NREMT

White Paper

In 1966, a paper titled "Accidental Death and Disability: The Neglected Disease of Modern Society" is published by the National Academy of Sciences. This paper, commonly referred to as ________ __________ is considered the birth of modern EMS

American Heart Association

In the 1980s, the ______ ______ ________ increases the emphasis on cardiovascular disease prevention, science, and education. Additional levels of training are added to the existing curriculum and despite advances, the scope of practice for various levels lacks unity.

U.S. Department of Transportation

In the 70s, this federal agency developed the first EMT National Standard Curriculum including textbooks and paramedic NSC

National Registry of Emergency Medical Technicians; National Highway Transportation Safety Administration

In the 1990s, the _____ ____ ___ ___ ___ ___ advocates for the creation of a national training curriculum and the _______ ___ ____ ___ ___ begins work on the EMS Agenda for the Future

National EMS Education Standards (NEMSES)

In the 2000s, the NHTSA identifies universal knowledge and skills for EMS professionals through the new _________ ________ ______ __________. This new curriculum replaces the National Standard Curricula created by USDOT.

EMR

CPR, AED, Oral airways, airway obstruction, manual airway techniques, BVM ventilation, oxygen therapy, airway suctioning, manual BP, auto injector, bleeding control, assisted childbirth

EMT

EMR skills + humidified oxygen, venturi mask, automated transport ventilators, nasal airways, pulse oximetry, auto BP, assisted medications, spinal immobilization, splinting, tourniquet, MAST/PASG, mechanical CPR, assisted complicated childbirth

AEMT

EMT skills + multilumen airways, blood glucose monitoring, IV/IO insertion, medication administration

Paramedic

AEMT skills + BiPap/CPAP, needle decompression, percutaneous cricothyrotomy, ETCO2/capnography, NG/OG tube, intubation, direct laryngoscopy, PEEP, ECG interpretation, manual defibrillation/cardioversion, transcutaneous external pacing, extensive medication administration, thrombolytic therapy

Scene safety

What is an EMT's first priority ALWAYS?

Acute stress

an immediate physiological and psychological reaction to a specific event. The event triggers the body's fight or flight response

Delayed stress

a stress reaction that develops after the stressful event. It does not interfere with the EMT's ability to perform during the stressful event. Posttraumatic stress disorder (PTSD) is an example of ________ _______

Cumulative stress

the result of exposure to stressful situations over a prolonged period of time. This leads to burnout for many EMTs.

Critical Incident Stress Management (CISM)

is a formalized process to help emergency workers deal with stress

- diffusing sessions are held within 4 hours of the incident

- debriefing sessions are held 24 to 72 hours after the incident

Occupational Safety and Health Administration

oversees regulations concerning workplace safety, including infectious disease precautions

Minimum PPE

Gloves and eye protection should be used during any patient contact situation and are examples of...

Expanded PPE

The use of disposable gown and mask for significant contact with body fluids. Use a high-efficiency particulate air (HEPA) mask or a N-95 respirator for suspected airborne disease exposure, such as tuberculosis

not enter; emergency care

Unless cleared by a hazmat specialist, an EMT is expected to _____ ______ and not begin _______ ______ until patients have been decontaminated or otherwise cleared by hazmat crews

not enter; safe distance

When it comes to crime scenes, EMS providers should ____ ______ a crime scene unless law enforcement has determined it is safe. EMS providers may be advised to respond to the call but maintain a _____ _______ away until cleared by law enforcement. This is sometimes called "staging for PD"

highly reflective traffic safety vest

In extrication situations, federal law requires EMS workers wear approved _______ ______ ____ ____ ______ when working on roadways, around traffic, or at an accident scene

Power lift

A method of lifting where one keeps the object close to the body, using the legs to lift and not the back (legs bent, back straight). Use a power grip with palms UP and all fingers wrapped around the object.

Urgent move

the patient has a potentially life-threatening injury or illness and must be moved quickly for evaluation and transport

includes rapid extrication

Rapid extrication

an urgent move used for patients in a motor vehicle; it requires multiple rescuers and a long backboard. The patient is rotated onto a backboard with manual cervical spine precautions and removed from the vehicle

Non-urgent moves

used when there are no hazards and no life-threatening conditions apparent.

includes direct ground lift, extremity lift, direct carry method, and draw sheet method

Log roll technique

commonly used to place a patient on a backboard or assess the posterior, can be done while maintaining manual cervical spine precautions

should have at least 3 trained personnel

Stair-chair

excellent for staircases, small elevators, etc. Does not allow for manual cervical spine protection, CPR, or artificial ventilation

Backboard

used primarily for cervical spine immobilization, allows for CPR and artificial ventilation.

requires 4 people

scoop stretcher

allows for easy positioning with minimal patient movement. good for reducing patient discomfort during movement

rear

when approaching a helicopter, never approach from the

left

if the patient is pregnant and needs to be on a backboard, they should be placed on the ___ side

advance directives

written instructions, signed by the patient, specifying the patient's wishes regarding treatment and resuscitative efforts

includes DNRs and living wills

assault

a person can be guilty of ______ even if another person only perceived that they intended to inflict harm. Physical contact is not required to be guilty of assault.

battery

physically touching another person without their consent

negligence

the most common reason EMS providers are sued civilly

includes a breech of four core values:

- duty to act: the EMT had an obligation to respond and provide care

- breech of duty: the EMT failed to assess, treat, or transport patient according to the standard of care.

- damage: the plaintiff experienced damage or injury recognized by the legal system as worthy of compensation

- causation (proximate cause): the injury to the plaintiff was, at least in part, directly due to the EMT's breech of duty

gross negligence

exceeds simple negligence. It involves an indifference to, and violation of, a legal responsibility.

- reckless patient care

- can result in civil or criminal charges

abandonment

once care is initiated, EMS providers cannot terminate care without the patient's consent. This is the termination of care without transferring the patient to an equal or higher medical authority

continuity of care; billing; subpoena; crimes

EMTs can release patient information without consent when:

1) the information is necessary for ________ ___ ______

2) the information is necessary to facilitate ______ for services

3) the EMT has received a valid __________

4) reporting possible ________, abuse, assault, neglect, certain injuries, or communicable diseases

obvious signs of death

decomposition, rigor mortis, dependent lividity, and decapitation are all _________ _______ ____ __________ and mean that resuscitation is not necessary

dead on arrival; suicide; assault; abuse; crime

Law enforcement or the medical examiner must be notified for situations including:

1) any scene where the patient is ______ ____ _______

2) _______ attempts

3) _________ or sexual __________

4) child _______ or elder _________

5) suspected ________ scene

6) childbirth

repeater

a type of base station that receives low-power transmissions from portable or mobile radios and rebroadcasts at higher power to improve range

mobile data computers

relay digital information instead of voice transmissions

can display the address of the call and routing information

allow digital communication with dispatch and other responding units

reduce the volume of routine radio traffic

federal communications commission

the FCC regulates all radio operations in the United States and has allocated specific frequencies for EMS use only

F.A.C.T documentation

F- factual: the PCR should be fact-based, not opinion based

A - accurate: the PCR should be as accurate as possible

C - complete: the PCR should be complete unless circumstances dictate it appropriate

T - timely: the PCR should be completed as soon as possible after transfer of care

objective documentation

based on facts, findings, or observations that are highly difficult to dispute. Objective documentation is not about being "right"

subjective documentation

based on opinions or perceptions and can be easily disputed. Subjective documentation is about being "right" about your opinion. Subjective information from the patient, however is acceptable and should generally be documented in quotations

associated symptoms

patient complaints in addition to the chief complaint

pertinent negatives

signs or symptoms you have reason to suspect but the patient denies having

abduction

movement away from midline

adduction

movement toward the midline

Shock or Trendelenburg Position

supine with legs elevated

Fowler's position

seated with head elevated and knees bent

ligaments

connect bone to bone

tendons

connect muscle to bone

axial skeleton

consists primarily of the skull, spinal column, and rib cage

7

how many cervical vertebrae are there?

12

how many thoracic vertebrae are there?

5

how many lumbar vertebrae are there?

5 fused vertebrae

how many vertebrae are in the sacrum?

4 fused vertebrae

how many vertebrae are in the coccyx?

appendicular skeleton

consists of the bones of the arms, legs, and pelvis