Ch 1-5 and 20

What is a profession?

An occupation in which practitioners have specialized knowledge or skills recognized by an organization or agency.

What is professional development?

A career-long pursuit that continues beyond initial paramedic education.

What is professional ethics?

The rules or standards that govern the conduct of members of a profession.

What is the paramedic’s professional obligation?

Acceptance and adherence to a code of professional ethics and conduct.

Who is legally responsible for the clinical and patient-care aspects of an EMS system?

The EMS system medical director.

As whose designated agent does a paramedic practice?

The EMS system medical director.

What is delegated practice?

The practice of medicine by paramedics under authority delegated by a licensed physician medical director.

Are paramedics autonomous medical practitioners?

Generally no; paramedics practice under delegated authority from a physician medical director.

What is scope of practice?

The procedures, medications, assessments, and treatments a provider is educated, trained, and legally authorized to perform.

What is the best distinction between an AEMT and a paramedic?

The scope of practice allowed.

What is certification?

The process of verifying that an individual has completed required education and demonstrated minimum competency.

What is licensure?

The governmental process of granting legal permission to practice a profession.

What is reciprocity?

The process by which one state recognizes a certification or license from another state.

Does National Registry certification automatically authorize practice in every state?

No; the paramedic must still meet the state’s certification or licensure requirements.

What are the four nationally recognized EMS provider levels?

EMR, EMT, AEMT, and Paramedic.

Which EMS level is NOT one of the four nationally recognized levels?

Critical Care Paramedic (CCP).

What is a desirable characteristic of a paramedic?

The ability to establish rapport with a wide variety of patients.

How should paramedics provide care regarding a patient’s ability to pay?

Without regard to the patient’s ability to pay.

What is evidence-based medicine?

Combining clinical expertise with the best available clinical evidence while considering patient needs and preferences.

What is the role of initial paramedic education?

It is the foundation and beginning of professional education, not the end.

What does professional development require?

Continued learning through education, experience, research, and skills development throughout one’s career.

What is community paramedicine?

A form of mobile integrated health care that extends healthcare services into the community.

What is mobile integrated health care?

A model that uses EMS resources to provide healthcare services outside traditional emergency response.

What is critical care transport medicine?

Transport of patients who require advanced critical-level medical care, often between specialized hospitals.

What is tactical EMS?

EMS care provided in high-risk tactical environments.

Where do many tactical EMS practices and techniques originate?

Military medicine.

What is industrial medicine?

Workplace healthcare involving safety inspections, accident prevention, and medical screening of employees.

What is corrections medicine?

Healthcare provided to patients in correctional institutions.

What is sports medicine?

An expanded EMS role in which paramedics may work alongside athletic trainers.

What emerging role of EMS focuses on improving health and preventing illness?

Health promotion.

What aspect of paramedic work falls under public health?

Educating the public about illness prevention.

What is the modern paramedic’s role?

Providing patient care, making clinical decisions, practicing within scope, using evidence-based care, and continuing professional development.

When did the modern EMS system begin developing significantly?

The late 1960s.

What landmark 1966 report exposed deficiencies in prehospital emergency care?

Accidental Death and Disability: The Neglected Disease of Modern Society.

What did Accidental Death and Disability: The Neglected Disease of Modern Society accomplish?

It brought national attention to deficiencies in prehospital emergency care and helped stimulate development of modern EMS.

Who developed an early formal system of battlefield triage and transport?

Dominique-Jean Larrey.

During what conflict were early formal systems of triage and transport developed?

The Napoleonic Wars.

What is triage?

The process of prioritizing patients based on the urgency of their medical needs.

What is a tiered response?

Sending different levels of EMS personnel or resources to an incident in stages.

What is a mutual-aid agreement?

A prearranged agreement between neighboring EMS systems to provide assistance during major incidents.

What should every EMS system have prepared for a catastrophe?

A disaster plan.

What is online medical direction?

Real-time medical consultation with a physician, usually by radio or telephone.

What is offline medical direction?

Medical direction provided through protocols, standing orders, and guidelines established before a call.

What are standing orders?

Pre-established medical instructions that allow paramedics to perform specified interventions without contacting a physician.

What type of medical direction provides direct access to medical consultation?

Online medical direction.

What type of medical direction includes established protocols before the call?

Offline medical direction.

What specialized hospital center should be part of every EMS system?

A trauma center.

What is an EMS system?

A coordinated network of personnel, equipment, facilities, communications, and policies designed to provide emergency medical care.

What is the National EMS Scope of Practice Model?

A model that defines the national levels of EMS provider practice and their associated scopes.

What are the four National EMS Education Standards provider levels?

EMR, EMT, AEMT, and Paramedic.

What is the main difference between an AEMT and paramedic?

The scope of practice and level of care they are trained and authorized to provide.

What is a paramedic’s medical authorization based on?

Delegated practice from a licensed physician medical director.

What is the purpose of EMS protocols?

To provide standardized clinical guidelines for patient assessment and treatment.

What is a paramedic’s expected level of functioning in the dynamic prehospital setting?

Providing care within their scope using established protocols and medical direction while exercising appropriate clinical judgment.

What is scene safety?

Identifying and managing hazards before and during patient care.

What is the first priority of EMS personnel at a potentially dangerous scene?

Protect themselves and their crew from becoming additional patients.

What is PPE?

Personal protective equipment used to protect EMS personnel from hazards such as blood, body fluids, chemicals, and infectious materials.

What are standard precautions?

Practices used to reduce exposure to blood and body fluids and prevent disease transmission.

What are common occupational hazards for EMS personnel?

Vehicle crashes, infectious disease, hazardous materials, violence, lifting injuries, fatigue, and environmental hazards.

Why is roadway safety important for EMS personnel?

EMS personnel are at risk of being struck by vehicles while working near roads and highways.

What is provider wellness?

Maintaining the physical and mental health of EMS personnel.

How can paramedics promote wellness?

Through adequate sleep, nutrition, exercise, stress management, and appropriate support.

What is fatigue?

A condition that can impair judgment, reaction time, decision-making, and physical performance.

What is EMS research?

Systematic investigation used to improve EMS knowledge, treatment, systems, and patient outcomes.

What does the future enhancement of EMS strongly depend on?

The availability of quality research.

How can paramedics contribute significantly to EMS research?

By collecting patient and treatment data accurately and completely.

Why is accurate data collection important in EMS?

It provides reliable information that can be analyzed to evaluate treatments, practices, and patient outcomes.

What is evidence-based practice?

Using the best available research evidence together with clinical expertise and patient considerations to guide care.

Why have many traditional EMS treatments and practices been abandoned or refined?

Research has shown that some traditional practices are ineffective, unsafe, or less beneficial than newer approaches.

What is quality improvement?

A process of identifying problems, measuring performance, and implementing changes to improve patient care and system performance.

What is peer review?

Evaluation of a paramedic’s knowledge, skills, or performance by individuals of similar rank and competency.

What is To Err Is Human: Building a Safer Health System?

A landmark report that brought attention to medical errors and patient safety.

What are the three major types of failure discussed in relation to medical errors?

Knowledge-based failure, rule-based failure, and skill-based failure.

What is a knowledge-based failure?

An error caused by lacking the knowledge needed to make the correct decision or perform an appropriate action.

What is a rule-based failure?

An error caused by applying an incorrect or inappropriate rule, protocol, or procedure.

What is a skill-based failure?

An error involving incorrect performance of a familiar task or skill.

Is logic-based failure one of the three major failure categories?

No.

What is the affective learning domain?

The domain involving attitudes, values, emotions, and behaviors.

What is the cognitive learning domain?

The domain involving knowledge, recall, understanding, and critical thinking.

What is the psychomotor learning domain?

The domain involving physical skills and performance.

What is ventilation?

The movement of air into and out of the lungs.

What is oxygenation?

The process of getting oxygen into the blood.

What is the difference between ventilation and oxygenation?

Ventilation is movement of air; oxygenation is getting oxygen into the blood.

What is respiratory distress?

A condition in which a patient is having difficulty breathing but is still compensating.

What is respiratory failure?

A condition in which the respiratory system can no longer adequately maintain oxygenation and/or ventilation.

What are signs of increased work of breathing?

Accessory muscle use, retractions, increased respiratory effort, and abnormal respiratory rate or depth.

What are accessory muscles?

Muscles used to assist breathing when normal respiratory effort is insufficient.

What can altered mental status indicate in a respiratory patient?

Possible severe respiratory compromise or respiratory failure.

What is a silent chest?

An ominous finding in severe asthma indicating extremely poor air movement.

What is asthma?

A condition involving airway inflammation, bronchoconstriction, and increased airway reactivity.

What is wheezing?

A musical breath sound commonly associated with narrowed lower airways.

What is COPD?

Chronic obstructive pulmonary disease characterized by persistent airflow limitation.

What is emphysema?

A form of COPD involving destruction of alveolar walls and loss of elastic recoil.

What is chronic bronchitis?

A form of COPD characterized by chronic airway inflammation and excessive mucus production.

What is pneumonia?

An infection and inflammation of lung tissue.

What are common findings in pneumonia?

Fever, cough, sputum production, crackles, and dyspnea.

What is pulmonary edema?

Accumulation of fluid in the lungs, commonly associated with left-sided heart failure.

What is orthopnea?

Difficulty breathing while lying flat.

What is a pulmonary embolism?

A blockage of pulmonary circulation, usually caused by a blood clot.

What are possible signs of pulmonary embolism?

Sudden dyspnea, chest pain, tachycardia, hypoxia, and anxiety or restlessness.