Overview of EMS Resuscitation During Contamination While Wearing PPE
In the face of evolving diseases, unexpected industrial accidents, and potential threats from domestic and foreign terror activities, emergency services must be prepared to provide safe and efficient first aid procedures whilst using protective gear. These safeguards, known as personal protective equipment (PPE), could be critical in events involving chemical, biological, radiological, or nuclear threats (CBRN), which are often made worse by explosions and injury (ET). The primary focus of emergency treatment is the basic life-supporting processes: managing the airway, breathing, and circulation (ABC). In a contamination event, treatment priority also considrs applicable antidotes (AABCs). The most common guidelines for protective equipment used are the U.S. Occupational Safety and Health Administration (OSHA) PPE protection levels, named A, B, C, and D.
Instances of CBRN threats are not uncommon, as history has proven. Deadly viruses like Ebola, severe acute respiratory syndrome (SARS), and Middle Eastern respiratory syndrome (MERS) have made the use of PPE crucial for medical teams, in order to protect against infection from airborne or physical contact. In places like the U.S., the potential for accidental exposure to hazardous materials can occur through the industrial production, transportation, and storage of chemicals. For example, in April 2013, an explosion at the Adair Grain Fertilizer Company in Texas involving large amounts of ammonium nitrate killed 15 people and affected 160 others.
There’s also the risk from foreign terrorist threats, like the sarin gas attack in Damascus, Syria in 2013, where 36 people had to be evacuated by United Nations emergency personnel. Even within countries, threats can occur – like in 1984 when a cult in Oregon caused 751 casualties by releasing a bacteria called Salmonella typhimurium. These historical situations show that there are ongoing global CBRN and ET threats. All this underscores the need for properly trained emergency teams.
Why do People Need EMS Resuscitation During Contamination While Wearing PPE
In some emergency situations, such as known attacks involving chemicals, biological agents, radioactive substances, or other hazardous materials, there’s a need for immediate medical help, called resuscitation. This is also true for situations where the type of attack or threat is unknown. Personal Protective Equipment (PPE) is used during such resuscitations to protect both the victim and the healthcare provider from being further harmed by these hazardous substances.
When a Person Should Avoid EMS Resuscitation During Contamination While Wearing PPE
There are certain reasons why people shouldn’t be involved in resuscitation (life-saving actions to restart heart or breathing). One of these can be the difficulty in wearing Personal Protective Equipment (PPE) which is gear designed to protect health workers from infections, and performing resuscitation while wearing it. People who may have been exposed to harmful substances and are thus ‘contaminated’ should also not be involved in the rescue and resuscitation process.
People with a past history of uncontrollable fear in enclosed spaces, a condition called claustrophobia, and severe reaction to high temperatures known as heat stroke, should not be chosen to participate especially if there are other healthy and stronger team members available to do the task.
Equipment used for EMS Resuscitation During Contamination While Wearing PPE
In cases of emergencies, our doctors and nurses need to wear a special type of gear known as Personal Protective Equipment (PPE). This is to ensure their safety while helping people who might be injured in areas that could be harmful because of substances known as hazardous materials (shortened to HAZMAT). The type of PPE they wear depends on how risky the situation is. More advanced PPE is used for more risking situations, although this can also increase the level of stress for the person wearing it. So, it is critical to pick the right PPE for the right task. These safety gears follow rules set by a group called the United States Occupational Safety and Health Administration, or OSHA for short.
The first level, known as Level A, offers the strongest protection. It is mostly used for situations where the threat isn’t known. Level A PPE protects the user against harmful liquids, gases, and vapors. This includes a face mask that maintains a high-pressure environment (positive pressure) and is attached to a breathing device (self-contained breathing apparatus or SCBA). It also includes suits that completely cover the individual, resistant gloves, and special boots.
Level B offers protection against harmful liquids, and gases, but not vapors. It includes a positive-pressure face mask coupled with a breathing device (SCBA), a hood, resistant clothing, gloves, boots, boot covers, and a shield to cover the face.
Level C is often used in healthcare facilities. It includes a mask that covers all or half of the face, a device that purifies air before it’s inhaled (air-purifying respirator), a special hood, resistant clothing, gloves, boots, and a face shield.
The last level, Level D, offers the least protection and is usually composed of a work uniform, gloves, boots, safety glasses, and face shield.
These various levels of PPE provide protection against a wide range of hazards when used correctly.
Who is needed to perform EMS Resuscitation During Contamination While Wearing PPE?
Emergency medical services (EMS) are made up of various professionals who could be emergency medical technicians, paramedics, firefighters, military professionals, and doctors. These individuals must often be fit, willing, and capable to participate in this line of work. Certain factors such as claustrophobia (fear of small spaces), sensitivity to heat, or pregnancy might restrict somebody from being part of the EMS team. This team needs to clearly define roles and who’s in charge before they start practicing. They also need to have a shared purpose because once they put on their Protective Personal Equipment (PPE, the clothing and devices used to keep themselves safe), it can become harder to communicate properly.
Preparing for EMS Resuscitation During Contamination While Wearing PPE
Training for situations dealing with chemical, biological, radiological, nuclear and explosive threats (CBRN+ET) can provide confidence to those who are selected to help people in contaminated environments. Current research shows that training that focuses on managing the consequences of the threat and practicing large-scale emergency response exercises can increase success.
How is EMS Resuscitation During Contamination While Wearing PPE performed
Emergency Medical Services (EMS) personnel often respond to victims of emergencies like a chemical, biological, radiological, nuclear, or explosive threat (CBRN+ET) and get them to medical facilities quickly for decontamination and treatment. But now, there’s some thought given to providing immediate on-site help to victims as it might increase their chances of survival and lessen their injury time. The idea is to conduct treatment procedures for large injuries, managing airways and blood circulation, respiratory protection and giving oxygen, all while they are still at the scene of the accident. This method has shown success in military situations though it does add an extra layer of complexity, especially if the victim’s heart stops.
When a victim is unconscious, their vital health statistics like blood pressure and heart rate have to be evaluated. But due to the protective clothing worn by the EMS – which often blocks vision and hampers hand movements – this can be a challenge. To overcome this, it has been suggested to use a device called a cardiac defibrillator that monitors heart activity. It can also help when the EMS can’t feel the victim’s pulse because of the gloves they’re wearing and guide them to provide electric shocks if the victim’s heart stops.
Providing chest compressions – crucial during a heart attack – is physically tough. When performed while wearing thick protective suits, the task can be more challenging leading to poorer quality of CPR. There’s also the issue of keeping track of the time of compression cycles, getting good location on the chest for compressions, and other complexities due to decreased sight and hearing because of the protective gear. But training can help improve performance.
Finally, managing a victim’s airways is pivotal to ensure they get enough oxygen. Research has shown that using a basic airway device known as a laryngeal mask airway (LMA) is the easiest to work with as it has a high success rate and is versatile. It’s also easier to use when the patient’s position isn’t ideal. Once the patient can be moved and placed properly, the EMS can then switch to a more advanced technique known as endotracheal intubation that is considered the best for managing airways. But as it requires special measures, they usually perform it once the patient is positioned correctly on the stretcher. Overall, while it sounds complex, these measures can significantly increase survival rates for victims if implemented correctly.
Possible Complications of EMS Resuscitation During Contamination While Wearing PPE
Every team member who is required to wear Personal Protective Equipment (PPE), like masks or gloves, has a chance of getting exposed to contamination. This could be due to unexpected situations or mistakes in the system. The same risks are present when applying emergency medical procedures. To give an example, one such procedure is endotracheal intubation – it’s when a tube is inserted into the windpipe to help a person breathe. If done incorrectly, it can result in the tube being inserted into the food pipe instead, tearing in the windpipe, food or drink entering the lungs, or the tube only entering one section of the lungs.
Those being rescued and the rescuers themselves might experience dehydration or excessive fatigue due to the effort needed to escape from a dangerous environment. This strain can increase because of the physical effort required to carry and use the PPE, which is necessary for safety.
What Else Should I Know About EMS Resuscitation During Contamination While Wearing PPE?
In emergency situations, just as with trauma cases, every second matters when treating a patient – this is also true when medical professionals are wearing personal protective equipment (PPE). The medical team must diagnose and treat the patient quickly, while also planning for their safe movement or removal from the scene.
Doctors rely on recognizing patterns of symptoms to make effective treatment plans. For example, they can identify a condition called cholinergic toxicity by noticing a combination of symptoms such as heightened vital signs, wide pupils, and dry skin.
Triage, or deciding who gets treated first, is typically done by prioritizing those who are most sick but also have a good chance of recovery. In the same way, care must be given based on each patient’s multiple needs. It’s about addressing what’s immediately life-threatening before doing a full clean-up and detailed treatment.
Their clinical decisions should focus on quick action, reducing overall exposure to hazards, and putting as much distance as possible between the threat and the people affected.