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SECTION 13
MEDICAL ASSISTANCE
Index
1. |
DEFINITIONS: |
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1.1 |
Medical
Disaster: |
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A
medical disaster is defined as an incident where community�s medical
resources are taxed beyond their normal limits. |
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1.2 |
Central
Ambulance Communications Center (CACC): |
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Central Ambulance Communications Center is located in Wallaceburg. |
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CACC
dispatches the Lambton County Ambulance Service and Lambton County
Fire/Rescue Departments. |
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Sarnia
Fire/Police Dispatch notifies and updates CACC as required. |
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1.3 |
Paramedic: |
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Personnel who responds for the Lambton County Ambulance Services |
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1.4 |
Incident Site
Manager: |
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Person
who is designated to oversee the entire on-site response and coordinate
the efforts of all responding agencies |
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Within
the CVECO organization, this would be the Incident Commander |
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1.5 |
Ambulance Site
Coordinator: |
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The
Senior Paramedic of the first responding ambulance assumes this role. It
may be transferred to an ambulance supervisor or manager upon their
arrival at the emergency scene. |
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When
this role is established at an incident, the CACC Dispatcher must be
advised of the person filling the role and of any changes taking place. |
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Within
the CVECO organization this person would report to the Mobile Command
Post and fill the role of Ambulance Incident Commander |
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Index
1. |
DEFINITIONS: |
Continued |
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1.6 |
Ambulance
Traffic Control Officer: |
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This
role is assigned to a Paramedic after the Triage Officer, if more
ambulances than the initial response are being requested. |
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1.7 |
Triage Officer: |
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This
role is assigned to one or more of the first arriving Paramedic. |
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This role may
start with an industry responder and responsibility transferred to a
Paramedic when they arrive on scene. |
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If
more than one Triage Officer has been assigned then the additional role
of �Triage Coordinator� must be assigned to one person to oversee the
coordinated triage of the entire scene. |
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1.8 |
Safety Officer: |
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The
ambulance service may appoint a Safety Officer to ensure ambulance
personnel are taking the necessary measures to protect themselves. |
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If
sufficient ambulance manpower is not available, this task may be added
to the (municipal/industrial) on-scene Safety Officer role. |
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1.9 |
Landing Site
Coordinator: |
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Role
of a person (fire, police, industry, or ambulance service) to coordinate
the safe landing of a helicopter to evacuate casualties from the
emergency scene. |
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Index
2. |
INDUSTRY REQUESTING
AMBULANCE ASSISTANCE: |
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2.1 |
Ambulance responses would not normally require a Code 8, however
incidents involving multiple injuries would. |
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2.2 |
If a
Code 8 is issued, complete the CVECO Code Notification Checklist and fax
to Sarnia Fire/Police Dispatch |
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Reference
Section 8 - Code 8 Noticeable Occurrence for more details |
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2.3 |
Calls
received by Sarnia Fire/Police Dispatch (911) for medical assistance are
transferred to Wallaceburg to the Central Ambulance Communications
Centre, (CACC). |
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The request for
medical assistance may activate the tiered respond system where
municipal Fire and/or Police may be dispatched to the scene. |
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2.4 |
When
requesting ambulance response be prepared to answer the following
questions when asked by the CACC Dispatcher. |
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Ambulance
Service for what City or location? |
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Name of plant
and person who is calling and the telephone number at which they can be
reached? |
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Is the patient
conscious? Breathing? Bleeding? |
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What is the
nature of the emergency? |
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Number of people
injured |
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Provide clear
instructions on the location and address of the plant |
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What happened
(explosion, fire, gas release) |
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Wind direction
and speed. |
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2.5 |
The
Dispatcher will then dispatch an ambulance to the appropriate industry
and address given so approach can be made from a safe direction. |
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2.6 |
Details provided will allow for an appropriate number of ambulances to
be dispatched and an alert to be sent out to all hospitals advising them
of the situation. |
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2.7 |
The
hospitals will then have time to prepare themselves for the number and
types of casualties. |
Index
3. |
CVECO MEMBER PROCEDURES: |
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3.1 |
Each
CVECO member is expected to have internal emergency procedures that will
outline their requirements when medical aid assistance is required.
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3.2 |
As a
minimum the procedures will include. |
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Information the
Plant Dispatcher is to provide CACC Dispatch. |
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Notification of
plant personnel who may be of assistance in the emergency. |
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Personnel
assigned to meet and escort the ambulance to the medical scene |
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Staging area if
multi-ambulance response is required. |
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Safe access and
exit routes to and from the scene. |
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How to deal with
a �pronouncement in the field� |
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Index
4. |
TIERED RESPONSE AGREEMENT: |
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4.1 |
Lambton County EMS Service and the Sarnia Fire & Rescue Service have a
tiered response agreement. |
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4.2 |
Tiered
response comes into effect should the ambulance service/system become
overwhelmed to the point that an ambulance cannot be dispatched and
reach the scene within ten minutes (10 minutes) of receiving a Code 4
response (life-threatening call). |
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4.3 |
If the
call type is one agreed upon by the Fire Department and the Ambulance
Service (e.g. cardiac arrest, patient requiring extrication), the Sarnia
Fire & Rescue will be requested to respond and assist until the arrival
of the ambulance. |
Index
5. |
LAMBTON COUNTY MEDICAL RESPONSE: |
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5.1 |
Lambton County Medical Services will respond ambulance according to the
information provided by the CVECO member. |
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5.2 |
For
multi-casualty incidents, the Ambulance Service will up-grade the
response accordingly and contact the Lambton Hospital Group of the
situation. |
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5.3 |
The
Ambulance Service may provide an Ambulance Site Coordinator who will act
as their Incident Commander and work out of the Mobile Command Post. A
Triage Officer who will coordinate the triage activities at the scene
and a Traffic Control Officer if more vehicles are being requested. |
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5.4 |
The
coloured identification vests they will wear at the emergency scene
identify the Ambulance Service coordinators. |
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Lime Green Vest
- Ambulance Site Coordinator (Incident Commander) |
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Orange Vest -
Traffic Control Officer |
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Orange Vest -
Triage Officer |
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Orange Vest -
Paramedic |
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5.5 |
CVECO
members with medical facilities may treat walking wounded to prevent the
hospitals from being overwhelmed with casualties |
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5.6 |
The
Lambton Hospital group will implement their internal emergency
procedures to handle the incoming casualties. |
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5.7 |
The
casualties will be sent to any one of the following Lambton County
Hospital Group locations |
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Sarnia General
site on Mitton Street |
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St. Joseph�s
site on Russell Street |
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Charlotte
Eleanor Englehart site in Petrolia |
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Wallaceburg (as warranted) |
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Strathroy (as warranted) |
Index
6. |
INDUSTRY REQUESTING AMBULANCE
STAND-BY: |
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6.1 |
In
cases where a major event has happened, and no injuries have occurred
but the potential still exists for people to become injured, a call to
the Ambulance Dispatch using the 911 system is appropriate. |
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6.2 |
Give
the details of the event to the Ambulance Dispatcher and an ambulance,
if available, will be placed on standby at your plant or at a safe
location nearby. |
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Index
7. |
INDUSTRY MEDICAL SERVICES: |
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7.1 |
CVECO
members with medical facilities may treat walking wounded to prevent the
hospitals from being overwhelmed with casualties during multi-casualty
events. |
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7.2 |
The
following companies have medical facilities with treatment beds, a nurse
and first aid responders. |
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Bayer Inc. |
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Dow Chemical |
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Imperial Oil |
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Nova Corunna |
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Nova Sarnia |
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Nova St. Clair |
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Shell Refinery |
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Sunoco Refinery
Inc. |
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7.3 |
The
industry medical staff network through their �Environmental Association
Health Professional organization. |
Index
8. |
CHEMICAL CONTAMINATION: |
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8.1 |
Lambton County EMS personnel will not transport a patient who is
contaminated with a chemical. |
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8.2 |
As
part of their first aid procedures, CVECO member should have the patient
decontaminated by removing the casualties clothing (if required) and
ensuring the patient has been washed clean in a safety shower or by some
other means to remove any chemical contamination. |
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8.3 |
Decontamination equipment is available if required. Information on
obtaining it is found in Section 14 - Hazardous Materials &
Decontamination. |
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8.4 |
If any
chemical(s) are involved fax MSDS product information to the Sarnia
Fire/Police Dispatcher. To the CACC Operations Centre and to the Sarnia
General Hospital. |
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Sarnia
Fire / Police Dispatcher Fax - 344 -
8789 |
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Sarnia
General Hospital Fax - 339 - 7264 |
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Central Ambulance Communications Centre Fax
- 519 - 627 - 9918 |
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8.5 |
The
CACC Operations Center Dispatcher can be contacted by telephone for
non-emergency calls by calling - 519
- 627 - 1678 |
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Index
9. |
TRIAGE TAGS: |
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9.1 |
Triage
is assessing patient injuries, tagging them with emergency services
triage tag to assist in treatment priority. |
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9.2 |
CVECO
members with first aid responders may assign someone as a Triage Officer
until relieved of that role by a responding Paramedic. |
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9.3 |
Triage
tags are generally placed on the patients left wrist, or if an
amputation has occurred, the right wrist. |
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9.4 |
The
tags also have a master numbering system so no two tags have the same
number. |
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9.5 |
Tags
have tear off sections, to make it easier to track patients by their tag
number. |
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9.6 |
CVECO
members who use triage tags should use the same tags as the Lambton
County Ambulance Service. |
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9.7 |
The
triage tags can be obtained through the CAER Administrator. |
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Index
10. |
TRIAGE CATEGORIES: |
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Patients are
triaged into the following categories; |
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10.1 |
RED
Immediate: |
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Patient has a life threatening injury/illness |
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High
probability of survival if transported immediately and receive
definitive care within 30-60 minutes |
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Patients with injuries with poor chance of survival (crushed chest,
crushed skull, 3rd degree burns greater than 50% or 2nd degree
greater than 75%) are still tagged red, but are the last reds to be
transported |
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10.2 |
YELLOW
Urgent: |
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Patient has a potentially life threatening injury/illness |
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Delay of definitive care 2-3 hours is not anticipated to threaten
outcome |
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10.3 |
GREEN
Delayed: |
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Patient does not have a potentially life-threatening injury-illness |
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Extended delay in receiving definitive care should not threaten outcome |
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10.4 |
BLUE
Deceased: |
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Patient is obviously deceased |
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Patient is in cardiac arrest or respiratory arrest and you lack
sufficient personnel to
perform resuscitation. |
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Index
11. |
PRONOUNCEMENT IN THE FIELD: |
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11.1 |
The responding Paramedic after consultation with the Base Hospital
Physician, may, if the situation warrants, make a field pronouncement. |
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11.2 |
Pronouncement may be made if in the medical judgement of the Base
Hospital Physician, the patient has died and initiation of medical
treatment by Paramedics is not appropriate, or the patient has died and
continued treatment of the patient would be ineffective and therefore,
inappropriate. |
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11.3 |
In all cases of sudden death, the Police must be notified and attend at
the scene. In the case of a field pronouncement, the Paramedic will not
leave the scene until a Police Officer arrives. |
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11.4 |
The CVECO member should leave the scene undisturbed and secure the area
to prevent any personnel from entering the area until the Police arrive.
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11.5 |
It is then the Police Officer's responsibility to notify the Coroner and
make the arrangements for the removal of the body. |
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Index
12. |
HELICOPTER ASSISTANCE: |
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12.1 |
If a helicopter is required to evacuate a casualty, the need or request
will be coordinated though the Lambton County Ambulance Service and CACC. |
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12.2 |
If a helicopter is to land at a designated site to evacuate a casualty a
�Landing Site Coordinator� must be appointed to coordinate the safe
landing of the helicopter. |
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12.3 |
Fire, Police, Ambulance or industry personnel based on available
manpower may fill role of the Landing Coordinator. |
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12.4 |
The Landing Coordinator must wear the following safety equipment |
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High
visibility vest or coat |
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Secured
safety helmet with visor |
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Safety
goggles or glasses |
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Index
13. |
HELICOPTER LANDING SITE: |
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13.1 |
The helicopter�s pilot-in-command is responsible for selecting the
landing site and has the final decision on whether or not to land. |
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13.2 |
Using the helicopter�s airborne vantage point, the pilot will select the
site that best meets the following conditions. |
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A clear
area oAt least 33 meters x 33 meters (100� x 100�) is required for the
helicopter to land. |
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Note: |
Gravel and sand sites should be avoided if possible, due to the
potential of injury from flying dust particles and reduced visibility. |
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A safety
area outside the helicopter landing area, extending an additional 33
meters (100�) for the purpose of controlling vehicle and personnel
access during landing and take-off |
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The
selected site will not affect the rescue effort underway |
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The site
should be away from overhead wires or utility poles |
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The landing
surface should be as flat as possible |
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No lose
debris should be within the landing site or the safety area. |
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