Introduction to EMS

Flashcards for review on Emergency Medical Services (EMS) concepts, protocols, and regulations.

What event started modern EMS standards?

1966 — Department of Transportation created EMS standards after the 'White Paper' report.

What’s the National Registry of EMTs (NREMT)?

A national certifying organization founded in 1970 to standardize EMT training across states.

What are the four levels of EMS training?

EMR → EMT → AEMT → Paramedic.

What’s the difference between scope of practice and standard of care?

Scope = what you’re legally allowed to do; Standard = how you’re expected to do it.

What’s the main goal of quality improvement (QI)?

To identify problems, correct them, and improve overall care.

What’s the EMT’s first priority on every call?

Personal and scene safety.

What’s patient advocacy?

Protecting the patient’s rights, privacy, and well-being, such as bringing their glasses or locking their home.

What’s the purpose of medical direction?

Physicians oversee EMT care through written protocols or radio/phone orders.

What are Standard Precautions?

Infection control steps to protect from bloodborne or airborne pathogens.

What does OSHA regulate for EMTs?

Workplace safety and bloodborne pathogen precautions.

When should you wear an N-95 or HEPA mask?

When treating a patient suspected of having tuberculosis (TB).

What’s the Ryan White CARE Act?

Allows EMTs to find out if they were exposed to a life-threatening disease while providing care.

What are the 3 stages of stress?

Alarm → Resistance → Exhaustion.

What’s the difference between acute, delayed, and cumulative stress?

Acute = right after incident; Delayed = PTSD (later on); Cumulative = burnout over time.

What are the 3 Rs of reacting to danger?

Respond → Radio → Reevaluate (never re-enter until cleared by police).

What’s resilience?

The ability to recover quickly and stay emotionally strong under stress.

What’s the golden rule of lifting?

Lift with your legs, not your back.

What are the rules for lifting?

Feet shoulder-width apart, back straight, don’t twist, keep weight close to body.

When should you do an emergency move?

When the scene is unsafe or the patient must be moved immediately (e.g., fire, explosion, gas leak).

When is an urgent move used?

When a life threat exists but time allows quick spinal precautions (e.g., before cardiac arrest worsens).

When is a nonurgent move used?

When there is no life threat — do a full assessment first, then move carefully.

What are common patient-carrying devices?

Wheeled stretcher, stair chair, scoop stretcher, basket stretcher, vacuum mattress.

What’s the power grip?

Palms up, hands about 10 inches apart, fingers all gripping — strongest grip for lifting.

What’s the recovery position used for?

Unconscious patient with no spinal injury — keeps airway open and allows drainage.

What’s expressed consent?

When a patient directly says 'yes' — must be informed of what’s happening.

What’s implied consent?

Used when a patient is unconscious or unable to decide and needs life-saving care.

What’s involuntary transport?

When a patient is a danger to self/others and requires law enforcement or court order.

What are the four elements of negligence?

Duty to act → Breach of duty → Damage → Causation.

What’s abandonment?

Leaving a patient after care begins without transferring to equal or higher care.

What’s confidentiality under HIPAA?

Patient info can only be shared with other healthcare professionals involved in care or by subpoena.

What’s a DNR or POLST?

Legal documents that tell EMS not to perform CPR or specify life-sustaining preferences.

What’s the Good Samaritan Law?

Protects people who voluntarily give emergency care in good faith from being sued, usually for civilians, not on-duty EMTs.

What should you do at a crime scene?

Focus on patient care first, but avoid disturbing evidence — note what you touch.

NHTSA’s 10 Components of an EMS System

Regulation/policy, Resource management, Human resources, Transportation, Facilities, Communications, Public information/education, Medical direction, Trauma systems, Evaluation (QI).

Critical Decision Making:

Gather info → interpret → decide treatment/transport.

EMS roles in public health:

Injury prevention, vaccinations, disease surveillance, education.

Research:

Evidence-based practice = decisions based on scientific research (not just tradition).

Types of Diseases:

Hepatitis B/C (bloodborne), TB (airborne), HIV/AIDS (blood exposure).

Immunizations EMTs should keep updated:

Hep B, TB test, flu shot.

Stages of death and dying (Kubler-Ross):

Denial, Anger, Bargaining, Depression, Acceptance.

Critical Incident Stress Management (CISM):

A structured system of crisis intervention and support services for individuals and groups exposed to traumatic events

When to push vs. pull:

Push > pull whenever possible; keep back locked, elbows bent, arms close.

Body Mechanics Rule:

Keep weight close to body and in line with center of gravity.

Spine board use:

Used for suspected spinal injury or vehicle extraction (long board = car crashes).

Res Ipsa Loquitur:

“The thing speaks for itself” — legal concept in negligence cases.

Proximate Causation:

Harm was directly caused by EMT’s action/inaction.

Safe Haven Laws:

Parent can leave infant/child at EMS/police/fire station without penalty.

Special Reporting:

Must report child/elder abuse, sexual assault, gunshot wounds, or domestic violence.

Chain of EMS System

patient

citizen calls 911

emergency medical dispatcher

EMS

EMT

emergency department staff

allied health staff

Standing orders

written protocols established by a medical director that outline specific actions and treatments that EMTs can perform in pre-determined emergency situations

Offline vs online medical direction

Offline medical direction: protocols and standing orders established in advance

Online medical direction: real-time communication with a medical director during emergencies.

What is patient outcomes

The long term survival of patients

What are evidence based techniques

Methods supported by research and clinical evidence to improve patient care

What are pathogens?

Microorganisms such as bacteria, viruses, fungi, and parasites that can cause disease in humans

What is standard precaution

A set of infection control practices used to prevent transmission of diseases.

What is critical stress management (CISM)

a system that includes education and resources to prevent and help stress

What is power lift

A lifting technique that involves bending at the knees to lift heavy items while keeping the back straight, enhancing safety and efficiency.

What does bariatric mean

related to the treatment of obesity, especially concerning medical care and equipment.

Extremity lift

Method of carrying or lifting a patient in which one rescuer slips hand under the patients armpits and grasps the wrists, while another grasps the patients knees

Direct ground lift

A technique used to lift a patient from the ground to a stretcher in which 2 or more rescuers kneel, curl the patient to their chests, stand, then reverse the process to lower the patient to the stretcher

Draw-sheet method

A technique for moving a patient on a stretcher by grasping and pulling the loosened bottom sheet of the bed

Assult vs battery

Assult: Placing a person in fear of bodily harm

Battery: Causing bodily harm to or restraining a person.

Physician's Order for Life-Sustaining Treatment (POLST)

Physician order that states not only the patient's wishes regarding resuscitation attempts but also the patient's wishes regarding artificial feeding, antibiotics, and other life-sustaining care if the patient is unable to state those desires later.

Tort

A civil, not criminal offense

Libel vs slander

Libel: false info in written form

Slander: false info stated verbally

What is the National Emergency Medical Service Systems Act (NEMSSA) of 1973?

Federal law that helped create national funding and standards for EMS systems.

How did military medicine (Korea/Vietnam) influence EMS?

Field care advances (trauma, evacuation) led to modern civilian EMS systems.

What’s the difference between bloodborne and airborne pathogens?

Bloodborne spread via blood/fluids (HBV, HCV, HIV); airborne spread via droplets (TB, flu).

What mask is required by OSHA for TB exposure?

NIOSH-approved N-95 or HEPA respirator.

What’s the rule about approaching potentially violent scenes?

Don’t enter until police secure it; turn off sirens/lights and observe from a distance.

Name 3 types of emergency moves.

Clothes drag, incline drag, blanket drag, firefighter’s drag.

How should you position a patient in shock?

Supine (flat on back); don’t elevate legs or lower head.

What’s the last step before turning over a patient to ED staff?

Ensure patient centered, rails up, stretcher locked.

What does in loco parentis mean?

Person (e.g., teacher, camp counselor) temporarily stands in place of a parent and may give consent for a minor’s care.

What’s the difference between morality and ethics?

Morality = personal beliefs of right/wrong; Ethics = professional behavior standards.

What is decontamination vs. contamination?

→ Decontamination = removing or neutralizing hazardous material;

→ Contamination = contact with harmful substances (chemical, biological, radiological).

What are OSHA’s key requirements for EMTs?

Infection control plan, training, PPE, vaccinations (especially Hep B), and post-exposure evaluation.

What is duty to act?

Legal obligation to provide care while on duty and within jurisdiction.