EMS Systems Flashcards
EMS
Emergency Medical Services
Describes the four levels of EMS practice
National EMS Scope of Practice Model
KSAs
Knowledge, Skills, & Abilities
For any role in emergency services and health care, ___ must continue throughout your career
Education
This process verifies that a provider meets the minimum required KSA competencies for safe and effective emergency operations and patient care
Certification
NREMT
National Registry of EMTs
NEMSIS
National EMS Information System
How often does the NREMT survey EMS providers to evaluate the applicability of the exam?
Approximately every 5 years
The legal authority to practice in your state
Licensure
Verification process of a health care providers qualifications
Credentialing
Credentialing is typically directed and overseen by a ___
Physician medial director
4 Licensure levels
- Emergency Medical Responder
- Emergency Medical Technician
- Advanced EMT
- Paramedic
In some cases, EMTs may be specifically credentialed to perform either ___
Fewer or additional techniques in their area or to work in certain types of care systems
___ has basic emergency care and operations training, and is focused on managing the emergency scene and initiating immediate life-saving care before the ambulance arrives
An EMR
EMRs may also perform roles ___ with more advanced training
Under the direction of providers
___ has additional depth and breadth of training in basic emergency care and transportation of sick and injured patients
An EMT
Although not always the first to arrive, ___ most commonly focus on initial stabilization of the scene and fundamental emergency care
EMTs
___ are the primary link between the emergency scene and the health care system
EMTs
___ has additional preparation that includes training and education in specific aspects of advanced life support
An AEMT
ALS
Advanced Life Support
The ___ primary focus is on more advanced assessment techniques and selected emergency interventions know to improve patient outcomes
AEMTs
IV
Intravenous therapy
___ Have the greatest breadth and depth of education and training among emergency care providers
Paramedics
___ preparation focuses on ALS assessment; diagnostic and treatment tools and techniques
Paramedics
___ function as part of a collaborative response, working under medical direction with EMS providers of other levels to help extend the reach of the health care system
Paramedics
The standards for prehospital emergency care and the people who provide it are governed by the ___ and are typically regulated by ___
- Laws of each state
- An office of EMS operating under the state’s department of health
Most states requirements follow or exceed the guidelines recommended in the current ___
NHTSA EMS Education Standards
NHTSA
National Highway Traffic Safety Administration
A 12-digit ID number issued at no charge to all EMS professionals
National EMS-ID number system
Who issues the National EMS-ID number?
NREMT
Main areas of EMT focus
- Scene size-up
- Patient assessment
- Treatment
- Transport
- EMS as a career
Star of Life symbolism
Bars:
1. Detection
2. Reporting
3. Response
4. On-scene care
5. Care in transit
6. Transfer to definitive care
Serpent and Staff:
1. Staff of Asclepius, an ancient greek physician deified as the god of medicine
2. Staff represents medicine and healing
3. Skin-shedding serpent being indicative of renewal
ADA
Americans with Disabilities Act of 1990
Protects people who have a disability from being denied access to programs and services that are provided by state or local governments and prohibits employers from failing to provide full and equal employment to the disabled
ADA
Title I of the ADA protects EMTs with disabilities ___
seeking gainful employment under many circumstances
States have requirements prohibiting people with certain ___ from becoming EMS providers
Legal infractions
EMS as we know it today had its origins in ___
1966 with the publication of Accidental Death and Disability: The Neglected Disease of Modern Society
After the publication of Accidental Death and Disability, who was directed to take action on the issue?
Congress directed the NHTSA to enact the Highway Safety Act of 1966 and the Department of Health, Education, and Welfare (now the DHHS) to enact the Emergency Medical Services Development Act of 1973
Who published the Accidental Death and Disability?
Jointly by the Committees on Trauma and Shock of the Nation Academy of Sciences/National Research Council
DHHS
Department of Health and Human Services
Who administers EMS at the federal level?
DOT
First EMT textbook
Emergency Care and Transportation of the Sick and Injured “The Orange Book” 1971
Who published the Orange Book?
American Academy of Orthopedic Surgeons
In the late 1970s the DOT developed a ___ for the education and training of paramedics and identified part of the course to serve for EMTs
recommended National Standard Curriculum
When was AEMT developed?
During the 1980s
In the 1990s the NHTSA created the ___
EMS Agenda for the Future
Provides over-arching guidelines for the minimum skills each level of EMS provider should be able to accomplish
National EMS Scope of Practice Model
Because licensure is a state function, laws are enacted at the ___ level to regulate how EMS providers will operate, and they are then executed by the ___. Finally, the ___ should provide regular oversight and support to EMS personnel
- State
- State-level EMS administrative offices that control licensure
- Local medical director
A medical director can limit the scope of practice but cannot ___
Expand it beyond state law
The complete list of approved skills in the National EMS Scope of Practice Model can be found at ___
www.ems.gov
AEDs
Automated External Defibrillators
What cardiac dysrhythmias can an AED treat?
- Ventricular fibrillation
- Ventricular tachycardia
The EMR course focuses on providing ___
Immediate care with limited equipment prior to the arrival of the ambulance
EMS courses are ___-based
Competency
On arrival at the scene, you and any other EMTs who have responded should ___
Assume responsibility for the assessment and care of the patient and follow the proper packaging and transport of the patient to the ED, if appropriate
The AEMT course is designed to ___
Add knowledge and skills in specific aspects of ALS to providers who have been trained and have experience as EMTs
The ___ completes an extensive course of education and training that significantly increases knowledge and mastery of basic skills and covers a wide range of ALS skills
Paramedic
Multidisciplinary, national review of all aspects of EMS delivery
EMS Agenda 2050
5 key aspects of a people-centered EMS system in the EMS Agenda 2050
- Comprehensive, quality, convenient care
- Evidence-based clinical care
- Efficient, well-rounded care
- Preventive care
- Comprehensive and easily accessible patient records
EMS Agenda 2050 guiding principles
- Inherently safe and effective
- Integrated and seamless
- Reliable and prepared
- Socially equitable
- Sustainable and efficient
- Adaptable and innovative
Public Safety Access Point
911 Communication Center
Assists dispatchers in providing callers with vital instructions to help them deal with a medical emergency until EMS crews arrive
EMD
EMD
Emergency Medical Dispatch
Aims to increase the ability of EMS providers to practice in other states through the REPLICA
Interstate Commission for EMS Personnel Practice
___ is not a form of EMS licensure reciprocity. It extends a privilege for EMS personnel from member states to practice on a short-term or intermittent basis under approved circumstances in other members states
REPLICA
REPLICA
Recognition of EMS Personnel Licensure Interstate CompAct
Each EMS system has a ___ who authorizes the EMTs in the service to provide medical care in the field
Physician Medical Director
The appropriate care for each injury, condition, or illness encountered in the field is determined by the ___ and is described in ___
- Medical director
- A set of written standing orders and protocols
Standing orders are part of ___
Protocols
Designate what the EMT is required to do for a specific complaint or condition
Protocols
Providers are ___ to consult medical direction before implementing standing orders
Not required
Ongoing working liaison between the medical community, hospitals, and the EMTs in the service
Medical director
If treatment problems arise or different procedures should be considered, they are referred to the ___ for their decision and action
Medical director
Determines and approves the continuing education and training that are required of each EMT in the service
Medical director
Medical control is provided either ___
Off-line (indirect) or online (direct)
Consists of direction given over the phone or radio directly from the medical director or a designated physician
Online medical control
Medical direction can be transferred by the ___
Physician’s designee
Consists of standing orders, training, and supervision authorized by the medical director
Off-line medical control
The ___ will identify an EMS physician or other designee, usually at a local hospital who can be reached by radio or telephone for medial control during a call
Service’s protocols
Although each EMS system, medical director, and training program has latitude, their training, protocols, and practices must conform to ___
The EMS legislation, rules, regulations, and guidelines adopted by each state
The area which an EMS system is responsible for prehospital care
Primary Service Area
Daily operations and overall direction of the service are provided by an appointed ___
Chief executive officer and several officers who serve under them
Method of delivering health care that utilizes the prehospital spectrum of care resources
Mobile Integrated Health Care
MIH
Mobile Integrated Health Care
This model offers access to care for patients within communities who may have limited medical resources, and leads to better service for those who are homebound or disabled
MIH
Involves experienced paramedics who receive advanced education and training to equip them to provide services within a community
Community paramedicine
Information gathered by NEMSIS can be found at ___
www.nemsis.org
The ___ is responsible for maintaining ___, ensuring that all staff members under their supervision meet appropriate medical care standards on each call
- Medical director
- Quality control
A strategy for quality that promotes a learning culture that holds employees accountable for behavioral choices by balancing fairness and accountability
Just Culture
Encourages trust within the agency and promotes reporting of errors and mishaps so their causes can be found and measures developed for prevention
Just Culture
A quality management process that encourages team members at every level of the health care system to ask “how are we doing now?” and “what can we do to be better?”
CQI
CQI
Continuous Quality Improvement
A proactive process of development capitalizing on strengths and addressing challenges
CQI
HROs
High Reliability Organizations
To be an ___ means that the organization has a commitment to teamwork, a culture of safety, and a commitment to CQI in an effort to prevent errors
HRO
In ___, information is gathered about processes, performance, and outcomes. Evaluation of this information generates ideas to improve performance and efficiency, these ideas are tried and evaluated, and the cycle continues
CQI
This cycle in CQI is known as ___
Plan-do-study-act
The ___ phase involves gathering and analyzing information
Plan
The enacting of the ideas generated in the plan phase is the ___ phase
Do
The ___ phase evaluates any significant positive or negative changes that resulted from the implementation of the new idea
Study
If the change is positive, then a larger part of the EMS system adopts the change in the ___ phase
Act
At every level, CQI is a learning and improvement process rather than ___
Simply a way to punish identified problems
Measures care against a predefined standard or benchmark
Quality Assurance
Continuous cycle that measures the behavior and implements actions to improve performance
Quality improvement
3 possible sources of errors
- Rules-based
- Knowledge-based
- Skills-based
Detailed plans that describe how certain patient issues are to be managed
Protocols
As an EMT you are a patient care ___
Advocate
Knowing the reason for your actions gives you time to ___
Reflect and make a more informed decision
Proper ___ by the EMS provider can significantly impact an agencies ability to process medical insurance claims, provide eligibility for financial grants for training or equipment, and provide evidence of competent practices
Documentation
HIPAA
Health Insurance Portability and Accountability Act
ET3
Emergency Triage, Treat, and Transport
The key to being a good EMT a providing high-quality care is ___
Your commitment to continual learning and increasing your knowledge and skills
Examines the health needs of entire populations with the goal of preventing health problems
Public health
The concept of prevention applies to both the ___
Patient and EMS provider
The goal of public education should be to create an environment where the need for EMS is ___
Decreased
The focus of the public health arm of health care is ___
Prevention
___ focuses on strategies that will prevent the event from ever happening
Primary prevention
Vaccines are an example of ___ within public health
Primary prevention
In a ___ strategy, the event has already happened. The question is how can we decrease the effects of the event?
Secondary prevention
Helmets and seatbelts are examples of ___
Secondary prevention
___ is focused on procedures that have proven useful in improving patient outcomes
Evidence-based medicine
EBM
Evidence-based medicine
Keeping in mind what is in the best interest of the patient is referred to as being a ___
Patient advocate
Consistent adherence to a code of honest behavior
Integrity
Aware of and thoughtful toward the needs of others
Empathy
Able to discover problems and solve them without direction
Self-motivation
Uses persona to project a sense of trust, professionalism, knowledge, and compassion
Appearance & hygiene
Able to perform or delegate multiple tasks, ensuring efficiency and safety
Time management
Able to understand others and have them understand you
Communications
Able to work with others and able to know your place within a team; able to communicate while giving respect to the listener
Teamwork and diplomacy
Places other in high regard or importance; understands others are more important than self
Respect
Constantly keeps the needs of the patient at the center of care
Patient advocacy
Pays attention to detail; makes sure what is being done for the patient is done as safely as possible
Careful delivery of care
