NREMT - EMS Operations

The cold zone or clean zone is

an area where adequate decontamination has ensured that there will be no spread of any hazardous materials and EMS are able to fully treat patients.

Traffic law requires that an ambulance must

stop for a stopped school bus and wait until the bus driver turns off the flashing lights and retracts the stop sign

When cutting the wires of a battery inside a vehicle...

The negative battery cable, often black in color, should be cut first. This will create a break in the electrical circuit of the vehicle. Be sure not to touch any metal component of the vehicle while doing this!

When approaching an intersection...

Always drive as far left as reasonable

You should never pass on the right because...

drivers are taught to pull to the right when they see an emergency vehicle.

Waiting for traffic to clear or taking a longer route may be safer but it...

will greatly reduce your response time in an emergency. Use these as a last resort and have good justification.

A mechanical-piston device and load distributing band device are capable of...

providing constant chest compressions for the patient in cardiac arrest

START triage uses the mnemonic

RPM(Respirations, pulse, mental status). Using this tool allows you to quickly and accurately triage any number of patients.

The cold, or green, zone is where the...

majority of treatment will occur. Patients in the cold zone have been decontaminated but emergency personnel should still take appropriate safety precautions.

If the pediatric patient is apneic but does have a pulse, you should..

reposition their airway and check for respirations.

If they still are not breathing...

you should administer 5 rescue breaths and then recheck respirations

If the patient is still apneic, they should be triaged as..

Deceased

If the pediatric patient is apneic and pulseless, they should be...

Deceased

A windshield survey is a

quick survey that will help you to form a general impression of the condition of the occupants in the vehicle and the resources you will need to help them.

Command, triage, and transportation are the

core of what all activities during a mass casualty incident are based on. Maintaining these three components creates a basic framework to help organize the mass casualty incident.

Autonomy refers

to the patient's right to refuse medical care. It also includes the patient's right to choose medical care. Despite having a life-threatening medical condition, you cannot force the patient to allow treatment or transport in this situation.

CHART

C- Chief Complaint

H- Patient Medical history and history of incident

A- Patient assesment

R- Treatment

T- Transport

Red tags...

(immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival.

Yellow tags

- (observation) for those who require observation (and possible later re-triage). Their condition is stable for the moment and, they are not in immediate danger of death. These victims will still need hospital care and would be treated immediately under normal circumstances.

Green tags

- (wait) are reserved for the "walking wounded" who will need medical care at some point, after more critical injuries have been treated.

Mitigation involves

early warning to disasters in an effort to try and reduce the destruction of an event.

The six basic components of the incident command system are:

command, operations, planning, logistics, finance, and safety.

Decontamination

is an important process at any hazardous materials incident and should be performed prior to placing patients in emergency apparatus. It is A process that involves removing, preventing, or reducing the spread of hazardous materials

DUMBELS

defecation, urination, miosis, bradycardia, emesis, lacrimation, salivation

A disaster is an incident

with 100 or more patients

a MCI can have anywhere from

twenty-six to ninety-nine patients

Patients in cardiac arrest are an absolute contraindication

for all types of aeromedical transport

Medically stable patients should use

ground transport

A DNR or Do Not Resuscitate Order is another name for

an advance directive

A GCS of less than 10 may mean

that a patient would benefit from aeromedical transport.

HEPA stands for

High Efficiency Particulate Air

Hepatitis C is a condition

in the liver that can lead to many life threatening conditions as the disease progresses throughout the patient's life. It is primarily spread through blood to blood contact.

Fire Hazard - Red

Flash Point-temp to incite air

Scales from 1-4 with increasing deadliness

HEALTH HAZARD - Blue

Scales from 1-4 with increasing deadliness

Reactivity (Instability) - Yellow

Scales from 1-4 with increasing deadliness

Specific Hazard - White

OX or OXY Oxidizer

W (with line through it) Use no water

Alpha radiation is a

very weak type of radiation that can be stopped by the skin.

The primary blast injury is

caused by the shockwave hitting the body.

Secondary blast injuries are caused

by fragments being propelled through the air and striking the body.

Tertiary blast injuries are

when the body is projected onto an object (i.e. thrown into a wall), or the object strikes them (i.e. a building collapsing onto someone).

During a technical rescue incident.

the safety of the rescue patient comes "last"

When performing safe parking, ensure that you

have parked far enough from the scene of the crash so that you have a safe working area as well as a buffer zone in case another vehicle strikes the emergency apparatus.

When parking your emergency vehicle to block oncoming traffic at the scene of a crash...

Park at a 45 degree angle to deflect traffic away from the incident if a vehicle does hit the emergency apparatus. If you need to shut down all lanes of the road, don't hesitate to do so. Your safety and the safety of all personnel at the scene is more important than keeping a road open for travel.

Type I ambulances are

a box-stylepassenger compartment on a truck chassis.

Type II ambulances are

a van chassis with a raised roof in the patient compartment.

Type III ambulances are

a box-stlye passenger compartment on a van chassis.

A patient's HIV status is protected healthcare information and therefore should not be

shared with the police unless you are presented with a formal subpoena

The Safety Officer is

ultimately in charge of deciding whether it is safe to proceed with a rescue operation.

The multiplex system is made up

of multiple duplex channels.

Duplex systems

send and receive data over the same frequency.

Combining duplex systems allows

for multiple tiers of communications to occur at once.

The helicopter crew's first priority is to

keep everyone safe. Approaching a helicopter without direction from a crew member is extremely dangerous and should never be done.

A Physician Orders for Life Sustaining Treatment (POLST) form is a

document created by you and your doctor that informs emergency care providers what kinds of treatments you want (and don't want) in a medical emergency.

Presence of fluids, airbag deployment, and electrical system components are

all categorized as vehicle hazards.

Environmental hazards include

time of day, weather, and temperature.

A strike team is

organized to include the same kind and type of resource.

Each strike team should havee.

a designated leader and have the ability to communicate between all single resources in the team.

A strike team may be

a part of a task force

Spinal boards were introduced to EMS in 1968 originally

for extrication of patients from diving accidents. Protocols were updated to include widespread use of spinal boards by the DOT in 1984.

On-line medical control is

through the use of radio or phone communication. Your standing orders or protocols all work off of off-line medical control. If you called to request additional medicine or something outside of your scope of practice, you are working off of on-line medical control.

Incendiary devices are

those that have decreased explosive power but increased heat production and potential to produce burns..

How far do you park from a fire hazard?

100 feet

The street you responded to is not considered confidential

True

None of our senses can detect radiation.

We must use a radiation detector in order to determine if it is present or not.

In Any distance of 30 nautical miles, or more, from a care facility,

the patient would get there faster by air. Thirty nautical miles is equal to 34.5 miles.

Libel and slander are

both defamatory statements, but libel is written and slander is spoken.

Battery is

unlawful contact.

Malfeasance is a

willful and intentional action that injures someone.

Life jackets, or personal floatation devices, should be

worn any time you are operating in or around water.

Nonmaleficence requires the

paramedic to provide the appropriate treatment to a patient while doing as little harm as possible.

Cribbing is used

to stabilize cars involved in motor vehicle crash while extrication is occurring.

The highest level of training for technical rescue is

the technician. The technician is trained to recognize a hazard, use specialized equipment, and supervise, perform, or participate in a technical rescue.

Airbag deployment can mimic the classic starring pattern caused by a patient's head hitting the windshield

True

You should never leave an elderly suicidal patient

alone. You may have to break into a house or room, especially if the patient is unconscious. You should always be prepared that a suicidal person has a weapon that could harm you, and you should call police as necessary.

The type of anthrax that poses the largest threat to the human population is

inhalation anthrax

Due regard

Heightened sense of responsibility when driving an ambulance

Only use lights and sirens if life-threatening emergency

Must stop at all traffic signs

Park in fend off position (angle); 100 ft behind

Hot zone

zone where hazmat could do damage; must wear lots of PPE

Warm zone

Where decontamination occurs; still need PPE

Cold zone

Where treatment can occur

Helicopter landing

60-100 ft square (ideally 100×100)

Approach from angles 10-2 oclock; pilot cue

Helicopter take off

Into the wind