Home Interviews THMG028 – Decontamination, Part V: EMS with Will Bedoya

THMG028 – Decontamination, Part V: EMS with Will Bedoya


In this episode, we talk EMS with Will Bedoya, who is one of our esteemed EMT colleagues. We’ll discuss what happens to patients and his thoughts on decontamination from the warm zone to the hospital.

Complete Show Notes

2:25 Introduction to Will Bedoya

  • EMS lieutenant at one of the largest EMS fire agencies in the Northeast
  • Has worked at this agency for 10 years or so
  • Started at EMT B (Basic) and worked his way up to becoming a BLS instructor
  • Got bored with that and became a paramedic – currently considered a first line officer on the EMS side
  • Also a New York state certified lab instructor, an American Heart Association ACLS and BCLS paddle instructor, and a part-time instructor on Long Island

4:10 What is Haz-Tac?

  • Haz-tac refers to hazardous materials and tactical response
  • Will’s team has an ambulance whose members are specifically trained to administer treatments related to decon
  • They’re trained to receive patients in the warm zone (never in the hot zone) and they know how to begin the decon process immediately
  • His team can go in and start advanced life support – IVs, intubation, drug administration, EKG monitoring, etc.
  • Firefighters and EMS/EMT are very separated when responding to decon situations
  • In haz-tac, everyone is trained to do pretty much anything

8:00 Evolutions in Haz-Tac

  • New viruses like ZIKA and Ebola have definitely changed how Will does his job
  • As with anything, response varies based upon the size of your agency and where you’re located
  • They up triage, presume the worst, and treat patients appropriately – always considering their approach to that patient, how they transport, who’s exposed to that patient, and how to properly notify receiving hospitals

13:00 Treatment of First Responders vs. Civilians

  • There’s no actual difference in terms of care – there is a difference in who they treat first, though
  • Treating civilians before first responders jeopardizes rescue efforts because there are less first responders to help civilians – so, they treat first responders first
  • Take care of yourself first, then your partner, then other first responders, then civilians
  • Civilians can only help themselves, while first responders can help dozens of patients

14:50 Different Zones and the Haz-Tac

  • Consider that zones can be anywhere – places AND people – and they move around
  • Anyone can be contaminated, even people who are asymptomatic
  • Extremists and people in the warm zone have more intense medical treatments, while those in the hot zone are more focused on decon
  • Individuals in the hot zone need to have proper PPE, jumpsuits, gloves, masks, hoodies, etc. and should also be taped
  • There’s a specific process of disrobing that must be followed to avoid cross-contamination or contaminating your bare skin or anything you have underneath
  • If you don’t have time to remove your PPE appropriately because you’re out of air, EMS will continue cleaning you off but will also evaluate you physically
  • They also take into account if you’re not fully decontaminated, along with all of their equipment and people who have come into contact with you

19:30 The Role of EMS in the Response Process

  • Patient care doesn’t change in the ambulance if someone is still contaminated – their biggest concern is whether the victim is viable
  • If a potentially viable patient is contaminated, EMS personnel wear PPE while engaging in patient care in the ambulance
  • There can be various EMS crews in different zones – helps with avoiding contamination
  • Will’s agency carries CO2 meters at all times – some also carry RAD meters, but it depends greatly on the size of your agency and your budget

24:20 EMS and Hazmat Teams

  • Whether EMS brings a hazmat tech along in the ambulance varies greatly based on the size of the incident and the number of resources they have on hand
  • One of his jobs as a lieutenant is to get on the job and quickly make a decision on how the situation is going to unfold – part of that is figuring out whether his crew needs more resources/other teams

28:05 Triaging Treatment with Tags

  • Kick triage is a quick assessment of whether people are safe and whether the scene is safe
  • First, they determine who can walk and/or who has minor injuries (green tags) – they don’t need to be treated immediately
  • RPMS (respiratory, perfusion, and mental status) – teams start right where they are and assess whether people are breathing
  • Respiratory is the first thing they check on – they open the airway once – if the patient doesn’t start breathing, they black tag them and walk away; if they do start breathing, they go to red tag
  • Perfusion is next – basically, they just squeeze the victim’s thumbnail – greater than 2 seconds, they’re red tag; less, you can move on to mental status
  • Next, you talk to them – if they can’t follow simple commands, they’re red tag; if they can, they’re yellow tag
  • Jump start is a pediatric triaging system that also works well – allows you to identify and triage people within 5 seconds when done properly

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