1. EMS Operations Flashcards by Lorin Uttinger

Type 1 Ambulance

chasis-cab light duty pickup truck

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Type 2 Ambulance

modern style “full van”

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Type 3 Ambulance

chasis-cab light duty “van”

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fend off position

placing ambulance 50ft or so in front of the scene for safety
position should be uphill and upwind

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landing zone for light-flight

aread prepared for aircraft landing usually 100ft x 100ft

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management program that controls and directs emergency resources and operations for an MCI event

incident command system

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an event where there is not enough resources to handle the current rate of casualties

Mass Casualty Event (MCI)

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agreement bw EMS systems to coordinate w/ each other

mutual aid

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different services (EMS, Law, State, etc.) compliment each other and share command

unified command

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in field (tags)

primary triage

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reassessed in treatment area

secondary triage

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4 branches of incident command

Logistics
Operations
Planning
Finance/Admin

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what is the branch of incident command responsible for gear, responder allocation, food & supplies

logistics

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what is the branch of incident command responsible for EMS safety

operations

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what is the branch of incident command responsible for providing into from past events

planning

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what is the branch of incident command responsible for tracking cost throughout event

finance/admin

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SMART Tag Triage

what is the criteria given for each SMART tag?

GREEN:
YELLOW:
RED:
BLACK:

GREEN: (walking wounded) no life threats

YELLOW: no present life threats and is stable but needs transport

RED: (critical) breathing w/pulse but has poor vitals
* alive bit have life threats that need rapid transport
* they will be black in secondary traige

→ open airway
→ rx for schock
→ control bleeding

BLACK: (DOA) no care is done

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SMART Tag Triage

3 steps to assess whether a patient is a yellow or red tag

Step 1: assess respirations
→ breathing or not? open airway (Y-RED) (N-BLACK)
→RR? under 10, over 30 (RED)
10-30 move on

Step 2: radial pulse? Y, move on
→ if NOT present: check CRT and control bleeding
→ CRT >2sec RED and control bleeding
→ CRT <2sec move on

Step 3: mental status
→ ask pt to grip your hands
→ responsive (YELLOW)
→ no response (RED)

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Hazardous Materials

Identify the function and example of: Asphyxiants

Function: displace O2 in air, dilute oxygen concentration
Ex: mathane gas

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Hazardous Materials

Identify the function and example of: Carcinogens

Function: cancer causing agents
Ex: asbestos

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Hazardous Materials

Identify the function and example of: Cardiotoxins

Function: can cause heart attack/EKG disturbances
Ex: certain types of snake venom

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Hazardous Materials

Identify the function and example of: Corrosives

Function: acids and bases that are haxardous
Ex: sufuric acid & bromine

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Hazardous Materials

Identify the function and example of: Hemotoxins

Function: destruction of RBC
Ex: snake venom/spider bite

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Hazardous Materials

Identify the function and example of: Hepatoxins

Function: damage to liver over time
Ex: alcohol/ tylenol/ chloroform

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# Hazardous Materials Identify the function and example of: **Nephrotoxins**

**Function:** destruction of kidneys **Ex:** mercury, arsenic, lead

# Hazardous Materials Identify the function and example of: **Nerve Poisions**

**Function:** destruction of NS ability to function **Ex:** sarin, tabun, VX

# HAZMAT Zones this will affect provider ONLY when **exposed directly**

primary contamination

# HAZMAT Zones substance is passed by **touch**

secondary contamination

written product info required by OSHA

Material Data Safet Sheet

what are the 9 classes of hazardous materials

1. explosives 2. gases 3. flammable liquids 4. flammable solids 5. oxidizers 6. posinous 7. radioactive 8. corrosives 9. misc.

what are the 3 things shipping papers must include

1. substance name 2. UN ID# 3. class

# Medical Terminology word root

**foundation** of word → body part, organs, organ systems, color

# Medical Terminology prefix

**before** word root; gives word root meaning

# Medical Terminology suffix

**after** word root → procedure, condition, disease or part of speech

# Medical Terminology combining vowel

a vowel that usually joins one or more root words

# Medical Terminology * anterior → * superior → * proximal → * medial → * deep → * ventral → * bi-lateral → * supine →

* anterior → **front** * superior → **above** * proximal → **closest** * medial → **middle** * deep → **inside** * ventral → **"belly side"** * bi-lateral → **both sides** * supine → **lying face up**

# Medical Terminology * posterior → * inferior → * distal → * lateral → * superficial → * dorsal → * uni-lateral → * prone →

* posterior → **back** * inferior → **below** * distal → **farthest** * lateral → **side** * superficial → **surface** * dorsal → **"spinal side"** * uni-lateral → **one side** * prone → **face up**

# Medical Terminology sitting pt. on stretcher to breath better at a 45° angle

semi-fowler

# Types of consent "I want you to take care of me"

expressed consent

# Types of consent you explain to pt. steps of procedure, process, etc.

informed consent

# Types of consent pt. unstable/unresponsive, AMS, law **assumes** they consent (want rx)

implied consent

# Types of consent parents would sign on transport but they are alone, *do not delay care*

minor consent

# Types of consent prisoners, "papered", mental health eval

involuntary consent

pt. has the right to ____ care all together/certain procedures

pt. has the right to **refuse** care all together/ certain procedures

criteria for refusing care

* ask pt. at least 3x that you are willing to transport them * pt. must be AOx4 and 18y/o and of sound mind

# End of Life Care what should be done if pt. is unable to make decisions

advanced directive

# End of Life care person "in charge" if pt. is unable to make decisions

power of attorney

criteria for dead on arrival (DOA)

* unresponsive * NO chest rise/fall * NO carotid pulse/heart beat * NO pupil activity * NO blood pressure * decapitation * decompisition

# End of Life Signs body stiffening

rigor mortis

# End of Life Signs blood pooling lowest point of body

dependent lividity

# End of Life Signs body cooling to room temp

algor mortis

# End of Life Signs decomp. of body tissue 40-100 hrs post death

putrefication

# Legal your boundry of EMS

scope of practice

# Legal written plans for certainexact situations

protocols

# Legal what **you** can do

standing orders

# Legal your **actions** during care | what would another provider would do in the same situation

standard of care

# Legal **failure** to provide same care a person w/ same training would provide

Negligence

# Type of Negligence performing an act **outside** scope of practice

malfeasance

# Type of Negligence performing an **authorized act wrong** ## Footnote *mistake*

misfeasance

# Type of Negligence failure to perform an action when should have ## Footnote *NONE*

nonfeasance

# Type of Negligence willfull or reckless action with disregard to duty/care of pt.

gross negligence

# Legal discontinue care w/o consent

abandonment ## Footnote this is why we TRANSFER CARE to someone at the same/higher level than you (SIGNATURES!)

# Handover & Documentation transfer of care **S B A T**

**S**ituation *(what happened; main concern)* **B**ackground *(most important info pertaining to injury/illness)* **A**ssessment *(vitals/physical findings)* **T**reatment

# Handover & Documentation patient care report **C H A R T** **S O A P**

**C**hief Complaint **H**istory *(pt. and hx of event)* **A**ssessment **R**x **T**ransport *(where pt. was found all the way to transfer of care at hospital)* **S**ubjective *(what pt. reports)* **O**bjective *(what you see/vitals)* **A**ssessment **P**lan *(treatment, movement, transport)*

# Handover & Documentation risk factors that don't align w/ chief complaint

pertinent negatives ## Footnote documented in PCR