EMS FINAL TEST

Good Samaritan law

protects care providers if they do standard of care in good faith

Duty

Legally obligated to do something

Standard of care

what you’re allowed to do based off your medical level (defined by medical director)

PCR

Patient care report

Ethics and values

moral principals and maintaining your skills. Values=core beliefs

Capacity

someone’s ability to give consent for their care.

If under 18, they can’t consent.

if drunk/mental illness, can’t consent

competence

atient’s ability to understand what is going on around them

Expressed consent

Expressed: person 18, alert, competent, says yes or no

Informed consent

they’re given info, then they choose (ex: before surgery in hospital)

Must state: level of training, why you think they need care, what care you plan, and consequences related to that care/refusal of care

battery

illegal physical contact (ex, tying someone to a pole)

criminal law

body of law dealing with crimes and punishment.

Advance directive

legal document that lets a patient to say BEFOREHAND what their wishes are if they become incapacitated due to a medical illness or severe injury.

(Ex: who can make decisions for Bob, donating organs, prolong/not life, pain management)

POLST

Physician’s Orders for Life-Sustaining Treatment (advanced directive)

Used when seriously ill patient is near end of life

DNR

do not resuscitate

negligence

carelessness, a deviation from the standard of care. causing patient further harm

Confidentiality

can’t give away details to others that hint who your patient was (what they said, looks, acts)

IF the patient says you can in WRITING or the court/police ask, then you can talk about patient

HIPAA

Health Insurance Portability and Accountability Act (made in 1996)

mandated reporters

EMR must report infectious diseases, crime injuries, child/elder abuse, violence

Medical information tags

identify allergies, medications, or medical conditions

crime scene

try not to touch anything, only enter if safe. Report anything you do more or touch

What is the role of the National Highway Traffic Safety Administration, and how is it related to EMS?

responsible for reducing deaths, injuries, and economic costs from motor vehicle crashes on U.S. highways through research, education, and safety standards

what does NHTSA stand for

National Highway Traffic Safety Administration

what is the role of Disaster Medical Assistance Teams?

provide rapid-response, high-quality medical care during public health emergencies, disasters, and large-scale events

what does DMAT stand for

Disaster Medical Assistance Teams

who developed triage

Dominique Jean Larrey

Accidental Death and Disability: The Neglected Disease of Modern Society was an study, which led to what important thing?

Congress passing the National Highway Safety Act

what is the National Highway Traffic Safety Act

a gov agency that sets standards and guidelines to improve road safety and EMS training.

The EMS system - what happens

1. Witness of incident calls 911

2. The Emergency Medical Dispatcher (EMD) sends the appropriate resources.

3. Emergency Medical Responders arrive to assist the patient

4. EMTs and Paramedics continue care and transport the patient to the hospital.

5. Once at the hospital, care is transferred to emergency department personnel.

what are parts of an integrated health service

1. EMS research

2. Medical direction

3. Education systems

4. communication/dispatch

   NOT HEALTH INSURANCE

what is a Medical Director?

a physician who oversees and guides the medical care provided by EMS people

what are the 6 principles of EMS Agenda 2050?

1.inherently safe and effective,

2. integrated and seamless,

3. reliable and prepared,

4. socially equitable,

5. sustainable and efficient,

6. adaptable and innovative

what are the 4 Levels of EMS Education and Training.

1. EMR - often 1st on scene (police officers, firefighters, industrial workers, and other public service providers)

2. EMT - basic ambulance care, transportation, and assessment

3. AEMT (advanced EMT) - Intermediate EMT who did extra learning, like staring IV lines, advanced airway care, and giving more medication

4. Paramedic - advanced life support care, administer meds, interpret electrocardiograms, monitor cardiac rhythms, and perform cardiac defibrillation

Third-service or public utility model

In this model, services are typically operated by non-fire-based government entities within cities or counties.

Alliance model

involves a partnership between a fire service and a private ambulance service.

Crew Resource Management (CRM)

1. pointing out safety hazards

what is Public Safety Answering Point (PSAP)?

a designated 911 dispatch center

what is scope of practice?

1. It shows what jobs/skills each type of EMS is legally allowed to do.

2. MOST THE TIME what you can do is determined by state/regional laws.

3. shows what license/certification required

This model is nationally recognized

off-line medical direction

protocols (guidelines on how to treat stuff) and standing orders (permission to give interventions: med, oxygen)

on-line medical direction

orders on what to do from a physician directly

chief complaint

the main problem, the reason they needed med care

CQI

continuous quality improvement

DMAT

Disaster Medical Assistance Team - very fast EMS people

baseline health status

preemployment medical examination to determine overall health status prior to beginning a job.

what does OSHA stand for

Occupational Safety and Health Administration

OPIM

Other Potentially Infectious Materials (materials other than blood that might carry infectious pathogens)

vaccines one should get

COVID-19, Hepatitis A and B, Influenza, Measles, Meningitis, Mumps, and Tetanus

Standard Precautions Vs Universal Precautions

Standard: Guidelines to deduce risk of disease in health care recommended by CDC (Centers for Disease Control and Prevention)

Universal: approach were you consider everyone infectious until proven not (GUILTY UNTIL PROVEN INNOCENT)

what does NFPA stand for

NAtional Fire Protection Association

4 ways pathogens (disease) enter body

Ingestion (swallowing)

Injection (puncture, sting, bit, needle)

Absorption (through skin)

Inhalation (breathing)

Cleaning Vs Disinfection

Cleaning is removing dirt, dust, and debris from a surface, while disinfecting is killing germs on a previously cleaned surface

Airborn and Bloodborn Diseases (yes/no vaccine)

Air: COVID-19 (yes) + Tuberculosis (no)

Blood: Hepatitis (b - yes, C - no) + HIV/AIDS (no)

Zika

virus spread by bite of some mosquito types

signs/symptoms similar to common flu

can cause brain damage in fetus (if mother is bit)

Ebola (EVD, Ebola virus disease)

often fatal if not treated

Swine flu (H1N1), Avian Influenza

form of influenza

from pigs, spread to humans (swine)

from birds spread to humans (Avian)

SARS

Severe acute respiratory syndrome

Methicillin-resistant Staphylococcus aureus (MRSA)

antibiotic resistant

People with weakened immune systems are at a higher risk (like people in hospitals, healthcare facilities, nursing homes)

exposure control plan

rocedures designed to minimize the risk of infection following exposure to pathogens

Document exposure, report to company/agency, visit doctor

CRM

Crew Resource Management

• a behavioral training program focused on improving team performance and reducing human error in high-risk environments

Placards

identify hazardous materials with coded colors and numbers

codes are in US department of transportation Emergency Response Guidebook

what is CISM and CISD

Critical Incident Stress Management

Critical Incident Stress Debreifing (mental health pros and 1st respondents talking after hard call)

when to move patient

when situation is dangerous for them to be in

when you can’t assess ABC or bleeding

if you need to get to someone else who needs lifesaving care (if Bob is in cardiac arrest inside a room and Jeff is sitting with a broken leg in the doorway, move Jeff to get to Bob)

body mechanics

LIFT WITH LEGS (feet shoulder width apart, back straight). If you break your back, you’re just one more person to treat

drags

clothing drag

blanket drag

shoulder drag

strap drag

when going downstairs, grab the patient under the shoulders and pull them headfirst as you walk backward

Emergent vs Standard move

emergent - relocating a patient immediately due to a life-threatening danger (e.g., fire, explosion risk), without time for spinal precautions.

standard - non-urgent patient transfer where proper assessment and spinal precautions can be taken to ensure safety

direct ground lift

moving patient from floor to bed/stretcher

One person supports upper body and head, other supports lower body.

start on one knee and then stand up together whole holding them

extremity lift

ground to chair or stretcher (or chair to stretcher)

one person holding knees. One person holding patient up from under the armpits and holding the patients wrists

direct carry

from bed to stretcher

one person supports neck and shoulders, other supports lower back and knees

stretcher types

single operator (one person loads stretcher into ambulance)
dual operator (2 people)

Power stretcher (automatic)

Bariatric stretcher (for obese people. Max 1600 lbs)

Extrication vest

An extrication vest is a medical device used to stabilize and immobilize a patient's spine and torso during removal from confined spaces, such as vehicles after accidents.

Pedi-Board

spine immobilization board for infants and children

Fowler’s positions

fully sitting

semi-Fowler’s position

semi sitting

shock position

lying on back, feet elevated 6-12 inches

(don’t do if significant chest/head injury)

log roll

also be used for transferring a supine patient onto a long backboard when there is a likelihood of neck or back injury

Lift-and-Slide onto Long Board

minimum 5 people lift victim (4 body, one stabalizes neck and head), then slide the board beneath the patient and place them down

restraining people

need at least 4 people to help - each person to 1 limb

check ABC often.

victim restrained face up

Positional Asphyxia

Positional asphyxia is a form of suffocation that occurs when a person's body position/restraints prevents adequate breathing.

psychophysiology definition

how disease processes affect how the body functions

perfusion

circulation of blood through tissues

cardiopulmonary system

respiratory and cardiovascular system working together

what happens when perfusion fails?

SHOCK

aerobic vs anaerobic metabolism

aerobic: enough glucose and oxygen

anaerobic: occurs when not enough oxygen

(can’t make lots of energy. overuses waste products)

patent

open and clear. no obstructions and stuff

bronchoconstriction

lower respiratory tract

muscle spasm around small tubes in the lungs (bronchioles) - reduces airflow

causes: asthma, allergic reactions

breathing averages

12 - 20 breathes per minute (adult at rest)

tidal volume of 500 mL of air (adult at rest. Often lower for females)

medulla’s function

in brain - controls breathing (initiates breathing, inhaling stuff)

strokes and brain tumors (and brain trauma) affect this area

dehydration signs

dry eyes, sunken eyes, rapid heart rate, low blood pressure

edema

poor fluid distributation

causes swelling in ankles and feet

Permeability problems

when capillary leaks fluid

causes infections + diseases

hypertension

AKA High blood pressure

cardiac output

amount of blood ejected from heart in 1 min

(function of stroke volume + heart rate)

average is 5 liters per minute

heart rates over 180

actually decrease stroke volume, cause heart doesn’t have time to fill up entirely

compensation

if drop in blood pressure (cause lesson blood overall), the blood vessels narrow

Anatomical position

sitting up, face forward, arms down, palms up

anterior vs posterior

anterior is front

posterior is back of body

lateral

is the side of the body, located away from the midline.

medial

anything towards the midline

superior vs inferior

closer to the top of the head (superior)

more towards the feet (inferior)

proximal vs distal

closer to the torso (proximal)

or further away from it (distal)

physiology

the study of the functions and processes of the body's systems and organs.