NREMT EMT 1: Scene Size-Up and Safety - Establishing an Incident Action Plan

Establishing an Incident Action Plan

An incident action plan (IAP) is a set of procedures to manage emergencies. It's like having a recipe for a disaster – you need to know what to do in the right order to save lives and prevent further harm. Imagine you're at a restaurant and the kitchen catches fire. You need a plan to evacuate everyone safely.

Key Steps / Core Facts

• Incident Commander (IC): The person in charge of the scene, responsible for making decisions and coordinating efforts. (e.g., "Who's in charge here?")
  • Why it matters: The IC ensures everyone works together effectively.
  • Example: A police officer or a team leader.
• Scene Size-Up: Assessing the situation to identify hazards and resources. (e.g., "What's the situation?")
  • Why it matters: Knowing the scene helps you make informed decisions.
  • Example: Look for potential dangers, such as downed power lines or chemicals.
• Command Structure: Establishing a clear chain of command to avoid confusion. (e.g., "Who's in charge of what?")
  • Why it matters: A clear command structure prevents mistakes and ensures accountability.
  • Example: Designate specific roles, such as incident commander, operations chief, and safety officer.
• Resource Management: Coordinating resources, like personnel, equipment, and vehicles. (e.g., "What do we need?")
  • Why it matters: Having the right resources in place saves time and lives.
  • Example: Request additional personnel or equipment as needed.
• Risk Management: Identifying and mitigating potential hazards. (e.g., "What could go wrong?")
  • Why it matters: Reducing risks prevents further harm and saves lives.
  • Example: Look for potential hazards, such as downed power lines or chemicals.
• Communication: Establishing clear communication channels to ensure everyone is informed. (e.g., "How will we talk to each other?")
  • Why it matters: Good communication prevents mistakes and ensures everyone is on the same page.
  • Example: Use a common language and establish a communication plan.
• Accountability: Ensuring everyone is responsible for their actions. (e.g., "Who's responsible for what?")
  • Why it matters: Accountability prevents mistakes and ensures accountability.
  • Example: Designate specific roles and responsibilities.
• Debriefing: Reviewing the incident to identify lessons learned and areas for improvement. (e.g., "What did we do right or wrong?")
  • Why it matters: Debriefing helps you improve your response for future incidents.
  • Example: Review the incident, identify what went well and what didn't, and make changes for next time.
• IAP Review: Regularly reviewing and updating the incident action plan to ensure it remains effective. (e.g., "Is our plan still good?")
  • Why it matters: A good IAP is essential for responding to emergencies effectively.
  • Example: Review the plan annually or after significant changes.

What Laypeople Can Do

• If you witness an emergency, call 911 or your local emergency number immediately.
• Provide basic first aid, such as CPR or the Heimlich maneuver, if you're trained to do so.
• Keep bystanders away from the scene to prevent further harm.
• Stay on the phone with the emergency operator and provide as much information as possible.
• Follow any instructions from emergency responders or authorities.

Common Mistakes

• Mistake: Not establishing a clear command structure.
  • Fix: Designate a clear incident commander and establish a chain of command.
  • Why: A clear command structure prevents mistakes and ensures accountability.
• Mistake: Not assessing the scene properly.
  • Fix: Conduct a thorough scene size-up to identify hazards and resources.
  • Why: Knowing the scene helps you make informed decisions.
• Mistake: Not coordinating resources effectively.
  • Fix: Establish a clear plan for resource management and coordination.
  • Why: Having the right resources in place saves time and lives.

Quick Practice Scenarios

1. You're at a concert and someone collapses. What should you do first?

Answer: Call 911 or your local emergency number immediately.

1. You're at a restaurant and a fire breaks out. What should you do first?

Answer: Get everyone out of the building quickly and safely.

1. You're at a sporting event and someone is injured. What should you do first?

Answer: Call 911 or your local emergency number immediately and provide basic first aid if you're trained to do so.

Last-Minute Exam Cram

• Agonal breathing is NOT normal breathing – start CPR.
• Normal vital signs: heart rate 60-100 beats per minute, blood pressure 90-120 mmHg, respiratory rate 12-20 breaths per minute.
• SAMPLE: Situation, Ailment, Medications, Past medical history, Last meal, Events leading up to the incident.
• OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Insurance.
• CPR compression depth: at least 2 inches – like pushing down a soda can.
• CPR rate: 100-120 compressions per minute – like a metronome.
• Don't delay calling 911 – every minute counts.
• Don't try to move someone who's injured unless it's absolutely necessary.
• Don't give medication unless you're trained to do so and have the proper equipment.