McHenry Western Lake County EMS System Mandatory CE for Paramedics, EMT-B and PHRN s Active Shooter Bag Online CE 2016 This Continuing Education will look at the new Active Shooter Bag contents. Remember, the patient still needs to be assessed using START and the kits are specialized equipment to concentrate on Bleeding Control. Once the patient is moved to a Safer location, Primary and Secondary Surveys will be done. The Equipment What is in the Active Shooter Bag? Each department will be issued an Active shooter Bag. The Red bags signify ALS equipment and the Blue bags signify BLS equipment. Each ALS kit should contain the following: Maxpedition Bag Trauma Scissors Each BLS kit should contain the following: Maxpedition Bag Trauma Scissors Sharpie Markers (2) Sharpie Markers (2) Rescue Blanket (4) Rescue Blanket (4) HyFin Chest Seal (4) HyFin Chest Seal (4) Celox Rapid gauze (4) Celox Rapid gauze (4) CAT II Tourniquet (4) CAT II Tourniquet (4) Olaes Bandage (4) Olaes Bandage (4) Decompression Needles (4) 1
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Each compartment is set up in the following fashion: 3
The following are links to videos showing how each of the items that are specific to the bag, can be used. Remember, your primary goal is quick control of bleeding and quick airway interventions. There will be other crews that will continue treatment. 4
HyFin Vent: https://www.youtube.com/watch?v=lhssztkqnaa (a good video review of a pneumothorax) https://www.youtube.com/watch?v=qvqkucue1xg (the HyFin Vent package being opened) Celox Rapid gauze: Celox Rapid gauze is treated with Chito-R TM (mix of Celox Chitosan granules and bio adhesive). This allows the dressing to hold in place 50 times stronger than previous dressings. The dressing is to be applied directly into the wound and used to fill the wound space. Direct pressure should stop bleeding in one minute. https://www.youtube.com/watch?v=vfktsccsafq 5
Olaes Modular Bandage: The Olaes Modular bandage is a multi-purpose gauze that can be used on many different types of critical wounds. The following video shows different applications for life threatening bleeding. All of these applications can be done quickly to help stabilize your patient. https://www.youtube.com/watch?v=y4xjx1poivq (There is no sound) https://www.youtube.com/watch?v=nd3oj6e5hri View 1:45-11:30 and 19:35-24:10 CAT Tourniquet: A tourniquet is used on an arm or leg to stop bleeding from a survivable wound. The Combat Application Tourniquet (C-A-T) is a small and lightweight one-handed (i.e., the victim can self-apply the tourniquet) tourniquet that completely occludes arterial blood flow in a limb. To apply this tourniquet, it is ideally placed on the bare arm or leg a few inches above the site of bleeding (between the bleeding and the heart). 6
Next, one pulls the self-adhering band to tightness and securely fastens it back on itself. Then, the windlass rod is twisted until bleeding has stopped and there is no longer a palpable pulse. The windlass rod is then locked in place with the windlass clip. Then, the self-adhering band is adhered over the windlass rod. To complete the process, everything is secured by grasping the windlass strap and pulling it tightly and then fastening it to the opposite hook on the windlass clip. Obviously, it is important to practice with the device prior to attempting to use it in a critical life-threatening situation. There are a few tips for tourniquet users. One may need a second tourniquet between the first tourniquet and the heart if bleeding is not controlled with the first tourniquet. One should not place a tourniquet directly over a knee or elbow, because it may not be effective. One should not place a tourniquet directly over a pocket that contains bulky items. Tighten the tourniquet enough to eliminate any arterial pulsation beyond the tourniquet. Whenever a tourniquet is used, it is important to expose and clearly mark all tourniquet sites with the time of tourniquet application with an indelible market. This is important because it will help medical personnel understand the situation with the treated limb and perhaps estimate the chance of survival for tissue that has been deprived of blood flow. If a tourniquet is applied, understand that loosening it periodically to allow circulation to return to the limb might well cause unacceptable additional blood loss, so this should not be done. Per SOPs, do not loosen or remove the tourniquet. https://www.youtube.com/watch?v=gufwxaljyii 7
A review of START TRIAGE 8
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McHenry Western Lake County EMS System Mandatory CE for Paramedics, EMT-B and PHRN s Active shooter Bag Online CE 2016 NAME: DEPT. DATE: 1. The CAT Tourniquet should be removed at what point? a. Once a hemostatic agent has been applied b. Pre-hospital care does not remove the tourniquet c. When Fentanyl won t control the pain d. When ordered by the trauma surgeon 2. Upon contact with a patient, the response team we do a full Primary and Secondary survey? a. True b. False 3. When using Celox Rapid gauze, how long is direct pressure applied to the wound? a. 5 minutes b. 10 seconds c. until bleeding stops d. 1 minute 4. The only item that the BLS Bag does not have is what? a. Chest decompression needle b. AED c. HyFin Chest Seal d. Olaes Modular Bandage 5. Per START Triage, how long should we do CPR? a. 5 cycles b. 60 compressions c. we don t start CPR d. Until the team leader tells you to move on 6. Before placing the HyFin Vent Chest Seal, the provider should? a. Clean site with alcohol b. Check the depth of the wound with a sterile catheter c. Shave off chest hair with a razor d. Wipe away excess blood 13
7. How should the HyFin Seal be placed? a. It does not matter how it is placed b. With the center of the seal inferior to the wound c. With the center of the seal posterior to the wound d. With the center of the seal over the wound 8. Where should the cup of the Olaes bandage be placed? a. Medial to the wound b. Remove the cup before you apply the dressing c. Directly over the wound d. Inferior to the wound 9. What information needs to be written on the CAT Tourniquet after application? a. Patient blood type b. Initials of who applied tourniquet c. Location of tourniquet d. Time that tourniquet was applied 10. What is the minimum number of people needed to apply a tourniquet? a. Patient self administered b. 2 EMTs c. 2 Police Officers d. Trauma Surgeon THIS QUIZ IS MANDATORY FOR ALL EMT-P, EMT-B, AND PHRN S WITHIN THE MCHENRY WESTERN LAKE COUNTY EMS SYSTEM. IT IS DUE IN THE EMS OFFICE NO LATER THAN 3/31/17 TO REMAIN IN GOOD STANDING. PLEASE FAX THIS QUIZ TO 815/206-3455, THEN CALL CINDY TABERT AT 815/334-3174 TO CONFIRM THAT SHE RECEIVED IT. THANK YOU. 14