EMD REVIEW Flashcards
Response determinant code methodology :
Chief complaint protocol number Determinant level Determinant descriptor number Problem suffix Determinant code
What is the four Commandments of emergency medical dispatch that is obtain doing case entry interrogation:
Chief complaint
patients Age
status of consciousness
status of breathing
“Triage” means.
To sort out or prioritize information
The use of lights -and -sirens by responders.
Should be carefully thought out
preplanned, and allocated with the use of medical approved protocol
In the past EMD was seen as the “weak” link in the chain of survival because.
There was a gap in the patient’s care between the call for help in the arrival of responders.
A cardiac arrest patient has a better chance of survival if.
The link of the chain of survival are instituted promptly and unbroken.
The term “cardiac arrest “means.
The heart has stopped beating effectively.
The chain of survival is.
A concept developed by that AHA that describes the link of care necessary to best treat cardiac arrest victims.
A defibrillator is designed to.
Enable the heart normal condition system to restart.
The year 1989 was important for EMD because.
EMD standards was published.
EMDs are life impactors because.
They provide stability in a time of crisis.
A caller who is not with the patient.
May have information valuable to the EMD.
Paramedics need no further training to be EMD.
False
Initial training and a good set of protocols is all EMD needs to give pre-arrival instructions.
False
The four primary objectives of the MPDS are:
Safety
system response
patient care
and information for the responders
The case entry protocol question “is she/ he breathing?” is designed to discover.
If the patient is breathing.
The four Commandments of EMD should be:
Obtain during case entry interrogation.
The ECHO determinant level allows for:
A dispatch decision during Case Entry and the preplanned response of resources not normally assigned to EMD calls.
Key questions provide the information necessary to:
Ensure scene and responder safety, prioritize the EMD response, provide patient care and inform responders
When should Post-dispatch instructions be provided?
following determinant code selection when appropriate and possible.
The four Priority symptoms are:
Chest pain
abnormal breathing
serious hemorrhage
decreased level of consciousness.
The case entry protocol is:
similar to the field responders initial assessment or primary survey.
Spiders, insects, or snake bites should be handled on.
Protocol 2 Allergies (reactions)/Envenomations(stings,bites)
Back pain should only be selected as the Chief complaint when it is initially clear on case entry that the cause is NON-RECENT traumatic or NON-TRAUMATIC back pain. If unclear, select
Protocol 30 traumatic injuries (specific)
When the complaint description is breathing-related tracheostomy (teach or stoma) problems in the conscious patient go to.
Protocol 6 breathing problems.
Severe thermal burns to the eye almost always affect the face or head and should be handled on.
Protocol 7 burns ( scalds)/Explosion (blast)
If the complaint description involves hazardous materials (toxic substances) that pose a threat to bystanders or responders, go to
Protocol 8 carbon monoxide/inhalation/hazmat/CBRN to address scene safety
Heart attack symptoms should be handled on.
Protocol 10 chest pain ( Non-Traumatic)
(>16) when the complaint description involves both non-traumatic chest pain and breathing problems go to
Protocol 10 chest pains to facilitate the use of the aspirin diagnostic and instructions tool
When the complaint description is a seizure, go to
Protocol 12 convulsions/seizure regardless of consciousness and breathing status
Pregnant patient who have “illness “as the primary complaint should be handled on
Protocol 26 sick person (specific diagnosis) unless the problem concerns vaginal bleeding,
Labor, miscarriage, or water break
The complaint of sickle cell crisis or thalassemia should be handled on
Protocol 26 sick person (specific diagnosis)
For insignificant or peripheral puncture wounds such as household pins, needles, tacks, or stepping on nails
Use protocol 21 hemorrhage/lacerations or protocol 30 traumatic injuries (specific) as appropriate.
For the conscious and breathing patient when the caller initially report “stroke” or the sudden offset of one or more of the stroke symptoms listed on protocol 28 additional information protocol select protocol
Protocol 28 stoke
Chest pains due to trauma (current or non-recent) should be handle on
Protocol 30 trauma injuries (specific)
Ground level falls cost by fainting, near fainting or dizziness should be handled on
Protocol 31 unconscious/fainting (Near)
If the chief complaint and status of consciousness and breathing are unknown initially (3rd party caller) go to
Protocol 32 unknown problem (Man Down)
If at any time the caller expresses that he/she may be in danger advise
Advise the caller to get to safety immediately “if safe to do so “ and call back.
Gap Theory
EMD caused gaps in conversation during interrogation or advice that cause the caller to insert demands or make uncooperative statements. It is theorized these gaps create a lack of caller confidence in the EMD
Severe eyes injuries
Direct blow Eyeball cut open Eye leaking fluid ( traumatic) Flying object Penetrating object
Protocol 16 eye problems/injuries Rule 1 No treatment should be given until emergency units arrive. Penetrating objects must not be removed prehospital care of this injury requires the attention of a trained Basic life support professional since both eyes move together they make cover both eyes with a non compressive dressing (working around a penetrated object) this minimizes spontaneous eye movement until hospital intervention is possible
PDI—-Post-dispatch instructions
Chemical burn
Chemical in eye
Chemical burn burns to the eye almost always affect the face or head and should be handle on protocol 7 burns (scalds)/explosion
Chemical in eye Gently flush with lots of water continue flushing until help arrive
For a patient with a non-categorizable complaint who does not have any identifiable priority symptoms use
Protocol 26 Sick person
If the complaint description appears to be medical in nature
Rule 3 Choose the chief complaint protocol that best fit the patient’s foremost symptom with priority symptom taking precedence
If the complaint description involves trauma
Rule 2 Choose the chief complaint in protocol that best addresses the mechanism of injury
For a patient with a non-categorizable complaint who does not have any identifiable priority symptoms use
Protocol 26 Sick Person
If the chief complaint in and status of consciousness and breathing are unknown initially a third-party Caller go to
Protocol 32 unknown problem (Man Down)
Patient assessments for the field provider relies primarily on?
Visual and tactile clues
The EMD’s assessment is dependent upon:
Structured, protocol -driven interrogation
The head-tilt method of airway control is the only recognized DLS method
Yes, because instructions for the head tilt are easily understood in a none visual setting
Pre-arrival instructions are scripted
To standardize EMD patient care and ensure that instructions are not omitted
DLS instructions for relieving an airway obstruction include the use of back blow as a last resort
False
Teaching a layperson CPR in a classroom differs from DLS instructions in that:
The classroom provides a visual setting with plenty of time to practice.
What protocol is use for Airway / Arrest / Choking (Unconscious)-Infant < 1 YR
Protocol A
What protocol is used for Airway/ Arrest/ Choking ( Unconscious) - Child 1-7 YRS
Protocol B
What protocol is use for Airway/ Arrest/ Choking ( Unconscious) - Adult > 8 YRS
Protocol C
What protocol is use for Chocking (Conscious) - Adult / Child/ Infant
Protocol D
What protocol is used for Childbirth - Delivery (Panels 1- 18)
Protocol F Childbirth-delivery
What protocol is use for Tracheotomy (stoma) Airway / Arrest / Choking (Unconscious) - Child 1-7 YRS
Protocol Yb
What protocol is used for Tracheotomy ( Stoma) Airway/ Arrest/ Choking (Unconscious) - Adult > 8 YRS
Protocol Yc
A patient > 35 with chest pain is considered a heart attack patient until proven otherwise
Rule 2 Protocol 10
MODERATE Eyes Injuries
Chemical burn
Chemical in eye
Post- Dispatch Instructions. There is no time to lose with chemical injuries; the caller must flush the patient eye(s) immediately with copious amounts of water. Continue this until help arrives. The fluid stream should be gentle but steady, as squirting water cause unnecessary discomfort. I
Proper Verification Of Critical Information
Advise the caller to verify location and call back number
“Axioms” tell us:
how to do things.
Dispatch Danger Zones
Neglect
“Zero-Minute Response”.
The EMD’s provision of dispatch life-support instructions prior to arrival of responders has led to the concept of Zero-Minute Response this concept enables patient to receive immediate care from a remote can’t take prior to the arrival of the responder
Re-freak event
A predictable event doing the course of a call when the caller reacts to seeing, are being reminded of, The patient’s state of destress. It is much more likely to occur when the patient is a relative or a loved one.
Repetitive Persistence
Hysteria-controlling technique where the EMD, by repeating identical phrases of the same calming message or request, can help most colonists regain self-control and become able to provide answers to Interrogation are deliver pre-arrival care
What card is use for tracheotomy (stoma) Airway/Arrest/Choking (unconscious) Infant <1yr
Protocol Ya
AED Support use protocol is:
Protocol Z
The nine SHUNT protocol s of the MPDS are:
3 - Animal Bite/Attacks
5- Back Pain (Non- Traumatic or Non-Recent Trauma)
7- Burns (Scalds)/Explosion (Blast)
17- Falls
20- Heat/Cold Exposure
21-Hemorrhage/lacerations
22- Inaccessible Incident/Other Entrapments(Non-Vehicle)
25- Psychiatric/ Abnormal Behavior/ Suicide Attempt
26- Sick Person(Specific Diagnosis)
ECHO Determinant Descriptor NOT BREATHING Situations
Not breathing at all 9-E-1 Breathing uncertain (AGONAL) 9-E-2 Hanging 9-E-3 Strangulation 9-E-4 Suffocation 9-E-5 Underwater 9-E-6 COMPLETE obstruction 11-E-1
Pre-Arrival Instructions Protocols are:
A- Airway/Arrest/Choking (Unconscious)-Infant 8yrs
D-Chocking (Conscious)-Adult/Child/Infant
F- Childbirth-Delivery
Y -Tracheotomy ( Stoma) Airway/Arrest/Chocking (Unconscious)
Z - AED Support
Ineffective breathing "Barely breathing" "Can't breath at all" "Fighting for air" "Gasping for air" (Agonal Breathing) "Just a little" (Agonal Breathing) "Making funny noises" (Agonal Breathing) "Not Breathing" " Turning Blue or Purple" When volunteered at any point during case entry code as
ECHO on 2, 6, 9,11,15, 31
Determining Agonal Breathing
When a patient is unconscious or not alert and is breathing abnormally or irregularly, or when mandated by the protocol, the EMD she tell the caller to say “ now” every single time the patient takes a breath in. If the time between breaths is 10 seconds or more, this should immediately be considered INEFFECTIVE BREATHING that is likely a fading AGONAL (dying) respiratory pattern. Check a maximum of four breaths ( three intervals tested)
(Read verbatim) okay, I want you to say “ Now”
Every single time she/he takes a breath in starting immediately.
>10 sec. Interval =AGONAL
Abdominal pain in a female of child bearing age (15-50) who has fainted ( or near fainted) is considered
An ectopic pregnancy until proven otherwise
Alert patients with abdominal pain and a confirmed diagnosis of aortic aneurysm should be coded as
1-C-2
Epigastric pain (above navel) in cardiac age-range patients (female >45, males >35) is considered
A “heart attack” until proven otherwise
Five techniques of call management
- Minimize call - processing gap.
- Focus on the caller’s message, not the way it’s delivered.
- Acknowledge the caller emotion
- Use calming technique throughout the call.
- Use repetitive persistence when necessary
ANI/AZLI information should always be verified to ensure accuracy.
True
When call for help, the caller may hear more ring tones then the caller does.
True
In effective telecommunication, volume is generally more important than rate.
False
____________allows speech - and - hearing - impaired callers to communicate with caller taker by signing their mediate to an interpreter.
Video relay
Study show the ECCS for most emergency caller is between:
1 and 2
The “hysteria threshold” refers to:
The point at which a caller loses control over her/ his actions and emotions.
When using the repetitive persistence technique , the call taker should repeat a statement verbatim using a firm but caring tone. The statement should include:
An action and reason for the action.
Silent “gaps” during a call elevate caller anxiety.
True
List five techniques for working with child caller anxiety
- Ask to speak to an adult when necessary
- Get to the child level
- Determine the correct address
- Determine the correct call back number
- Tell the child to stay on the phone
List three questions you should ask yourself when working with foreign-language callers
- Dose the caller know enough of my language to Communicate?
- How do I obtain foreign-language support ?
- When should I send an initial response
Best definition for “code of ethics”
Standards of conduct established by a professional organization
The difference between criminal and civil law
Civil law exists to resolved conflicts between individual and / or organization . Criminal law is enacted to protect society.
Changing social conditions can lead to the recognition of new duties for emergency dispatchers
True
Legal action brought against a public safety agency can damage public opinion even when the agency is found no liable in the courts.
True
The legal concept of foreseeability:
Consider the emergency dispatcher’ limited ability to predict evens based on the limited information provided by the caller.
The legal concept of detrimental reliance:
Applies when someone relies on the promised effort of another for help or assistance and, as a result , misses the opportunity to act in a manner that would have improved the situation .
A wake-effect collision is a traffic collision that directly involves one or more. Emergency vehicle.
False
The academy recommends that calltakers verify addresses and callback numbers by repeating the information back to the caller and asking for confirmation.
False
When possible, emergency dispatcher should ask the caller for permission before giving pre-arrival instructions.
False
Confidentiality breaches can invoke legal action.
True
List the four elements required to prove negligence in a court of law.
- Duty
- Breach of duty
- Injury or damage
- Causation
Effective quality improvement is:
A continuous process designed to improve human performance thought measurement, feedback,and education.
To recertification as an IAED Emergency Dispatcher ( one discipline), you must verify completion of at least _________ hours of approved CDE during the recertification period.
24 hours
The motto of any quality improvement effort should be:
Practice until you’re perfect!
Individual feedback should always be provided in private. Composite feedback ( for the agency and for each staff) should be posted for everyone to see
True
Continue dispatch education should be part of any quality improvement program.
True
List the seven protocol components evaluated on the case evaluation record.
- Case entry
- Chief complaint selection
- Key questions
- Dispatch life support instructions
- Diagnostic & Instruction tools
- Final coding
- Customer service
What is the difference between eustress and distress?
Eustress is motivating. Distress is disabling.
Burnout is best described as:
A psychological condition that hinders performance as the result of stress overload.
Substance abuse is an example of:
A negative response to stress.
Physical exercise is an example of:
An effective stress management technique.
Meditation is an example of :
An effective stress management technique.
Binge eating is an example of:
A negative response to stress.
When developing your personal stress management strategy, you should
Develop a flexible schedule and do things you honestly enjoy.
It is normal for people to have strong reactions to unusually traumatic events.
True
List the four hallmark of distress.
- Persistent feelings of fatigue
- Loss of motivation for the job
- Negativity
- Persistent cynicism
Frenza’s Law
A thing not looked for is seldom found.
When using the AGONAL BREATHING Detector, if the time between breaths is _________ seconds or more, this should immediately be considered INEFECTIVE BREATHING that is likely a fading, AGONAL (dying) respiratory pattern
10
After providing the instructions from panel 12 of protocol F, the caller reports the he can see the baby’s buttocks. Which panel should you go to next
F-20 Other Parts Presenting
After providing the instruction from panel 4, the caller reports the she see both the baby’s head and a hand. Which panel should you go to next.
Panel F-5 Head
The caller should be instructed to cut the cord after thy placenta has been delivered
False
After providing the instructions from panel 20, the caller reports that he can see the baby’s hand and arm but not the baby’s head. Which panel should you go to next
BREECH positioning: Hand(s) without head Arm(s) without head Cord without head BREECH Positioning-25
After providing the instructions from panel 28 for the second time, the caller reports that she counted 40 pulses. Which panel should you go to next?
Check answer
Putting the baby to the mother’s breast to feed may help control postpartum hemorrhage.
True
If a cord rupture occurs, you may need to access the instructions in panel 10a at any time during the childbirth process
True
10a Ruptured Cord
I want you to CLENCH the bleeding area of the cord in your hand and SQUEEZE it tightly. hold it for ONE MINUTE. DONT let go.
WITHOUT pulling on the cord, GET a STRING ( shoelace) and tie it tightly in TWO places AROUND the CORD–one 3 INCHES (8 cm) BELOW it. Tie the side CLOSEST to the baby FIRST. Return to Sequence