400s (404.03-411.04) Flashcards
What are the 4 hospital status’s?
1: Green Open
2: Yellow Caution (1 hour notification, all ED beds full, 2 or more ambos waiting, Special equipment down)
3: Red Bypass (Overcrowded to point resources unavailable) Always take critical patients to closest hospital
4: Black Closed (cannot receive patients due to extraordinary circumstances)
What region are Mesa ambos in?
East
Under altered protocols what calls get ambos?
1: Code
2: Drowning
3: Childbirth
4: Stroke
5: 2n1 medical (1 ambo)
Under altered protocols when can you request ambo?
1: Enroute based off of CAD comments
2: On scene after triage
3: Stable patients should be encouraged to go POV but NO ONE SHALL BE DENIED AN AMBO IF THEY REQUEST
How often should hospitals update their status?
1: Often as necessary
2: Every 24 hours
3: Every 15 min during mass casualty
What must be present for someone to be INI?
1: No significant MOI
2: No complaints of injury
3: No pain
4: No Illness
5: No obvious injuries
6: No impairment
7: Does not want assessment
8: Not altered
9: A/Ox4
What are common disposition codes?
321: Med call with patient
322: MVA with injuries
323: MVA vs Ped
324: MVA no injuries
331: Lock in
381: No patient
611: Cancelled
554: Citizen assist
Who is responsible for ensuring EPCR done on all patients?
Captain
When should EPCR be finished by?
End of shift
ALS members may delegated ALS to BLS members for documentation, when this is done what should happen?
ALS member should co sign
What should you do if EPCR down?
Document on notepaper and complete when back up
What happens when EPCR not finished?
After 1 shift: Email to Captain CC BC
2nd shift: EMail to BC
3rd: BC and AC
4: AC
What if you need to add something to a epcr?
It can be re sent to you, you cant make changes to original data and must document in the addendum section.
Include name employee number, date time at bottom
If valid DNR is present do we have to honor family wishes?
No, If any doubt initiate care
What makes for a valid DNR?
1: Orange form (not a copy)
2: All patient info
3: Signed by patient Licensed health care provider and a witness
4: Readily available (less than 2 min)
What does a DNR bracelet mean?
Simply lets you know there is a DNR but DOES NOT replace actual document
What if a document other than a DNR is presented?
Start efforts and patch
What do you need to do if you dont initiate efforts because of a DNR?
Document that DNR present and valid, and pt has no vital signs. Include with documentation
To request a follow up contact EMS and provide what info?
1: Incident date, number, time
2: Unit and shift
3: Patient name
4: Hospital and transport agency
5: CC/MOI
What if you have a child on a school bus in an MVA that doesnt require transport?
May leave them with school official, they are not required to sign
Once contact is made you cannot terminate the patient provider relationship until what?
1: Care transferred to equal or higher care
2: Remain with patient until this transfer happens
3: Convey all relevant information to accepting provider
Who signs when transferring a patient?
The member of that crew with the highest medical certification
When can PD transport a patient?
1: Patient met criteria for a refusal
2: Patient being transferred to alcohol treatment type facility after patch for refusal
3: If patient refuses to sign with no obvious conditions, video refusal may be appropriate
4: Document officer badge number and get signature
When are we required to ride in?
REQUIRED
1: Controlled substance administered
2: RSI
3: Respiratory or Cardiac arrest
4: Stoke alert
5: Cardiac alert
RECOMMENDED (Must be supported in narrative)
6: Active seizure epilepticus
7: Imminent delivery
8: Electrical therapy used
9: Immediate trauma pt
10: Ped seizure
11: ACS
12: Respiratory distress
13: “Unstable Patients”
14: ALOC
15: Eclampsia
16: Meds given with no improvement
17: IV Infusion (continuous)
18: Restraints
19: Vaginal bleeding with pregnant viable fetus (24 weeks)
20: Request of Ambo medic
When is it acceptable to use the Ipad to take pictures and videos?
1: Pic of scene to aid treatment at hospital
2: Refusal
3: Rhythm strip, med list, DNR etc
Must use Ipad through ZOI software not on the Ipad camera
When is emergency issue gear required to be inspected?
Every Saturday
Captain’s contact BSO to get emergency issue, when should BSO contact EMS to get a replacement for emergency issue?
When gear will be out longer than 3 shifts
How much continuing education for BLS members?
24 hours (5 hours of Peds) CE provided if cant complete must use target solutions or get your own CEs
How many CEs do ALS providers need?
48 hours minus ACLS, total is 60
How many shifts are required for ALS integration?
Not less than 9 not more than 30
How many attempts do you have to pass the department integration process?
2
During a QM who is allowed to view case details?
Only those assigned to QM
100% of what type of med calls should be QMed?
High Risk encounters
1: Respiratory cardiac arrest
2: Multi system trauma
3: Specialized procedure (RSI)
4: Refusals
5: Minors
6: Field termination
7: Specialized equipment used (vent)
8: Controlled substance
9: STEMI Stroke
10: Opioid OD
11: Transfer of ALS to BLS
What are potential outcomes of QM?
1: None
2: Discussion
3: Addendum to record
4: Letter to crew
5: Review of policy
6: Meeting with EMS
7: Further training for crew
8: Tape and chart
9: Probation
What must happen when an AED that is part of our program is used?
Must be reported to medical director overseeing program unless it was purchased for home use
Who can you report compliance issues to?
Captain or compliance officer
May be written or verbal
Without fear of retaliation
May be anonymous
