Emergency Med - Intro

highway safety act of 1966

established by the department of transportation, required states to develop regional EMS systems

emergency medical services act of 1973

provided funds for the development of local, state, and regional EMS systems and established 15 essential components of an EMS system

emergency medical responders

true time sensitive interventions -- CPR, AED, Naloxone

emergency medical technician

provide basic emergency care -- oxygen and immobilization

advanced EMT

provide emergency care -- IV, some meds, sometimes rhythm analysis

paramedic

provide advance emergency care -- airways, advanced rhythm interpretation, extended medications

defibrillator

most important factor in surviving a cardiac arrest

rotary wing air transportation

used for air transportation 15-100 miles or 30-40 miles in rough terrain/heavy traffic

fixed wing air transportation

used for air transportation greater than 100 miles, pressurized, and requires ground transportation

level 1

full ED capabilities, all specialty services, emergency surgery available 24/7, conducts teaching and research

level 2

full ED capabilities, some specialty services, emergency surgery available 24/7

level 3

full ED capabilities, without specialty services, emergency surgery on-call

level 4

ER with minimal capabilities

red

triage level first priority, most urgent, life-threatening but will likely survive if treated

yellow

triage level second priority, urgent, systemic but not life threatening injuries, can wait 45-60 mins without risk

green

triage level third priority, non-urgent, will not deteriorate for several hours

black

triage level, dead, unresponsive with no spontaneous ventilation or circulation, slim change of survival

emergency medical treatment and labor act

EMTALA stands for

EMTALA

ED must evaluate/treat regardless of payment, all patients must be offered a medical screening exam and any emergency condition must be stabilized; responsibility is on sending physician facility to perform MSE and treat if unstable

capacity

clinical determination that a patient has the ability to use and understand information to make a decision for their care

competency

global assessment and legal determination made by a judge

against medical advice

patient wants to leave, must have capacity, must discuss treatment and potential worsening symptoms and even death

advanced directive

a legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding his or her medical care

do not resuscitate

a written order instructing healthcare workers to not perform lifesaving cardiopulmonary resuscitation

beneficence

physician acts for patient's benefit

non-maleficence

do no harm

autonomy

right of competent adult to make informed decision about their own medical care

justice

fairness, void of bias and unfair decisions

disaster

sudden ecologic phenomenon of significant magnitude that requires external assistance

primary blast injury

direct effect of blast overpressure on tissues

ex: spalling, shearing, implosion

secondary blast injury

due to collateral damage from flying objects or shrapnel

tertiary blast injury

results from victim being propelled through the air and striking stationary objects

quaternary blast injury

burn, smoke inhalation, or chemical agent release as a result of blast

bioterrorism

the release, or threat of release, of a biologic agent among a civilian population for the purpose of causing illness or death in humans, animals, or agriculture that results in the spread of fear and disruption of daily life