Emergency Rescuer Occupational Qualification cheat sheet

Legal duty to rescue generally arises from a pre-existing relationship, a contractual duty (e.g., employed rescuer on duty), or having created the danger; bystanders without such duty are not criminally liable for failure to act in most jurisdictions.

Good Samaritan protections typically require: action taken in good faith, no expectation of compensation, no gross negligence or willful misconduct, and care within the rescuer's training level.

Consent: express consent is stated; implied consent applies to an unresponsive patient or a minor without a guardian present when delay would risk life or limb.

Informed refusal requires the patient be legally competent, adequately informed of risks, and the refusal documented; a competent adult may refuse even life-saving care.

Confidentiality: patient information may be disclosed only for treatment, billing, legal obligation, or serious threat to an identifiable person; minimum necessary information principle applies.

Scope of practice: a rescuer must not exceed the skills for which they are certified; performing unauthorized advanced procedures can void legal protection and constitute negligence.

Negligence elements: duty, breach of duty, causation, and damages; all four must be shown for liability.

Mandatory reporting duties commonly cover suspected abuse of children or vulnerable adults, certain communicable diseases, and exposure incidents; report to the designated authority, not to the public.

Documentation: record objective findings, times, interventions, and refusals contemporaneously; alterations after the fact undermine legal defensibility.

Scene size-up sequence: hazards, mechanism of injury or nature of illness, number of patients, need for additional resources, and personal protection - before patient contact.

Traffic incidents: position apparatus to shield the scene, place warning devices upstream, wear high-visibility ANSI Class 2 or 3 garments, and never turn your back to moving traffic.

Downed power lines: treat all lines as energized; establish a safe zone beyond the span of the line plus the distance the line could swing; only the utility may de-energize.

Confined spaces require atmospheric testing (oxygen, flammables, toxics) before entry; most jurisdictions classify them as permit-required with attendant and retrieval systems.

Structural collapse indicators: visible leaning walls, new cracks, sagging roof lines, falling debris, and sounds of movement; establish a collapse zone at least 1.5 times the wall height.

Hazard control hierarchy: eliminate, substitute, engineer controls, administrative controls, then PPE - PPE is the last line of defense.

Wind direction determines the safe approach for smoke, gas, and chemical releases: approach from upwind and uphill, and stage at a safe distance.

Utility isolation: identify and shut off gas, electricity, and water when safe and authorized; confirm isolation with the utility or a qualified person.

Reassessment is continuous; a scene that was safe at arrival can degrade - re-evaluate after each significant change.

Primary assessment order: general impression, level of consciousness (AVPU), airway, breathing, circulation, and major bleeding control; life threats are corrected as found.

Vital sign baselines for adults: respiratory rate 12–20/min, heart rate 60–100/min, systolic BP about 90–120 mmHg, SpO2 ≥94% on room air; trends matter more than single values.

SAMPLE history: Signs and symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading to the injury or illness.

OPQRST for pain: Onset, Provocation/palliation, Quality, Region/radiation, Severity (0–10), Time.

Glasgow Coma Scale: eye 1–4, verbal 1–5, motor 1–6; total 3–15; GCS ≤8 indicates severe head injury and likely need for airway support.

START triage categories: Green (walking wounded, minor), Yellow (delayed), Red (immediate, life-threatening but salvageable), Black (deceased or expectant).

JumpSTART modifies START for children: respiratory rate threshold is 15–30/min, and five rescue breaths are given to apneic children with a pulse before assigning Black.

Transport decisions weigh time-criticality, patient stability, distance, and destination capability (trauma center, burn center, PCI or stroke center); load-and-go for unstable patients.

Positioning and monitoring during transport: spinal precautions as indicated, oxygen to maintain SpO2, continuous reassessment, and secure all equipment and the stretcher.

Adult CPR: compressions at 100–120/min, depth 5–6 cm (2–2.4 in), full recoil, compression fraction >60%, and a 30:2 compression-to-ventilation ratio for one or two rescuers without an advanced airway.

High-quality CPR metric targets: compression rate 100–120/min, depth 5–6 cm, complete chest recoil, minimal interruptions (<10 s), and avoid excessive ventilation.

Child CPR: 30:2 for a single rescuer, 15:2 for two rescuers; depth about one-third of chest diameter (approximately 5 cm); infant depth about 4 cm.

AED use: apply as soon as available, follow voice prompts, clear the patient before each shock, resume compressions immediately after the shock, and minimize pauses.

Choking adult or child: encourage coughing if effective; if ineffective, deliver 5 back blows and 5 abdominal thrusts (Heimlich) alternating; for an infant, 5 back blows and 5 chest thrusts.

Severe external bleeding: direct pressure first, then wound packing for junctional or deep wounds, then a tourniquet placed 5–7 cm proximal to the wound, tightened until bleeding stops, and time recorded.

Shock recognition: pale, cool, clammy skin, rapid weak pulse, rapid shallow breathing, altered mental status, and falling blood pressure; treat with supine position, oxygen, warmth, and rapid transport.

Anaphylaxis: intramuscular epinephrine into the anterolateral thigh is first-line; antihistamines are adjuncts and do not replace epinephrine.

Recovery position for an unresponsive patient who is breathing adequately and has no suspected spinal injury; monitor airway continuously.

Spinal motion restriction indications: altered mental status, intoxication, midline neck or back pain, focal neurologic deficit, distracting painful injury, or a dangerous mechanism.

Cervical collar sizing: measure from the chin to the shoulder; the collar must support the chin without hyperextension and must not obstruct the airway.

Log-roll requires a leader coordinating the team, maintaining in-line spinal alignment, and moving on a single count; the patient's head is controlled by one person throughout.

Splinting principles: immobilize the joint above and below the fracture, pad bony prominences, assess distal pulse, motor, and sensation before and after splinting.

Traction splint use is limited to midshaft femur fractures with no pelvic, knee, or lower-leg injury; contraindicated with suspected pelvic fracture or significant deformity at the knee.

Pelvic binder placement: at the level of the greater trochanters, tightened to stabilize suspected pelvic fracture and reduce internal bleeding.

Impaled object: stabilize in place with bulky dressings; never remove it unless it obstructs the airway or CPR.

Amputation: control bleeding, wrap the stump with a moist sterile dressing, and transport the amputated part wrapped in gauze, sealed in a bag, and placed in ice water - never directly on ice.

Head injury: maintain oxygenation and blood pressure, avoid hypotension and hypoxia, and elevate the head of the stretcher about 30 degrees if no shock is present.

Search patterns: line search for open ground, grid search for defined areas, and sector search for water or wide areas; the search area is divided and documented to avoid gaps and duplication.

Rescue priorities: self-rescue, then rescue of the team, then rescue of the public - rescuers must not become additional victims.

Rope system components: anchor, mainline, belay, and backup; every life-safety rope system needs a redundant anchor and a belay.

Knots: figure-eight on a bight for a secure loop, water knot for webbing, and bowline for a fixed loop; inspect and dress every knot before loading.

Load limits: life-safety rope and hardware are rated for human loads; never exceed the manufacturer's working load limit and inspect gear before and after each use.

Litter operations require a litter tender, a belay operator, and a system safety officer; communication between them must be confirmed before movement.

Extrication: stabilize the vehicle, disconnect the battery, and use glass management before cutting; protect the patient with a barrier during cutting and spreading.

Technical rescue categories: rope, confined space, trench, structural collapse, water, and vehicle/machinery; each requires specific training and equipment.

Equipment checks: inspect for wear, corrosion, and expiration; log inspections; retire gear after a shock load or visible damage.

Fire tetrahedron: fuel, oxygen, heat, and the chemical chain reaction; extinguishment removes one or more of these components.

Fire classes: A (ordinary combustibles, water), B (flammable liquids, foam or dry chemical), C (energized electrical, non-conductive agent), D (combustible metals, dry powder), K (cooking oils, wet chemical).

PASS technique: Pull the pin, Aim at the base, Squeeze the handle, Sweep side to side; only for small, incipient fires with a clear escape route.

Flashover indicators: high heat at floor level, rollover of flames in the smoke layer, and spontaneous ignition of furnishings; evacuate and cool the gases.

Hazmat recognition: placards, labels, UN numbers, shipping papers, and the ERG (Emergency Response Guidebook) for initial isolation and protective action distances.

Hazmat zones: hot (contamination), warm (decontamination and control), and cold (support); only trained personnel in appropriate PPE enter the hot zone.

Decontamination sequence: gross removal, soap and water wash, rinse, and containment of runoff; do not let contaminated patients into the treatment area.

Radiation protection: time, distance, and shielding; the inverse square law means doubling the distance reduces dose to one-quarter.

Wildland fire behavior drivers: fuel, weather, and topography; always identify two escape routes and a safety zone before engaging.

Incident Command System structure: command, operations, planning, logistics, and finance/administration; span of control is typically 3–7 subordinates per supervisor.

Transfer of command requires a briefing covering situation, resources, actions taken, and plan; command is formally transferred, not assumed informally.

Radio discipline: identify unit, state the message, use plain language, keep transmissions brief, and acknowledge receipt; use clear text rather than codes when interoperating.

Closed-loop communication: sender transmits, receiver repeats back, sender confirms; this prevents medication and instruction errors.

Handoff reports use SBAR: Situation, Background, Assessment, Recommendation.

MCI communications: designate a triage officer and a transport officer; report patient counts by triage category to command at intervals.

Accountability: personnel accountability reports track who is on scene; every responder must check in and out through the designated system.

Mayday: declare early when lost, trapped, out of air, or disoriented; give location, unit, and problem, and activate the personal alert safety system.

PPE selection follows a hazard assessment; the employer must provide and train on PPE at no cost to the worker.

Gloves are not a substitute for hand hygiene; perform hand hygiene before and after glove use and change gloves between patients.

Respiratory protection: N95 or higher filtering facepiece for airborne particles requires fit testing and a user seal check before each use; surgical masks do not seal.

Structural firefighting turnout gear includes helmet, hood, coat, pants, boots, gloves, and SCBA; it provides limited chemical protection and is not a hazmat suit.

SCBA: check cylinder pressure, confirm the bypass and regulator function, and know your point-of-no-return air; low-air alarm typically activates at about 25–33% remaining.

High-visibility garments: ANSI/ISEA Class 2 for most roadside work, Class 3 for high-speed or low-light environments; retroreflective material degrades with washing and age.

Hearing protection is required when noise exceeds 85 dBA over an 8-hour average; use the noise reduction rating to estimate attenuation.

Heat illness prevention: hydration, work-rest cycles, and acclimatization; heat stroke is a medical emergency requiring rapid cooling.

Post-exposure: wash immediately, report the exposure, and follow the jurisdiction's post-exposure prophylaxis protocol for bloodborne pathogens.

Scene safety is the first priority; no patient care begins until hazards are identified and controlled and PPE is in place.

Standard precautions apply to all patients regardless of diagnosis: gloves, eye protection, and gown or mask when splash risk exists.

Vaccination status, including hepatitis B, should be documented for all rescuers; unvaccinated rescuers follow a defined exposure protocol.

Sharps: never recap a needle by hand; place sharps in a rigid, puncture-resistant container at the point of use.

Rescuer fatigue degrades CPR quality; rotate compressors about every 2 minutes, ideally during AED analysis or rhythm checks.

Lifting mechanics: keep the load close, bend the knees, avoid twisting, and use team lifts for stretchers; back injuries are among the most common rescuer injuries.

Violence and aggression: maintain an exit route, keep a barrier between you and the patient, and withdraw if the scene becomes unsafe.

Vehicle safety: seat belts for all occupants, secure equipment, and driver fatigue management; emergency vehicle crashes are a leading cause of responder death.