Exam 1

Chapter 1: Difference Between EMT and Paramedic

• Emergency Medical Technician (EMT):

  • Primary provider level in many EMS systems.

  • May receive training in:

    • Advanced airway intervention.

    • Limited medication administration.

    • IV fluid therapy.

  • Scope of Practice: Expanded scope is not recognized at a different certification level.

• Paramedic:

  • Highest EMS skill level for national certification or licensure.

  • Significant changes in training since 1998 US DOT paramedic curriculum revision.

  • In 2009, new National EMS standards were established.

  • By 2013, paramedic students must complete accredited programs and pass the NREMT exam (some states have separate tests).

  • Training hours required: 1000-1500.

  • Paramedics operate under the guidance of a licensed physician.

  • Pharmacological Intervention: Considered the biggest differentiator from EMTs.

Societal Expectations

• On and Off Duty Attributes: Expected to exhibit integrity, empathy, self-motivation, confidence, communication skills, teamwork, respect, patient advocacy, injury prevention, careful service delivery, time management, and administrative skills.

• Primary Responsibilities Include:

  • Preparation for service.

  • Responding to emergencies.

  • Scene management.

  • Patient assessment and care.

  • Patient transfer and report documentation.

  • Returning to service.

• Ethical Standards: Must adhere to a code of ethics, maintain credibility, and uphold a professional appearance.

M.A.S.H. Units

• Mobile Army Surgical Hospitals (MASH):

  • Developed during the 1950s and the Korean War.

  • Introduced to deliver hospital-type services closer to combat zones, improving patient survival rates.

  • Employs helicopters for patient transport.

Chapter 2: Continuous Quality Improvement (CQI)

• CQI Goals:

  • Focus on assessing current EMS practices and improving them to reduce problems proactively.

  • CQI Process Should Include:

    • Identifying system-wide issues.

    • Evaluating issues and forming remedy lists.

    • Developing action plans with enforcement timelines.

    • Re-examining processes and modifying protocols as necessary.

    • Aiming for excellence in patient care through constructive feedback, not punitive measures.

Ethics, Morals, and Laws

• Ethics:

  • Professional codes established by organizations guiding care delivery focused on duty and fairness.

• Morals:

  • Personal principles influenced by culture and experience, guiding individual decisions in complex situations.

• Law:

  • Codified rules enforcing behavior and rights, including confidentiality and duty of care; failure could lead to legal consequences.

  • Unlawful Practice: Performing paramedic functions without proper licensure is illegal.

Chapter 3: Stress and Adaptation

• Stress:

  • Any event prompting physical, emotional, or mental reactions that require adaptive responses.

  • Types of Stress:

    • Eustress: Positive stress motivating achievement.

    • Biologic Stress: Body’s non-specific response to demands.

• Response to Stress: Fear, anxiety, anger, or confusion can arise as reactions.

Proper Lifting Technique

• Strategies to prevent injury while lifting:

  • Coordinate lifts before executing.

  • Maintain a strong back posture; lift with legs, not back.

  • Avoid carrying heavy loads alone; utilize equipment.

Critical Incident Stress Management (CISD)

• Used post-trauma to help EMS personnel express feelings about incidents and aiming to mitigate PTSD risks.

• Timing:

  • Diffusing sessions should take place shortly after a traumatic event, while formal counseling happens later.

Action as a Healthcare Provider when Sick

• Follow infection control policies if exposed to patients' bodily fluids:

  • Turn care over to another provider.

  • Clean affected areas and comply with reporting protocols.

Benefits of Staying in Shape

• Physical fitness aids quicker recovery and reduces injury risk.

• American Heart Association’s 7 Factors for Heart Health:

  • Get active, control cholesterol, eating better, manage blood pressure, maintain a healthy weight, reduce blood sugar, quit smoking.

Chapter 4: Prevention and Interventions

• Engineering Control/Passive Intervention:

  • Modifying product designs to prevent injury.

• Primary Prevention:

  • Actions stopping injuries before they happen.

• Secondary Prevention:

  • Interventions after injury to prevent worsening.

• 4 E’s of Prevention:

  • Education, enforcement, economic incentives, and engineering/environment modifications.

Teaching Prevention Techniques

• Effective teaching strategies:

  • Use good judgment, be nonjudgmental, adapt messages.

  • Tailor examples based on target groups and situation sensitivity.

Injury Prevention for Children

• Education for children can have broader benefits beyond immediate lessons.

Chapter 5: Advanced Directives and Legal Responsibilities

• Advance Directive:

  • Written document laying out a patient’s wishes for future medical care.

  • Types include Do Not Resuscitate (DNR) and organ donation orders.

• Good Samaritan Law:

  • Provides legal immunity when helping injured persons voluntarily.

Chapter 6: Laws vs Ethics

• Laws:

  • Codified rules regulating behavior, with potential penalties for violations.

• Ethics:

  • Principles guiding professional conduct, often detailed in codes of conduct.

HIPAA and Paramedics

• HIPAA:

  • Safeguards patient privacy and offers sanctions for breaches.

  • Requires EMS agencies to appoint a privacy officer.

• Exceptions: Circumstances like mandatory reporting or valid law enforcement requests.

Negligence in Paramedicine

• Components of Negligence:

  • Legal duty to act, breach of duty, proximate cause, and resulting harm.

Chapter 7: Communication in Emergency Care

• Communication Process:

  • Involves encoding messages, human interactions, and feedback loops.

• Enhanced 911 System: Gathers and displays location information for dispatch.

• Radio Communication Standards:

  • Speak clearly and slowly utilizing standard protocols; communicate necessary medical information.

Anatomy and Physiology Overview

• Transverse Plane: Divides the body into upper and lower sections.

• Directional Terms:

  • Superior/Inferior, Lateral/Medial, Proximal/Distal, etc. defines body positions clearly.

Chapter 8: Blood Sugar Management

• Hyperglycemia: High blood sugar resulting from lack of insulin.

• Electrolyte Functions:

  • Facilitate bodily functions and nerve signal transmission.

Chapter 9: Effects of Stress on Health

• Prolonged Stress: Negatively affects health, causing conditions such as depression, heart disease, and others.

Chapter 11: Patient Assessment

• Dysarthria: Speech impairment likely caused by neurological issues.

• General Impression: Initial assessment guiding care prioritization based on observed symptoms and environment.

• Palpation Techniques: Specific methods for assessing abdominal conditions and identifying tenderness or distress.

Sonorous Respirations and Orthopnea**:

• Sonorous Respirations: Often indicate partial airway obstruction due to tongue positioning.

• Orthopnea: Indicates breathing difficulty while lying flat; patients often prefer sitting or propped up.