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Jodhpur Park, Kolkata

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IMPACT OF ROAD ACCIDENTS
• Road traffic accidents kill more than 1.25
million every year across the world
• It is the number 1 cause of death among 15-29
year olds
• 20-50 million are injured in non-fatal crashes
• Disability and long term health expenses
become a big burden for the survivors

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WHAT IS EMERGENCY RESPONSE

The immediate care given to a

person who had an accident or has
become ill or has been injured

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WHY IS EMERGENCY RESPONSE IMPORTANT
• Often referred to as Golden Hour – The first hour after
injury is most critical for the survival of the victim
• Quick response by emergency medical services to vehicle
crashes is an important way to reduce the severity of
injuries.
• Factors for survival
• Efficient emergency notification
• Fast transport of qualified medical personnel
• Correct diagnosis at the scene
• Prompt transport to the point of treatment

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AIM OF EMERGENCY RESPONSE

Preserve Life

3 Ps Prevent
injuries/condition from
worsening
Promote recovery

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ROLE OF A FIRST RESPONDER
• Bridge the gap between the time of accident and the arrival of
physician
• Ends when medical assistance begins
• Doesn’t intend to compete with or take place of the physician

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A GOOD FIRST RESPONDER
• Be Healthy – Very important to be fit yourself
• Prompt – Be prompt to respond to a situation
• Self conscious – Protect yourself
• Observant – Notice all signs
• Resourceful – Make best use of all things
• Gentle – Should not cause pain
• Tactful - Should not be alarming
• Sympathetic – Should be comforting

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SKILLS REQUIRED
Skills for treating injured Skills for patient care
- Controlling airway, breathing and - Manage patients with Heart attacks
circulation - Seizures
- Controlling external bleeding (hemorrhage) - Heat stroke
- Treating shock - Alcohol & Drug abuse
- Treating wounds - Poisonings
- Splinting injuries to stabilize extremities

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TYPES OF AMBULANCE
Cardiac Ambulance: Contains Ventilator, ECG, Monitoring Devices & Paramedic staff
Basic Ambulance: Contains Patient bed, pulse oxi-metry, oxygen delivery devices
Neo-Natal Ambulance: Contains Incubator, IC Ventilator, Paramedic attendant
Patient Transport Vehicle: Having patient bed
Air Ambulance: Having Ventilator, defibrillator, infusion pumps, ballon pumps, oxygen
cylinder, trained doctors & nurses
Mortuary Ambulance: Having Mortuary stretcher

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Let us learn about some Ambulance Equipment

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ALWAYS REMEMBER

+ = lives saved!

C = Cardio A = Automated
P = Pulmonary E = External
R = Resuscitation D = Defibrillator

Early resuscitation and prompt defibrillation can result in a

50% chance of survival.
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EQUIPMENT IN AN AMBULANCE
Well equipped ambulances will - Ambulance chair
have the following equipment - Nebulizer
- Patient bed - Oxygen Supply unit
- ECG Monitor - BP Measurement Unit
- Defibrillator - Splints and Bandages
- Spinal Board - Other first aid items
- Ventilator - Pulse Oxymeter
- Suction Unit - Transcutaneous cardiac
- Infusion Syringe pump pacemaker
- First Aid Kit
Wall mounted Aneroid
For measuring pressure

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FIRST AID KIT

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OTHER ITEMS NEEDED
• Oxygen cylinder
• BP instrument, Stethoscope
• AED
• Ambu bag, Laryngoscope, Airways and Masks
• Manual foot operated suction pump
• I.V. Fluid and I.V. Sets
• Tourniquet

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USING AED IS VERY SIMPLE
Once the AED is with you, open the
defibrillator case.
You will find:
Towel – to dry the chest
Razor – to remove any thick hair
AED pads – to place on the person’s
chest
Don’t worry – the AED will talk you
through what you need to do!

Using AED is virtually mistake proof

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USING AN OXYGEN CYLINDER
• Use in case of respiratory distress or
trauma Pressure
Reducing
• Attach flowmeter with humidifier with Pressure
1/3rd water and with pressure gauge to Gauge

threaded outlet of Oxygen cylinder

Oxygen
• Connect the tube to mask and outlet output
Safety
• Turn on the key of cylinder valve Humidifying
bottle

• Apply mask over patients nose Oxygen

Pipe
• Regulate flow meter (2-3 L/min to adult
and ½-2L/min to child)

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 Crash Victim Management

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CRASH VICTIM MANAGEMENT
Immediate Phase
• Triage: Prioritize patient for treatment or transport
• Resuscitation: Revival of patient
• A- Airway
• B – Breathing
• C – Circulation
• Safe Evacuation from vehicle
• First Aid
• Safe Transport to hospital

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PROVIDE FIRST AID
• All efforts should be at reaching the nearest hospital
• Total time taken should be less than an hour
• 5-10 mins at the accident site
• 30-45 mins to reach nearest hospital

• Look for injury signs

• Pain & Swelling
• Deformity, lesions and bleeding
• Altered mental status & unconscious
• Hypotension or shock
• Cardiac Arrest

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INJURY AND SYMPTOMS
• Head injury
• Vomiting
• Convulsion
• Consciousness
• Spinal Injury
• Pain
• Swelling
• Crepitus – sound from bone
• Loss of sensation in arms, legs or body

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 Patient Movement

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YOUR OWN SAFETY FIRST
• Your own safety is important. You cannot help if you get injured
• Proper technique needed for moving patient without injury
• Correct body movement, grip and device is needed to avoid injury to
• To Yourself
• To the victim
• Specific technique needed for patient with head injury, spinal injury,
pregnancy, obesity
• During lifting maintain precaution for yourself
• Shoulder and Pelvis should be aligned
• Hands to be held close to legs
• Power grip gets maximum force
• Palms should face up
• Hands about 10 inch apart
• All fingers at same angle Power Grip: Correct
grip 22
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YOUR OWN SAFETY IS VERY IMPORTANT

Good posture – Shoulder and Pelvis aligned Bad posture – can be dangerous

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PATIENT MOVEMENT
If nothing else is available, use a sheet or blanket:
 Center the patient.
 Tightly roll up excess fabric on the sides.
 Use the cylindrical roll to grasp fabric and lift patient.

 Use Backboard for moving patients

 In Supine position
 Immobilized patients
 Log roll the patient to place on the backboard
 Keep as close to the patients side as possible
 Keep your back straight
 Roll the patient onto the board without stopping

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IF NO STRETCHER IS AVAILABLE TO CARRY PATIENT

Clothes
Drag Blanket
Drag

Arm to Arm
Drag Arm Drag

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REMOVING A VICTIM FROM ACCIDENT VEHICLE
 First move legs from the pedals if he was
driving
 Rotate patient so back is toward open car
door.
 Place arms through armpits and support
head against your body.
 Drag patient from seat to a safe location
 Rapid extraction of patient should be
avoided since it can cause spinal injury
 Be sympathetic and compassionate

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CARRYING PATIENT ON A STRETCHER
Wheeled Ambulance stretcher
• Victim should be strapped
• if victim has suspected spinal injury or multisystem trauma
• If victim needs CPR

Bariatric Stretcher
• Specialized for overweight or obese patients
• Has wider wheel base for stability
• Can hold up to 400 kilo weight
• Remember Pushing is better than Pulling
• Always get a good hold otherwise you may hurt yourself
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OTHER TYPES OF STRETCHERS

Collapsible Stretcher

Sked Stretcher

Basket Stretcher
Perforated Roller Stretcher

Scoop Stretcher

Spine Board Transport Stretcher Sheet

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TYPES OF STRETCHER
Stretchers are a key component of any Emergency Response Unit

 Collapsible Stretcher: Most commonly used. Some models have 2 wheels

 Some can be folded in half
 Used in areas difficult to reach
 Weighs less than wheeled stretchers
 Can be folded and stored in small space

 Sked Stretcher: Can be rolled into tubular package. Holds patients on both sides. Is
uncomfortable but provides support and immobilizes. Can be used for patients with spinal or
back injury mainly used for air ambulance

 Spine Board: Long, flat and made of rigid plastic. Provides rigid support during movement of a
person with suspected spinal or limb injuries. Holes serve as handles and for straps

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TYPES OF STRETCHER
 Basket Stretcher: Used for remote and outdoor locations. The basket is designed to be
used where there are obstacles to movement or in slopes. The patient is strapped into the
basket for safety.

 Roller Stretcher: Attached with wheels for easy transport. Generally used on plain surface

 Scoop Stretcher/Orthopedic Strecher: for Spinal injury. Scoop stretchers reduce the
chance of undesirable movement of injured areas during transfer of a trauma patient, as
they maintain the patient in a supine alignment

 Transport Stretcher Sheet: For Emergency Usage

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 Some common accident injuries

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 Fracture

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FRACTURE AND SPRAINS
•Fracture refers to an injury that affects the skeleton and can be caused by
the application of direct and indirect force. The general signs and
symptoms are:
 Pain at or near the point of injury which gets increased by movement
Movement may be difficult or impossible
Swelling or bruising of the injured parts
Deformity at the point of fracture
Shock may occur

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DO’S IN CASE OF A FRACTURE
• Check the (D)anger, (R)esponse, (A)irway, (B)reathing and (C)ompression for
Blood Circulation of the victim (DRABC)
• Always control severe bleeding before immobilizing the fracture
• Place sufficient padding to support fracture site
• Immobilize fracture site
• Do not force bones back into the wounds or massage the affected area
• Give proper padding before shifting the patient to the hospital. Do not move
without proper support
• Apply ice pack to control swelling and reduce pain
• Treat to prevent shock

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TYPES OF FRACTURE

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SPLINT
• As per Wikipedia “A splint is defined as a rigid or flexible device that
maintains in position a displaced or movable part”. There are many types of
splints:
• Ankle splint
• Finger Splint
• Nasal Splint
• Posterior lower leg splint
• Posterior full leg
• Posterior elbow splint Ulnar Gutter Splint
• Sugar tong
• Thumb Spica Sugar Tong Splint Wrist Splint
• Ulnar gutter splint
• Wrist splint
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SPLINTS
Splinting can be achieved in different ways and it may not be rigid always
• Vacuum splint
• Air splint
• SAM splint
SAM splint Vacuum splint Air splint
• Traction splint
• Cervical collar
• Extraction splint
• Spine board Extraction collar
Buddy wrapping
• Buddy wrapping Traction splint
Cervical collar

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ARM SLING
• Place folded base vertically over one arm,
with pointed directly under the elbow of
injured arm
• Lower ends of base at the side of the neck
using a square knot
• Make several twist with apex and tie a
knot
• Hide the knot

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UNDER ARM SLING
• Same procedure as arm sling
except that the lower end of the
base is tucked under the injured
arm.
• Secure end of base and apex
with a square knot the center
indention at the back.

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 Head Injury

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HEAD INJURY
• Head injury involves damage to the brain or the structure of the skull
surrounding the brain
• Head injuries are serious injuries and none of them should not be overlooked
• There are 5 main types of head injury
 Cuts: Although they look alarming, but it can be serious only if it is caused
by a large blow
 Concussion: This is a traumatic injury to the brain if caused by a large blow
 Contusion: (or bruising) This may occur to the brain after an injury, which
causes swelling of tissue
 Hemorrhage: Bleeding inside the skull
 Compression: Can be caused due to too much bleeding
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FIRST AID FOR HEAD INJURY
• Protect the victim’s airway by tilting back, the jaw, whilst treating them as
if they have a spinal injury
• Apply pressure to any scalp wounds that are bleeding
• Watch for vomiting
• If conscious, lay them on the floor with head and shoulders slightly raised.
If they are unconscious, place them in the recovery position whilst
protecting their neck
• Check for responses. Constantly reassure them
• Constantly check their breathing and level of consciousness until helps
arrives.

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BANDAGE FOR HEAD INJURY
• Fold the base at least 2-3”
• Place folded base aligned with eyebrows
• Pull back and cross-over at the back, tucking
apex beneath
• Pull both ends in front/secure with a square knot
at the center of the folded base/tuck ends
• Pull down apex (tuck sides neatly)
• Tuck apex neatly at cross-over area

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 Cardio
Pulmonary
Resuscitation
(CPR)

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CARDIOPULMONARY RESUSCITATION
• Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies,
including heart attack or near drowning, in which someone's breathing or heartbeat has stopped.
• CardioPulmonary Resuscitation is a technique of basic life support for oxygenating the brain and
heart until appropriate, definitive medical treatment can restore normal heart and ventilator
action.
• CPR does the following:
 Maintains an OPEN and CLEAR Airway
 Maintains breathing by external ventilation
 Maintain blood circulation by external cardiac massage
• CPR is useful for
 Cardiac arrest: Heart attack
 Respiratory arrest: Drowning, Foreign body in throat, Drug overdose, Suffocation, Accident
Injury

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PRINCIPLES OF CPR
• CPR restores effective circulation & ventilation
• CPR prevents irreversible cerebral damage due to anoxia (absence of oxygen). When
the heart is not able to supply oxygen to the brain for 4 mins, brain may suffer
irreversible damage.
• CPR can be performed by anyone who knows how to do it ANYWHERE,
IMMEDIATELY, WITHOUT any EQUIPMENT

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CPR STEPS – CHECK RESPONSE
Shake shoulders gently
Check Response
Ask “Are you all right?”
Shout for help
If he responds
• Leave as you find him Open Airway
• Find out what is wrong
• Reassess regularly
Check Breathing

30 Chest compressions

2 Rescue breathing

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CPR STEPS – SHOUT FOR HELP
• Call anyone who is near
Check Response
you and ask for help.
• Do not leave the patient
alone Shout for help

Open Airway

Check Breathing

30 Chest compressions

2 Rescue breathing

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CPR STEPS – OPEN AIRWAY
• Tilt Head and Lift chin.
Check Response
This can be done by trained
or untrained rescuers
• No need for finger sweep Shout for help
unless solid material can be
seen in the airway Open Airway

Check Breathing

30 Chest compressions

2 Rescue breathing

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CPR STEPS – CHECK BREATHING
• Look, Listen and feel for
Check Response
normal breathing
• Do not confuse agonal
(painful) breathing with Shout for help
normal breathing
• Occurs normally after Open Airway
the heart stops in upto
40% of cases
• Described as barely, Check Breathing
heavy, noisy or
gasping breathing 30 Chest compressions
• Sign of cardiac arrest
2 Rescue breathing

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CPR STEPS – 30 CHEST COMPRESSION
• Place the heel of one hand
Check Response
on the centre of the chest
• Place other hand on top
• Interlock fingers Shout for help
• Compress the chest
 Rate 100 per min Open Airway
 Depth 4-5 cms
 Equal compression
relaxation Check Breathing
• If possible change CPR
operator every 2 mins 30 Chest compressions

2 Rescue breathing

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CPR STEPS – 2 RESCUE BREATHING
• Pinch the nose
Check Response
• Take a normal breath
• Place lips over mouth
• Blow until the chest rises Shout for help
 Give breath about 1s
• Take about 1 second Open Airway
• Allow chest to fall
• Repeat the steps
Check Breathing

30 Chest compressions

2 Rescue breathing

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 Click icon to add picture
OU
K Y
AN Contact us @
TH Paramedical Institute of Kolkata
4th Floor, 1/504 Gariahat Road,
Jodhpur Park,
Kolkata 700068

www.paramedikol.com
+91 9007769004
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