EXSS 288 Exam 1

Define Emergency medical services (EMS) system

A network of community resources and medical personnel

What is the purpose of EMS?

bring rapid medical care to a victim with a life-threatening injury or illness

The survival and recovery of critically injured or ill victims depends on:

1. Early recognition and response
2. Early activation of the EMS system
3. Care provided until more advanced medical personnel take over
4. Pre-hospital care provided by advanced medical personnel
5. Hospital care
6. Rehabilitation

A lay responder is:

someone who has not been professionally trained to a higher level of medical care.

What is the bystander effect?

The bystander effect is the social theory that states individuals are less likely to offer help to a victim in the presence of other people (great number of people, the less likely they are to help).

a professional responder is:

Someone who is trained with a duty to act

When a lay responder calls 911 to activate EMS, what information should they provide?

1. Name
2. Describe the situation
3. Number of individuals involved
4. Location and directions
5. What treatment is being given

Wait for a dispatcher to tell you what to do

What should you do until advanced personnel arrive?

1. Stay with the victim
2. Monitor the situation
3. Adjust care as needed
4. Inform advanced personnel

What are examples of professional rescuers?

police officers

Fire fighters

Lifeguards

Athletic trainers

A professional rescuer must keep what current?

Their certification

Knowledge of new issues and developments in emergency care

Who handles pre hospital care?

Emergency Medical Technicians (EMTS)

Describe the differences between EMT-Basic, EMT-intermediate, and paramedics

EMT-Basics are responsible for providing basic emergency treatment for respiratory, trauma, and cardiac emergencies. EMT-intermediates are trained to administer some medications and intravenous fluids. Paramedics provide advanced medical care for critical patients with sophisticated medical equipment and about 30 types of drugs.

Who cares for a patient when they arrive at a hospital?

Physicians, nurses, medical specialists, and other health care professionals

What is the purpose of rehabilitation?

Return the victim to their previous state of health

What are the two umbrella groupings within sports medicine?

Human performance and injury management

What roles fall under the human performance group of sports medicine?

Exercise physiology, biomechanics, sport psychology, sports nutrition, and sports massage

What roles fall under the injury management group of sports medicine?

practice of medicine

Sports physical therapy

Athletic training

Who is most directly responsible for all phases of health care in an athletic environment?

Athletic trainer

What are the main roles of an athletic trainer?

injury prevention, providing initial first aid and injury management, evaluating injuries, designing and supervising rehabilitation

Athletic trainer works under direct supervision of a:

team physician

What are some roles of the team physician?

Serves to advise and supervise the athletic trainer

Compiling medical histories and conducting physical exams (pre-participation screenings)

Diagnosing an injury

Deciding on disqualifications

Who has the final say on when an athlete returns to competition following injury?

Team physician

True or false; fitness professionals exemplify the relationship between performance enhancement and injury prevention

True

Sports medicine team is part of the _______ in athletic settings

EMS System

Who works through emergency situations, as well as assisting in injury prevention and rehabilitation?

Sports medicine team

What are the three key things to remember in regards to an emergency action plan?

1. Provide steps and guidance for what to do in an emergency situation
2. Should be reviewed at least once per year with all involved personnel
3. Helps to ensure that the best possible care is provided in an emergency

What should an emergency action plan include?

1. Venue directions (map)
2. Emergency personnel
3. Emergency communication
4. Emergency equipment
5. First responder roles

What are blood borne pathogens?

Bacteria and viruses present in blood and bodily fluids, which can cause disease in humans

What are the 3 most common blood borne pathogens?

1. Hepatitis B Virus (HBV)
2. Hepatitis C Virus (HCV)
3. Human immunodeficiency virus (HIV)

What is hepatitis B?

* liver infection resulting in swelling, soreness, and loss of normal liver function
* Signs include flulike symptoms, fatigue, weakness, nausea, headache, fever, possible jaundice
* Prevented by 3 part vaccination process over 6 months

What is hepatitis C?

* liver disease caused by the Hep C virus
* Most common blood borne infection in the US (3-5 million cases, 67% infected with HCV develop liver disease)
* No vaccinations or treatment

What percentage of Hep C victims show no symptoms?

80%

Human Immunodeficiency Virus (HIV):

* virus that causes AIDS
* No vaccine, currently treated with “drug coctails”

What are the 4 conditions that must be met for a pathogen to spread?

1. Pathogen is present
2. Pathogen passes through correct entry site
3. Person is susceptible to pathogen
4. Sufficient quantity is present to cause disease

What are 3 ways a pathogen can spread?

1. Direct contact: infected bodily fluids from one person enter another’s body
2. Indirect contact: person touches and object that contains bodily fluid from an infected person
3. Droplet and vector borne transmission: person inhales droplets (like from a cough/sneeze), or skin is penetrated by an infections source (bite, sting, etc)

Who created universal precautions to protect against the spread of blood borne pathogens?

OSHA

What are the universal precautions to prevent blood borne pathogens?

1. Hand hygiene
2. Personal protective equipment (PPE)
3. Work practice controls
4. Equipment cleaning and disinfecting

What is the most effective measure to prevent the spread of infection?

Hand washing

When should you use alcohol based sanitizers?

1. When soap and water are not available
2. Hands are not visibly soiled

What are examples of personal protective equipment?

* disposable gloves
* Gown
* Mask
* Protective eyewear
* Breathing barriers

What are the workplace controls for blood borne pathogens?

1. Disposing of sharps in puncture resistant, leakproof, labeled containers
2. Avoid splashing, spraying, and spattering of infectious materials
3. Removing and disposing of soiled protective equipment
4. Cleaning and disinfecting all soiled equipment and surfaces
5. Not eating, drinking, smoking, applying cosmetics, or touching body area in environments where exposure is possible
6. Isolating contaminated areas

Define liability

The state of being responsible for harm

What is the scope of Practice?

The treatment that someone is allowed to provide based on their state and professionally dictated qualifications

True or false: The certification for CPR/AED for adult, child, and infant is different.

True

What is the standard of care?

The minimum level of care: communicate proper info to prevent injury, recognize the victim in need, attempt to rescue, and provide emergency care

What is negligence?

When you fail to do something someone with your same level of certification would do.

In order for there to be negligence, these 3 need to be in play:

1. Duty of care: you have a legal responsibility as you are certified and able to provide care
2. The standard of reasonable care was not met (ex within scope of practice, feel short to prevent further injury)
3. Damages; harm. This is the most important part if someone is being sued for negligence

What are the 3 types of torts?

* Nonfeasance: act of omission; forgetting to do something
* Malfeasance; act of commission; committing an act that is not under your qualification or certification
* Misfeasance; incorrect; doing something improperly, even when you have the qualifications to do it

True or false; training supersedes the Good Samaritan law

True

What is the Good Samaritan law?

encourages those with no duty to provide care to help in an emergency situation. They must

* act within their scope of practice
* Act in good faith
* Not be negligent
* Not expect anything in return

Duty of Care is a:

legal responsibility

What must you state when obtaining consent from a conscious adult or parent of a minor?

1. Name
2. Level of training
3. Ask permission to help
4. Explain suspected condition
5. Explain plan of care

What do you have if the victim is unconscious or a parent is not available to gain consent?

implied consent

What do you do if someone refuses care?

1. Call EMS and document!
2. Inform victim why they need care and what might happen if they don’t receive it
3. Always stay with them (don’t touch them)
4. May lead to battery if you do something despite their refusal
5. If the victim falls unconscious, implied consent will allow you to act

You could be held responsible for abandonment, unless:

1. The scene becomes unsafe
2. You are too tired to continue
3. The victim shows obvious signs of life

What is the Health Insurance Portability and Accountability Act of 1996?

HIPAA protects individually identifiable health information such as name, DOB, medications, test results, address, SSN, etc. Do not share any information regarding physical/mental health, providing or payment for health care that could identify a person.

Why should you always document everything?

* helps medical personnel treat a patient following your care
* Help create future preventative plans and protocols
* Can protect you in the case of a lawsuit

Who should you ask for forms to protect yourself agains a lawsuit following emergency care?

Hospital or EMS

What are the 5 major body cavities?

* cranial
* Spinal
* Thoracic
* Adbominal
* Pelvic

What is the purpose of the respiratory system?

To allow oxygen into the body and release CO2

What is the normal respiration rate for a resting adult and a resting child?

12-16 per minute for an adult

18-30 per minutes for a school aged child

What is the purpose of the circulatory system?

carrying oxygenated blood throughout the body

What is the purpose of the nervous system?

Transmit signals, and regulate the body

It is the most complex of all the body‘s systems

What are the components of blood?

Red blood cells

White blood cells

Platelets

Plasma

What is the purpose of the musculoskeletal system?

* support the body
* Protect the organs
* Allow movement
* Store minerals
* Produce RBC
* Produce heat

What is the purpose of the integumentary system?

(Skin)

Protection

Cooling

What is the purpose of the endocrine system?

* regulatory system
* Pituitary gland regulates growth
* Thyroid regulates metabolism and nervous system
* Pancras is responsible for insulin
* Adrenal gland regulates sympathetic nervous system through hormone release

What is the purpose of the digestive system?

Provides the body with electrolytes, water, and energy

Eliminates waste

What is the difference between systolic and diastolic blood pressure?

systolic pressure is the maximum pressure the heart exerts while beating, while diastolic pressure is the amount of pressure in the arteries between beats.

What is the age range of a victim by age for respiratory trauma?

Adult is 12 and over

Child is 1-12

Infant is below 1

What is the age range of a victim by age for cardiac/AED trauma?

Adult is 9 and above

Child is 1-8

Infant is below 1

What are the 3 important steps to follow in an emergency?

1. Size up the scene
2. Perform a primary assessment
3. Summon advanced medical professional

True or false: care is the same for all ages of victim

False

What should you do when sizing up a scene?

use a careful and systematic approach that utilizes all of your senses quickly


1. Ensure safety
2. Identity necessary PPE
3. Determine MOI
4. Determine number of victims
5. Identify if helps is necessary

What is a primary assessment?

used to assess and correct life threatening situations

Activate EMS

What are the ABCs ?

airway

Breathing

Circulation

What are things to note in a primary assessment for an unconscious athlete?

1. Position
2. Responsiveness
3. Equipment considerations
4. ABCs
5. Provide care as determined

True or false: you should always remove equipment from an injured athlete to treat them

False; if possible, always leave equipment on

What are the 4 steps of performing a primary assessment?

1. Are the conscious?
2. Are they breathing?
3. Do they have a pulse?
4. Is there bleeding and is it severe?

How should you check for alertness?

Tap, shout, tap

AVPU

What is the AVPU scale?

a scale used to assess alertness

Alert

Verbal

Painful

Unresponsive

What are the two ways to open an airway?

1. Head tilt chin lift
2. Jaw thrust (for when there is a suspected head/neck/spine injury?

True or false: when in doubt, assume there was a head, neck, or spinal injury.

True

How long should it take you to check for breathing?

No longer than 10 seconds

True or false: agonal gasps count as breathing

False

What are agonal gasps indicative of?

a cardiac issue

What pulse points should be used for adults and children?

carotid/radial for adult/children

Brachial for infants

What type of victims should be given two ventilations if found not breathing?

1. Drowning victims
2. Victims of hypoxia (low levels of oxygen)
3. Children and infants

What are the steps of giving ventilations?

1. Position and seal the resuscitation mask
2. Open the airway and blow into the mask

How often should ventilations be given?

For an adult, 1 every 5 seconds

For a child, 1 every 3

Ventilation should last about 1 second and make the chest clearly rise and fall

What are 3 recovery positions?

1. Face up (maintain open airway)
2. Modified HAINES (High arm in endangered spine)
3. Infant recovery position

When should you call before giving care?

* if there is any cardiac condition
* Time dependent
* Unconscious adult
* Unconscious infant/child with a cardiac condition

When should you provide care before calling?

* breathing emergency
* Drowning
* Cardiac arrest
* Drug overdosE

When should you move a victim?

1. When the scene becomes unsafe
2. Reaching another victim
3. Need to provide proper care elsewhere

What is a normal BPM for a resting adult or child?

60-80 for adults

80-100 for children

What is a normal respiration rate for a child and adult?

12 per minute for adults

20-25 for children

What vital signs do you need to check for in a secondary assessment?

1. Pulse
2. Respiration
3. Blood pressure
4. Temperature
5. Skin color
6. Pupils
7. State of consciousness

How do you measure blood pressure?

with a sphygmomanometer (blood pressure cuff)

What is a normal blood pressure?

115-120 mmHg over 60-80 mmHg