EMT Study Guide

body substance isolation (BSI)

wash hands after each call

appropriate PPE (gloves, glasses, gowns, masks)

10% bleach solution (good for 3 weeks) for blood borne cleanup

EMT immunizations

MMR, Hep-B, TB test (≥ 1 per yr), no AIDS immunization

proper lifting techniques

know physical limitations of self and partner, keep weight close (carrying/lifting), lift w/ legs and back in a squat, no reaching

improper lifting

#1 cause of EMT injury

haz-mat scene precautions

1. concern for your own safety (most important)

2. do not enter an unsafe scene

3. set up safe zone if first unit in

4. approach from upwind and uphill

5. do only what you are trained to do

critical incident stress

caused by EMT response to death or serious injury

defusing

early intervention that occurs @ the scene or a bit after the incident; made to stop negative stress process that may happen in hours right after a disaster response

critical incident stress debriefing

a psychological, emotional, and educational group process to diminish the impact of critical incident stress (best if done within 48 hrs of incident)

golden rule for medical/legal & ethical issues

"Do on to others as you would have others do on to you"

public health law article 30, part 800

has rules and regulations in reference to EMS & immunities - EMT can't be held liable until gross negligence can be proven

act 30 sect 3013

immunity from liability

good Samaritan act

made to protect private non-certified ppl who assist in emergency treatment from legal action (with exception of gross negligence)

- does not cover EMT in NYS

how to prevent litigation

stay within scope of practice/standard of care & DOCUMENT

negligence

deviation from the standard of care as recognized by law

criteria for negligence

duty to act, breech of duty, injury occurred, proximate cause

proximate cause

injury resulted from improper action ro failure to act

assault & battery

when the EMT is charged for treating an adult without consent

consent

agreement by the patient to accept medical intervention

informed (actual) consent

patient is told (in a way they understand) the nature and extent of a procedure and its risks;

patient fully understands the procedures & risks, and accepts

i.e. patient listens to you and says yes pls help me

implied consent

unconscious, mentally impaired, or child in a true emergency where there is a significant risk of death, disability, or deterioration, LAW assumes patient or guardian would give consent

i.e. someone passed out and dying, don't need permission

abandonment

termination of the doctor patient relationship without without patient consent & not allowing patient time to find another physician while care is still needed. OR transferring a patient to another professional who is not of the same level or higher training as you

e.g. leaving a patient on the side of the road OR giving them to an emt when you're a medic

delegated practice

systems medical physician delegates the rescuer to carry out actions on their behalf

on line medical direction

medical control

off line medical direction

standing orders and/or protocols

quality improvement

system of internal & external audits; monitors pre hospital care to achieve optimal excellence in patient services; when quality issues are discovered, suggestions are made to prevent reoccurrence

documentation NYS PCR forms

- legal document that reflects upon its author

- sloppy incomplete records suggests similar patient care

- NO personal comments form EMT

- if you didn't write its you didn't do it

what to include in documentation NYS PCR forms

- fill out all shaded areas

- dates & times of ambulance call

- info from patient, bystanders, & physical examination

- observations @ scene (subjective)

- physical findings (objective)

- treatment rendered & changes in patient condition

incomplete RMA

cause of a large number of documentation errors; make sure to fully fill out the PCR form with as much info as possible and have police officers witness the signature of the person refusing medical aid

quality patient care and well written PCR

met's best protection against possible legal proceedings

criteria upon which the emt may pronounce death

- rigor mortis (stiffening of muscles--first happens to eyelids and jaw)

- dependent lividity (reddish purple discoloration in lower parts of the body)

- decapitation

- decomposition

- valid NYS prehospital DNR form with patient

decision not to initiate CPR

pronouncement of death

communications

- 10 medical channels on nassau medical control -- use channel #10

channel #10

use for notifications and EMT medication unless otherwise directed

EMD (emergency medical dispatch)

concept of delivering pre-prescribed scripted instructions to emergency callers prior to the actual arrival of medical technicians

emergency medical dispatcher (EMD)

a vital link in the chain of survival & treatment

brady

slow

contra/anti

against

des/dis/dys

disorder/difficult

tachy

fast

cardio

heart

cerebro

brain

cephalo

head

hemi

half

hypo

deficient/below

huper

above/excess

inter

between

intra

inside

anterior (ventral)

towards the front of the body or body part

posterior (dorsal)

towards the back of the body or body part

superior

above/upper

inferior

below/lower

superficial

near the surface

deep

remote to the surface

internal

inside

external

outside

proximal

near to the point of attatchment

distal

farthest from the point of attachment

medial

towards the midline of the body

lateral

away from the midline of the body

coronal plane

divides body in half front and rear

medial plane

division of body down the middle left and right

cranial (cephalic) superior

towards the head

caudad (inferior)

towards the feet

supine

lying on spine, face up

prone

lying on stomach, face down

abduction

movement away from the midline of the body

adduction

movement towards the midline of the body

flexion

act of bending

extension

act of straightening

tissue

collect of specific cells that carries out a specific function

connective tissue

forms the supporting and connective surfaces of the body

muscle tissue

composed of cells specialized to contract, thereby exert force used in motion

types of muscle tissue

Skeletal (striated), Involuntary (smooth), Cardiac

nervous tissue

specialized cells that receive stimuli and conduct nerve impulses to various organs

nose

warms and humidifies air, traps dust

pharynx

throat

larynx

voicebox

epiglottis

protects the larynx

visceral pleura

surrounds each lung

pariteal pleura

lines thoracic cavity

trachea

windpipe

carine

bifurcation of the trachea

alveoli

air sacks

bronchi

passageway to lungs

valecula

valley between epiglottis and tongue

normal drive

level of CO2 in blood (pCO2)

hypoxic drive

level of O2 in the blood (pO2) COPD paients

CO2

gas primarily responsible for controlling respirations

inhalation

diaphragm contracts, moves downward causing the thoracic cavity to enlarge from top to bottom

exhalation

all muscles relax, passive process, elastic tissues contract

chest rise

most effective means of determining adequate breathing

tidal volume

air moved in and out during a normal respiration (500 cc)

total lung capacity

6000 mL (6L)

vital capacity

amount of air moved during a forceful exhalation, after a full inhalation (1000cc)

minute volume

tidal volume x resp rate/min

% oxygen in room air

21

% oxygen in expired air

16

hypoxia

inadequate O2 for cellular needs

apnea

absence of breathing

dyspnea

difficulty in breathing