Emergency Medical Services and Rescue Operations
EMS and rescue operations
EMS questions test assessment, prioritization, and scope of practice. The primary assessment is airway, breathing, circulation, and a rapid neurological check; the secondary assessment is history and head-to-toe. Know CPR and AED sequence, bleeding control, shock management, and the difference between load-and-go and stay-and-play patients. Medical direction and protocols define scope; fire officers do not exceed it.
Mass casualty triage: START (simple triage and rapid treatment) uses respirations, perfusion, and mental status, often remembered as 30, 2, can do. More than 30 respirations per minute, capillary refill over 2 seconds or absent radial pulse, or inability to follow commands places a patient in immediate (red). Otherwise delayed (yellow); minor (green); deceased or expectant (black) according to local protocol.
Rescue operations include vehicle extrication (stabilize, access, disentangle, package, transport), confined space, trench, water, and rope rescue. Rescue versus recovery is a risk-benefit decision.
Worked example: At a multi-vehicle crash, a patient breathing 36 times per minute and unable to follow commands is tagged immediate (red). A walking patient with minor cuts is green. Do not delay transport of red patients to treat green ones.
Rule of thumb: Fix breathing and bleeding first; triage fast, treat fast, move fast.