Emergency Medical Services and Rescue Operations
Core Concepts
Understand the patient assessment sequence: scene size-up, primary assessment (ABCs and life threats), secondary assessment, and reassessment. Know the difference between medical and trauma patients and the criteria for rapid transport. Master basic airway management, bleeding control, and shock recognition. In rescue, understand the phases: locate, access, stabilize, disentangle, and transport. Know the categories of rescue-vehicle, structural collapse, confined space, trench, water, high-angle, and swiftwater-and the difference between rescue and recovery. Understand the incident command integration for rescue and the role of the rescue group supervisor.
Traps to Watch
Questions often blur rescue and recovery-once survivability is ruled out, operations shift to recovery and risk-taking must stop. Watch for candidates who prioritize disentanglement before stabilization. In vehicle rescue, stabilization precedes extrication; in trench rescue, shoring precedes entry. Confusing the primary and secondary assessments, or forgetting reassessment, is common. Also watch for questions that assume the firefighter is the highest medical authority-follow local protocols and medical direction.
Worked Example
A patient with a penetrating chest wound and deteriorating breathing: the primary assessment identifies the life threat, and treatment (occlusive dressing, rapid transport) follows immediately. Rule of thumb: life threats found in the primary assessment are treated before the secondary assessment begins; do not complete a full head-to-toe before addressing an airway or hemorrhage.
Rule of Thumb
Locate, access, stabilize, disentangle, transport-stabilization always precedes disentanglement, and survivability governs rescue vs. recovery.