EMR PREP Flashcards
What is the purpose of the EMS System?
To provide emergency care and transport to victims of sudden illness or injury.
What is the typical sequence of events from the time an emergency occurs and EMS is activated to the time the patient is transferred to the in-hospital care system?
A person will call for help, the person will be provided patient care instructions from dispatch, EMS will be dispatched, patient care will be transferred to EMS and care will be provided to the patient on scene, during transport to the hospital and then care transferred to the hospital staff
What are 5 of the 10 classic components of an EMS system?
Regulation and Policy - each province has its own laws
Resources and management - each province must have central control of EMS resources
Human resources an training - all persons staffing an ambulance and transport patients must be trained
Transportation - patients must be safely and reliably transported by ground or air.
Facilities - every seriously ill or injured patient must be delivered in a timely manner to an appropriate medical facility
Communications - a system for public access and dispatchers and crews and hospital staff
Public information and education - EMS personnel should participate in public education programs with a focus on injury prevention and how to access EMS
Medical Control - Each EMS system must have a physician as its medical director
Trauma systems - each province must develope a system of specialized care for trauma patients, rehabilitation centres, and a system for transporting patients to those facilities
Evaluation - each province must have quality improvement system in place for continuous evaluation and upgrading of its EMS system.
What are 2 basic ways to access the EMS system ?
Through 9-1-1 and a non 9-1-1 number
How many nationally recognized levels of training are offered in the EMS System?
4
EMR - ABC, Patient Assessment, CPR, AED, Bleeding Control, Stabilization of injuries to spine and extremities, Care for medical and trauma patients, check blood glucose, SpO2(as permitted provincially)
PCP - + IVs, administer symptom relief drugs, pulse ox, glucose testing, manual defibrillation, complex immobilization procedures, patient restraint, staff and drive ambulance
ACP - + advanced procedures and administer many medications
CCP - + more medications and advanced techniques
What certifications may you encounter when dealing with aeromedical staff?
PCP, ACP, CCP, Nurse, Physician
What are 3 types of medical facilities to which an EMS patient may be taken?
Trauma Centre
Burn Centre
Stroke Centre
Pediatric Centre
Perinatal Centre
Poison Centre
What roles to EMRs fill at the scene of an emergency?
Protect your safety and that of your crew
Gain access to the patient
Access the patient
Alert additional EMS resources
Provide care based on assessment findings
Assist other EMS personnel
Participate in record keeping and data collection as required
Act as a liaison for other public safety workers
What are an EMRs responsibilities ?
Guard your personal health and safety
Maintain a caring attitude
Maintain your composure
Keep your appearance neat, clean and professional
Maintain socioeconomic and cultural sensitivity
Keep knowledge and skills up to date
Keep your knowledge of local, provincial, national issues affecting the EMS system up to date
What are 2 types of medical control ? - Describe each.
Direct and Indirect
Direct - when the medical director or another physician directs an EMS rescuer at the scene of an emergency. May be over the phone, radio, or in person.
Also know as “online”, “base station”, “immediate” or “concurrent”
Indirect - Protocols for the care of patients, also known as “offline”, “retrospective” or “prospective” and includes things like system design and quality management.
An on-scene medical supervisor represents which kind of medial control?
Direct Medical Control
What are 4 techniques you can use to avoid such responses as nausea or fainting in an emergency situation?
Remind yourself your patient needs you and your skills and you must be in control to give the best care
Close your eyes and take several long, deep breaths. when you feel in control resume care
Change your thought patterns - hum very quietly or mentally sing a peaceful song
Eat properly to maintain your blood sugar
What are the 5 stages of the grieving process?
Denial
Anger
Bargaining
Depression
Acceptance
In addition to providing medical care, what can you do to help a dying patient?
Do everything possible to maintain the patient’s dignity
Show the greatest possible respect for the patient
Communicate
Allow family members to express rage, anger, and despair.
Listen with empathy
Do not give false assurances, but allow for some hope
Use a gentle tone of voice
Let the patient know that everything that can be done will be done
Use a reassuring touch, if appropriate
Do what you can to comfort the family
What are 5 signs of chronic stress and burnout?
Cognitive - Confusion, inability to make judgements or decisions, loss of motivation, memory problems, loss of objectivity.
Psychological - Depression, excessive anger, negativism, hostility, defensiveness, mood swings, feelings of worthlessness.
Physical - Constant exhaustion, headaches, stomach problems, dizziness, pounding heart.
Behavioural - Overeating, increased use of drugs or alcohol, grinding teeth, hyperactivity, lack of energy.
Social - Frequent arguments, decreased ability to relate to patients.
What are some negative feelings an EMR’s family may have about their job?
Lack of understanding your job
Fear of separation or of being ignored
Worry about on-call situations
Frustrated desire to share your pain
Give 3 examples of situations that may cause stress during critical incidents
Serious injury or death of a rescuer in the line of duty
Multiple-casualty incident
Suicide of an emergency worker
An event that attracts media attention
Injury or death of someone you know
Any disaster that results in loss
What is Critical Incident Stress Debriefing?
A system developed to help rescuers cope with critical incident stress that is a team made up of peer councillors with mental heath professionals.
How does debriefing differ from defusing?
Debriefing is held 24 - 72 hrs post event. it is confidential. Rescuers are urged to explore any physical, mental, or emotional symptoms they are experiencing
Defusing - shorter and less formal - held within hours of the critical incident and attended only by those most directly involved and lasts 30 - 45 min. A chance to vent their feelings and get information they may need before a lager group meets.
How does an infectious disease spread from person to person ?
Droplet infection
Blood-to-blood contact
Open wounds/exposed tissue
What are the differences between cleaning, disinfecting, and sterilizing ?
Cleaning - wash with soap and water
Disinfecting - cleaning and the additional use of a chemical such as alcohol or bleach to kill many of the microorganisms on an object.
Sterilization - a process in which a chemical or other substance, such as superheated steam, kills all the microorganisms on an object.
What equipment is needed to take BSI precautions?
Cleaning equipment
Personal Protective Equipment - Eye protection, gloves, gowns, masks
BSI - Body Substance Isolation
What is cross contamination?
When disease or infection is transferred by a rescuer to another through soiled PPE or contact with exposed equipment.
List 5 immunizations that should be kept up to date by an EMR
Tetanus prophylaxis - every 10 years
Hepatitis B vaccine
Influenza vaccine - every year
Polio vaccine
Measles, mumps, rubella (MMR) vaccine
What rule applies to all unsafe emergency scenes?
If a scene is unsafe, make it safe before you enter. Otherwise wait for help.
What is an EMR’s scope of practice?
Defined by provincial law
Follow standing orders and protocols as approved by the medical director
Consult a medical director any time there is a question about the scope of practice
Communicate clearly with and completely with the medical director.
Follow the orders of the medical directory
Explain the difference between express and implied consent
Express Consent - a verbal consent, or node or affirming gesture from a competent adult.
Implied Consent - in an emergency situation where an unconscious patient is at risk of death, disability, or deterioration of the condition. It also applies to a conscious patient that has refused care and then become unconscious and to a patient that has refused care but is not competent to refuse care. (drugs, alcohol…)
What is an advance care plan?
Also known as an advance directive or health care directive (HCD) - is written in advance of an emergency and expresses a patient’s desire regarding the rendering or withholding of treatment options. It must be signed by the patient.
What is a DNR order and what should an EMR do when presented with one?
DNR - Do Not Resuscitate - a doctor and family mediated form - documents the wish of the chronically or terminally ill patient to not be resuscitated. It allows the EMR to legally withhold resuscitation. Must be physically in your hand - contact medical control if any doubt.
