Division 5: Emergency Medical (32) Flashcards
What does the EMS Operational Program Manager do
Manages the EMS system within PG county.
Appointed by the Fire Chief, typically an Assistant Fire Chief (or civilian manager).
Role is EMS Commander
Define Priority 1
And
Priority 2
Priority 1 - Critically injured or ill, requiring immediate medical attention, unstable. Also Sepsis, STEMI, and Stroke.
Priority 2 - Less serious, requiring medical attention. Not immediately endangering patients life.
Each EMS response consist of how many phases?
What are they?
13
Preparedness
System access
Incident prioritization
Response configuration
Response deployment
Pre-arrival
On-scene care
Disposition
Notification/Consultation
Transportation
Transfer of Care
Documentation/Data Collection
Return to Service
What is the minimum staffing for EMS unit
2 EMS clinicians
For a BLS unit, what level must the primary provider and the driver have to treat
Primary - County credentialed BLS approved by Medical Director and affiliated
Driver - County credentialed Medical Responder or higher
Any support clinicians must be county credentialed as an EMT or student of an approved BLS training program.
What Certs are required to be operational?
MIEMSS Continuing Education
AHA CPR training
AED training
Maintain their affiliation with PG EMS Operational Program
Who is responsible for Operational readiness of the vehicle and all equipment is present beginning of each shift?
Supervisors
Who is notified if any equipment is missing
The crew member must notify the immediate supervisor.
Complete a Loss Damage Report, And contact the EMS DO for replacement.
What system is used to query 911 callers,
How many factors determine assignment and what are they.
Medical Priority Dispatch System (MPDS)
3
- CC
- Severity
- Incident description
How long do EMS units have to notify they are enroute to a call
60 seconds
What is the #1 Pre-Arrival Consideration
Safety, to be considered prior to any action
When identifying a Staging location, how far does it need to be?
Within 1 mile of the incident, unless its deemed unsafe by unit officer
Staging in the station will ONLY occur if the incident at or within a 1 mile radius of the station.
When does the concept of implied consent apply?
Non-emancipated minor, unconscious, intoxicated/impaired, or their judgment or ability to respond is compromised.
When should the need for ALS resources be considered
Once an initial assessment and vitals are completed
For a minor, who signs the patient refusal
The patients legal guardian
Can a EMS clinician initiate a refusal
No, not for any person that has requested medical care.
What are the 4 Factors in determining the patients transport
- Clinical needs
- System Requirements - hospital status
- Patients Medical Request
- EMS Clinicians preference - proximity to station, need for supplies
What notifications must be made at the time of transport to communications (5)
- Patient priority
- Trauma Decision Tree (trauma)
- Medical Destination
- ETA
- Starting Mileage (optional)
What priority are warning devices used for patients
Priority 1 - uses visible and audible emergency warning devices to nearest hospital
Priority 2 - without use of warning devices to most appropriate hospital. The transport MAY be accomplished with warning devices
Priority 3 - without warning devices
At the hospital what must the driver do
Status on the radio
Turn off engine
Remove Keys
When must an ePCR report be completed
Any time a unit is dispatched on an EMS related incident.
When should the ePCR be completed later? (5-1)
If the Limited EMS resources Plan is in effect
And a State approved short form is to be left at the facility
When will PSC inquire about EMS unit status at the receiving facility (5-1)
After 60 minutes
If an item is not available at hospital or battalion apex, where can you go? (5-1)
You can still request a one for one exchange from the hospital staff,
Or Coordinate with an EMS Duty Officer
If an item is missing from Apex machine, what should you do (5-1)
Email the EMS Logistics Office
How often must providers complete CPR/AED course (5-2)
Every 2 years
How often should AED in-service training programs be completed (5-2)
Annually by all AED providers
What is the minimum that the AED Daily check sheet should be kept (5-2)
3 years
When should the AED be downloaded (5-2)
Immediately, regardless if shock was advised
What is the role of each for AED use (5-2)
Battalion Chief
Station Officer
EMS Provider
Battalion Chief - ensure all maintain CPR/AED certification
Station Officer -
ensure all maintain CPR/AED certification,
Used with protocol standards,
Review all AED uses and PCR are complete and accurate,
Downloaded Immediately,
Daily check sheets are completed,
Notify EMS QA of any issues.
EMS Provider -
Same as above, but also Ensures AED is operational at all times
What is COMAR, Title 30 (5-3)
State regulations that reference EMS requirements within the State of Maryland
Annotated (abbreviated) Code of Maryland Regulations
Whose responsibility is it to oversee EMS certification, recertification, decertification of providers (5-3)
The Medical Director
and the Bureau Chief Fire/EMS of Training Academy
If a volunteer changes affiliation, when and who should be notified (5-3)
MIEMSS and within 30 days
What do you need to be an ALS provider (5-3)
- NREMT certification as EMT-I or EMT-P
- State of Maryland licensed ALS provider
- Affiliated with PGFD (required by COMAR)
Who overseas the ALS internship process (5-3)
the Bureau Chief of the Fire EMS Training Academy (or his/her designee)
What are the requirements to fulfill affiliation as an ALS provider (5-3)
Complete 4 hours of ALS Annual Skills
Complete a minimum of 24 hours on ALS unit (during regular work hours, each quarter)
Who is excluded from ALS requirements (5-3)
Rank of Battalion Chief and above
Personnel that are on extended light duty and sick leave, FMLA, or IOJ (during absence)
A waiver may be submitted in certain cases
What happens in cases of failure to meet ALS requirements (5-3)
Reclassified as an ALS intern (to complete all phases of internship)
Disciplinary action (Gen Order 11-04)
If you have an exception for over 1 year as a ALS provider what happens (5-3)
You are required to
Have a MD State protocol review class by FETA
Have a skills competency assessment completed by FETA
Interview with County Medical Director
When should the Prince George’s County Adult Health Services Home Health Agency be called (5-4)
Numerous calls over a period of time for the same thing
Epileptics with recurrent seizures, possibly due to poor health practices
Diabetics who continually experience diabetic emergencies, due to poor health practices
Who should be contacted to initiate Adult Heath Services Home Agency (5-4)
Adult Protective Services, to request a home evaluation with explanation and facts
What is the new term for LZ or Landing Zone (5-5)
Helispot
Who is responsible for all MEDEVAC communications (5-5)
MIEMSS
You are required to communicate with SYSCOM
A MD State police Duty Officer is stationed in SYSCOM to dispatch MSP Helicopters
Who contacts PSC for MEDEVAC (5-5)
The Incident Commander, forwards through PSC and PSC notifies SYSCOM with the information
What information needs to be given for MEDEVAC (5-5)
of Patients
Ages and Sex
CC and Specialty Referral Type
Trauma Category
Weight, if multiple patients
Helispot
Required Additional Resources
ADC Map Coordinates, if available
If the flight crew needs assistance, what should happen (5-5)
The Incident Commander or Ranking Officer should designate a BLS provider, unless they specifically ask for an ALS provider.
Before departure arrangements will be made to get the provider back to station.
Who is responsible for a safe Helispot
What is required? (5-5)
The Incident Commander
- 1 Engine with minimum staffing - locates water supply and has full PPE, do not deploy lines yet.
- Controlled area (no pedestrian or traffic) 100x100 feet
- No loose material, or wires, poles etc
- No lights shined at Air craft
What are 3 important rules around the Helicopter (5-5, attachment)
Stay Clear of the Rear at all Times
Do not approach unless the main rotor has stopped
No vehicles within 150 feet of
What are considered First Response Units (5-6)
Paramedic Engines, Paramedic Supervisors (non transport units)
Who is responsible for ensuring that units remain stocked per check sheets,
How long are check sheets kept for? (5-6)
Station Officers and Volunteer Chiefs
Checks sheets should be retained for a minimum of 3 years after that they may be discarded.
Per 5-7, Who has EPI Pen and EPI Jr. (5-7)
BLS Units must carry 1 of each
The station is also issued 1 of each as replacement stock.
No other units have them
How are the EPI pens replaced (5-7)
When used the BLS unit will replace with the Stock from the Station
The station will replace by requesting EMS Services Officer or EMS Duty Officer (EMS801)
If EPI pen is broken a loss damage report is filed. If used dispose in sharps
Define RED and YELLOW hospital status (5-9)
RED - the hospital has no ECG monitored beds available
YELLOW - the hospital has no BEDS (or level of staffing) to manage Priority 2 or 3 patients
Define BLUE alert (5-9)
The EMS jurisdiction is taxed to its limits, due to mass casualty, snow, flooding, etc
Can a Hospital on RED and YELLOW take a priority 1 patient? (5-9)
YES, priority 1 patients shall be transported to the closest appropriate facility regardless of the alert status
If two hospitals are both RED and YELLOW where should the provider go? (5-9)
Within a 20 min drive time, the provider will disregard the status and go to the closest facility
Which status is preferred RED or YELLOW? (5-9)
It is preferred to transport to RED (no ecg) than YELLOW (no beds)
What should you do if you are transporting to a RED or YELLOW hospital? (5-9)
You should consult and advise the staff the reason for transport to their facility
If a BLS has a ECG patient, and the closest hospital is on RED, where should this unit go (5-9)
Continue to that hospital (the closest one on RED)
Who can declare a BLUE alert (5-9)
EMS Duty Officer, until canceled by EMS Duty Officer
What does the BLUE alert do to RED and YELLOW hospital alerts? (5-9)
It overrides those alerts (suspends) EMS providers will transport to the closest facility unless the hospital is on RE-ROUTE alert
Can a Priority 1 patient go to a hospital on “Mini-Disaster” alert? (5-9)
No , regardless of priority
What is the purpose of Re-Route? (5-9)
What do you do if 2 close hospitals are both on re-route
Who can put a hospital on re-route
It’s for when the hospital is overtaxed and the EMS wait time has become too long.
If 2 close hospitals are on re-route get directions from EMS duty officer
The EMS DUTY officer can place a hospital on re-route at anytime
How long should an EMS provider wait at the Hospital (and who should they talk to first)
After this time How long should you wait Whom should be contacted next? (5-9)
The EMS provider should wait 20-30 mins, Then contact the ED Charge Nurse
Then after 10 more minutes they should contact the EMS Duty Officer
(The EMS Duty Officer will contact the ED Charge Nurse to find out why the delay)
When is Re-Route Considered by the EMS Duty Officer (5-9)
When the facility is holding 3 or more units with a wait of 30 mins or greater
If a facility is on Trauma by-pass, where should your patient go? (5-9)
The next closest Trauma Center
If the patient is in cardiac arrest or has an unstable airway go to the nearest emergency department.
Define Blue Alert (5-10) who can call a Blue Alert
When the system is taxed to its limits because of MCI, snow, icing, flooding, or other instances.
(Suspends yellow alert)
PGFD’s EMS program Manager
How many patients can the MAB handle (5-10)
How many are in the county (MAB)
What is the minimum staffing
How many MAB’s are in the area
20 immobilized patients,
1 Bus,
Minimum staffing is 3
7 MAB in National Capital Region
How many MCSU’s are in the Department?
How many patients can each handle? (5-10)
What is the minimum staffing
There are 2,
MCSU 855 - 100 patients
MCSU 849 - 50 patients
Minimum is 3 persons
What method is used to assess in a MCI (5-10)
What defines RED, YELLOW, GREEN, and BLACK
Is CPR initiated during triage?
START TRIAGE
30 seconds each patient
Respirations, Perfusion, Mental Status
RED - airway compromise, rr over 30, cap refill over 2 secs, unable to follow commands
YELLOW - reps under 30 cap refill less than 2 secs, able to follow to commands
GREEN - walking wounded
BLACK - pulseless, apneic after opening airway.
No CPR is not initiated during triage
What are the different groups (and their jobs) set up during a MCI according to the Gen Order (5-10)
How does this get started?
Triage Group - Use START triage with tape, prioritize patients
Treatment Group - patient care, maintain communications with transport group for patient movement
Transport Group -
EMS Staging -
EMS Supply Unit -
EMS Communications Unit -
The IC may add a “MCI Task Force” to the initial assignment
