Chapter 26: EMT and Paramedics

Why do EMTS and paramedics work irregular hours?

Because emergency services function 24 hours a day

EMT hierarchy rank- lowest to highest

1: Emergency Medical Responder(EMR)

2: Emergency Medical Technician(EMT)

3: Advanced Emergency Medical Technician (EMT)

4: Paramedic

Do requirements for EMTS/Paramedics vary by state?

Yes they do, some states take the NREMT(like NJ) and others have their own test.

How is employment growth looking for EMTs and Paramedics?

Expected to grow faster than average for all occupations

Where should EMTs and Paramedics get CPR certified?

American Heart Association

Who accredits EMT and Paramedic training programs?

CAAHEP

What is a first responder? What are some examples of first responders?

The first people to arrive to the scene after an accident. EMTs, paramedics, firefighters, and police officers are all first responders?

Who has the best job opportunities in EMT and paramedic work?

Those with advanced certification.

What do EMTs and paramedics do?

Assess the nature of the patient’s condition while trying to determine whether the patient has preexisting medical conditions

What do EMTS and paramedics follow in order to provide appropriate care and transport the patient?

Medical protocal and guidelines

Emergency treatment is carried out under the medical direction of who?

A physician.

What must be done to a patient before transporting them in the ambulance?

Immobilizing them and placing them on stretchers.

True or False: Head/neck immobilization is still commonly done.

False, it’s been found that the amount of time it takes for a patient to be neck immobilized is too long and can waste valuable time.

Who is most likely to drive the ambulance during an emergency? Paramedic, Advanced EMT, EMT, or EMR, and why?

The EMR because they have the least amount of skill and experience so it would be wasteful to not put those more experienced with the patient.

Who does the NREMT certify?

Emergency medical service providers at all the four levels.

What are the only things an EMR can do?

Assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies. Transport patients in ambulance under medical direction.

What can an EMT do?

Perform interventions with basic equipment found on ambulance. Things they are certified for and as it varies by state.

What is the difference between an EMT and advanced EMT?

The difference is slowing going away however advanced EMTs are allowed to use more complex equipment along with the basic equipment of an EMT.

Who provides the most extensive prehospital care?

Paramedics

What are some things a paramedic can do that an EMT cannot do?

Deliver drugs to a patient orally. Start an IV, specifically into bones as well, interpret EKGs, perform endotracheal intubations, and use monitors and complex equipment.

What can EMTs and paramedics be exposed to?

Hepatitis B, AIDS, and violence from mentally unstable patients.

In what types of working conditions do EMTs and Paramedics work in?

They must work in all types of weather and do kneeling, bending, and heavy lifting. It can also be very stressful.

Where do most EMTs and Paramedics work?

Metropolitan areas

Where is it most common to find volunteer EMTs?

In small cities, towns, and rural areas

Percentage of EMTs and Paramedics in Private ambulance services? Local Governments? Hospitals?

46% in Private ambulance Services

28% in local governments

19% in hospitals

What are the prerequisites to applying to a formal EMT training program?

A high school diploma and a CPR certificate.

How long does it take to complete an EMT training program?

From less than a year to 2 years.

What degree may a paramedic need to apply to a paramedic training program?

an Associate’s degree

True or False: All 50 states require certification at each EMT level

True

How often do EMTs and Paramedics have to recertify?

Every 2 years.

Why will openings arise in EMT and Paramedic?

Due to growth and from workers leaving the occupation due to limited ability to advance, modest pay, and benefits in private-sector jobs.

What does the acronym BE FAST mean? What condition is it used for?

This acronym is used for strokes and it means “Balance, Eyes, Face Droop, Arms(and legs)/Assessment, Speech, Time

What are some symptoms/signs of a stroke?

They present with weakness, disorientation, lack of proper ambulation, face drooping when smiling, poor balance, speech slurring, arm falling when both are asked to be raised, difficultly with both eyes following finger

Why is time crucial when treating a stroke?

If it’s been too long they can no longer issue TPA which is an anti-coagulant used for clotting strokes

How do you treat hyperthermia?

Slowly(to prevent shock) put ice packs/cold towels on patient pulse points, hydrate the patient if it can be tolerated, remove patient from hot area, take off hat and socks

How do you treat hypothermia?

Slowly(to prevent shock) put Warm packs on pulse points, remove them from cold area if possible, have them lay on a blanket and cover them with one

Why should a hot wash cloth not be used when treating a patient with hypothermia?

Because when the heat wears off all that will be left is the damp skin which will attract cold.

What should be the first step when treating a patient?

Introduce yourself, ask their name, determine if they are a minor, ask for consent

What must EMTs and paramedics do between patients?

change gloves

How do you treat amputation?

While wearing gloves, apply direct pressure to occlude bleeding, do not stop applying pressure and do not remove any gauze, just add gauze. Apply a tourniquet if amputation must be done.

Why can removing gauze hurt a patient?

When taking off the gauze you are also removing the clot that you created.

What are some signs of hemolytic shock? How can it be quickly treated?

They may be light-headed, anxious, clammy, pale, cold, sweating profusely, and have a high heart rate. Elevate the amputated limb, lay the patient down, and cover them.

How to deal with anaphylaxis?

Figure out what allergen is causing this, try to get information from family, check for epipen if it is not there use your own. Do stabbing motion into thigh and leave the epipen there for 10 seconds. After do a massaging motion into the area. If symptoms do not subside within 15 minutes, use a second epipen. Double check that uvula is not swelling, it could cause choking.

How to treat foreign object in eye?

Do not remove object, flush the eyes out and patch both eyes.

Why is it important to patch both eyes?

Because eyes move together, so patching both eyes prevents movement

What do you do if the object is too large to patch in?

Patch around the object

How do you wrap a patient’s arm when their shoulder needs to be immobilized?

Use a triangular bandage, tie a knot for the elbow to rest in, put triangular point of bandage over patient, put sling under arm then bring it back up to tie the cloth together, apply gauze in any places where it is uncomfortable for the patient, then put a swathe around the sling to secure it. Check for numbness every few minutes.

How to treat tooth avulsion?

Clean tooth before returning it to socket, have patient hold it in its place, if they cannot hold it there place it in a glass of milk.

Why is it important to try to hold the tooth in it’s position?

It creates a natural barrier to bacteria and helps preserve the nerve and tooth.

Why can placing the tooth in milk help the tooth?

The milk is high in calcium which helps keep the tooth alive and strong.

How many hours of clinical experience is required for paramedics?

700 hours