EMS World

AUG 2011

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 25 of 71

CASE REVIEW Learning Point Family reunifi cation can be an important element of public safety response. than 10% of the OC active ingredient for standard pepper sprays, 5% in most animal-repellent sprays, and up to 20% in some wildland sprays. All concen- trations are effective in incapacitating animals and humans when a spray is directed to the face. Pepper “hotness” is measured on the Scoville scale. Scoville heat units (SHUs) corre- late to the amount of capsaicin present in a pepper or pepper product. An SHU value of 1 million units will produce temporary debil- itating results and stop an attacker. Many sprays designed for criminal deterrence also contain a small amount of fl uorescent dye. This is invis- ible to the naked eye, but an ultravi- olet light will cause it to fl uoresce on exposed skin. This is used to identify an attacker. Case Discussion The Attack Crew participated in the patient triage and gathering and reporting of information vital to estab- lishing the cause of this incident. They reduced parental concern by recognizing family needs and, where possible, allowing family members to assist in calming patients and sharing information. It is important in pepper spray incidents for hazardous-materials teams to provide rapid scene evalu- ation and chemical identifi cation, though in many incidents it’s diffi cult to identify the exact chemical used. In this incident, rapid detective work identifi ed the chemical, source and area of likely exposure. This allowed symptomatic victims and others to be managed appropriately without unnec- essary transports or decontaminations. The Attack One Crew knew hazardous-materials exposures often result in multiple-casualty incidents, and important information may come from transporting the most symptomatic patients to hospitals. In this incident, there was an effi cient exchange of information between the scene and the ED. This is facilitated if one knowledgeable EMS member from the transporting crew remains on a radio at the hospital. That individual would be aware of who was working the scene, which party had what informa- tion, and what questions needed to be answered at any given time. In other incidents the ED can do rapid testing for toxins, and in some cases provide information back to the fi eld that results in patients being treated there and not removed to hospitals. Alter- natively, it may discover a substance is unusually toxic, more victims need to be transported to hospitals, and a few EDs may even have to be taken offl ine to handle incoming patients and provide further decontamination. The Attack One crew also chose to use the regional poison control center for coordination of toxicology infor- mation. These facilities can coordi- nate information exchange between hospitals and out to the community when doctors’ offi ces, clinics and other medical facilities may be seeing the aftermath of a large chemical release. In potential hazmat incidents involving children, victims require evaluation and sometimes care at the scene, then a coordinated approach to transportation and communication with parents. When possible, rescuers should allow parents, teachers and guardians to assist in calming students and facilitating management of those acutely injured or ill. SUCTION-EASY™ Manual Oral Suction System Simple, safe and effective system for oral suction! • Ready to use - Manual unit does not require batteries or electricity. • Compact - Convenient storage in special duty bags, airway bags, pockets and more. • Easy to use - No detailed training or setup time required. • Disposable - Safe with no clean up and no risk of cross-contamination. Call: 614.853.1504 Visit us at www.eminnovations.com to learn more and view a listing of our distributor partners. Enter to win a FREE Suction-Easy unit by emailing us at info@eminnovations.com. (10 units will be given away each month through December) For More Information Circle 25 on Reader Service Card 26 AUGUST 2011 | EMSWORLD.com Learning the Incident Management System lets school offi cials function effectively with emergency responders in addressing students’ needs. School systems can provide PIOs and commu- nication centers for contacting parents and reunifying families. This can be useful for emergency personnel, as schools often have available phone systems and personnel to make calls, as well as parent and guardian names, and can defi nitively tell worried parents their children’s status. James J. Augustine, MD, FACEP, is medical advisor for Washington Township Fire Department in the Dayton, OH, area. He is director of clinical operations at EMP Man- agement in Canton, OH, a clinical associate profes- sor in the Department of Emergency Medicine at Wright State University in Dayton, and a member of EMS World Magazine’s editorial advisory board. Contact him at jaugustine@emp.com.

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