ems fire chiefs handbook

Question 1

Even in the smallest departments, a chief will likely require support from a ___________to effectively administer an EMS program

Answer 1

qualified fire-based EMS officer

Question 2

Although the duties of admin­ istering an EMS program can and often are delegated, the responsibility for EMS rests with who?

Answer 2

The fire chief

Question 3

Most fire departments began providing EMS as a reaction to a ________the service from hospi­tals experiencing medical personnel shortages during World War II, following major disasters where EMS was not available in sufficient quantity, or when the quality or timeliness of EMS was in question.

Answer 3

crisis-absorbing

Question 4

Fire departments protect _____ EMS protects ____.

Answer 4

property, people

Question 5

Traditionally, property is owned by who?

Answer 5

wealthy members of society, or at least those with jobs, savings, and resources

Question 6

The typical EMS patient is often what?

Answer 6

not wealthy, but more likely a member of the lower socioeconomic sector of society

Question 7

America’s first ambulance service was reportedly started by who and what year?

Answer 7

the U.S. Army in 1865

Question 8

During World War II, the loss of hospital personnel to the war effort caused many hospitals to turn their ambulance services over to volunteer groups and organizations capable of operating a motor vehicle for this type of service. Typically, who was these groups?

Answer 8

these were fire departments, police departments, or funeral homes.

Question 9

During the 1960s, the medical community began to focus on what type of care?

Answer 9

cardiac care

Question 10

The long-range effects of quality emergency medical care on mortality were discussed in a 1966 report by the National Research Council’s National Science Foundation, entitled ___________

Answer 10

“Accidental Death and Disability, the Neglected Disease of Modern Society.”

Question 11

a 1966 report by the National Research Council’s National Science Foundation, entitled “Accidental Death and Disability, the Neglected Disease of Modern Society.” The report, more commonly referred to by the EMS community as ___________

Answer 11

“The White Paper,”

Question 12

The White Paper,” concluded that, of the mobile emergency teams studied, most had an average response time of more than ____ minutes, and had inadequately equipped and trained crews.

Answer 12

40

Question 13

________addressed EMS issues by developing specifications covering ambulance attendant training, equipment requirements, and the design of the emergency vehicle itself.

Answer 13

the Highway Safety Act of 1966 (Standard 11)

Question 14

The ________ designated federal funding to improve EMS across the nation through the development of regional EMS systems.

Answer 14

The Emergency Medical Services Systems Act of 1973

Question 15

The Emergency Medical Services Systems Act of 1973 designated federal funding to improve EMS across the nation through the development of regional EMS systems. Specific requirements outlined by this act included?

Answer 15

training and certifi­cation, interagency cooperation, equipment development, communications, and public education-are still recognized today as key elements of effective EMS systems.

Question 16

In the ____, much of the federal funding for EMS programs was reduced or eliminated

Answer 16

mid-1980s

Question 17

At the federal level, who serves to coordinate government involvement in EMS.?

Answer 17

the National Highway Traffic Safety Administration (NHTSA) under the Department of Transportation (DOT)

Question 18

______operates a Web portal (www.ems.gov) facilitating access to the broad range of federal agencies who work collaboratively to coordinate and develop EMS systems in the United States

Answer 18

NHTSA

Question 19

_______develops the national standard educational curricula for various levels of EMS providers, supports research and planning for EMS, operates a central data collection and reporting system for emergency medical services (the National EMS Information System, or NEMSIS), and develops federal purchasing standards for ambulances, among other activities.

Answer 19

NHTSA

Question 20

Most state EMS agencies are housed within the

Answer 20

state health department

Question 21

State EMS directors, medical directors, state training coordinators, data coordinators and trauma coordinators often participate in the _______ , a non-profit organiza­tion (www.nasemso.org).

Answer 21

National Association of State EMS Officials (NASEMSO)

Question 22

credentialing, or granting authority to practice, continuing education, medical treatment protocols, and public information, education, and relations (PIER) programs are often handled what level.

Answer 22

at the local or regional

Question 23

Two physician groups influential in providing guidance and direction on emergency medical care are the

Answer 23

American College of Emergency Physicians (ACEP, www.acep.org) and the National Association of EMS Physicians (NAEMSP, www. naemsp.org).

Question 24

A relatively new organization, works to educate legislators on fire-based EMS and assure fire service participa­tion in national policy discussions on EMS.

Answer 24

Fire Service-Based EMS Advocates (www.fireserviceems.com),

Question 25

Some communities rely solely on a _____ whether private, hospital-based, or a separate governmental entity

Answer 25

third service,

Question 26

The particular emergency medical services offered are predicated on what three things?
Each of these factors influences fire-based EMS program start-up as well as continuation over time.

Answer 26

community need, willing­ ness of the fire department to deliver, and cost.

Question 27

____firefighters is the most common approach to the delivery of fire-based emergency medical services.

Answer 27

Cross training

Question 28

A cost containment solution has been to train ______and as fire department EMS providers

Answer 28

employ civilian personnel

Question 29

The practice of medicine is restricted by law to physicians and other licensed providers such as

Answer 29

podiatrists, dentists, and nurse practitioners

Question 30

When advanced life support was first extended into the community in the ___, paramedics were empowered to deliver care under the license of a supervising physician. This concept of EMS providers acting as physician extenders is known as

Answer 30

1970s

delegated practice .

Question 31

who provides care to patients under the supervision and license of a specific physician medical director.

Answer 31

every EMS provider from the emergency medical dispatcher (EMD) emergency medical responder (EMR) to the emergency medical technician (EMT) to the paramedic

Question 32

The ________provides medical oversight of the EMS program and is (or should be) a crucial link between regulatory authorities (such as state or regional medical boards) and the fire department.

Answer 32

fire department EMS medical director

Question 33

The job description for a medical director varies considerably. Recommended roles and duties have been outlined by both the

Answer 33

American College of Emergency Physicians (ACEP) and the National Association of EMS Physicians (NAEMSP).

Question 34

______are designed to monitor and contin­ually improve care provided;

Answer 34

Quality improvement (QI) programs

Question 35

Supervision of EMS providers is also a medical director duty, whether performed directly through ride-alongs or field responses, or indirectly through _____ or EMS officer-delegated observation.

Answer 35

chart review

Question 36

The medical director is responsible for clinical care provided by EMS members of the department. As such, he or she should possess strong EMS
quali­fications, including:

Answer 36

Board certification in emergency medicine
Prehospital care experience
Competence in all the skills expected of fire department EMS providers
Approval by state and regional EMS authorities

Question 37

Operational decisions are not ordinarily within the scope of the _____although the fire chief and EMS officer(s) may benefit from consultation with the medical director.

Answer 37

medical director,

Question 38

medical directors are often afforded the ability to limit the practice of an EMS provider by progressive disciplinary actions, the circumstances of these actions must ______, when they affect employment, must allow an employee due process

Answer 38

be spelled out in a contract and

Question 39

who is in the best position to resolve hospital concerns .

Answer 39

The fire department EMS medical director

Question 40

The duties of administering a fire-based EMS program are often delegated to

Answer 40

a qualified EMS officer

Question 41

so-called alphabet courses

Answer 41

ACLS (Advanced Cardiac Life Support), PHTLS (Prehospital Trauma Life Support), PALS (Pediatric Advanced Life Support), and so on.