EMS 430 questions Flashcards
A patient is defined as
a person who presents with subjective and / or objective signs and/ or symptoms or a complaint which results in evaluation and / or treatment
A patient encounter is dependent on neither treatment nor transport nor cooperation from the patient. If a technician _______
perceives a medical problem that requires evaluation, a patient encounter has been made and a full patient care report must be completed.
Controlled substances will be stored at all times in the locked storage safe mounted in each ALS vehicle with a numbered seal. Access t the locked storage safe will be limited to the _____
Paramedic Officer-in-Charge of the ALS Company or Paramedic assigned to the ALS Company
Completed JFRD Controlled Substances daily Checklist will______
remain with the notebook until collect by the District/ Battalion Chief and forwarded to the Quality Improvement Officer
A Baker Act is an involuntary mental health commitment by law enforcement. What are the criteria for a Baker Act/
- Mentally incompetent, danger to self or others
- Suicidal
- Homicidal
A mentally competent patient is considered to give informed consent when any of the following occur
patient verbally gives permission to treat
patient gives written permission to treat
patient does not object as you begin assessment.
In order to give informed consent, a patient must be legally allowed to act as an adult. This means that the patient must be: At least 18 years of age OR Emancipated. Less than 18 and married or legally released from custody of parent or guardian. The exceptions to this are?
- An unmarried pregnant minor may give consent for medical problems related to her pregnancy
- An unmarried minor mother may give consent for her child
If a patient is incapacitated or otherwise not mentally competent, decisions regarding the patient’s medical treatment can be made by an agent with durable power of attorney. The agent must be?
a person who is 18 years of age or older, who must present JFRD with a notarized power of attorney document, signed by the patient and two witnesses.
If medical personnel are concerned for the safety of a minor and the parent or legal guardian refused treatment and transport, contact_______/
- the Rescue District / Battalion Chief
- law enforcement for assistance with transport
In examining and treating a person who is apparently intoxicated , under the influence of drugs, or otherwise incapable or providing informed consent, the emergency medical technician / paramedic , shall ?
proceed wherever possible with the consent of the person
-if the person reasonably appear to be incapacitated and refused his or her consent, the person may be examined if he or she is in need of emergency attention , with his or her consent, but reasonable force shall not be used.
Each time a controlled substance is administered, The controlled substance inventory will be checked and documented on the JFRD Controlled Substance Daily Checklist. You should?
Inspect the controlled substance for expiration date and damage
Errors made on the JFRD Controlled Substance Daily Checklist will be noted by?
single line through the error and initialed by the person correcting the error.
Daily Inspections of controlled substance will occur
anytime the Paramedic Officer-in-Charge or Paramedic assigned to the ALS Company is relieved.
If a stocked spare rescue ( able unit ) is not staffed for the day, the Officer-in-Charge or Paramedic assigned to the ALS Engine will, with the witness present, verify that the numbered seal is intact and document accordingly , If the sea is broken_________.
contact the appropriate Rescue District/Battalion Chief
On the first day of each month: The Paramedic Officer-in-Charge or paramedic assigned to the ALS company will, with a witness present ?
- Inspect the controlled substances for expiration date and damage
- Audit the JFRD Controlled Substance Daily Checklist, ensuring that the actual count and the documented count are the same.
The monthly chief inspection should occur when?
on either the 23rd, 24th, or 25th of each month.
Who restocks all controlled substances?
The Rescue District / Battalion Chiefs
When will restocking of controlled substances occur?
- minimum Rescue or ALS Engine inventory is reached
- Month prior to expiration date
- Prior to holiday or weekend when stock is close to minimum Rescue inventory.
Until returned any expired or damaged controlled substances will be labeled?
DO NOT USE
Expired or damaged controlled substances will be turned in to ?
The rescue District/ Battalion Chief during normal business hours
Patients in police custody can still sign an AMA Refusal or Non-Emergency/ Non-Transport Waiver if
if allowed by law enforcement
If the patient in police custody is unstable, transport to the closest, most appropriate hospital. If the patient is stable?
law enforcement will dictate the hospital destination.
If law enforcement refuses to remove the handcuffs to allow the patient to sign, document in the Narrative section of the PCR that the patient verbalized a refusal of treatment.
Sign your name in the proper refusal signature box where the patient would normally sign and have the law enforcement officer sign the Witness signature in the PCR.
If Law enforcement restrains the patient, ensure
they follow behind the rescue in case the restraints need to be removed.
No patient will be strained in the prone or “hg-tied” position. Restrained patients
shall be placed in the supine position
When restraints are in use , circulation to the extremities shall be evaluated at least
every 5 minutes
Methods of restraints for JFRD personnel include
- soft limb restraints
- stretcher straps/ harness
- wide cloth
According to SOG 1090
-should be recorded every 5 min for unstable patients
15 min for stable patients
-min of 2 required for all transported patient
If the laptop is not functioning following a transport
a paper “responsibility” signature must be completed
For EMS purposed, a competent patient shall be defined as one who meets all the following criteria
- over 18y/o or a court emancipated minor
- is awake, alert and fully oriented to person , place, time and event
- no intoxicated and under the influence of drugs, of otherwise incapable of providing informed consent
who can sign for a legally competent patient
no one else
the documented refusal is only valid with
an appropriate witness signature
The JFRD officer who is documenting and executing the legal refusal ______
CANNOT sign as the witness
Signed refusal on the EMS field copy will be?
completed and filed at the station
Appropriate witnesses
- spouses
- relatives
- law enforcements
- friends
- other fire/ rescue personnel
The purpose of Quality Improvement is to
promote practices that will provide the highest quality, pre-hospital emergency care
The intention of Quality Improvement is to
identify individual and system weakness, and will develop plans to improve patient care
The Quality Improvement program will be a dynamic process, changing with the identified needs of the department and consisting of the following three aspects.
Proactive
Concurrent
Retrospective
Administration of the continuous Quality Improvement program will be the responsibility of the?
Medical Director
Division Chief of Rescue
Assistant rescue Chief
Quality Improvement Officer
When JFRD personnel suspect that abuse or neglect to a child or vulnerable adult has taken place, they shall Treat related injuries and Transport all suspected cases.
If treatment is refused request law enforcement , Stay with patient until law enforcement arrival and ?
the Rescue District/ Battalion Chief
A vulnerable adult is defined as one who, due to their ____may ne unable to adequately provide for their own car of protection
age or disability
Notify the Division Chief of Rescue via email _____ indicating that you have reported the case the Florida Abuse/Neglect registry, Including ONLY the first name and ID Number of the contact person.
within 24hours
Unquestionable death criteria Patients meeting the following criteria shall be considered DOS: unresponsive, apneic, pulseless. In addition, the patient shall meet at least one of the following criteria:
patient has lividity
rigor mortis
clear signs or body decay
open cranium brain matter
pt is decapitated or severed trunk
Blunt chest trauma or multi system trauma patients meeting the following criteria shall be considered DOS:
Apneic, Pulseless
-if cardiac rhythm is asystole or wide complex ventricular rhythm of 30 or less with out pulse document time and call code
For patient not meeting the Unquestionable death criteria Resuscitation efforts may be terminated only when all of the following criteria is met
no shocks prior to JFRD arrival
patient is 18 years or older
rhythm remains asystole after providing 20 min of full ACLS
Arrest was not witnessed
Airway breathing management , monitor Sp02, administer 02 via proper adjunct to maintain oxygen saturation of
95% or greater
Exceptions not to transport patients 65 or older are
non-symptomatic competent patients without a documented chief complaint
documented sign refusal
Exceptions not to transport patients 15 years of age or younger
superficial injuries when a competent parent or legal guardian is on -scene r documented signed refusal of treatment / transport
Transport of unstable patients should begin
within 10 min when possible
The officer in charge will decide the transport destination after considering what?
unstable patient - transport to the closest appropriate facility
stable- transport to the hospital where the patient is usually seen and pt records
Pediatrics should be secured to the stretcher_____ exceptions may be made for level of distress and treatment
with the pediatric restraint device , or their own car seat
All patients except ___, may be transported to Stand Alone Emergency Departments
- chest pain
- pregnancies
- baker acts
- post cardiac arrest with ROSC
- trauma alerts and trauma reds
I patients not assessed by medical staff within ______ or arrival , consult with Charge Nurse or Nurse manager for guidance, if there is an issue contact your District / Battalion Chief
15 minutes
Rescue personnel will transfer patient to the hospital stretcher in a timely and expedient manor. It transfer is delayed more than ____ notify FRCC.
30 minutes
Once on hospital property the patient?
will not be removed
Air Transport Units ATUs should be considered for critically ill or injured patients any time ground transport time to the closest appropriate hospital exceeds ______
20 minutes
Dogs that are individually trained to do work or perform task for people with disabilities. This is know as ?
service dog
The work or task a dog has been trained to provide?
must be directly related to the person’s disability
