Training At SLVFD: Medical Update

4 March 2004

Training is not just a single event, or even a series of events, at Sugarloaf Fire Rescue. Rather, it is a continuous process that goes on every week of every month of every year. The types and sources of training are many and varied. While much of the training is offered either at station 10 or one of the other departments in the Lower Keys, some is at Monroe County's Joe London Fire Training Facility north of Marathon on Crawl Key, at the Florida State Fire College in Ocala, or elsewhere. While some training is sponsored by Monroe County Fire Rescue or offered by Florida Keys Community College, one of the mainstays of SLVFD training is the in-house training session every Thursday evening. SLVFD member Diana Nelson reports on a recent of these in-house training sessions:

One Thursday training meeting each month is devoted to medical training. Recently, we reviewed what to do when arriving at a trauma scene. We were reminded by our instructor, EMT-B Brent Nelson, about the essentials of performing a rapid trauma assessment. Although we as firefighters may not have to perform the rapid trauma assessment very often, it's an important thing for everyone to be familiar with, especially at a volunteer station where so many respond in their personal vehicles.

There is always a chance that the firefighter may arrive on scene before the County Paramedic and ambulance. In that situation, the firefighter can be a great help until and even after the ambulance and paramedic arrive. The firefighter should be able to deal with any immediately life-threatening conditions and also be able to inform the paramedic of the situation and the patient's condition. This helps to speed up the process of getting the patient much needed medical care. The prepared firefighter will also be able to better perform immediate and possibly life saving steps until the paramedic can reach the scene and begin care.

Brent made sure everyone was reminded of the importance of wearing their personal protective equipment (PPE) and making sure the scene was safe before approaching. We discussed the steps that should be taken to ensure that the patient's airway, breathing, and circulation were adequate. Since we had just recently completed our CPR re-certification class, we were all very familiar with what to do if a patient wasn't breathing or didn't have a pulse. We reviewed the acronym "DCAP-BTLS", which stands for deformities, contusions, abrasions, punctures and penetrations, burns, tenderness, lacerations, and swelling, and summariezes the conditions to be watchful for during an initial assessment of the patient Brent also reminded us to keep an eye out for the mechanism of injury ("MOI") that caused the injuries because it will help us consider injuries that may be very serious but hard to detect, especially in the first few minutes after an injury has occurred.

One of the very first things that must be done when a significant injury has occurred is to make certain that any injuries to the spinal column (which includes the neck) are not made worse by the patient moving. If there has been injury to or near the spinal cord, any motion at all may cause extensive and permanent injury. It is very important that the patient remain calm and still until elvaluated. Thus, we practiced "holding c-spine", putting the c-collar on a patient (shown in the top photo above), and getting the patient secured to a rigid stretcher, which is called a backboard. These devices and procedures help keep the patient's spine aligned and stable so that the risk of permanent injury is reduced while being moved and transported. We also practiced the "standing take-down" (shown in the above photo), which is a procedure where the responders use a backboard to lower a standing patient down to the ground. It was a good night of review since many of our calls involve motor vehicle accidents where there is a high probability of trauma.