Chapter 2- Volume 1

Question 1

Accidental Death and Disability: the The neglected disease of modern society

Answer 1

Published by: The national Academy of Sciences, national research council in 1966.

“White paper” that spelled out the deficiencies in prehospital emergency care and suggested guidelines for training, better ambos, and better equipment

•lack of uniform laws and standards, •poorly equipped ambos, •poor quality ambos, •lack of communication between EMS and hospitals, •inadequate training, •inadequate hospital staff

Question 2

Highway safety act

Answer 2

Created in 1966

Promogulated initial EMS guidelines for the US

Question 3

EMERGENCY MEDICAL SERVICES SYSTEMS ACT

Answer 3

1973 by Congress

Provided funding for a series of projects related to the delivery of trauma care.

Question 4

Consolidated Omnibus Budget Reconciliation Act (COBRA)

Answer 4

1981

Wiped out federal funding for EMS

The small amount that remained went to state preventive-health and health-services block grants.

Question 5

Statewide EMS Technical Assessment Program

Answer 5

1988 by NHTSA

Defines elements necessary to all EMS systems

Regulation and policy, resources management, Human Resources and training, transportation, facilities, communications, trauma systems, public information and education, medical direction, evaluation (QI)

Question 6

Quality Improvement

Answer 6

An evaluation program that emphasizes service and uses customer satisfaction as the ultimate indicator of system performance.

Question 7

Emergency Medical Services for Children

Answer 7

1993 by the institute of medicine

Pointed out deficiencies in pediatric emergency care in the United States.

Question 8

Trauma Care Systems and Development Act

Answer 8

1990 by Congress

Provided funding to states for trauma system planning, development, implantation, and evaluation.

Question 9

Ontario Prehospital Advanced Life Support (OPALS) study

Answer 9

A study conducted of prehospital practices and outcomes

Question 10

National Highway Traffic Safety Administration (NHTSA)

Answer 10

An agency of the US Government established by the Highway safety act of 1970 to carry out safety programs to improve motor vehicle and highway safety, particularly to prevent vehicular crashes

Question 11

EMS Agenda for the Future

Answer 11

1996 by NHTSA

Examined what had been been learned during the prior three decades of EMS and endeavored to create a vision for the future of EMS in the United States.

Attributes:
Integration of health services, EMS research, legislation and regulation, system finance, Human Resources, medical direction, education systems, public education, prevention, public access, communication systems, clinical care, information systems, evaluation

Question 12

National Incident Management Systems (NIMS)

Answer 12

A system administered by the US Secretary of Homeland Security to provide a consistent approach to disaster management by all local, state, and federal employees who respond to such incidents

Question 13

EMS: at the crossroads

Answer 13

2006 by national academies institute of medicine

Study that found that there were significant problems at the federal level: government leadership in emergency care was found to be fragmented and inconsistent.

Insufficient coordination, coordination of transport within regions is limited, disparities in response times, uncertain quality of care, lack of readiness for disasters, divided professional identity, and limited evidence base.

Question 14

The national report care on the state of emergency medicine: evaluating the environment of emergency care systems state by state

Answer 14

2006 by American college of emergency physicians (ACEP)

Pointed out the significant problem that existed in all aspects of emergency care. Overall, emergency services are so overstressed that the quality of care has been compromised.

Causes: inadequate funding, patient overcrowding, lack of alternate care facilities, problems with medical liability, the effect of illegal immigration.

Question 15

National Transportation Safety Board (NTSB)

Answer 15

An independent US government investigative agency responsible for civil transportation accident investigation, including investigation of aviation accidents and incidents, certain types of highway crashes, ship and marine accidents, pipeline incidents, and railroad accidents.

Question 16

Service types of EMS

Answer 16

Fire based, third service, private (profit or nonprofit), hospital-based, volunteer, hybrid (combination of any of these)

Question 17

Chain of survival

Answer 17

As defined by the American Heart Association, the five most important factors affecting survival of a cardiac arrest patient: immediate recognition and activation of EMS, early CPR, rapid defibrillation, effective advanced life support, integrated post cardiac arrest care.

Question 18

PSAP

Answer 18

Public service access points

Question 19

PPCI

Answer 19

Primary Percutaneous coronary intervention

Question 20

National EMS education instructional guidelines

Answer 20

Developed in 2009

Replaced the various curricula that had been previously published to guide EMS education.

Question 21

National EMS core content

Answer 21

Published by NHTSA in 2005

Defined the body of knowledge, skills, and abilities desired and EMS personnel.

Question 22

The national EMS scope of practice

Answer 22

Published in 2005

Consensus document that supported a system of EMS personnel licensure that was common in other allied health professions and was designed to serve as a guide for states and territories in developing their scope of practice legislation, rules, and regulations.

Question 23

Scope of practice

Answer 23

The range of duties and skills paramedics and other levels of EMS certification are allowed and expected to perform

Question 24

Medical director’s roles in an EMS system are?

Answer 24

Educate and train personnel, participate in personnel and equipment selection, develop clinical protocols and corporation with expert personnel, participate in quality improvement and problem resolution, provide direct input into patient care, interface between the EMS system and other healthcare agencies, advocate within the medical community, Serve as the medical conscience of the EMS system, including advocating for quality patient care.

Question 25

Medical oversight

Answer 25

Medical policies, procedures and practices established by the medical director of an EMS system

Question 26

Peer review

Answer 26

A process of self evaluation by profession such as EMS in which qualified individuals within the profession or service assess ongoing practices to maintain standards and improve performance

Question 27

Intervener physician

Answer 27

A physician at the scene of an emergency who is not affiliated with EMS or not affiliated with the EMS service that has been dispatched to the scene

Question 28

Prospect of medical oversight

Answer 28

Guidelines established by medical Director in advance of emergency calls, such as those regarding selection of personnel and suppliers, training and education, and protocol development

Question 29

Interoperability

Answer 29

A feature of the emergency and Public Safety communications infrastructure that allows personnel from different jurisdictions and systems to communicate with one another effectively

Question 30

Pre-arrival instruction

Answer 30

Instructions from a medically trained dispatcher to a person at the scene of an emergency on how to initiate life-saving first aid with the dispatchers help while waiting for the on scene arrival of emergency personnel

Question 31

Accreditation

Answer 31

A system ensuring that education programs for paramedics and other EMS personnel levels meet minimal guidelines for faculty, facilities, equipment, medical oversight, clinical affiliations, and financial stability

Question 32

Licensure

Answer 32

The process by which a governmental agency grants permission to engage in a given trade or profession to an applicant who has attained the degree of competency required to ensure the Public’s protection

Question 33

Certification

Answer 33

The process by which an agency or association grants recognition to an individual who has met its qualifications

Question 34

Registration

Answer 34

The process of entering one’s name and essential information within a particular record, done in EMS to verify the providers initial certification and to monitor recertification

Question 35

Reciprocity

Answer 35

The process by which an agency grants automatic certification or licensure to an individual who has comparable certification or licensure from another agency

Question 36

National EMS organizations

Answer 36

National Association of emergency medical technicians (NREMT), national Association of search and rescue (NASAR), national Association of EMS educators (NAEMSE), national Association of EMS physicians (NAEMSP), international flight paramedics association (IFPA), national EMS management association (NEMSMA), national Council of state EMS training coordinators (NCSEMSTC)

Question 37

Leader ship guide to quality improvement for emergency medical services systems

Answer 37

Published in 1987 by NHTSA

Guidelines:
Leadership, information and analysis, strategic quality planning, human resources development and management, EMS process management, EMS system results, satisfaction of patients and other stakeholders

Question 38

Rules of evidence

Answer 38

Guidelines that must be followed for permitting a new medication, process, or procedure to be used in EMS

Guidelines:
There must be a theoretical basis for the change, there must be ample scientific human research to support the idea, it must be clinically important, it must be practical affordable and teachable.

Question 39

Types of medical errors

Answer 39

Skill-based failures, rule based failures, knowledge base failures

Question 40

Where do medical errors occur?

Answer 40

Handoff, communication issues, medication issues, airway issues, dropping patients, ambulance crashes, and death pronouncements.

Question 41

Evidence-based medicine

Answer 41

The conscious, explicit, and judicious use of scientific evidence of effectiveness and decisions about the care of a patient or patients.

Question 42

E– 911

Answer 42

Enhanced 911 provide several features not found in a standard 911 system, such as caller location and the call back number