Emergency Medical Responder for Climbers (EMRC)

Emergency Medical Responder certification focused on the climbing environment.

This 80 hour course will provide the national standard Emergency Medical Responder( formerly known as First Responder) curriculum necessary for EMR certification. All requirements will be met allowing North Carolina and/ or National Registry testing and discuss the special considerations applying to the climber. EMRC will provide basic skills and experience in application to emergencies on peaks and crags. The student will be performing emergency medical interventions on cliff side where the skills will be most needed.

Prerequisites:
Be 18 years of age, an emancipated minor,or have completed parent/ guardian orientation.
Complete the EMRC pre-course study modules.
Have an ability to comfortably move through 4th class terrain unroped.
Have an ability to belay and follow a lead climber through moderate 5th class terrain on top rope.
Have an ability to protect easy fifth class terrain on lead.
Have a moderate knowledge of climbing and self rescue systems.
Arrive to each course day with functional climbing harness, helmet, weather/activity appropriate clothing, nourishment,shelter and first aid kit.

Locations: rumbling bald, rocky face, Crowders, stone, Moores, pilot. New Hampshire? New river gorge?

BLSC Course Goals
1:Provide understanding of national standard EMR curriculum.
2: Student understands providing for climbing related emergencies.
3: Student demonstrates competence providing EMR interventions in climbing terrain.
4: Discuss Advanced Life Support interventions and how to effectively provide EMR skills after formal rescue personnel arrive.
5:Provide an opportunity for student to test for EMR certification.

NATIONAL EMS SCOPE OF PRACTICE MODEL
Medical Responder
The primary focus of the Emergency Medical Responder is to initiate immediate lifesaving care to critical patients who access the emergency medical system. This individual possesses the basic knowledge and skills necessary to provide lifesaving interventions while awaiting additional EMS response and to assist higher level personnel at the scene and during transport. Emergency Medical Responders function as part of a comprehensive EMS response, under medical oversight. Emergency Medical Responders perform basic interventions with minimal equipment.
Educational Requirements: One of the eligibility requirements for licensure at this level requires successful completion of an accredited Emergency Medical Responder training program.

Emergency Medical Responder
Description of the Profession
The Emergency Medical Responder’s scope of practice includes simple skills focused on lifesaving interventions for critical patients. Typically, the Emergency Medical Responder renders on-scene emergency care while awaiting additional EMS response and may serve as part of the transporting crew, but not as the primary care giver.
In many communities, Emergency Medical Responders provide a mechanism to increase the likelihood that trained personnel and lifesaving equipment can be rapidly deployed to serious emergencies. In all cases, Emergency Medical Responders are part of a tiered response system. Emergency Medical Responders work alongside other EMS and health care professionals as an integral part of the emergency care team.
The Emergency Medical Responder’s scope of practice includes simple, non-invasive interventions to reduce the morbidity and mortality associated with acute out-of-hospital medical and traumatic emergencies. Emergency care is based on assessment findings. Additionally, the Emergency Medical Responder provides care designed to minimize secondary injury and comfort the patient and family while awaiting additional EMS resources.
A major difference between the lay person and the Emergency Medical Responder is the “duty to act” as part of an organized EMS response.
In some systems, Emergency Medical Responders serve as a part of the crew on transporting EMS units; however, the EMR is not intended to be the highest level caregiver in such situations. They must function with an EMT or higher level personnel during the transportation of emergency patients. The scope of practice model of an EMR is limited to simple skills that are effective and can be performed safely in an out-of- hospital setting with medical oversight.
After initiating care, the Emergency Medical Responder transfers care to higher level personnel. The Emergency Medical Responder serves as part of an EMS response system that ensures a progressive increase in the level of assessment and care.

Psychomotor Skills
The following are the minimum psychomotor skills of the EMR: • Airway and Breathing
o Insertion of airway adjuncts intended to go into the oropharynx
o Use of positive pressure ventilation devices such as the bag-valve-mask o Suction of the upper airway
o Supplemental oxygen therapy
• Pharmacological interventions
o Use of unit dose auto-injectors for the administration of life saving medications
intended for self or peer rescue in hazardous materials situations (MARK I, etc.) • Medical/Cardiac Care
o Use of an automated external defibrillator • Trauma Care
o Manual stabilization of suspected cervical spine injuries o Manual stabilization of extremity fractures
o Bleeding control
o Emergency moves

Course schedule
Module 1: Coffee,greetings, introductions,administration,equipment check and safety.
Module 2: Approach-conversations/demonstrations- BLS summary, Compressions practice.
Module 3: Adult/Child/ Infant CPR/AED with on cliff adult assessment/CPR practice.
Module 4: Adult/ Child/Infant RB and FBAO with on cliff adult practice.
Module 5: ALS familiarization. PIAT scenario. Course debrief. Descent.
Module 6:
Module 7:
Module 8:
Review:
Testing:

Resources
Instructors() [1:3 instructor to student ratio]
Adult manikin () Child manikin () Infant manikin () [1:2 manikin to student ratio]
CPR face shields() Rescue masks () One way valves ()
AED trainer () IV demo kit () advanced airway demo kit ()
Climbing Rope () [one setup and per two students]
Fixed line() [ one fixed line per two climbing lines]
Rack () [adequate for leading,top rope and fixed line anchors]

Budget

Expenses
Manikins- $5 per person. $30 total
Climbing gear- $10 per person. $60 total
Transportation- $ 40 per course. $40 total
Admin- $10 per person. $60 total
Lead instructor- $200 per course. $200 total
Assistant instructor- $100per course. $100 total
Course insurance
TOTAL 6 person course- $490

Income-
Q

Climbing scenarios

80 hour course covering the National Standard Medical Responder curriculum in a climbing environment and focused on climbing related scenarios.

Prerequisite:  BLSC, ability to lead climb confidently and smoothly at 5.8 level, moderate knowledge of climbing self rescue.

Sudden cardiac arrest at base of cliff
Fall on rock  thumb amputation.
Rock fall arterial bleed. TQ. BLSC
Fbao at hanging  snack break belay. BLSC
Lead fall  hangar pop  biner through cheek w/ broken teeth. 
Impaled object  in eye Sam splint cone.
Slab slide.  Massive abrasion.
Ledge fall  bilateral  open ankle fx.
Belayer snake bite /. leader lowered off rope.  
4th class terrain fall with compound tib fib. 
Lightning strike respiratory arrest. BLSC
Avalanche subject uncovered BLSC 
Ice leader fall. Sucking chest wound. BLSC
Bouldering fall. Spinal shock.   BLSC
Top belayer collapse,climber stranded.  RCPR/BLSC
Rock fall. Near foot amputation.
Rock strike to chest.  Commodious cordis.   BLSC
PENDELUM swing causing aortic tear.  
  Causing tension pneumothorax. BLSC
climber found on ledge hypothermia.        BLSC
                 Causing tamponade
Suspension trauma arrest.        BLSC 
Heat stoke?   BLSC
Severe allergic reaction. BLSC
Hyponatremia
Carabiner grab injury
Belayer testicular torsion :  open the book.
Ankle injury..(closed)Ottawa foot and ankle rules:  ankle taping

Cause of Death activity

G-- gated circulation.  Blockage. PE 
R-- respiratory: no oxygen/hypoxia,  failure to add glitter
A--  Available vessel size changes: sliding container changes
V-- volume loss: pop off valve water drain
E-- electrical pump failure:  tickling/jabbing the pump
S-- structural pump failure:  rope compressing the pump