EMR chapters 1 & 2

EMR roles can vary pending _____ and _______ of general practice

state; location

EMRs provide a link between the first actions of __________ and more _________ care

bystanders; advanced

in ____, congress enacted the emergency medical services ___, creating a multi-tiered, ________ system of emergency health care with standardized ________

1973; act; nationwide; training

the EMS system is a network of _________ resources and _________ personnel that provides ___________ medical care

community; medical; emergency

types of EMS Systems

fire based systems, private service, third-party services, hospital based services and other services

fire based services are operated by _____, county or _______ fire rescue departments

local; regional

private services are for or not-for _____ companies hired by local government for specific __________ areas

profit; geographical

third-party services are provided by _________-based EMS departments that are not subject to fire or _____ departments and are common amongst _____ cities

community; police; large

hospital based services are ________ up, monitored, and run by _____ hospital systems

backed; local

other systems include other _____ and private systems that do not fir one of the other ______ such as private __________ response systems

police; models; corporate

components of an effective EMS system

regulation and policy, resource management, human resources and training, transportation, facilities, communications, public information and education, medical direction, trauma systems, and evaluation

regulation and policy can be _____ or _____ based

local; state

scope of practice refers to the range of duties and skills that an EMR is ________ and ________ to perform when necessary, using _______ care and based on level of _________

allowed; expected; reasonable; training

scope of practyice provides guidance to ______, but does not have regulatory ___________

states; authority

responders must be aware of _________ that exist for their level of training/____________

variations; certification

levels of EMS training/certification

emergency medical responder, emergency medical technician; advanced emergency medical technician, and paramedic

an EMR is the _____ on scene and begins the course of action, collecting __________ to pass on to next level of personnel when they arrive or are ready to _________

first; information; transport

an EMR works and ________ with other ___ and medical personnel as well as law _________, emergency __________ and others

communicates; EMS; enforcement; management

an EMR is responsible to ensure ______ to yourself and ___________

safety; bystanders

an EMR is responsible to gain safe ______ to patient

access

an EMR is responsible to determine life-__________ conditions and provide immediate ____

threatening; care

an EMR is responsible to ______ more advanced personnel

summon

an EMR is responsible to _____ more advanced personnel

assist

a secondary responsibility of an EMR are to ______/_____ bystanders, or asking them to help

control; direct

a secondary responsibility of an EMR is to _____ bystanders from danger

protect

a secondary responsibility of an EMR is to ______ what you saw, heard and did at the scene

record

a secondary responsibility of an EMR is to __________ patient’s family and friends

reassure

EMRs should ____ together, have effective __________ with other team members

work; communication

EMRs should maintain a _____ and professional __________

caring; attitude

EMRs should control your _____ and _________

fears; anxiety

EMRs should present a __________ appearance

professional

EMRs should be keeping your _______ and _____ up to date

knowledge; skills

EMRs should maintain a ____ and ________ lifestyle

safe; healthy

medical direction is the process by which a __________ directs the care given by ___-of-hospital providers to individuals who are ________ or ill

physician; out; injured

medical direction is usually done by a medical ________, who assumes ___________ of care given

director; responsibility

2 types of medical direction

indirect and direct

indirect or offline medical direction is ________ orders

standing

direct or online medical direction is when EMTs speak directly to __________ for procedures not covered under _________ orders

physicians; standing

types of stressful situations

dangerous, physical and psychological demands, critically injured or ill people, death and dying patients, overpowering sights, smells and sounds, multiple-patient situations, angry or upset patients, family or bystanders, and emotional crisis

emotional crisis’ usually occur _____ or immediately _____ the event

during; after

resuscitation is ALWAYS attempted for a victim without _____ or ____________ except if: valid ___ present at scene, patient with obvious signs of _____, or in a situation ____________ to EMRs life

pulse; breathing; DNR; death; endangering

obvious signs of death: _____ decay, _____ ________, obvious _____ wounds, and dependent ______

tissue; rigor mortis; mortal; lividity

first stage of the grieving process

denial/disbelief

denial/disbelief is the _______ to accept the event has occurred or the ______________ of it

refusal; seriousness

second stage of the grieving process

anger

third stage of the grieving process

bargaining

fourth stage of the grieving process

guilt/depression

final stage of the grieving process

acceptance

critical incident stress are emergencies that involve serious _______ or _____. This can disrupt everyday _____ and ___________ balance

injury; death; mental; emotional

critical incident stress can cause change in _________ with other

interactions

critical incident stress can cause increase or decreased ______

eating

critical incident stress can cause uncharacteristic _____ or ________

humor; silence

follow-up care includes working with supervisors to arrange for a professional ____________ when self-acknowledging _________ of stress

counseling; symptoms

critical thinking is defined as __________ clearly and rationally to identify the connection between ____________ and ________

information; actions

when you use critical thinking, you are constantly identifying new ___________, adapting to the information logically in _____ to determine you best next ________, and anticipating how these actions will affect the __________

information; order; actions; patient

problem solving is defined as the ability to use readily _____________ resources to find __________ to challenging problems

available; solutions

problem solving often requires _________ and _____________

creativity; adaptability

4 areas of closed loop communication

sender, message, receiver, and feedback

the sender of a message is usually a ______, or individual that takes _____ at the scene; they give distinct and efficient _________

leader; charge; directions

the received of a message must give ________ knowledge they received and understood the message by ___________ it; they also must acknowledge when they _____ and ________ the task

sender; repeating; begin; complete

when communicating with families, demonstrate ____________ as well as confidence and _______

credability; empathy

when communicating with families, build ________ and establish _____

rapport; trust

when communicating with families, speak _______, and in terms the family can __________

slowly; understand

when communicating with families, be prepared to ______ information, if necessary

repeat

when communicating with families, be open and _______, especially about the patient’s condition. minimize _____ but avoid giving false ____ or misleading information

honest; fears; hope

when communicating with families, ________ the family that everything that can be done is being ____

reassure; done

the team leader oversees the entire emergency/___________ and ensures everyone works as a ____ to help promote the best possible outcome for the __________

situation; team; patient

the team leader is responsible for assigning and understanding the team _____

roles

the team leader is responsible for setting clear ____________

expectations

the team leader is responsible for __________, directing and acting decisively

prioritizing

the team leader is responsible for ___________ on the bigger picture

focusing

the team leader is responsible for monitoring ___________ while providing _______

performance; support

the team leader is responsible for acting as a ____ _______

role model

the team leader is responsible for _________ the team

coaching

the team leader is responsible for ____________ and summarizing progress

re-evaluating

the team leader is responsible for _________ debriefing sessions

leading

team members provide ____ with skill and __________

care; expertise

team members are responsible for having the necessary ___________ and skills to perform their assigned _______

knowledge; roles

team members are responsible for staying in their assigned _____ but _________ others as needed, as long as they maintain their own assigned _____________

roles; assisting; responsibilities

team members are responsible for communicating with the team leader if they feel they cannot perform their assigned ______, identify something the team leader may have __________ or recognize a _________ situation or need for _______ action

roles; overlooked; dangerous; urgent

team members are responsible for focusing on achieving ______

goals

team members are responsible for sharing pertinent ___________

observations

team members are responsible for asking relevent ___________

questions

team members are responsible for participating in a ___________ session

debreifing

crew resource management emphasizes the use of all __________ resourced to promote effective and efficient _________ and reduce the likelihood of human ______

available; teamwork; error

all members must use ________-_____ communication

closed-loop

crew resource management centers around the team ________, who coordinates the actions and activities of team _________ so that the team functions __________ and efficiently

leader; members; effectively

crew resource management guides team _________ to communicate _________ and openly with the team _______ about __________ or time-critical descisions

members; directly; leader; dangerous

if a problem arises, team members MUST get the team __________ attentions, state their _______, describe the _________ and suggest a _________

leader’s; concern; problem; solution

team member’s if high-performance teams keep their skills and ___________ current and practice together _________

knowledge; regularly

high-performance teams hold __________ sessions after each event

debriefing

the purpose of debriefing is to take a closer look at _________ made and the actions taken with the goal of identifying opportunities for ___________ at the system, team and individual _______

decisions; improvement; levels

four components of debriefing

review, analyze, reflect and summarize

_______ is when the team leader provides a brief recap of the emergency and interventions used

review

________ is when the team reviews and evaluates objective data obtained during the event

analyze

_________ is when the team looks on the actions they took and why, discusses the pros and cons of actions and identifies changes that could be made to improve outcomes

reflect

__________ is when the team recaps main takeway points and develops a list of action items

summarize