EMS Systems, Safety, Legal Issues, Communication & Documentation

Comprehensive question-and-answer study cards covering EMS systems, legal concepts, infectious diseases, patient communication, consent, and documentation guidelines.

Who provides national oversight and model guidance for EMS?

The National Highway Traffic Safety Administration (NHTSA).

Who has governmental control over its own EMS system?

Each state.

Who issues an EMS provider's license?

The state.

What does the National Registry of Emergency Medical Technicians (NREMT) provide?

National certification; it does not issue the state EMS license.

What is reciprocity in EMS licensure?

A process that may allow an EMS provider licensed or certified in one state to meet requirements in another state; exact requirements vary by state.

Who can serve as an EMS medical director?

A physician (MD or DO) who treats humans.

What does an EMS medical director help establish?

The system's protocols and guidelines.

When should an EMS provider contact medical direction?

When unsure about treatment, when a situation is not clearly covered by protocol, or when clarification about a treatment or medication is needed.

What does QI stand for in EMS?

Quality Improvement.

What do Quality Improvement (QI) personnel review?

Patient Care Reports (PCRs), protocol compliance, and patient outcomes.

How can Quality Improvement (QI) affect EMS protocols?

QI can identify the need for protocol or guideline updates.

What is evidence-based medicine?

Clinical care based on the best available scientific research, patient outcomes, medical research, and recommendations from medical organizations.

What is the basic process for updating clinical guidelines?

Research -> evidence -> evaluation -> updated guidelines or protocols.

Why are standard precautions used in EMS?

To protect EMS providers and patients from exposure to potentially infectious materials.

What are examples of standard precautions?

Gloves, masks, eye protection, and other appropriate personal protective equipment (PPE).

What is the key difference between a sign and a symptom?

A sign can be seen or measured; a symptom is stated by the patient.

How do objective and subjective information relate to signs and symptoms?

Objective information corresponds to signs; subjective information corresponds to symptoms.

What PPE may be appropriate for a coughing patient with blood-tinged sputum?

An N95 respirator and eye protection or a face shield.

What should be placed on a coughing or spitting patient when appropriate?

A surgical mask.

What type of infectious agent is Ebola?

A virus.

What type of infectious agent causes tuberculosis?

Bacteria.

What type of infectious agent causes malaria?

A protozoan.

What type of infectious agent is a tapeworm?

A helminth.

What does a virus require to reproduce?

A living host cell.

What does MRSA stand for and what type of organism is it?

Methicillin-resistant Staphylococcus aureus; a bacterium that is resistant to certain antibiotics.

What is an antigen?

A substance that stimulates an immune response in the body.

What is informed consent?

Consent given after the patient understands what is being done, relevant risks and benefits or alternatives, and what may happen if treatment is refused.

What is implied consent?

Consent assumed during an emergency when the patient cannot communicate and a reasonable person would want treatment.

What is expressed consent?

Consent given verbally or nonverbally.

According to the instructor, can a 16-year-old biological parent make medical decisions for her own child?

Yes.

Does becoming a biological parent automatically emancipate a minor?

No. Becoming a parent does not automatically emancipate the minor.

What is negligence?

Failure to provide the expected standard of care that results in harm or damages.

What is the distinction between assault and battery?

Assault = threat; battery = contact.

What is abandonment in EMS?

Leaving a patient without transferring care to an appropriate person.

To whom should patient care generally be transferred?

A provider with a similar or higher level of training who can meet the patient's needs.

What is duty to act?

A legal obligation to provide care when working in a role or jurisdiction where that duty applies.

Is an off-duty EMS provider automatically required to stop at every accident?

According to the instructor, generally no.

What do Good Samaritan laws generally do?

They may provide legal protection to people who voluntarily provide emergency assistance, depending on the jurisdiction and circumstances.

What do the medical abbreviations Rx, Tx, and Hx stand for?

Rx means Prescription, Tx means Treatment, and Hx means History.

What does PCR stand for?

Patient Care Report.

What is Enhanced 911 or E911?

A system that can provide location information in addition to caller information.

How should an EMS provider communicate with a hearing-impaired patient?

Stand in front of the patient, keep your face visible, speak clearly, articulate words, and use writing or other appropriate methods as needed.

How long did the instructor recommend keeping radio transmissions when possible?

About $20\text{ seconds}$ or less.

Why should EMS providers avoid using 10-codes?

Use clear language because different agencies may interpret 10-codes differently.

What should an EMS provider do after receiving important information or an order by radio?

Listen, repeat it back, and confirm correct understanding.

What is the difference between empathy and sympathy?

Empathy = understanding the person's experience; sympathy = feeling sorry or concern for the person.

How should an alert and oriented patient with shortness of breath generally be positioned?

Upright or in a position of comfort, when appropriate.

What types of information are included in the DOT Minimum Data Set?

Patient demographics, chief complaint, level of responsiveness, skin or perfusion information, vital signs, and primary assessment information.

What two things should treatment documentation always include?

The treatment provided and the patient's response.

What details should be documented when oxygen is administered?

Delivery method, flow rate, the patient's response, and relevant changes in vital signs.

What does the SOAP acronym stand for in documentation?

Subjective, Objective, Assessment, Plan.

What does each component of the SOAP format represent?

S = Subjective (what the patient reports); O = Objective (what the provider observes or measures); A = Assessment (the provider's assessment of the condition); P = Plan (what the provider plans to do or provide).

When should a family member be removed from a resuscitation area?

When the person becomes hostile, belligerent, or a safety threat.

Who becomes the immediate priority if your EMS partner suddenly collapses while you are treating a patient?

Your partner.

What defines a mass-casualty incident (MCI)?

Multiple patients, limited resources, and increased scene complexity.

Why should EMS providers obtain more than one set of vital signs?

Vital signs can change, and repeated measurements reveal trends showing whether the patient's condition is improving, worsening, or staying the same.