Chapter 1 Flashcards
EMS is a
system
EMS system consists of a team of …, provides … care and … and is governed by …
health care professionals; emergency; transport; state laws
after you pass the certification exam, you are eligible to apply for …
state licensure
licensure is the process by which states ensure … in an examination setting. this allows states to manage who can function as a health care provider
applicant competency
in most states, there are four training and licensure levels: .., …, …, and …
emr; emt; aemt; paramedic
an emr has very … training: provides care before … and may assist in the …
basic; ambulance arrives; ambulance
An EMT has training in … (…), including:
…
….
assisting patients with …
basic life support; BLS; automated external defibrillation (AED); airway adjuncts; certain medications
an AEMT has training in specific aspects of…, including:
- …
- administration of a limited number of …
life support (ALS); intravenous (IV) therapy; emergency medications
a paramedic has extensive … training, including
…
emergency …
…
other advanced assessment and treatment skills
ALS; endotracheal intubation; pharmacology; cardiac monitoring
licensure requirements differ from state to state. generally, the requirements to be licensed and employed are:
… or equivalent
proof of …. against certain …
successful completion of a … and …
valid …
successful completion of a recognized health care provider … course
successful completion of a state-approved … course
successful completion of a state-recognized … exam
successful completion of a state recognized … exam
demonstration of the … and … abilities necessary to safely and properly perform all the tasks and functions described in the defined role of an EMT
compliance with other state, local, and employer provisions
high school diploma immunization; communicable diseases background check; drug screening; drivers license BLS/ CPR (cardiopulmonary resuscitation) EMT written certification practical certification mental; physical
(americans with disabilities act-ADA- of 1990) protects people who have a disability from being denied access to .. and … that are provided by state or local govs
programs; services
(americans with disabilities act-ADA- of 1990) prohibits employers from failing to provide full and equal employment to
the disabled
(americans with disabilities act-ADA- of 1990) Title I protects EMTs with disabilities who are seeking … under many circumstances; Employers with a certain number of employees are required to adjust processes so that a candidate with a disability can be considered for a position and modify the … or how the job is …
gainful employment; work environment; normally performed
origins of ems include:
volunteer ambulances in …
field care in …
field medic and rapid helicopter evac in …
world war i; world war ii; Korean conflict
as recently as the 1960s and early 1970s emergency ambulance service and care … in the US
varied widely
EMS as we know it today originated in … with the publication of Accidental Death and Disability: The neglected DIsease of Modern Society (more commonly known as “…”)
1966; the white paper
The DOT published the first EMT training curriculum in the early
1970s
the American academy of orthopaedic surgeons prepared and published the first EMT textbook in … it is often called “…”
1971; the orange book
efforts are under way to … of EMS education nationally
standardize levels
in the late 1970s, the DOT developed a recommended …
National Standard Curriculum
During the 1980s many areas enhanced the emt national standard curriculum by adding emts with advanced levels of training who could provide key components of … and …
ALS care; advanced life-saving procedures
in the 1990s, the National Highway Traffic Safety Administration (NHTSA) developed the …, a document with a plan to standardize the levels of EMS education and providers
EMS Agenda for the Future
(levels of training) federal level: the national EMS scope of practice model provides … this document provides overarching guidelines for the … each level of EMS provider should be able to perform
guidelines for EMS skills; minimum skills
(levels of training) state level: … regulate EMS provider operations
laws
(levels of training) local level: the … provides daily oversight and support to EMS personnel. examples include the medications that will be carried on an ambulance r where patients are transported
medical director
(levels of training) public BLS and immediate aid: millions of laypeople are trained in …–> teachers, coaches, and child care providers, people who regularly accompany groups on trips to remote locations, AEDs are used by laypeople
BLS/CPR
(levels of training) Emergency Medical Responders (EMRs) (not recognized by NJ): … … … …
law enforcement officers; firefighters; park rangers; ski patrollers
(levels of training) EMR training provides these individuals with the skills necessary to initiate … and assist EMTs upon their arrival. the course focuses on providing immediate … and … with ..
immediate care; BLS; urgent care; limited equipment
(levels of training) good Samaritans trained in … and … often show up at a scene and can provide valuable assistance; they can also interfere with operations and endanger themselves and others
first aid; CPR
(levels of training) Emergency medical technicians (EMTs): The EMT course requires about … hours, and even more hours in some states.
the EMT possesses the knowledge and skills to provide basic …
150 hours; emergency care
(levels of training) on arrival at the scene, the EMT, together with any other EMTs who have responded, assumes responsibility for the …, …, .., and … of the patient
assessment; care; packaging; transport
(levels of training) Advanced emergency medical technicians (AEMTs): the course adds knowledge and skills in specific aspects of … for those trained and with experience as EMTs:
…
advanced …
administration of a limited number of ..
ALS; IV therapy; airway adjuncts; medications
(levels of training) paramedics: extensive course of training- course hours range from … to more than … hours, divided between classroom and internship training. course may be offered within the context of an .. or … college program. training covers a wide range of ALS skills
1000; 1300; associate’s; bachelor’s
The EMS Agenda for the Future outlines 14 components of an EMS system: public … … care … direction integration of … … systems … … … systems … and … … system … public … … systems
public access clinical care medical direction integration of health services information systems prevention EMS research communication systems Human resources legislation and regulation evaluation system finance public education education systems
(components of EMS system)
public access:
easy access to help in an emergency is essential
the … system is the public safety access point
at the communication center, trained dispatchers obtain info and dispatch the … and other equipment and responders
an … system has been developed to assist dispatchers in providing callers with vital medical instructions until EMS arrival
911; ambulance crew; emergency medical dispatch (EMD)
(components of EMS system) communication systems:
from caller info, the dispatcher selects the appropriate parts of the emergency system to …
EMS may be: a … agency, other … agency, … services, …-based prograns and … services (less common)
activate; fire; non-fire gov; private; hospital; Native American tribal services
(components of EMS system) communication systems
new tech can help responders … their patients
locate
(components of EMS system) clinical care:
describes the pieces of …
describes the … for using that equipment
familiarizes EMTs with their … – that is, the main area in which an agency operates
familiarizes EMTs with …
equipment; scope of practice; primary service are (PSA); ambulance controls
(components of EMS system) human resources: focuses on the people who deliver the care:
…
interaction with other members of …
efforts are under way to allow EMS providers to move from … more seamlessly.
The EMS agenda for the future encourages the creation of systems to help protect the .. of EMS providers, including the development of …
compensation; medical community; state to state; well-being; career ladders
(components of EMS system) medical direction: a physician medical director authorizes EMTs to provide … in the field
medical care
(components of EMS system) medical direction
appropriate care is described in .. and …:
… are described in a comprehensive guide delineating the EMT’s cope of practice
.. are part of protocols and designate what the EMT is required to do for a specific complaint or condition
standing orders; protocols; protocols; standing orders
(components of EMS system) medical directions
providers are not required to consult medical direction before implementing ..
standing orders
(components of EMS system) medical direction
the medical director is the ongoing working liaison between the …, …, and the EMTs in service
medical community; hospitals
(components of EMS system) medical direction
medical control can be … or …
… (indirect): standing orders, training, supervision
… (direct): physician directions given over the phone/radio
off-line; online; off-line; online
(components of EMS system) legislation and regulation:’
Although each EMS system, medical direction, and training program has some latitude, its training, protocols, and practices must follow state …, …, …, and …..
legislation; rules; regulations; guidelines
(components of EMS system) A senior EMS official is usually in charge of necessary … such as scheduling, personnel, budgets, purchasing, and vehicle maintenance, and the daily operations of ambulances and crews.
a. Similar to a police chief or fire chief
b. Not in charge of …
administrative tasks; medical matters
(components of EMS system) integration of health services:
prehospital care by the EMT is coordinated with care administered by the …
care should be continued in the … (ED)
integration ensures that the patient receives ..
receiving hospital; emergency department; comprehensive continuity of care
(components of EMS system) Some EMS systems collaborate with local hospitals to improve patient outcomes associated with …, such as in heart attacks, trauma, and stroke.
time-sensitive treatment
(components of EMS system) mobile integrated health (MIH) care: new method of delivering health care that utilizes the …
prehospital spectrum
(components of EMS system) MIH has evolved as a result of the patient protection and affordable care act, with the goal of facilitating improved .. to health care at an …
access; affordable price
(components of EMS system) in the MIH model, health care is provided within the …, rather than at a physician’s office/hospital, by an integrated team of health care professionals; this new branch of health care is causing the evolution of … for EMS providers
community; additional training levels
(components of EMS system) MIH expansion of health care:
one new aspect is ..,. in whiche xperienced paramedics receive advanced raining to equip them to provide services within a community.
in addition tot he patient care services a paramedic would typically provide, services provided by community paramedics may include:
performing …
monitoring … or …
obtaining … samples
administering …
serving as ..
community paramedicine; health evals; chronic illnesses; conditions; lab; immunizations; patient advocates
(components of EMS system) evaluation: the … is responsible for maintaining quality control within the MEs system. the … program reviews and performs audits of the EMS system to identify areas of improvement and/or assign remedial training
medical doctor; continuous quality improvement (CQI)
(components of EMS system) evaluation:
information and skills in emergency medical care change constantly. … and … are important
refresher training; continuint education
(components of EMS system) evaluation:
minimizing errors is the goal
errors are not inevitable
errors can result from ..-based failure, ..-based failure, ..-based failure, or any combination of these problems
the … ccan be part of the reason for errors (for example, distractions, poor lighting)
when you are about to perform a skill, ask yourself, why am i doing this
using … or a copy of your protocol book can help limit errors
rule; knowledge; skills; environment
(components of EMS system) information systems: used to efficiently .. the care that has been delivered; once stored electronically, the information can be used to …
document; improve care
(components of EMS system) for example, stored info can help determine: how … a department has seen specific types of symptoms, average … for trauma patients, need for …, national …
often; on-scene; educational sessions; trends
(components of EMS system) system finance:
finance systems vary depending on which … is involved
personnel may be …, …, or a mix of these
EMTs may be asked to gather … information from patients, secure .. on certain docs such as HIPAA notifications, obtain … from patients to bill their health insurance company
organization; paid; volunteer; insurance; signatures; written permission
(components of EMS system) education systems
most ems training programs must adhere to … established by two accrediting organizations: committee on accreditation of educational programs for the Emergency Medical Services Professions (CoAEMSP) and Commission on Accreditation of Allied Health Education Programs (CAAHEP).
national standards
(components of EMS system) education systems;
Frequent continuing education, refresher courses, and computer-based or manikin-based self-education exercises are measures intended to …and …an EMT’s skills and knowledge.
maintain; update
(components of EMS system) ALS-level instructors and directors must hold a … degree
ALS training is usuaully provided in college, adult career center, or hospital settings
four year
(components of EMS system) prevention and public education
prevention and public ed are aspects of EMS where the focus is on …, which examines the health needs of … with the goal of … health problems
public health; entire populations; preventing
(components of EMS system) prevention and public ed
ems works with public health agencies in two ways:
… prevention focuses on strategeies that will prevent the event from ever happening
… prevention occurs after the event has already happened, to decrease the effects of the event
primary; secondary
(components of EMS system) EMS research: helps to determine and shape the .. of EMS on the community. application of evidenc-ebased practice is becoming an integral part of functioning as an EMS provider. patient care should be focused on procedures that have proved useful in improving patient outcomes. EMTS may be involved inr esearch through … the results could then be shared with the rest of the ems community.
impact; gathering data
(components of EMS system) EMS research:
… decision making is based on research
it is important for EMS providers to stay current on the latest advances in health care. be skeptical, ask questions, conduct your ownr esearch
evidence-based
roles and responsibilities of an EMT:
keep vehicles and equipment ready for ..
ensure the … of yourself, partner, patient, and bystanders
be familiar with ..
be an on-scene ..
perform an … of the scene
call for … resources as needed
gain … access
perform a … assessment
give emergency medical care to the patient while awaiting the arrival of ..
give … support to the patient, their family, and other responders
maintain … by working with other medical professionals
resolve … incidents
uphold … and … standards
ensure and protect …
give … support
constantly continue your .. development
cultivate and sustain ..
give back to the profession
an emergency; safety; emergency vehicle operation; leader; evaluation; additional; patient; patient; additional medical resources; emotional; continuity of care; emergency; medical; legal; patient privacy; administrative; professional; community relaitons
integrity: acting consistently; maintaining a firm adherence to a code of
hoenst behavior
..; being aware of and thoughtful toward theneeds of others
empathy
self-motivation: discovering problems and solving them without
someone directing you
appearance and hygiene: using your persona to project a sense of …, …, …, and ..
trust; professionalism; knowledge; compassion
self-confidence: knowing what you know and knowing what you don’t; being abe to
ask for help
…: perofmring or delergating multiple tasks while ensuring efficiency and safety
time management
…: understanding others and amking yourself understood
communicatiosn
…: being able to work with others; knowing your place within a team; communicating while giving respect to the listener
Teamwork and diplomacy
…: holding others in high regard or importance; understanding that others are more important than you
Respect
…: constantly keeping the needs of the patient at the center of care
Patient advocacy
…: paying attention to details; making sure that what is being done for the patient is done as safely as possible
Careful delivery of care
Findings or disclosures made by the patient should be discussed only in the following circumstances:
a. With those …
b. In limited situations, as required by …, with the police or other social agencies
treating the patient; law
protection of patient privacy has drawn national attention with the passage of the …
Health Insurance Portability and Accountability Act (HIPAA)
