EMS Systems (Vol. 1 Chp. 2)

Question 1

What are the out-of-hospital components of an EMS system?

Answer 1

Members of the community who are trained in first aid and CPR

A communications system that allows public access to emergency services dispatch and allows EMS providers to communicate with each other

EMS providers, including paramedics

Fire/rescue and hazardous-materials services

Law enforcement officers

Public utilities, such as power and gas companies

Resource centers, such as regional poison control centers

Question 2

What are the in-hospital components of an EMS system?

Answer 2

Emergency nurses

Mid-level practitioners (physicians’ assistants and advanced-practice nurses)

Emergency physicians and specialty physicians

Ancillary services, such as radiology and respiratory therapy

Specialty physicians, such as trauma surgeons and cardiologists

Social workers

Mental health providers

Rehabilitation services

Question 3

Define bystander

Answer 3

a family member, friend, or stranger to the patient who is present at the patient’s medical emergency

Question 4

Define basic life support (BLS)

Answer 4

Basic lifesaving procedures such as artificial ventilation and cardiopulmonary resuscitation (CPR)

Question 5

Define Advanced Life Support (ALS)

Answer 5

Advanced lifesaving procedures such as intravenous therapy, drug therapy, intubation, and defibrillation

Question 6

Define tiered response

Answer 6

Multiple levels of emergency care personnel responding to the same incident

Question 7

Approximately _______ to _________ years ago, scribes in Sumer, a civilization in Mesopotamia (southwest Asia), inscribed clay tablets with some of the earliest medical records.

Answer 7

4,000, 5,000

Question 8

What is the striking difference between the ancient tablets of Sumer and medical protocols today?

Answer 8

The lack of a physical exam

Question 9

In 1862 Egyptologist Edwin Smith purchased a papyrus scroll dating back to about 1500 BCE that contained what?

Answer 9

48 medical case histories with data arranged in head-to-toe order and in order of severity

Each case also had a format including title, specific instructions to the healer, and a projection of possible outcomes.

Section called the “Book of Wounds” explains treatments of injuries such as fractures and dislocations

Question 10

The Code of Hammurabi had medical fees and penalties based on what?

Answer 10

Social class of the patient

Question 11

Who devised the idea of the ambulance during the Napoleonic wars?

Answer 11

Dominique-Jean Larrey, one of Napoleons chief surgeons

Question 12

Dominique-Jean Larrey is credited with the development of the first what?

Answer 12

Prehospital system that used both triage and transport

Also credited with being the first to place a medical attendant in an ambulance

Question 13

When did the development of ambulances first occurred in the United States?

Answer 13

1861 during the Civil War by surgeon Jonathon Letterman.

Question 14

When and where was the first civilian ambulance established in the United States?

Answer 14

1860 in Cincinnati, Ohio, by the Commercial Hospital

Question 15

What effect did World War II have on EMS systems?

Answer 15

Many hospital-based ambulance services shut down and turned over ambulance services to local police and fire departments.

No requirements for minimal training or care were in place and many departments considered ambulance work as punishments

Departments sought to eliminate ambulance services as quick as possible

Question 16

What medical developments occurred during the 1950’s?

Answer 16

In 1956, physicians Peter Safar and James Elam pioneered the use of mouth-to-mouth resuscitation

In 1959 the first portable defibrillator was used at Johns Hopkins Hospital in Baltimore

In 1960 CPR was refined and deemed effective for human resuscitation

Question 17

What report spelled out the deficiencies in prehospital emergency care?

Answer 17

The 1966 publication “Accidental Death and Disability: The Neglected Disease of Modern Society” by the National Academy of Sciences

Question 18

The 1966 publication “Accidental Death and Disability: The Neglected Disease of Modern Society” listed what problems with EMS systems?

Answer 18

Lack of uniform laws and standards
Poorly equipped ambulances
Poor quality ambulances
Lack of communications between the ambulance and the hospital
Inadequate training of ambulance personnel
Inadequate physician and nursing staffing of hospital emergency departments

Question 19

When and what fire department first placed medical personnel with every engine ladder and rescue?

Answer 19

1960, Los Angeles Fire Department

Question 20

When was the National Registry of Emergency Medical Technicians first established?

Answer 20

1970

Question 21

What TV show gave a big boost to EMS?

Answer 21

Emergency!

Question 22

In 1973 Congress passed the Emergency Medical Services Systems Act which did what?

Answer 22

Provided funding for a series of projects related to the delivery of trauma care

Question 23

What act essentially wiped out federal funding for EMS?

Answer 23

The 1981 Consolidated Omnibus Budget Reconciliation Act