Patient-friendly rescue
Patient- friendly rescue or patient-oriented rescue describes the interaction of medical and technical rescue to free the injured from predicament such as entrapment or spills as a result of natural disasters, traffic or industrial accidents.
As a rule, patient-oriented rescue is used in a traffic accident. In this article, the measures applied are explained using the example of a traffic accident, whereby the basic principles also apply accordingly in other situations.
Basics and coordination between medical and technical staff
The main goal of the rescue is to bring the injured person to intensive care in a hospital in the shortest possible time. In each individual case, however, it is carefully but quickly weighed up whether the injured person can possibly be expected to be rescued a little longer if this can prevent possible injuries from worsening. This requires close and trusting cooperation between the fire and rescue services.
There are basically three types of patient-oriented rescue:
- Immediate rescue (formerly crash rescue): The so-called immediate rescue is about rescuing the patient from the vehicle as quickly as possible, even if the patient may have to risk further injuries. If the car is on fire, if it threatens to crash or if the patient's vital functions are missing , there is no time for a gentler rescue; the patient must then be saved as soon as possible in order to save his life. Consequential damage such as B. paraplegia can be accepted (guiding principle: “life before function”). This rescue method is now known as immediate rescue. So the immediate life saving is in the foreground, but attention is paid to the safety of the emergency services and the patient.
- Fast rescue: In the case of fast rescue, which is used in most cases, rescue measures are precisely tailored to the patient's condition and determined in cooperation between the emergency doctor and the head of the technical rescue (fire brigade).
- Gentle rescue: with gentle rescue, further measures are taken and work is carried out even more carefully in order to move the possibly injured spine as little as possible. However, this method is only used for injuries to the extremities and the spine alone, if there are no life-threatening injuries. However, it does not work slowly.
Patient-oriented rescue therefore means that the necessary rescue measures are always adapted to the patient's state of health. Immediate rescue is therefore patient-oriented, although further injuries to the patient are accepted. The principle applies: "As quickly as necessary, as gently as possible."
Execution when rescuing from accident vehicles
A patient-friendly rescue can be divided into the following five stages:
First opening
Before the first opening, there is an investigation by the group leader or the head of operations . In consultation with the rescue service, a quick initial opening is carried out, through which the emergency doctor or the rescue service can check the vital functions and discuss the further procedure and the risk to the patient with the fire service. Options for opening a vehicle for the first time include open doors or the side and especially the rear window. The front pane usually consists of laminated safety glass and is more difficult to open than other panes and is therefore unusual because of the additional risk of injury to the patient with glass splinters. The initial opening should allow access to the patient so that the emergency doctor can decide whether a gentle rescue is possible or an immediate rescue is appropriate. At the same time, the second attack team (the water squad) of the fire brigade secures the scene of the accident against road traffic and other sources of danger and ensures fire protection, while the hose squad provides the necessary equipment.
Behavior inside the car
If the rescue service has completed the first aid or in parallel with the first aid, a so-called “inner rescuer” goes into the vehicle. Its task is to calm the patient down and to inform them about the procedure and to explore the interior. Due to the large number of active safety devices, it is important to know where they are installed. The inner rescuer scans the vehicle for airbags. When doing this, attention should be paid to symbols such as “SRS” or “Airbag”. The rescuer also checks whether the vehicle is still carrying electricity. Depending on the situation, the possibility of de-energizing the vehicle is considered.
Vehicle security
In parallel to the initial opening and to check the vital functions, the vehicle is secured against movement. This is done with scaffolding wood, special substructure blocks or safety systems. To further stabilize the vehicle, the tires can be made airless by pulling the valves with pliers, cutting them off or unscrewing them with a special tool. As a result of this measure, the vehicle almost only rests on the substructure and no longer on the tires. The tires should not be punctured, as they can be used by the police as lane carriers.
Working opening
If the vehicle is severely deformed so that patient care is not possible or only possible to a limited extent, the vehicle body must be mechanically processed. This can be done in a number of ways. Often one or more doors are removed. In addition, the roof can be removed and the windshield cut through. A glass saw or a sheet metal ripper is usually used for this. It may also be necessary to open the floor pan.
Escape opening
The final step is to rescue the patient. An axially aligned rescue to the rear via the trunk with the scoop stretcher or a rescue board is preferred by the rescue service, as the patient's spine is thus least stressed. For this purpose, the floor body is cut on the side of the driver and front passenger seats. Then the engine compartment is tipped forward with a rescue cylinder so that the driver is free. In addition, it is often necessary to remove or bend the pedals to free the feet as well. If rescue to the rear is not possible or injury to the spine is ruled out, the patient is rescued through the door. In consultation with the rescue service, the patient is carefully turned and pulled out. Then the patient is rescued with the help of a rescue corset , a scoop stretcher or a spine board.
Participating organizations and emergency services
In Germany, technical rescue is usually carried out by the fire brigade ; in the event of major damage incidents, the Technical Relief Organization (THW) is also used.
The combination of medical care and technical rescue means that members of the rescue service and technical aid organizations (fire brigade, THW) work together.
Equipment for patient-friendly rescue
Technical rescue
The most important devices in patient-oriented rescue are hydraulic rescue devices such as
In addition, equipment for supporting and securing is important because vehicle movements are to be minimized. Which includes
- Firewood and special safety systems,
- Multipurpose train ,
- Lines and wheel chocks as well
- built-winds (as of rescue vehicles and partly on assistance delete's group vehicles can be found).
Medical care and transportation
In addition to the equipment for stabilizing the vital functions (emergency medication, ventilation, etc.), which is still used in the accident vehicle if possible, various devices are used to mechanically stabilize the spine in particular ( KED systems , scoop stretchers , cervical splints , vacuum mattresses, etc.) .).
Individual evidence
- ↑ Patrick Allinger: What actually is patient-oriented rescue? In: Technical assistance. Retrieved April 9, 2016 .
