Ultimate NREMT Practice

Offline protocols

Pre-established orders EMT can follow without communication with med-control

Online protocols

Direct communication orders EMTs receive from medical control before providing care.

Standing orders

One-time direction given by med control to be used in specific situations without needing to contact them.

Acute stress reaction

Immediate response to a specific event (fight or flight)

Symptoms of acute stress

• Increased HR and BP

• Pupil dilation

• Decreased blood flow to digestive tract

Delayed stress reaction

Occurs post-stressful event (may cause PTSD)

Cumulative stress reaction

Results over long period of time (may cause burnout)

Stress management tactics

Attitude

Outlets

Balance

Warning signs of stress

Irritability

Concentration

Sleeping

Mental health

Appetite

Interest

Drug and alcohol

Chronic pain

Infectious disease

Medical condition caused by growth/spread of harmful organisms within the body

Communicable disease

Can be spread from one person to another

Bloodborne pathogens

Microorganisms present in blood that can cause disease

Contamination

Presence of infectious organisms on foreign bodies

Exposure

Contact with body fluids or airborne particles in a way that allows disease transmission to occur

Bloodborne examples

Hep B

Hep C

HIV

AIDS

STD examples

HIV

Gonorrhea

Chlamydia

Syphilis

Airborne transmission examples

Influenza

Chickenpox

COVID

Foodborne examples

E. coli

Salmonella

Norovirus

Vector borne examples

Plague

Rabies

Lyme disease

Malaria

PPE examples

Gloves

Eye protection

Gown

Masks

Criteria to make a decision

18 y/o (emancipated minor/pregnant)

A&Ox4

No impairment (mental or drug based)

No suicide attempts

A&Ox4

Alert and oriented to:

Place

Person

Time

Situation

Expressed consent

Verbal or nonverbal consent

Informed consent

Pt understands procedure, risks, benefits, and alternatives to procedures

Implied consent

Pt is unconscious or unable to make rational or informed decision about care

In loco parentis

In case of minor, when a responsible party (not parents) consents for treatment

Refusal of care

Includes evaluation, care, transport - get to sign AMA

Must be capable of making decisions

HIPAA

Health insurance portability and accountability act

Covers medical or identifiable information

Mandatory reporting

Requirement to report abuse of any kind

DNR

do not resuscitate orders valid if

physical copy present

includes medical issues, appropriate signatures (pt and doctor), and expiration date

obvious signs of death

mortal damage (decapitation or similar)

dependent lividity

rigor mortis

putrefaction

scope of practice

care you are legally allowed to provide

standard of care

level of care expected to provide

duty to act

individuals responsibility to provide patient care

abandonment

termination of care w/o patient consent and proper continuation of care

assault

fear of immediate bodily harm

battery

unlawfully touching a person

kidnapping

seizing, confining, abducting or carrying a person away forcefully

false imprisonment

unauthorized confinement of a person

defamation

communication of false information that damage the reputation of a person

slander

verbal defamation

libel

written defamation

negligence

failure to fulfill duty within a standard of care that resulted in physical or psychological harm (with proximate cause)

requirements of documentation

patient info (includes complaint, assessment, vital signs, and demographics)

timing

all applicable sections

patient care refusal

must be competent adult patient (informed and educated)

either follows protocol or AMA

offer everyone care and transport

document

prehospital care report (pcr)

legal document that allows for continuity of care, education, and administrative information

Neruo-

nerves

hepato-

liver

arthro-

joint

-itis

inflammation

-algia

pain

-ic/-ous

pertaining to

sub-

under/below

poly-

many

post-

after

intra-

within

peri-

surrounding or protecting

pre-

before

a-/an-

without

ab-

away

ad-

towards

aden-

glandular

adren-

adrenal gland

aero-

air

alba-

white

ambi-

both sides

ano/us/al

anal

angi-

vessel

arter-

arterial

-ase

enzyme

-asthenia

weakness/lack of strength

audi/aur

related to ear or hearing

brachi-

arm

brachy/brady

short/slow

bronchi-

air tubes in lungs

carcin-

cancer

chemo

drug/chemical

chloro

green

chole/o

bile or gallbladder

chrom

color

-crine

secrete

contra

against/counter

cryo

cold

cyan

blue

cyst-

bladder, bag, sac

-centesis

puncture to remove fluid

-ectomy

surgical removal

-graphy

process of recording picture/video

-gram

record or picture

-plasty

surgical repair

-scopy

visual examination

-rrhage/-rhhagia

bursting forth, an abnormal excessive fluid discharge or bleeding

RUQ

liver, gallbladder, intestines, kidney

RLQ

intestines, appendix, ovary

LUQ

stomach, pancreas, spleen, kidney

LLQ

intestines, rectum, ovary

upper airway

nasopharynx, oral cavity, oropharynx, laryngopharynx (epiglottis, vocal fold cricoid cartilage), trachea, esophagus

lower airway

trachea, carina (spot where trachea bifurcates), bronchi, bronchioles, alveoli

right lung

3 lobes

left lung

2 lobes