EMS Operations & Foundations: Comprehensive Study Guide

Characteristics of Professional Behavior

Integrity, empathy, self-motivation, appearance and hygiene, self-confidence, time management, communications, teamwork and diplomacy, respect, patient advocacy, and careful delivery of care.

Maintaining Wellness

Protection from communicable diseases and scene hazards; proper nutrition; sufficient exercise, relaxation, and sleep; refraining from tobacco, drug use, and excessive alcohol consumption; taking time to enjoy life outside of EMS/Fire.

Signs of Provider Stress

Fatigue, anxiety, anger, and feelings of hopelessness, worthlessness, and guilt.

5 Stages of Grief

Denial, Anger, Bargaining, Depression, Acceptance.

Expressed Consent

Consent given verbally by the patient or their legal guardian.

Informed Consent

Consent obtained after explaining the treatment, its benefits, and the risks of refusing treatment so the patient fully understands.

Implied Consent

Applies when a patient is unconscious, unresponsive, or otherwise incapable of making rational decisions. The law assumes the patient would consent to necessary care and transport.

Consent of Minors

A minor is anyone under 18 years of age and cannot refuse care unless a guardian is present and agrees, or if the minor is legally emancipated.

Emancipated Minor Criteria

A minor who is married, serving in the military, has a child of their own, has court-ordered emancipation, or lives independently without relying on parental support.

DNR Components

Must state the patient's medical condition, include signatures of the patient (or legal guardian) and the physician, and must NOT be expired.

Reciprocity

Certification by endorsement where a provider is Nationally Registered and state-certified, allowing them to gain certification in another state.

Definitive Care

The hospital or trauma bay.

Effective Communication Steps

Identify yourself; maintain professional body language/uniform; look directly at the patient at eye level; speak slowly and distinctly; ensure only one person speaks at a time; ask one question at a time; do not assume elderly patients are hard of hearing; give patients time to respond; use reflective listening; explain procedures before doing them; never speak about the patient in front of them as if they aren't there.

Online Medical Direction

Direct consultation over the phone/radio with a physician, requiring online medical command approval for all pharmacological interventions (except oxygen).

Offline/Standing Orders

Written orders signed by the agency's medical director outlining specific directions, treatments, and permissions.

HIPAA

Protects all private patient information and demographics; details of a call cannot be shared with neighbors, roommates, or unauthorized individuals.

Functions of a PCR

Continuity of care, compliance and legal documentation, administrative information, reimbursement, education, and data collection for research.

Key PCR Components

Name, gender, DOB, address, dispatch details, chief complaint, initial scene appearance/patient presentation, signs and symptoms, care/treatment provided and patient response, vital signs, SAMPLE history, and OPQRST history.

Patient Refusal Protocol

Assess patient understanding, document findings, obtain signatures, and document all assessments in the PCR.

Body Substance Isolation (BSI) Protocol

If exposed to blood or body fluids, immediately turn over patient care, clean/wash the exposed area, activate the department infection control plan, and complete an exposure form.

Infection Control Plan Components

Exposure risk determination, education/training, vaccines, PPE requirements, TB/physical testing, post-exposure management, compliance monitoring, and record keeping.

Mandatory Reporting Situations

Gunshot wounds (GSW), dog bites, specific infectious diseases, suspected sexual or physical abuse, and neglect.

Mass-Casualty Incident (MCI)

An event involving 3 or more patients that places high demand on the EMS system and exhausts available resources.

Transport Protocol for MCI

Never leave the scene with patients if untriaged or untreated victims remain. Transport immediate patients first, followed by delayed, minor, and lastly expectant patients.

Immediate (Red Tag)

Priority 1; life-threatening injuries needing immediate care/transport.

Delayed (Yellow Tag)

Priority 2; serious injuries, but treatment/transport can be delayed briefly.

Minor (Green Tag)

Priority 3; 'walking wounded' with minimal injuries.

Expectant (Black Tag)

Priority 4; deceased or surviving injuries so severe that resuscitation is futile.

 START Triage Protocol (Adults) Step 1

Call out: 'Anyone who can walk, move to [designated landmark/green tarp].' Assign all who respond to Green (Minor).

Extrication

Safe removal of a patient from entrapment or a dangerous situation/position.

Entrapment

Condition where a person is caught in a closed area with no way out, or has a limb/body part trapped.

Primary Roles during Extrication

Ensure personal/team safety, provide emergency medical care, and prevent further patient injury.

Vehicle Hazards

Loaded shock-absorbing bumpers can release unexpectedly; maintain distance from front and rear vehicles.

PPE Levels

Level A: Full chemical suit; Level B: Non-encapsulating suit with SCBA; Level C: Non-permeable clothing with filter mask; Level D: Basic uniform with minimal protection.

DOJ Definition of Terrorism

Violent acts dangerous to human life violating laws, intended to coerce/intimidate a civilian population, influence government policy.

B-NICE

Biological, Nuclear, Incendiary, Chemical, Explosive.

CBRNE

Chemical, Biological, Radiological, Nuclear, Explosive.