Module 1 Test

What does EMS stand for?

Emergency medical services

Who started the Red Cross and when was this?

Clara Bartin during the Civil War (late 1800s)

What is the DOT and what is their role in EMS?

Department of Transportation, developed EMS national standards (what is expected, training, etc)

What does the National Registry of EMTs mean?

EMTs/paramedics are all trained with same skills and info, must pass national test (the National Registry)

What was created by a law in 1973?

National Emergency Medical Service Systems Act (NEMSSA), created 911 system and more laws/national standards for EMS

Name three standards that were created by EMS with the 1973 law.

Policy and laws on how and what to do, All should have a central area to receive calls, coordinate sending of ambulances, All EMS personnel trained with national standards, Transport to closest appropriate hospital

What is the definition of a trauma center (hospital)?

Trauma specialist doctor/nurse teams there 24 hours a day, handle trauma (gunshots, head injuries, etc)

Define Medical director.

Determines all medical procedures for a department

Name the components of the EMS system.

Patient recognizes problem, 911 call, emergency medical dispatcher answers and advises, calls emergency medical responders, EMTs go out to help, take patient to emergency department staff, given to allied health staff

What does enhanced 911 mean?

Provides caller number and location for landline phones

Whose safety is always the top priority at any accident scene?

Your safety is always your top priority

Prioritize the following as to whose safety is number 1 to you, then 2 and so on until the least concern for safety- patient, your EMT crew, bystanders wandering around, yourself.

Safety of you, then crew, patient, bystanders

EMT’s are patient advocates. What does this mean?

Assist and protect your patient, you watch out for them

What does transfer of care mean?

Deliver a patient to hospital and pass to someone of equal or above training, give verbal report (what happened, vital signs, trending condition, treatment)

Name three traits that EMTs should have.

Ability to life/carry equipment/patients up to 125 pounds, good eyesight (distance/reading), pleasant, sincere, cooperative, resourceful, self-starter, emotionally stable, ability to lead, respectful

All EMT’s are involved with quality improvement. What does quality improvement mean?

A team of EMT’s review past patient treatment to look for ways to improve patient outcome

Define Protocol

the steps for treatment in different medical conditions

Define standing order

written permission from medical director for the EMT/paramedic to follow protocols without having to talk to them live

What does designated agent mean?

EMT/paramedic that follows the protocols created by MD

Define On-line medical direction

talking to them on the radio or the phone for treatment permission

Define Off-line medical direction

written

How often do EMT’s need to be nationally recertified?

Must update skills every 2-4 years to keep EMT certification

What is the purpose of doing EMS research?

Focuses on improving patient outcomes (long term survival), test results show new skill techniques and equipment that improve patient treatment

List the six concepts of well being for an EMT

maintaining solid personal relationships, exercise, sleep, eating right, limiting alcohol/caffeine intake, seeing your physician regularly and keeping up to date on vaccines

What does standard precautions mean?

Steps to protect self from pathogens, protocols provide information on which precautions to take

What is the definition of a pathogen?

Anything that causes a disease (virus bacteria, mold)

Name two examples of precautions that should be taken

Body substance isolation, wearing PPE

What is OSHA and what does it do?

Occupational Safety and Health Administration, issued strict guidelines about precautions against exposure to bloodborne pathogens

Define PPE

personal protective equipment, refer to local protocols for wearing PPE

Name 5 types of PPE

gloves, goggles, masks, gowns, reflective vests, washing your hands with soap

Describe how to correctly remove gloves.

Pull at top of glove \#1 and pull glove inside out (use glove to take off other and not touch hand), use ungloved hand to pull off glove from the top, throw away, wash hands

Describe how to correctly do hand washing.

With soap, rub back and forth for 30 -60 sec, get between the fingers, both backs of the hands, under the nails, rinse with warm water

Covid 19

virus, Airborne droplets, contact, Fever, cough, sob, chills, aches, headache, sore throat, congestion, loss of taste/smell

AIDS

virus, Result of HIV, contact with blood, HIV attacks the immune system, can’t fight off infection

Chicken Pox

virus, Person to person, direct contact, aerosol inhalation, fluid, Hemorrhagic fever, itchy blisters (rash)

Ebola

virus, Infected blood or bodily fluid, Inflammation, tissue damage, clotting issues, fever

Influenza

virus, Airborne droplets from coughing/sneezing/talking, High fever, muscle aches, headaches, malaise, cough, sore through, rhinitis

Hepatitis

virus, A- Person to person through the fecal-oral route or consumption of contaminated food or water, B- lives on surfaces in dried blood for several days, Fatigue, low appetite, stomach pain, nausea, jaundice (usually resolves within 2 months of infection)

Meningitis

Bacteria, viral, respiratory/throat secretions, Infections of the brain/spinal cord membranes, fever, lethargy

Pneumonia

Bacteria, viral, Airborne droplets, Cough, fever, chills, difficulty breathing

Staphylococcal Skin infection

bacteria, Direct contact with bacteria (skin to skin contact and contaminated surfaces), Skin infection, abscesses,

Tuberculosis

bacteria, Airborne, highly contagious, Infects the lungs

Whooping Cough

bacteria, Person to person, spread through the air, Damages the cilia, airways swell, cough, runny nose, congestion, sneezing, fever, fatigue

The Ryan White

all first responders have the right to check with hospitals to see if past patients have communicable diseases.

Define stress

any situation that triggers a strong emotional response,

List and describe each of the three stages of stress

alarm reaction (flight-or-fight), stage of resistance (coping), exhaustion (loss of ability to resist/adapt to the stressor)

Define acute stress and give one example

develop soon after an incident, normal reactions to extraordinary situations. Often linked to catastrophe, argument

Define delayed stress and give one example

not evident until long after incident, may not recognize what is causing the problem, car accident

Define PTSD and what each letter stands for

posttraumatic stress disorder

Define cumulative stress and give one example

results from years of sustained low-level stressors, early signs are vague anxiety and emotional exhaustion, progresses to physical complaints/loss of emotional control/irritability/depression

Write the top five causes of stress

multiple-casualty incidents, calls involving infants or children, severe injuries, abuse and neglect, death of a coworker

Define what a sign means. Give an example.

Objective findings that can be seen/measured, high/low temperatures

Define what a symptom means. Give an example.

Subjective, perceived only by the person affected, feeling feverish/nauseated

Define eustress.

Positive form of stress that helps people work under pressure and respond effectively

Define distress

negative stress causing immediate and long-term problems with health and well-being

Write the top 3 ways of dealing with stress

exercise, devote time to relaxation, change shift or location for lighter call volume

Define CISM and why it is done.

Critical incident stress management, includes education and resources to prevent stress, ways to deal with stress appropriately when it occurs

Write and describe the 5 levels of death and dying

denial, anger, bargaining, depression, acceptance

List 5 methods that should be used to work with patients who are dying.

Recognize patient needs, be tolerant of angry reactions from patient/family, listen empathetically, do not falsely reassure, offer as much comfort as you realistically can

Define scope of practice

outlines the care you are able to provide, defined by state law and medical director

Is the scope of practice for the EMT the same from state to state?

no

Who determines the scope of practice?

National, state, local laws, statutes, and protocols

What is the primary ethical consideration for the EMT?

Making patient care and the patient’s well being a priority

Define standard of care.

How you should provide care

Describe how scope of practice and standard of care are different from each other.

Scope is what you can do, standard is how you should do it

Define expressed consent

the patient acknowledges that they want you to provide care or transport, the patient must provide informed consent to be valid (treatment, risks, and benefits explained)

Define implied consent

applies to patients who are unconscious or otherwise incapable of making an informed decision, shouldn’t be used unless there is a threat to life or limb, try to get consent from spouse/relative

Who needs to give the legal authority for treatment for children and mentally incompetent adults?

Parent or legal guardian, teachers and school officials

One exception is with In Loco Parentis.

Define this. In the place of a parent, emancipated minors

What happens with consent in a life threatening illness or injury?

Don’t need an adult’s consent

What about consent associated with minors who have children

They can make decisions for themselves, don’t need an adult’s consent

What about consent associated with those in the armed forces

Don’t need an adult’s consent

Under what two conditions would a patient be transported against their will?

Don’t have decision making capabilities (mentally ill, in behavioral crisis, developmentally delayed)

What is the main responsibility of an EMT when a patient refuses care?

Make sure that they are well informed and know the consequences of refusing care

Name four reasons why a patient would refuse care.

Financial concerns, fear, misinformation, personal values/belief

Name the four conditions that must be met for a patient to refuse care.

Patient must be legally able to consent, must be awake and oriented, must be fully informed, have to sign release form

Define liability.

Being responsible for something

Describe a liability situation that could happen when a patient refuses care.

EMT may still be held liable despite precautions, you didn’t fully assess the patient

Name the six strategies to use to convince patients to accept care.

Spend time speaking with the patient, listen carefully to determine why they’re refusing care, inform the patient of consequences of not going, consult medical direction, ask to talk to family, call law enforcement

Assault

Unlawfully placing someone in fear of immediate bodily harm (ex restraint)

Battery

Unlawfully touching a person (ex providing care without consent)

Define what a DNR involves.

Medical order written by a doctor instructing health providers not to resuscitate

Define advance directive.

Written document stating how you want medical decisions to be made if you lose the ability to make them for yourself

What is the difference between a DNR and a Physician Order for Life-Sustaining Treatment (POLST)?

DNR only applies when a person does not have a pulse/breath/responsiveness

What is a proxy?

Gives a person the authority to make healthcare decisions for another person

Define living will.

Written, legal document that spells out treatments you would and would not want

Negligence

Something that should have been done was not done or done incorrectly

Give an example of negligence.

Failure to diagnose, missing symptoms

What does tort mean?

Civil wrongs

What are the top two reasons for lawsuits against EMT’s?

Delayed response, failure to bring equipment

Duty to Act

Obligation to provide care to a patient

Define abandonment.

Not transferring a patient to someone at the hospital at your job level or above

Define moral.

Principles of right and wrong

Define ethical.

What guides your actions

Describe what the good samaritan law is.

Grant immunity from liability if rescuer acts in good faith within level of training

Can you be sued if you help as a good samaritan?

No, unless you have a license, are on duty, or violate the law

Define confidentiality

keeping patient history, condition, treatment private

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

Briefly state the four parts of HIPAA.

Electronic transactions and code standards requirements, privacy requirements, safety requirements, national identifier requirements

Define libel

written defamation