How to Treat An Open Wound

Something an EMT has to care for on an everyday basis is an open wound. They can be big or small, and be anywhere on the body. Proper treatment and care of an open wound is important to avoid the injury getting worse, and preventing any sort of infection or further damage. One of the most important wounds you will have to treat as an EMT, is an open chest wound. This is extremely important because of the threat to life that it imposes on the patient.

 To treat a wound other then the chest you want to clean out the wound and cover it, and you also have to make the decision to see if further action is needed such as stitches. For an open chest wound this works a little differently. The most important thing is to try to prevent any outside air from entering the chest. You want to use an occlusive dressing to form an air tight seal over the wound. Open chest wound treatment include instructing a patient (as long as their conscious) to exhale while this dressing is being applied. You want to tape down 3 of the 4 sides of the dressing. The reason for this is so that when the patient inhales, outside air is not entering the chest because the dressing that has been applied will be sucked next to the surface of the wound. When the patient exhales, air trapped inside can escape through the one side that is not taped down. The application of an occlusive dressing doesn't automatically eliminate all life threats associated with open chest wound treatment because blood and other fluids can accumulate under it and interfere with air being able to escape through it. The dressing would need to be gently removed, the area wiped or dabbed clean, and resealed as you get the patient to a medical facility or wait for help.

Ambulance Maintenance

Apart from the daily  life saving situations that an EMT takes part in, there are other aspects to the job that might go unnoticed. A huge part of the daily job for an EMT is ambulance maintenance. This includes not only cleaning the ambulance itself, but all apparatus on the ambulance. There are many things that go on in an ambulance on a day to day basis. From sick patients, to patients that are bleeding or have infections. Ambulance maintenance is a crucial part of the everyday job of an EMT. It is extremely important to keep the ambulance clean in order to prevent further sicknesses or infections in other patients, or for the EMT itself.

Ambulance Maintenance Includes :
     . A detailed infection control policy, which requires everything that touched a patient to be disinfected after each call.
     . Washing down the entire patient compartment.
     . Washing down the steering wheel and door handles inside and out.
     . Washing the trucks daily after each shift, or every other day depending on weather.
     . Washing down equipment that is used.
     . Stocking and re loading equipment for the day. 
     . Sweeping the truck.

All of the things mentioned above are important to keep the ambulance neat, tidy, and more importantly clean and free from any stains, spills, or infections. If ambulance maintenance is done effectively, the ambulance will always be ready for the next call, and for the day as well as preventing further possible illnesses.

How To Operate An Ambulance Stretcher

This post will go over the steps needed to operate an ambulance stretcher. Using a stretcher to secure and transport patient's in the ambulance patient compartment is something that EMT personnel have to do on almost a daily basis. There are important steps that need to be taken to secure the patient in the stretcher.

1.The first thing that needs to be done is to lower the stretcher. To do this, you want to look for the handle at the foot end of the stretcher which is placed under the mattress. After taking the weight off of the wheels, pull the handle. Make sure you (and your partner) are ready for the stretcher to come down. This means standing out of its way a little, and preparing to guide the stretcher to the floor. Never lift with your back. Instead, keep your back straight and squat; use the muscles in your legs.

2.Ensure the stretcher is on stable ground and will not roll or move when the patient is placed on it. Lock the wheels if applicable. Lower the sidebar on the side where the patient will load onto the stretcher. Place the patient onto the stretcher and situate them for comfort. Bring the sidebar back into an upright position for safety once the patient is secured.

3.Secure the patient straps, if applicable, for your stretcher. Secure the middle strap, bottom strap, chest strap and shoulder harness so they are snug, but not too tight.

4. Lift the cot by using good body mechanics to prevent personal injury during lifting. Spread your feet about 15 inches apart and balance your center of gravity between both. Keep your back straight and bend at the knees.

5. Transport the stretcher with one person guiding from the head and another person guiding from the foot to prevent the stretcher from going sideways or becoming uncontrollable. Communicate with your partner to ensure you both maintain control of the cot.

6. Transport the stretcher at an unhurried pace, taking care to coordinate with your partner around corners, inclines and declines to maintain control. Instruct the patient to keep their arms inside the stretcher at all times as you transport the cot to the ambulance or inside the facility. Suggest the patient give themselves a hug, or cross their arms over her middle, if their able.

Once the patient and stretcher are secured in the patient compartment of the ambulance, it is the EMT's job to give the patient medical care that is necessary and safely transport them to a medical facility. 

How To Give CPR

As I mentioned in my first post, EMT's are trained to deal with many life saving and life changing situations. One of the trauma emergencies that EMT's are trained to recognize and care for is after 30 compressions, open the victim's airway using the head-tilt, chin-lift method. Pinch the victim's nose and make a seal over the victim's mouth with yours. Use a CPR mask if available. Give the victim a breath big enough to make the chest rise. Let the chest fall, then repeat the rescue breath once morerdiac arrest. Cardiac arrest occurs when the heart stops working and results in death unless immediate care such as CPR is administered. The American Heart Association is an organization which determines guidelines that should be followed during CPR. EMT's must become certified to perform CPR according to the AHA.

CPR which stands for Cardiopulmonary Resuscitation, requires several steps to be taken. The first thing you would want to do as an EMT is attempt to wake the patient, and check for breathing. Step two is to begin chest compressions if the patient is not breathing. You do this by placing  heel of your hand in the middle of their chest. Put your other hand on top of the first with your fingers interlaced. Compress the chest at least 2 inches. Allow the chest to completely recoil before the next compression.The third step in the CPR process is to begin rescue breathing. After 30 compressions, open the patient's airway using the head-tilt, method. Pinch the patient's nose and make a seal over the patient's mouth with yours.  Give the patient a breath big enough to make the chest rise. Let the chest fall, then repeat the rescue breath once more. After these three steps you want to repeat step two and three a few more times. With 30 more chest compressions, followed by two more rescue breaths and continue to check for breathing throughout.  Repeat these steps until the patient wakes up, help shows up, or you arrive at a medical facility.