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First Responder

Transcript: Overlapping Needs 8/2/2014 0430: A representative from DNA met with the patient's husband. -The patient was a registered organ and tissue donor. -He wanted to honor her wish to save lives, if at all possible. Treatment was escalated to honor their wish Collaboration & Communication How can I & how do I impact others? Who's in the know First Responder Real life experience Rapid Support & Discussion Emergency room physicians, nurses, and paramedics provide aggressive interventions to stabilize our sickest patients Gaps in Communication & Fears Evidence Based Kristin Schwartz, MC, PsyD Goals & Objectives EMS/Pre-hospital Hospital ~Emergency Department ~Intensive Care Unit ~Operating Rooms Donor Network of Arizona Family, Financial, and Patient Outcomes ~Aggressive intervention for patient's with low GCS -Blood transfusions -T4 protocol ~$$$ ~Ethics of early/aggressive intervention ~Organ donation as a viable, positive outcome ~Timeliness UAMC ED began evaluating the patient at 0030 on 8/2/2014 Systolic blood pressure was dropping into the 40s The patient required transfusions and aggressive support (<12hrs 7 units of PRBs & 6 of FFP) Her injury was determined to be nonsurvivable Her husband decided to allow natural death Donor Network was notified @ 0310 on 8/2/2014 Hemodynamics Electrolytes Blood Gases Glucose Urine Output Ejection Fraction Questions? Continuation of care UAMC medical complex The gift of organ and tissue donation touches not just those who receive transplants, but their families, friends, and communities +Provider names (Notes & Run sheets) -Documentation -Provider follow up +Hemodilution -What fluids -How much -When +Early communication -ED referral -Preserve options Patient Care Outcomes Closure Donation Conversation Family Dynamics Communication/Understanding Social Support Family Advocates Timelines *Joseph, et al (2014) *Raoof, et al (2011) Her life. His choice. Their gratitude. The moment of generosity belongs to the family Shared Meaning ~Identify the benefit of aggressive care for patients as it relates to donation options ~Recognize the potential impact of timeliness on donation options ~Recognize the need for clear, concise, and complete communication as to patient care EMS crews are often the only sources of information on circumstances surrounding a patient's cause for admission 8/1/2014 23:23: EMS crew is dispatched to a rollover MVC - Upon arrival, the patient was breathing, had a weak pulse, and was unresponsive. -An IV was started, her breathing was facilitated by BVM, and she had standard c-spine precautions. While in route to UAMC, her breathing became increasingly labored and she became hypertensive. Care was transferred to ED providers between 0030 and 0112 on 8/2/2014 The gift of life has offered a 68-year old man, who was awaiting a liver transplant, a second chance. The gift of the right kidney transplant has offered a 60-year old Arizonan a new beginning A 68-year old woman received the left kidney transplant. Vision was restored for two individuals Those in need received the gift of skin & bone grafts Clinical Goals

First Responder

Transcript: Peripherals are devices are not an integral part of the computer but connect to it to improve its capabilities. Data Storage Tape Disks GPS Receivers Mobile Telephones are used for many tasks and can hold a large amount data often very important. Things are not always straightforward... CCTV CAMERAS Digital cameras can hold photos and video either in embedded memory or memory cards Network Switch is a computer-networking device that are mainly used to connect groups of network devices with each other Similar to Hub -Recognize which evidence sources are of evidential value -Differentiate between computer networks -Identify the network devices Used for security Used as evidence in a variety of cases Record on storage media or live monitoring IP Cameras Local Area Network (LAN) – is a computer network covering a small geographic area, like a home, office, or group of buildings e.g. a school. Wide Area Network (WAN) – is a computer network that covers a broad area (i.e., any network whose communication links cross metropolitan, regional, or national boundaries). Memory cards, also known as flash cards are devices for storing digital information Digital Video Cameras At the end of this session participants will be able to: Recognize which Evidence Sources are of evidential value Differentiate between Computer Networks Identify the network devices Network Attached Storage (NAS) Recording of voice memos Play the memos back Recording of presentations or conversations Upload to computer capability SIM CARD Router is a device that determines the next network point that a packet should be forwarded towards its destination It must be connected to at least 2 networks Memory Cards Network Router Documents Photos Emails and attachments Databases Financial Information Internet Browsing History Chat Logs Event Logs GPS Locations Hard drives are the major storage device within computer systems Portable Media Players Network Hub is a device for connecting multiple twisted pair or fibre optic ethernet devices together, making them act as a single network segment Computer Systems usually consists of hardware and software Also Computer Parts can usually be categorized into the Main Unit and Peripherals Server is a computer or device that provides information or services to other computers on a network A Server can run several services – e.g. web server, email server, file server, print server etc 1.Electronic Evidence can be related with almost any kind of investigation 2.Type and number of electronic devices increase daily 3.Electronic Evidence should be handled correctly in order to have value. Removable Media At the end of this session participants will be able to: Session Objectives VHS Recorders Digital Video Recorders Firewall is a hardware device or software service used to increase the security of a network. The task of a firewall is to either block or allow certain traffic from or to the network Potential Evidence Ports – are an endpoint or "channel" for network communications. Bandwidth – is the amount of information that can be carried through a cable or wireless feed Media Access Control (MAC) address – is a quasi-unique identifier assigned to most network adapters or network interface cards (NICs) by the manufacturer Computer Systems *Data stored on tape is more likely to be encountered is a business *Tapes are normally used for backup Network Hub Digital Audio Recorders Mobile Telephones STORAGE DEVICES Not all devices are what they seem! Evidence Sources Peripheral Devices First Responder Cybercrime & Electronic Evidence Photocopiers Is a standard that defines the protocols for communication, connection and power supply for devices that are to be connected Terminology and Devices Firewall Session Objective Video Recorders NAS is similar to external hard-drives with the difference that they offer their disk space for a whole network instead of just a single PC The Global Positioning System (GPS) is a space-based satellite navigation system that provides location and time information. Network Interface Controller (NIC) Knowledge Test Access Points create a network for WLAN devices and connect them to the rest of the network A subscriber identity module (SIM) is an integrated circuit that securely stores the international mobile subscriber identity (IMSI) and the related key used to identify and authenticate subscribers on mobile telephony devices Network Types *Compact Disk (CD) *Digital Versatile Disk (DVD) *Blu-ray Disks (BD) Mobile Telephones COMPUTER NETWORKS Hard Disks and Solid State Disks A network consists of connections between two or more computers that are linked by data cables or by wireless connectivity Network enables computers to share data and other resources between them Server Tablet Devices Video Games Consoles *Digital Video Cameras can hold photos and video either in embedded memory or memory cards. *Its important to tell the difference SA GREGORIO Y. ALGOSO, JR. USB Data Storage Devices Access

First Responder

Transcript: First responders must be trained to deal with a wide array of potential medical emergencies. Because of the high level of stress and uncertainty associated with the position, first responders must maintain physical and mental health. Even with such preparation, first responders face unique risks of being the first people to aid those with unknown contagions. The goal of most emergency medical services is to either provide treatment to those in need of urgent medical care, with the goal of satisfactorily treating the presenting conditions, or arranging for timely removal of the patient to the next point of definitive care. 911 is now available to: Emergency Medical Services are a type of emergency service dedicated to providing out-of-hospital acute medical care, transport to definitive care, and other medical transport to patients with illnesses and injuries which prevent the patient from transporting themselves Thank You! Curved Mayo Scissors A hospital is a health care institution proving patient treatment by specialized staff and equipment. There are many types of hospitals: - General hospital - District hospitals - Teaching hospitals - Clinics Wheelchair A first responder is an employee of an emergency service who is likely to be among the first people to arrive at and assist at the scene of an emergency, such as an accident, natural disaster, or terrorist attack. Astrid Astacio 14-2342 Alessandra Castillo 14-1655 Rangeli Felix 14- 2191 Gipssy Cepeda 14-1658 Pascual Ortiz 14-1736 Nicolee Cruz 14-1613 Nebulizing Mask First Responder Emergency Medical Services in Dominican Republic The First Responder For doing a better job those people needs a equipment. The first responder kit contains: Jack Knife Rope Gloves Hammer screwdrivers Plier Jack handle Emergency Unit First responder equipment A Certified first responder is one who has received certification to provide pre-hospital care in a certain jurisdiction. A community first responder is a person dispatched to attend medical emergencies until an ambulance arrives. Hospital Gurney Emergency medical services exists to fulfill the basic principles of first aid, which are to Preserve Life, Prevent Further Injury, and Promote Recovery. The Star of Life shown here, where each of the 'arms' to the star represent one of the six points, which are used to represent the six stages of high quality pre-hospital care, which are: - Early Detection - Care in Transit - Early reporting - Transfer to definitive care - Early Response Now in the Dominican Republic we have the 911. 911 is a emergency number that there you can communicate with the first responders in one call. Here in Dominican Republic that is now beginning. For that the services are limited per now. Gauze Emergency Medical Services Pediatric Nebulizer Purpose of Emergency Medical Service First responder duties Sterilized Gauze 62 ECG bpm

First Responder

Transcript: Amputated Phalange of the Right Hand Anaphylactic Emergency (Bee Sting on Left Arm) If patient is having difficulty breathing, have them sit in Fowler's position. If patient has low blood pressure, have them lie in supine or shock position. Pregnant patient and patients who are breathing but unconscious should lie laterally. *If a patient feels faint, do not have them sit or stand up because it could cause cardiac arrest. Remove the stinger from the bee sting. The method of removal is not as important as getting it out early, but scraping it off with a hard surface is recommended. Start Cardiopulmonary Resuscitation (CPR) as soon as possible using the latest guidlines from the American Heart Association. Again, make sure that further help is on its way. Administer the correct doses of adrenaline recommended in ALS guidelines, making sure not to give intramuscularly. Hypoglycemia (Diabetic Emergency) If patient is conscious, have them consume 10-20 g of glucose in liquid form, as granulated sugar, or as glucose tablets. Any food rich in sugar would be a solution, unless it also contains fat and proteins (ex: cake or cookies) which would prevent fast absorption of the sugar into the body. Check glood sugar levels after 15 minutes. If normal levels have not been reached repeat the process again 1-3 times as necessary. If patient is not conscious enough to receive oral treatment, call for further support. Administer 75-80 mL of 20% glucose or150-160 mL of 10% glucose intravenously. If patient rgains consciousness, glucose can be given orally. Cover stump and amputated phalange with saline- moistened sterile dressing. 5 4 2 Elevate and immobilize stump. Avoid as much manipulation as possible. 1 Jeannette Buenrostro, Maritsa Velarde, Jasmine Guevara Period 2, First Responder 2 3 Check patient's vitals. Call for additional help. Advanced Life Support (ALS) will be necessary. 2 3 Medical Emergency Treatment Scenarios Place phalange in dry plastic bag that can be sealed. Place bag in ice or ice water. Avoid any direct contact between body part tissue and ice which could result in permanent damage. 1 1 4 3 Conduct nuerological exam and take vitals. Treat any life threatening injuries.

First Responder

Transcript: First Responder 2020 Welcome!!!! WELCOME Question 2: What would you put in your kit answergarden.ch/1282986 Answer Garden example First Aid Kits 1 1 First Aid Kits Answer Garden Question 1 What types of kits are there answergarden.ch/1282942 Question 2: What would you put in your kit answergarden.ch/1282986 Types of Kits Various Types of First Aid Kits Pack/Troop Patrol Personal Car Kit Building Other types: Game What to put in the Kit? Question 2: What would you put in your kit answergarden.ch/1282986 Supplies Supplies Personal Car Kit Additional Items Add flashlight w/ batteries White cloth/handkerchief- in case car is disabled Blanket Help sign Gauze Tape Soap Scissors CPR barrier Pencil n paper Bandages Moleskin Antibiotic ointment Gloves Antiseptic wipes Shock FOCUS AREA 2 2 THE PROBLEM THE PROBLEM PLAN PLAN https://www.playfactile.com/kby8zmjkk9 TIMELINE TIMELINE #1 #3 #2 Stroke FOCUS AREA 3 3 THE PROBLEM THE PROBLEM PLAN PLAN TIMELINE TIMELINE #1 #3 #2 Choking Choking 3 4 THE PROBLEM THE PROBLEM https://medlineplus.gov/ency/presentations/100222_1.htm PLAN PLAN TIMELINE TIMELINE #1 #3 #2 5 Bites and stings Bites and Stings Bee and wasp Bee & Wasp Stings Do they have an Epi Pen?! Call 9-1-1 !!!!! Allergic ? 1) Check Call Care 2) Remove Stinger (if present) 3) Clean w/ Soap n Water 4) Apply Ice Chigger Chigger Spider Spider Most Bites are mild. Swelling redness discomfort Treatment Treat for shock Seek immediate care Examples: Black widow, Brown Recluse Seek help immediately for venomous. Non venomous 1) clean soap and water 2) apply ice Venomous nonvenomous snakes 6 Snakes... on a plane???? Identification of venomous snakes Venomous or not? Prevention PLAN Watch where you are hiking: piles of stones tall brush, depressions in the ground, hollows Stay on trails Watch when collecting firewood and climbing around rocks Use hiking pole to poke around (per handbook) What to do? Non Venomous Venomous s/s Redness swelling Burning pain Discoloured Tx 3Cs Keep victim calm and still Do not move or let them walk unless necessary Immobilize area below the heart Remove rings or jewelry Clean area and cover w/ clean bandage No ice; tourniquet Do NOT suck out of wound or cut wound Do not touch snake use phone to take pic if in safe area or try to remember its markings s/s Puncture wound Localized swelling and redness Tx Wash Soap and water Ointment Bandage PA Venemous Eastern Massasauga, Timber rattlesnake, Eastern Copperhead Ticks Ticks!!!! They're Everywhere Every Season 7 THE PROBLEM THE PROBLEM PLAN PLAN Remove Tick Wash the bite area with soap and water Apply antibiotic ointment Wash YOUR hands, wash the tweezers Check the bite area and the rest of your skin for the next month or so If you develop a rash or flulike symptoms see your doctor How to Remove a tick Removal

First responder

Transcript: A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. They have more skill than someone who is trained in basic first aid but they are not a substitute for advanced medical care rendered by emergency medical technicians (EMTs), emergency physicians, nurses, or paramedics (though many first responders are EMT). First responder courses cover cardiopulmonary resuscitation (CPR), automated external defibrillator usage, spinal and bone fracture immobilization, oxygen and, in some cases, emergency childbirth as well as advanced first aid. 48,000 Hospitals What is a First Responder? Outlook Employment is expected to grow about as fast as the average for all occupations through 2018. Job prospects should be good, particularly in cities and private ambulance services. Advantages Disadvantages: Potentially dangerous work environment (exposure to contagious diseases, traffic accidents, flames and smoke, violent situations Irregular work hours that may include nights and weekends Continuing education is required to maintain certification Can be physically strenuous and emotionally stressful Feeling of pride and satisfaction in knowing you've made a tremendous difference in someone's life Fire and police departments offer decent salaries (average annual salaries of about about $48,000 and $56,000, respectively, in May 2011) Work in a friendly and non-competitive environment High School Diploma or GED Graduate of an accredited school for First Responder. EMS experience preferred. Current Minnesota EMSRB certification as First Responder or above Current provider level CPR certification Valid drivers license in the state you reside Driving record must meet the criteria set forth by Essentia Health Must be a minimum of 21 years of age Certification Salary First responder Christi Klein Place of employment

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