before the crash…
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Before The Crash…. Kathy Strotmeyer PA American Academy of Pediatrics Pittsburgh, PA 412.885.0266 [email protected]. Today’s Objective…. Understand each other’s goals at the scene of a school bus crash. Increase levels of communication. - PowerPoint PPT PresentationTRANSCRIPT
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Before The Crash…Before The Crash…
Kathy StrotmeyerPA American Academy of
Pediatrics
Pittsburgh, PA
412.885.0266
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• Understand each other’s goals at the scene of a school bus crash.
• Increase levels of communication.
• Identify areas of cooperation to enhance effectiveness
Today’s Objective…Today’s Objective…
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EMS Roles & GoalsEMS Roles & Goals
• Provide patient care• Medically fragile
students• Locate patients –
accountability• Organize the scene• Remove patients
from scene
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Transportation Roles & Goals
Transportation Roles & Goals
• Identification & Control students
• Facilitate safety of students
• Collect crash data• Cooperate with
emergency responders
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AccountabilityAccountability
• Rosters
• Attendance
• Tracking
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RostersRosters• Name of student• Parent Contact
phone number• Pertinent medical
history (disabilities,illness, allergies etc.)
• Privacy laws are voided during an Mass Casualty Incident
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AttendanceAttendance• Who is on the bus
that day?• Who is on the bus at
the time?• Attendance
information at school accessible?
• Numbers on bus when all else fails.
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Pre-PlanningPre-Planning
• Definitions
• Command
• Information Management
• Logistics
• Communications
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Definition of Pre-PlanningDefinition of Pre-Planning
Preparation made by emergency service personnel for handling a specific incident which has not occurred so those personnel can do an intelligent and effective job in an organized manner
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Preplanning is crucial:Preplanning is crucial:• In an actual incident, size up may be difficult
– Accessibility may be poor (Cattle Chutes)– Vapor cloud may obstruct vision
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Preplanning is crucial:Preplanning is crucial:• Decisions must be made under many
difficult situations– Decisions made within a limited time– Decisions made under duress due to possible
impending severity of the incident
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• Preplans must be practiced and reviewed– Changes can be
made– Personnel can
become familiar with the plan
Preplanning is crucial:Preplanning is crucial:
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• Medical information in the hands of the bus personnel.
• Training– Equipment– Emergency evacuations– Lifts & carries– Students
• Crash procedures
School Bus Pre-Planning
School Bus Pre-Planning
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Steps to Pre-Planning…Steps to Pre-Planning…1. Who should attend?
– Police, EMS, Fire, Schools etc.
2. What are goals of each at the scene?
– Expectations, assumptions?
3. Logistical concerns…– Where do parents report– Where will children be taken…etc.– Who handles the media?
4. Role of Liaison…5. Communicate and compromise
when possible…
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CommandCommand• Unified Command
– School, Transportation Contractor, Police, EMS, Fire…
• EMS commands until patients removed, law enforcement commands during investigation
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Unified CommandUnified Command
E M S O p era tion s R escu e an d P atien t C are
P o lice O p era tion s S cen e C on tro l
In ves tig a tion
F ire O p era tion s H azard C on tro l
S ch oo l A d m in .L iason
Tran sp ort C o .L iason
Incident Com m ander O vera ll C om m an d er
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Unified CommandUnified Command• Multiple rescue / EMS
companies• Fire Departments• Police agencies• NHTSA, NTSB• DER, EPA• Haz Mat Teams• PEMA, Local EMA• Local Government• DPW
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Role of Transporters in Unified Command
Role of Transporters in Unified Command
• Verification and transfer of student information.
• Student custody/tracking.– Custody Vs. Care
• Establish information center for parent and school connection. – Red Cross
• Data collection for future liabilities.
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Incident CommanderIncident Commander
• Assess incident• Develops
appropriate EMS branch assignments
• Requests additional resources
• Work with other agencies
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Triage OfficerTriage Officer• Establish Triage area• Assign EMS
personnel to triage and tag pt’s
• Ensure all pt’s are seen and triaged
• Assist transportation officer
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TRIAGE TAGS• Red
• Yellow
• Green
• White
• Black
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Treatment OfficerTreatment Officer• Establish pt
collection/treatment areas
• Re-triage pt’s as necessary
• Notify transport officer of pt’s ready for transport
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Transportation OfficerTransportation Officer• Obtains status from local hospitals
• Assists with choosing staging area
• Assigns pt’s to transport vehicle
• Records number of pt’s and transport times and location
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Staging OfficerStaging Officer• Keeps track of apparatus and
personnel in staging area
• Send needed unit or personnel to area requesting them
• Sets up an equipment staging area
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Extrication OfficerExtrication Officer• Works with triage to
extricate priority pt’s first
• Works with fire department personnel for hazard mitigation
• Extricates pt’s in a timely and safe manor
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Other UC FunctionsOther UC Functions
•Logistics•Finance•Liaison•Planning•Safety•Information•Communications
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LogisticsLogistics• Vehicles to transport
non-injured or ambulatory injured patients
• School District policy regarding uninjured student release
• Access & egress to and from scene
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CommunicationCommunication• School or contractor
and EMS personnel• Parents• Media – practice
drill• Identify Decision
Makers• Crash Site Liaison
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Information ManagementInformation Management
• Public Information Officer
• Located away from scene if possible
• Parent communications• Student Tracking
information• Parent/Guardian
verifications & releases
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Family on the SceneFamily on the Scene• Family and friends
on scene• Calms patients ?• Try and utilize the
media to have parents go to a different location for information
• Who controls the family members?
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BystandersBystanders
• Bystander’s Safety
• Remember: Some are truly trying to help
• Rubber-neckers
• Patient confidentiality and modesty
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TrainingTraining• Practice drill – mock
disaster• Review & Modification
of preplan• Personnel become
familiar with plan and student disabilities
• Understand Roles involved – theirs and others
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School Bus Personnel School Bus Personnel TrainingTraining
School Bus Personnel School Bus Personnel TrainingTraining
• Classroom student training
• Bus drills with students including evacuation especially for special needs students
• Scenario training
• MCI events
• Rodeo training
• Accident Procedures
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School Bus AccessSchool Bus Access
• Doors• Emergency Doors• Side or rear
Windows• Windshield• Roof access• Sides• Floors
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Bus Crash InjuriesBus Crash Injuries
• Deceleration type injuries
• There may be no seat belts
• Crews may run out of immobilization equipment
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Height of PatientsHeight of Patients• Difficult to
extricate: patient fears
• Patients feet may be at the 4’ level and their head at the 8’ level
• Wheelchairs, Child Safety Seats
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Flow of Patient TrafficFlow of Patient Traffic• Tunneling into
patients if possible• Doors - front may
have to be removed to fit backboards
• Enlarge doors• Enlarge windows• Side wall openings• Roof openings
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Widening the Rear Door Widening the Rear Door
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Removing Side Windows
Removing Side Windows
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Side OpeningsSide Openings
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Removal of PatientsRemoval of Patients
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• You've done this a thousand times.• You've carefully thought out all the
angles. • It comes naturally to you.
• You know what you're doing, its what you've been trained to do.
• Nothing could possibly go wrong, right ?
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WRONG….WRONG….
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Summary & Questions
Summary & Questions