HAN 416 Midterm

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Resuscitation medicine

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155 Terms

1

Resuscitation medicine

a branch of medicine that focuses on the management and treatment of patients in cardiac arrest or other life threatening conditions such as severe trauma or shock

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2

2 fundamental predicaments during cardiac arrest

rapidly restart the heart after it ceases to beat and restart the brain while maintaining heart function

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3

lucas device

delivers manual compressions

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4

Targeted temperature management is a form of

post cardiac arrest management

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5

what does ttm do

protects the brain and other organs, targeted temp 32C for at least 24 hours

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6

TTM for patients with bleeding issues

higher temp

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7

TTM for patients with cerebral edema and seizures

lower temp

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8

is TTM performed in the pre hospital setting

no

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9

percutaneous coronary intervention (PCI)

treatment to open a blocked artery

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10

arteries

Blood vessels that carry oxygen rich blood through your body

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11

most common cause of anesthesia related deaths in 1958 were because of

aspiration

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12

Definition of Death

irreversible coma

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13

ETCO2

end-tidal carbon dioxide

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14

ETCO2 monitoring

provides an accurate assessment of arterial carbon dioxide retention values

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15

bougie

plastic rod passed into trachea

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16

Supraglottic Devices

can blindly be put in mouth. group of airway devices that can be inserted into the pharynx to allow ventilation, oxygenation, and administration of anesthetic gases without the need for endotracheal intubation

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17

RSI

rapid sequence induction

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18

medications used during rsi

etomidate, ketamine, rocuronium, midazolam

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19

prevalence of stroke

number 5 cause of death in U.S, every 40 seconds someone in U.S has a stroke, leading cause of long term disability, cost of stroke care in 2010 was 71B and is estimated to be 183B by 2030

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20

during a stroke 32,000 neurons lost

per second

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21

during a stroke 1.9 million neurons lost

per minute

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22

true or false, stroke accelerates again 3.1 weeks per minute

true

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23

primary stroke center

ct capabilities, tpa administration, neurology staff available

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24

comprehensive stroke center

verified by joint commissions, AHA, and ASA, specialized stroke care facilities, cerbrovascular capabilities, neurosurgical capabilities with neuro ICU, better rehab and outcomes for stroke patients

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25

mobile stroke unit

specialty care ambulance equipped with portable CT scanner, mobile laboratory, and telemedicine unit

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26

goal of mobile stroke unit

to rapidly assess and treat prehospital stroke patients

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27

Implementation of MSU in Suffolk

contacted every dept in MSU primary response area, remsco/remac approval, working with SCEMS, NYS DOH and exec office, educational lecture

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28

MSU staff includes

emt, paramedic, critical care RN, rad tech

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29

NY state first, stony brook approved for

blood transfusions on ambulances

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30

VAD

device that helps pump blood from the lower chambers of your heart to the rest of your body

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31

VAD indications

bridge to transplant, bridge to recovery, and destination therapy

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32

impella

percutaneous mechanical ventricular assist device

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33

VADs provide circulatory support by

increasing cardiac output, increasing coronary perfusion, increasing end organ perfusion, decreasing ventricular workload, and decreasing myocardial O2 consumption

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34

ECMO

blood is pumped outside of your body to a heart lung machine that removes carbon dioxide and sends oxygen filled blood back to tissues in the body

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35

why is an ecmo done

for patients waiting for or recovering from a heart transplant and may be an option when other life support measures haven't worked

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36

IABP

intra-aortic balloon pump consist of a think tube and balloon that a doctor inserts into the aorta leaving the heart. the inflation and deflation of the balloon pump help increase blood flow from the heart

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37

EMS licensure levels

EMR, EMT, AEMT, Paramedic

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38

Tiered Response

system where EMTs and paramedics respond separately

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39

EMT description

automated external defibrillation, airway adjuncts, assisting patients with certain meds

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40

AEMT description

IV therapy, administration of a limited number of emergency medications

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41

Paramedic description

endotracheal intubation, emergency pharmacology, cardiac monitoring, other advanced assessment and treatment skills

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42

History of EMS ancient times

emergency medici e

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43

history EMS napolenic wars

birth of horse drawn ambulances, the first recorded use of aircraft for medical evacuation were hot air balloons at the Prussian siege of pari sin 1870

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44

history of ems the US in the 19th century

1860s civillian ambulance services begin in Cincinnati and NYC, 1915 during serbian army retreat unmodified french fighter aircraft were used to ferry the injured. Crimean war: florence nightingale became known as the founder of the nursing profession

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45

the medical director is responsible for

maintaining quality control

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46

continuous quality improvement (CQI)

reviews and performs audits of the ems systems to identify areas of improvement and/or assign remedial training, minimizing errors is the goal

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47

CQI uses a

plan-do-study act cycle

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48

EMS works with public health agencies on

primary prevention and secondary prevention

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49

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50

In 2020the centers for medicare and medicaid services implemented a

pilot program called emergency triage, treat, and transport

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51

online medical direction

talking directly to a medical director or agent authorized to give orders for the medical director

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52

offline medical direction

using a book of protocols that give permission to do things without calling a doctor

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53

just culture ems

duty to avoid causing unjustifiable risk or harm, duty to follow a procedural rule, and duty to produce an outcome

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54

ET3

triage, treat, and transport

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55

consent

permission to render care

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56

expressed consent

the patient acknowledges he or she wants you to provide care or transport

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57

implied consent

applies to patients who are unconscious or incapable or making an informed decision

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58

involuntary consent

applies to patients who are mentally ill, in behavioral crisis, developmentally delayed. Obtain consent from guardian or conservator

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59

If true emergency exists and no consent is available

treat the patient, consent is implied

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60

forcible restraint

sometimes necessary with combative, legally permissible

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61

the right to refuse treatment

conscious alert adults with decision making capacity, assess the patient's ability to make an informed decision, if the patient appears confused or delusional, you cannot assume that the decision to refuse is an informed refusal

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62

before you leave a scene where a patient, parent, or caregiver has refused care

encourage the individual again to allow care, ask the individual to sign a refusal of care form, a witness is valuable in these situations, documents all refusals

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63

advanced directive

specifies treatment should the patient become unconscious or unable to make decisions

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64

a DNR order is an

advanced directive that gives permission not to resuscitate

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65

presumptive signs of death

unresponsive to painful stimuli, lack of carotid pulse or heartbeat, absence of breath sounds, no deep tendon or corneal reflexes, absence of eye movement, no systolic blood pressure, profound cyanosis, lowered or decreased body temp

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66

Definitive signs of death

decapitation, dependent lividity, rigor mortis, algor mortis, putrefaction

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67

rigor mortis

stiffening, occurs between 2-12 hours after death

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68

algor mortis

cooling of the body until it matches the ambient environment

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69

putrefaction

occurs between 40-96 hours after death

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70

scope of practice

outlines the care you are able to provide, usually defined by state law

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71

standards of care

manner in which you must act or behave, it is defined as how a person with similar training would act under similar circumstances.

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72

standards of care are established by

local custom, law, professional or institutional standards, textbooks, standards imposed by states

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73

duty to act

individual's responsibility to provide patient care. Duty to act applies once your ambulance responds to a call, once treatment is begun

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74

negligence

failure to provide same care that person with similar training would provide in same or similar situation

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75

elements that must be present for negligence to apply

duty, breach of duty, damages, causation

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76

abandonment

unilateral termination of care by health car provider without patient's consent and making provisions for continuing care

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77

abandonment may take place

at the scene, in the emergency department

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78

assault

unlawfully placing person in far of immediate bodily harm

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79

battery

unlawfully touching a person

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80

good samaritan law

if you reasonably help another orson, you will not be held liable for errors or omissions

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81

special mandatory reporting requirements

abuse of children, dog bites

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82

morality

it's what societies determine to be right and acceptable

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83

ethics

philosophy of right and wrong, moral duties, and ideal professional behavior

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84

general health, wellness, and resilience

physical, emotional, mental

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85

wellness

active pursuit of a state of good health

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86

resilience

capacity of an individual to cope with and recover from distress

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87

burnout

syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed

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88

code lavender stonybrook

can be whatever staff needs in that moment, code lavender is not formal debriefing or case review

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89

patient safety has typically been

outcome dependent

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90

error

failure of a planned sequence of mental or physical activities to achieve its intended outcome when these failures cannot be attributed to chance

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91

a slip or lapse occurs when

the action conducted is not what was intended

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92

a slip is observable

a lapse is not

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93

human factor

an applied filed of study that examines human abilities, limitations, behaviors, and processes in order to inform human centered designs

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94

psychophysiology of crisisL the crisis stress dynamic

homeostasis, stressor, disequilibrium

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95

general adaptation syndrome

alarm stage, resistance stage, exhaustion stage

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96

parasympathetic division

constricts pupil, stimulates tear glands, strong stimulation of salivary flow, inhibits heart, dilates arterioles, constricts bronchi, stimulates stomach motility and secretion, stimulates pancreas, stimulates intestinal motility, contracts bladder, stimulates erection

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97

sympathetic division

dilates pupil, no effect on tear glands, weak stimulation of salivary flow, accelerates heart, constricts arterioles, dilates bronchi, inhibits stomach motility and secretion, inhibits pancreas and adrenals, inhibits intestinal motility, relaxes bladder, stimulates ejaculation

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98

elder abuse is caused by

increased life expectancies, increased dependency on others, decreased productivity in later years, physical and mental impairments, limited resources for long term care of elderly, economic factors, etc

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99

identification of elder abuse

acts of commission, acts of omission, subtle signs such as theft of victim's belongings, and obvious signs such as wounds, untreated decubitus ulcers, poor hygiene

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100

characteristics of elder abuse

cuts across all demographic groups, people dependent on others for their care, especially among elders who are mentally or physically challenged, common causes involve elderly women abused by their sons, commonly live alone, may be mentally competent but fear asking for help, may be reluctant to give info about abusers for fear of retaliation

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