The duties of the first ambulance team to arrive at a major accident’s scene are essential in two ways (NSW Department of Health, 2008). First, they ascertain the rate at which other resources are mobilized to save as much casualties as possible. Secondly, they are important to give the receiving healthcare institutions the maximum time possible to prepare for the wounded. As such, the duties should be performed rapidly and efficiently.
The attendant in the crew assumes the role of Ambulance Commander (Silver Paramedic) while the driver takes the task of silver control. This paper aims to discuss the duties assigned to these roles of the first ambulance crew on the scene of major accident. Discussion On their arrival at the scene, the crew’s attendant should take the task of Ambulance Commander (AC) or Silver Paramedic and should remain in this position until relieved by a senior ambulance officer. There are various responsibilities assigned to this role.
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First, the attendant should carry out a rapid exploration of the site using either CHALET or METHANE mnemonic (Greaves et al, 2006, p. 560). Under CHALET, the attendant should a)estimate the number of Casualties, b) evaluate potential and present Hazards, c) identify Access paths for other emergency ambulances, d) identify the precise Location of the accident, e) identify already available and needed Emergency services, and f) evaluate to identify the Type of accident.
Under METHANE, the Ambulance Commander should evaluate the scene to identify Major accident, Exact place, Type of incident, Hazards possible and present, Access paths, estimated Number of casualties and Emergency services present and required. Having finished the evaluation and identification process, the attendant should feed back the gathered information to the driver to pass it to the Emergency Operations Center (EOC). The commander uses “triage sieve and sort” method to assign priorities to the casualties of the incident (Nocera & Garner, 2000, p. 35).
Other duties assigned to Silver Paramedic are to identify a parking point and casualty clearing station. The casualty clearing station should be located in an area that will enable smooth and rapid transfer of casualties to nearby hospitals. On the other hand, parking point should be easily accessible by other incoming ambulances. The attendant must not, under any situation, become involved in treating casualties. On the other hand, the crew’s driver should assume the role of silver control in which his/her major duty is to serve as a communication link between AC and EOC.
The driver should stay with the ambulance so as to remain in contact with the Silver Paramedic at all times (Trevithick et al, 2003, p. 165). His first duty is parking the ambulance as close to the incident sites and leave the beacon switched on. Once he/she has made contacts with the attendant, the driver should declare a major accident to the EOC at the earliest time possible providing all details based on either METHANE or CHALET. He/she should remain in the vehicle until instructed to do so by a senior ambulance officer. Conclusion
After arriving at a site of major incident, the foremost ambulance crew’s attendant should take the role of Ambulance Commander while the driver should assume role of Silver Control. The AC should carry out a rapid exploration of the site using either CHALET or METHANE mnemonic. SC on the other hand should act as a communication link between AC and EOC. References Greaves, I. , Porter, K. , Hodgetts, T. & Woollard, M. (2006). Emergency care: A textbook for paramedics. (2nd ed. ). Adelaide: Elsevier Health Sciences. Nocera, A.
& Garner, A. (2000). Australian disaster triage: A colour maze in the tower of Babel. Australian Journal of Emergency Management 15(2): pp. 35-40. NSW Department of Health. (2008, July). The management and operations of the Ambulance Service of NSW. General Purpose Standing Committee Report No. 2. August 1, 2010. <www. ambulance. nsw. gov. au/docs/... /081020councilreport. pdf> Trevithick, S. , Flabouris, A. , Tall, G. & Webber, C. F. (2003). International EMS systems: New South Wales, Australia. Resuscitation 59(2): pp. 165-170.
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