian �_ Pr�Ssur� �ints d_ T�urniquets �6. Ass�ss for Shdck Sho�k is a fai�ure of the circulator� system t,o pro�ride sufficient Ferfusi�n to the bady parts. a . Types i ) H�pavalemic (biood loss) 2} Metat�lic (loss of body fluid} 3} N�ur��nic �idss of nerv�us contr�l of the vas�ular spst,�m? �� Psqchagenic �the commd� faint} 5? Cardiog�nic �inad�quate functivning of the heart} 6} Septic (severe gen�ralized infectian with loss oi bi�d volume and direct blood v�ssel damage� 7) �naphylacti� 4a11ergic reaction - nan-vascular in nature) s !U � b. Signs and Symptoms of shock 1� R�stl�sness, anxiety , and mentai 3isarientation 2 } Pa11�r, p�leness 3) rapid pulse {�eak} 4 ) c�lness of extremities 5} Thir�t and dryness af mauth 6� Late signs - Bluish discaloration af skin, dilated pupils, uncansciousness, and irregular or gasping respiratians c. �h�cl� Managernent 1� Assess air�ray, �-Spine, a�d manitor brea�hing 2 } Stap major bieeding 3 y Elevate lo�ver extremities �€� Make patiant comfortabie - avoid rough handling �) Cvoi feverish patient - warm cold pa�ienG 6a hI�nit�r pa�ti�nt's LOC 7� Give th� patient nothing by mouth ?_ Perf�rm sec�ndary surv�y 8. �dminister appropriate treatment for specifi� injuri�s listed belaw. 9_ Continua��sly m�nit�ar and re-evaivate the patient Gunshot and Sfi.ab �ounds I_ P�rfarm pati�nt assessment and d�cument findings. 2_ Examine patient for entrance and exit wounds. Caver all wounds ��ith �t�rile dressings 3_ Stabilize impaled objects in place securely 4_ Apply high flow ax�gen $- 12 lpm via non-rebreatrier mask �. Treat for shock Head Trauma 1. Cc�ntroi c�rvical spine and perf�rm pati�nt assessment, document fin�ings. 2. All uncon$cious pa�ients wit�h su�pected head injury should he hyperventil�t�d bp bag-valve m�sk with r��rv�ir a�.d supplQmental ax�gen at a ra�e of 24 - 25 breaths Fer minut�e. . _ '. �f , � AutA Accidents i_ C�ntr�i �er vicai spin� and p�riorm patSent ass�ssment, dwcument findings. 2. For e�,t app1F Stif-neck cervical collar and KED. 3_ administer ap�rapriate treatment for specific injurie� as necossarq. Burns 1. Classifi�cati�ns of Burns a. First Degree I n�•ol Y es �pidermis and appe�rs red b. Second D�gree Invalves int�ermediat� skin leQel; dermis and �ppears red with blisters c. Thir�l D�gr�e Involves deep dermai �ith skin ioss and appears c�ry, whit� t� charr�d; sc�metimes app�ars dull gray d_ Critica�l �omplicated by fra�ctures or any degree of respiratory injur� and any third degree burns tnat involve the h�nds, f�et, genit�lia, or face, or any Lhird degre� burns that involve more that 1�� oi the body surface. �_ hi�erat�e Thir3 degree burns that includ� 2� t� 14� of the bodr area (excluding h�ds, feet, f�ce, or g�nitaiia) as �v�tl as second d�gree burns that ineolve 15� t�o 25� of the tx�dy surfare area and first degree burns that int�olve 54� tn 75� of the b�dp surfacp area. f . l�iiflor Ttiird degre� burns that inv�Ive le�ss than 2� of the t�y surfae� ar�a or second degr�e burns that invaive lass than 15� of the body surface area. � 12 2. Burn 14lanagement a. F�rform patient asses5ment an� �ldcument findings. St�p tha burning process if active burning is present. b_ Evaluatk patient for extent and sev�rity of burn(s} utilizing 'Rule of Nines". c_ Remc�ve ciothing and jewelry fram burn area e�cept �here clothing is sticking tA the skin. d. Cover the burned area wit,� dry, stefiie dr�ssings. Do not put an�thing on the burn toil, ointment or butt�er) e- If tt�ie burn was due tfl ch�mi�ai ag�nt, flush the area �arith large amounts of water. If the burn �ras du� to drp lime, brush off the dry lime priar to flu�hing. f_ Burn patients should receive high flo�v oxygen, $- 12 ipm via non-rebreath�r mask, if �h�rtness of breath, shock, or �vidence of respiratory injury is . p�esent. Fra�ctur�s 1. T�pes af Fractures a. Transver�e - the break is straight across the bane b. Spiral - tvv�ists around and through the bone c. Oblique - is at an oblique angle acrass the b�ne d. Com�inute�l - t17e bone is f�agmented inta more than two pieces �. Impa�t� - the ends �f the brak�n t�ones are jammed int�o each �ther f. Greenstick - passes onlp gart �,ray through the bone g_ Depre�ecl - when a part of the skull is "depressed" into the brain h. Corripression - aertebrae ma� be c�ushed, compressing upon each other 2. Fra�tur� Manag�ment a. S�lint fractures �rith appro�ariat,� immobilization de�•ice(i.e., Board Splint, Siing and $wafih, etc.}. b. Cover protruding bdne ends with st�rile dre�ings. Do NOT attemgt to push the back intA the injury �ite. c. Stc�� rileeding �rit,� direct �ressure or press��re goints. d. Be certain to imrnobilsze the j�ints both aba�e and below the ft�aeture sit� in long bo�e injuries. �_ E�ra�lu�te pulse distal t� injury bc�th before and aft,er splinting. Dacument these findings. . . 1 � � Eye Injuries i. Evaluat�e ma�;hanism af injury. For for�ign b�xii�s or chemical exposure, fiush eyes �vith large quantities � 1400cc to �p40cc) Qf �terile Normal Sa�line except with penetrating injury of the eyeball. 2. Cover L�oth e�es with eyepads and dry sterile dr�ssings. 3_ Maint.ain contact �vith the patienL for reassurance. 4. �h�n a protruding object is involved, cover the object for prot�ction and then cover t�e unaffecGed eye to preeent sympath�ti� m�vement. �IEDICAL EMERGEI�TCIES Unconsciaus Fatients i. Perfarm pataent assessment and document findings. 2_ Administer oxygen 8- 12 lpm via non-rebreatt��r m�sk. Seizures The m�jar c�uses of seizures are trauma epilepsy infectian, drug o�Ferdose, and hi�h bodp temgerature. 1. Types of Seizar�s a. iTeneralized seizure - invalves the entire b�cly and usually ends in a�ricul of u�consciousness - may last severai minut�s b. Fartial seizure - ma� tae limited ta one or more extr�mities or one side af the b�iy 2 _ Seizure �ianagement a. Perfarm patient assessment and document findings. b. Frot�ct pa�ients �ram injuring the�mseives bp maving objects tne patients may strike away f�om them and cusi�ic�ning the head with a piil�w or blanket. D� nat piac� anything in the patient's mauth. c. Dacument the severity and duration of seizures, duration of resting period bet�veen �eizures and possible precipita�ing causes. d_ Su�p4rt patients respirata�ns if n�c�ss�rp. • • 14 3- Poisonings A p�isan i� an element ar produet that causes harm t�o any cell when ing�st�d, inhaled, inject�ed, or at�,sorbed. a _ Signs and Symptams Signs of poison ingestion vary aecording to the substance involved. The follQwing are some comman signs: C�nstrictidn or dilation ot the pupils, altered c�nsciau�ne�s, egcessive sweating or salieation, extremely slow or fast pulse rate nausea or �amiting diarrh�a, abc�ominal pain, irreguiar respiration, cougi�ing, �is�inctive adar �degending on substance), burns around �nd in the mduth {if corrc3siee substance �s ir�gested}, convulsions, and unconsciousn�ss. b. Fcrisonirtg Management i} If airborne, move the patient tb a well ventilated area. 2 i Perform Fatient assessment and document finc�irigs. 3) �dmiruster o�gen and support respirations as n�eded. " 4�� see�tain the fallowing information: a� �hat was it b ) Haw much c) Ho�v long ago did it happen 5) Coll�ct a11 medicine viais �IiILD BiRT$ �tarinal Ue2��erp 1_ Perform p�tient as�essment on mather and document iindings. 2. Assist tT�e babp as it is delivered. Never att�mpt t,� pull tt�� baby out. 3. Suc�ion the mouth and nase with a sma11 bulb suction. Ins�rt the bulb squeezed and then r�iease the bulb ta suctian �ppropriatelp. Suctivtung map begin as soon as the head is �elivered. 4_ Do nat cut the umbiliGal card. � 5_ Perfarm patient assessment on the babp. . . 15 � 6• A�'se� a�ld d�cu�rnenG APGAR score A app�arance (��lor) F pulse (shoul3 be greatsr than 100 BPM� G grimace {refiex irritabiiity) A activity (muscle t�one) R respiratic�ns 7. �ra� the baby t�o preserve t�y heat. �_ Advise an Advance Lif� Support unit oi babp's conditian. 9. D� NOT raise the baby above the mother as this will cause t�ia baby's bl�od t�a flow back t,award th� placenta and may causa shock 14_ If t..�e baby does not breathe spontaneousl�, or if it is limp and it's d PG a R s�ofe is lo�, resuscitation should be instituted. Frolapsed Umbili�al Card 1. Periorrn patient assessment on mother and d�um�nt findings. 2_ Pl��e mother in supin� position with hips elevat�d. 3_ Administer �xpgen tao the moth�r �t 4-5 lpm �ia nasal �a�nnul�. 4. �ith a st�rile gloved hand, gently push th� baby up the vagina several inches to relieve the pre�sure on the umbilical cord. This positi4n must be maintained. �. �lrap exposed umbilicai �ofd �ith s#�erile dressing m�istened with sGerile Narmal Saline. 6. Ch�k and document pulse in umbilic.al cord. 7_ This is a medical emergency. Rapid transgort is essential for a positive out�ome. Bree�ch Birth i. Perform patient a�ment on mother and document findings. 2. Administer oxyge� tao the mott7er at 8- 12 lpm via non- rebreather mask. 3. If the baby's head is not delivered in three minutes, action must be taken tA prevent suffocation. �ith a st�eriie g�ooe hand, farm a"�l" wit12 fingers on both sid�� of the baby's nose and gush the vaginal �nrall awaq from the baby's face ur�til the head is delivered. NEVER attempt ta pu11 the babp out of the vagina. �. This is a medical emergencp. R�pid transport is essential far � a �o�i�ive outc�n�e. , . i� • Third Trimester Bleeding 1_ Periorrn patient assessment an mother and document findings. �. Administer oxygen tA mother at 8- 12 lpm via non- rebreather mask. �. Piace patient an left side to prevent hypatension. 4�_ Ide�er attaempt taa egamine the pataent internall�. EHVIRONMENTAL EI�iERGENCIES Heat Em�rgencies 1_ Perform patient a�,.,sment and d�ument findings. 2. I�love the patient to a shaded, well ventilat$d area. 3. �,drninist�r o�rgen at 4- b lpm �ia nasai c�nnula. 4�. Cool tx�e patient rapidly by �ppi�ing large amounts oi tepid w~ater. Do not appiy ice cover t�he patient with v+�et t�owels ar �iv� th� Fatient cold liqui� t� drink as all these pr�edures wili hamper th� body `s coaling process. Cold Emergencie� 1. Perform pati�nt ass�ssment and docum�ent findings. 2. Remo�� pataent from cald eneironment. 3. Remove any articies oi damp clothing fram the patie�nt. �_ C4ver the patient with blankets. 5. ��tmini�ter �xyg�n at 4- 61pm eia nasal cannula. 0 W�t.�r Related A�cidents 1. Sus�ect a cervical Qr head injury oa any patient in a water rel�ted �ecident. 2_ Control cervical s�ine and �erform pati�nL assessment and ddcument findings. � 3_ Begin resuscita�ive measures e�en if patient v�ras submerged far a ldng }�riod. Fuity immobiiize pati�nt as soon as passible. Snake and Insect Bites 1. Ferform patient as�essment and document findings. 2. Assess for necrasis in the affect�ed area. 3. Remove an� constricting clothing ar je�relry c�n the affect�d extremity. �_ Ir�mobilize t,he extremitp and keep ttle extxemity lo�er ttlan th� 1��1 of tYie heart. Do not a�pi� fce tA the wound. �� 5. Hss�ss for signs and sympGoms of anaphylactic shock i.e., a. It,�hing an� burning of the skin with fiushing, especiaily araund the face and chest b. S�eliing of the face and tAngue c. �Teak, rapid pulse d_ Low Blaod Pressure e. RestlQSSn�ss f _ Difficulty breathing g RespiratAr� wheezes 6. Try tA �btain th�e folldwing inf�rmataon: a_ The type of snake ar ins�ct. �If gossible, collect dead snake o� insect for identificationl. b_ V�lherQ did it bit� the patient and haw i�ng aga. Animal Bites � 1. Feriarm patient asse�sment and docu�nent findings. 2. Stop bleeding and cover wounds v�ith st�erile dressings. 3. A�minist,�r dxyg�n if nece�sary. 4_ Try t,� obtain t,he follvwing information: a. The type of animal b. �There �id it bite the pat�ent a�d how long ago 5. I�otify Animal Regulatian . � 1� � � 1� � Thitd TrimesGet Bleeding 1_ P�rf�rm patient asse5sment Qn moth�r and docum�nt iindings. 2_ Adn�inister oxygen to mdther at $- 12 lpm via non- rebreather mask. 3_ Place patient on left side t�a prevent hppotension. 4_ Idever attempt ta examine txi� pataent internally. ENVIROAMENZAL E�IERGENCIES Iie�t Emerg�ncies 1_ Perform patient asse�ment and document findings. 2. hdove the patient t�a a shaded, ��li ventilat�d area. 3_ Ac�mi�ister oxygen at 4-� ipm via n�sai cannula. �. C�oi the patient rapidly by applying large amounts oi Gepid �.t�er. Do not apply ice, cover the patient wit�h v�t tAV�rels, or �iv� the patient coid li�uid �o drink as all these proce�ures w�iii hamper the body's caoling process. Cald Emerg�nci�s i_ Perform ga�ient asse�sment and document findings. 2. Rerriove p�tient fram colcl environrnent. 3_ Remove any articles o1 damp clbthing from the patient. �€_ Gover the patient with blankets. �. ��ministaer �xygen at 4- 6 lpm aia nasal �annula. e W�t�r gelat�d Accidents � 1. Su�pect a cervical or head inJury on any patient in a�rrater relat.ed accident. 2_ Control ce�vieal spine and �erform Fatient a�sessment and dacument findings. 3_ Begin resuscitative measures ev�n if pa�i�nt w�s submerged fc�r a l�ng �riod. Fuliy immobiiize patient as soon as �ssibie. Snake and Insect Bites 1_ Perforrn g�tient assessment and d�umen� fir�dings. 2. Assess for necrasis in the �ffect�ed area. 3_ Remove any can�tricting clathing or je�,relry on the affected extr�mity- �. Immobiiize the extremity and keep the extremity lo�rer than the le�t�l of the heart. Da not ap�ly ice t� the wound. �� MEMORANDUM TO: Thc�mas i�. Bradford, Villaqe Manager F�'OM: i=ar1 R, f?c�deric��:, i=hief DAT� : i ��-s �2-'31 SUE�JEC�T: Palm Beach ��aunty F F:escue Training �rc�gram. Basi�_ F'c�l ice Fire Suppressi�_�n: While I have n�+t yet re��eived ��ourse �utline fram i=hief Murphy, the �_� +LlYS2 will �_c�ntain Basi�� Fire S�_ien�_elRehavi��r; in�_ident �=��mmand; Chemi�=a1 Fire Ey:tinquisher Use �nd Esasic Fire Department Equipment. The �_��urse will be appr��r,imately Eiqht c:8:> hc�urs in lenqth anr� begin t he 1 ast weeL:: in May. We wi 1 1 have Two r epet i t i ve c 1 asses, Fc�ur c:4:� h� �urs ea�_h for Tw� � week:s. The tc�tai c� �st is Overt ime ��nly and wil i be �bc�ut �1, 7i�C�. GG t� � 9�1 .8��c:►. UC►. Medi�al First F'esp��nder i=��urse: Atta�=hed is an ��utl ine of the cc�urse that will taE;e appror;imately Thirty (3��j ht�urs ��f traininq. We have tentatively s�_heduled the course ta beqin in June, with Tw� repetitive ��lasses per wee4::. The t��tal �_ost fc�r the Thirty h�_�urs sh�uld be ar��und �6,��c'►.i>c,i in overtime. MEMO�A�DUM Tt7; Th��mas ��. L�radfc�rd, Village M�n�ger FROM; �.:arl �'. f?� ��hief DATE: �:�`�--c:?'.��-'�1 SUE�JEGT: F'a1m �ea�h C:�.��nty Fire �:e��ue Training F'r��gr�m. �a�i�_ �'r_�1 ice Fire �uppres�i��na Whi1e I have n��t yet r�e+�eived ��urse �:,utl ine frc�m ��hief Murphy, the r_�_�urs� wil l��cmtain �a�i�� irp 5� ien�;.elL�ehavi�.�r; In�_ ident C:�_�mmand; �=:hemi��1 Fire E:�tinq��i�her Use �nd �S�si�_ Fire U�p�rtment Equipment. The �_�M��.�rse will be apprc��;im�tely Eight CB:� h��.�rs in lenQth �nci beqin the l�st wee�; in h1ay. We will tiave Twc� repetitive cla�ses, ��ur �:�:a hr_�urs ear�h f�r Twc� week:s. The t�:�t�l c��st is i7ver�time �_�nly �nd will be �bc�ut �1, 7�.rC�. C�Cr t�c� �1 . 8i�c=y. C�C�. Mediral �irst �:espr_�nder +�:L'�urse: Attached is �n c�utl ine ��f the �cc�urse that wi11 taFte appr�c,�;im�tely Thirty t3�:y:� h�.��irs �af training. We have tentatively s�_heduled the �c+�.�rse t�� begin in J�ine, with l"wu repetitive tl�s�es per we�F::. The t�_�tal �c�st fi��r the Thirty h��G�rs �hc,uld be �r�w��.�nd �E,,Ss:�t��.�:yi.� in �vert ime. " ! �' r ! - �� MEMORANDUM �� J �� TO: T. Bradford, Village Manager s y�� '�`�c�, <..3 J � �v=,�° �V ,.� FROM: C. Roderick, Chief of Police B <� �`z o,� ;. ,� 5? DATE: 06-04-91 li �--,-,-�� , ` . �� SUBJECT: First Responder & Fire Suppression training within current Budget. Having projected the current FISCAL budget to the end of the year with curbed spending, we are able to extract approximately $17,000.00. From Admin. Operations = $6,210.00 From Commo. Operations = $383.00 From Invst. Operations = $3,581.00 From Patrol Operations = $7,050.00 $17,224.00 From these funds, $4,025.00 are needed to cover the extra expense of the CAD/Records Management System that went over budget (to Commo. Capital Account). This leaves $13,199.00. From this, i will need about $2,000.00 put in the Patrol Overtime just to cover the Four more months that are high vacation periods. This leaves $11,199.00. Of this, $8,500 should cover the training time which would also be directed to Patrol Overtime. The remaining $2,699.00 I would like placed in the Patrol Misc. account to cover F.O.P. contract physicals and any other type emergency that may arise. If this is agreeable, I will get with Mr Kascaveles for the necessary paperwork to make the changes ' Boar,d of County Commissioners • Carol J. Elmquist, Chairman Fire-Rescue Administrator Karen T. Marcus, Vice Chair Chief Herman W. Brice Carol A. Roberts Ron Howard y � B �� Carole Phillips n a x �� U N` � � L�R�� ;� s Tg��FOF ��9 M� 10, 1991 � 4��STq y �'Iq }' � �i�� o �"91�. �0 Carl Rodrick � �,�,��;,;;':�$ � Chief of Poiice �'� � ��'�� J�; Villsge of Tequ�sto ��' � --,_.-----, , P.O. Box 32�3 ��" � f � `'' Tequesta Fl. 33�69-02�3 Dear Chief Rodrick: Atteched is a course autline far Fire Suppressian for Law Enforcement Officers. Please note th�t the prnposed caurse is divided into four (4) mein sub jects. We have discussed tt�e tirst three sub jects listed. The tast toptc listed, tncldent Cor�mand System, was suggested tor lnclusion by the Training 0lvision. These tapics can be fuliy covered during eight (8) hours ot training. i believe the course outlined provides a solid background in firefighting for police offic8rs, wtrile keeping yaur overtfine concerns to a minimum. The Caunty is not however, inflexible in regard to course �ength or cantent. in the event the Village desires additional or ditterent course materiat, we wi11 be t�iy happ�y to make chsnges �ccordingl� Upon s�uxessfut c:ompletion of the course, officers witt recetve certitic�tes ot compt�tian tr�n Paim Beach County Fire Rescue. The or�ginal caurse sched�le discuss�d, twa {23 four {4} hvur sessions, taught twice �total 16 hours) �s scc�pt�ile to the County Additianal ciasses m$y be scheduted if eny affic�rs r�ed to make-up ell or part of the ariginai ciass. i iook t�� to ��z�� yy�th yvu an this topic as soan as possibte. I remain as always s�aii�6le ta you for $ny questivns yau may have. / Thomas F_ Battdllort �riiet �0 �th Military Trail, Suite 101 . West Palm Beach, FL 3341 S.(407) 683-0010 La�v Enforcement-FlreflghtIng 1 st Responder CDURSE PUBPOSB: ro provide Iaw enforcement offlcers �vith the basic information needed to operaLe appropriately on fire scenes within their role as potential Pirst responders. This course will emphasize saf'ety and the interaction of taw enfacement officers with Palm Beach County Fire Rescue personnel on emergency scenes. CO�� OUTLINE Section I - FIRE SCIENCE Purpose - To provide the student with a basic understanding of hvw fires start, how they burn and how they are eZtinguished. A - Definitiona - B - Stages of Fire - 1 - Incipient 2 - Free Burning 3 - Smoldering C - Fire Tetrahedron 1 - Fuel 2 - Aeat 3 - Oaygen 4 - Che mical Reaction D - E�tinguishment Thea�y 1 - Temperature Reduction 2 - Fuel Re moval 3 - 4rySen Re moval 4 - Chemical Flame InhibiLion E - Classification of Fires 1- Class A- Comm�n Combustibles 2- Class B- Flammable Liquids 3- Class C- En�rgized Electrical Equipment 4- Class D- Flammable Metals Section II - FORTABLE E%TINGUISHERS Furaose - To provide the student with a basic understanding of portable ertinguishers, types available and their operatioa. A - Types 1 - Pressuce Water 2 - Dry Chemical 3 - Carbon Diozide 4 - Dcy Powder B - Ratings � 1 - Class A - 1-40 Z- Class B- 1- 640 3 - Class C - Non-Gonductive C - Maintenance of Eztinguishers 1 - Inspections 2 - Tagging D- Operation of Eatuiguishers - P-A-S-S 1 - Pull 2 - Aim 3 - Squeeze 4 - Sweep Section III - FIRB SCBNB SAFBTY Puroose - To provide the student with a basic understanding of incident priorities and the particular hazards presented by specific fire situations. A - Incident Priorities - RECEO B - Human Behavior C - Products of Combustion D - Struct�re Fire 1 - Flashover 2 - Backdraft 3 - Stove-top fires 4 - Electrical Fires 5 - Evacuation E - Vehicle Fires F - Dumpster Fires G - Bcush Fires H - Flammable Liquid Fires 1 - HazMat Section I V- INCIDBNl' COMMAND SYSTBI� Purpose - To provide the student with a basic understanding of the Modei Incident Command System as utiliZed by Pa1m Beach County Fire Rescue. A - History/Uevelopmeat B - Definitions C - Basic Strcrcture Review D - Emergency Scene �ganization