chapter 1 Flashcards
what is the seven step process of accessing the EMS system?
patient a citizen calls 911 Emergency medical dispatcher Emergency medical responders EMTs Emergency departments staff Allied health staff
when did the development of modern EMS system begin?
1960’s
when did the national highway safety act charge the US Department of transport with developing EMS standards and assisting the states to upgrade the quality of their prehospital emergency care?
1966
when was the NREMT founded?
1970
T or F. in 1973 the National Emergency Medical System Services Act was passed
True
Regulation and policy
each state EMS system must have in place enabling legislation (laws that allow the system to exist), a lead EMS agency, a funding mechanism, regulations, policies and procedures
Resource management
there must be centralized coordination of resources so that all victims of trauma or medical emergencies have equal access to basic emergency care and transport by certified personnel and a licensed and equipped ambulance to an appropriate facility
Human resources and training
at a minimum all those transporting prehospital personnel should be trained to the EMT level using national EMS education standards there are taught by qualified instructors
Transportation
safe reliable ambulance transportation is a critical component. most patients can be effectively transported by ground ambulances. other patients require rapid transportation or transportation from remote areas by helicopter or airplane
Facilities
The seriously ill or injured patient must be delivered in a timely manner to the closest appropriate facility
Communications
There must be an effective communication system that encompasses the universal system access number ( 911) and dispatch to ambulance, ambulance to ambulance, ambulance to hospital,l and hospital to hospital communications
Public information and education
EMS personnel may participate in efforts to educate the public about their role in the system, their ability to access the system, and prevention of injuries
Medical direction
each EMS system must have a physician as a medical director who is accountable for the activities of EMS personnel within that system. the medical director must be involved in all aspects of the patient care system including protocol development training and quality improvement
Trauma systems
in each state enabling legislation must exist to develop a trauma system including one or more trauma centers, triage and transfer guidelines for trauma patients, rehabilitation programs, data collection, mandatory autopsies, and means for managing and ensuring the quality of the system.
Evaluation.
each state must have a program for evaluating and improving the effectiveness effectiveness of the EMS system, Known as a quality improvement (QI) program, a quality assurance (QA) program, or total quality management (TQM).
When does care begin from the patients view?
For the patient care begins with the initial phone call to the EMD
what is a specialty hospital and what does it do?
One specialty hospital is the trauma center. in a trauma center surgery teams capable of comprehensive treatment of trauma patients are available 24 hours a day
4 different kinds of specialized centers/hospitals
Burn centers, pediatric centers, cardiac centers, and stroke centers
Who are the many others that make up the hospital portion of the EMS system? (important)
they include physicians, nurses, physicians assistants, respiratory and physical therapists, technicians, aides and others
What are the four general levels of EMS training and certification?
Emergency medical responder (EMR), emergency medical condition technician (EMT), advanced emergency medical technician (AEMT), paramedic
Critical decision making
- Gather information from scene, patient assessment, and other sources.
- Synthesize (interpret) information to make decisions regarding treatment and transport options.
What are 8 roles and responsibilities for an EMT? (Important)
Personal safety Safety of crew, patient, and bystanders Working with other public safety professionals Patient assessment and care Lifting and moving Transport Transfer of care Patient advocacy
What always comes before emergency care?
assessment
What are 4 good physical traits for EMT?
Important
Ability to lift and carry equipment and patients up to 125 pounds
Good eyesight (distance and reading)
Awareness of any problems with color vision
Good communication skills (oral and written)
what are 13 personality and character traits for a good EMT? (Important)
Pleasant Sincere Cooperative Resourceful Self-starter Emotionally stable Able to lead Neat and clean Of good moral character and respectful of others In control of personal habits Controlled in conversation and able to communicate properly Able to listen to others Nonjudgmental and fair
How to maintain up to date skills (Important)
Refresher courses
Continuing education courses
Conferences, seminars, and lectures
Where Will You Become a Provider?
Ambulance services Fire departments Rural/wilderness teams Urban/industrial settings Volunteering
National Registry of Emergency Medical Technicians
Registration for EMRs, EMTs, AEMTs, and paramedics who successfully complete NREMT examinations
May help in reciprocity (transferring to another state or region)
Beneficial when applying for employment
There are several ways you can work towards quality care these include
carefully preparing written documentation, becoming involved in the Qi process, obtaining feedback from patients and the hospital staff,
maintaining your equipment,
continuing your education
All patient care performed under direction of Medical Director: (5 things)
Ultimate responsibility for patient care Oversees training Develops treatment protocols Issues off-line medical direction (standing orders) Provides on-line medical direction
what reverses affects of opioids?
Naloxone
Definition of public health
the system by which the medical community overseas the basic health of a population
EMS Role in public health (4 things)
Injury prevention for geriatric patients
Injury prevention for youth
Public vaccination programs
Disease surveillance
Two ways research affects EMS
Focus on improving patient outcomes
Through evidence-based techniques
Evidence-based process (4 steps)
Forming a hypothesis
Reviewing literature
Evaluating the evidence
Adopting the practice if evidence supports it
why does the Dynamic nature of treatment make research difficult? (2 things)
Not all research is created equal.
Embrace best practices of conducting and evaluating research
Rely on the scientific method which is…
2 steps
General observations turned into hypothesis
Predictions tested to prove or disprove hypothesis
what are the types of medical research Peer-reviewed research in medical journals Articles in E M S magazines Not original research Not peer reviewed
- Peer-reviewed research in medical journals
- Articles in EMS magazines
- Not original research
- Not peer reviewed
T or F The Americans with Disabilities Act (A D A) has set strict guidelines preserving the rights of Americans with disabilities.
True
what is included in The EMS system? (8)
911 or another emergency access system, dispatchers, E M Ts, hospital emergency department, physicians, nurses, physician’s assistants, and other health professionals
REMEMBER
- E M S dates back to Napoleonic times.
- Modern E M S standards come from 1960s–1970s and National Emergency Medical Service Systems Act (N E M S S A).
REMEMBER (four levels of EMS providers
Emergency Medical Responder, Emergency Medical Technician,
Advanced EMT, Paramedic
Requesting orders from a physician by radio is an example of what kind of medical control?
on-line
What innovation was introduced in the Korean and Vietnam wars that is now common in many E M S systems?
Specialized emergency medical centers devoted to the treatment of trauma
techniques or practices that are supported by scientific evidence of their safety and efficacy, rather than merely on supposition and tradition.
evidence-based techniques
a physician who assumes ultimate responsibility for the patient-care aspects of the EMS system.
Medical Director
Medical Direction:
oversight of the patient-care aspects of an EMS system by the Medical Director. Direction can be either off-line or on-line.
standing orders
a policy or protocol issued by a Medical Director that authorizes EMTs and others to perform particular skills in certain situations.
