General Standards of Care Flashcards
When is the general standard of care applicable?
- At all things when a paramedic is providing pt care while on duty
- Pt care provided by a paramedic in general
- Pt care pertaining to certain illness/injury
- Under all environmental conditions providing personal safety
General measures: Pre-scene/at scene, paramedic will?
- Use appropriate route and speed (Marvilis), operate lights amd sirens responsibly
- Confirm call info and location
- Upon arrival at scene, assess environment (Routes of entry/exit, safety)
- EMCA
How do you request assistance from allied sources?
• 10-200, 10-2000, red button
Upon approaching pt, paramedic shall?
- Introduce yourself & partner
- Gain consent
- Establish trust
- Protect pt from hazards and exposure to environmental conditions
- Wash hands after each pt contact
Operational procedures directly/indirectly impacting pt care on regular basis
- Personal Cleanliness
- Cleanliness/decontamination, maintenance, safety of the equipment and ambulance itself (vehicle checks)
- Completion of Ambulance Call Reports
- Familiarization or legislation, standards, and procedures Pertaining to health and safety, and communicable diseases
- participation in training and continuing education
Patient assessment
• Regardless of dispatch priority coding, assume existence of serious life-threatening conditions until proven otherwise
Environmental Assessment
- Pt condition
- House condition
- Demeanor of family
- Seek medical information, medical alerts, medications
- collect and transport other relevant identification (health card)
History Assessment: Concurrent with or following the primary survey
- Establish CC, why pt called?
- listen history of present illness or incident:
- question patient directly, question others on scene
- seek medical identification
- observe patient behaviour
- sample history
- determine CTAS level
Physical assessment: performing primary survey
• Look test • C-spine • AVPU • ABC’s (clear ABC’s before moving on) • Look for external hemorrhage • Establish baseline vitals: - HR - RR - BP - SPO2 - GCS - Pupils - Skin • Load & Go decision
- primary survey completed within two minutes unless major problem encountered*
If a patient is uncooperative or combative leading to limitations in your assessment what do you do?
- Do your best to game patient’s consent
* if patient remains uncooperative: document, document, document!
Initiate cardiac monitoring on the following patients:
- VSA
- Moderate/severe shortness of breath
- Unconscious/altered LOC
- collapse, syncope (fainting)
- suspected cardiac ischemia
- CVA (stroke)
- Overdose
- Major/Multi trauma
- Electrocution
- Submersion injury
- hypo/hyperthermia
- abnormal vitals or alteration in cardiac rhythm
Secondary exam/ongoing exam
• Elicit history if not already done
• Vitals:
-RR, skin, pulse, BP, pupils, GCS
• perform complete head to toe
- should be completed in five minutes or less*
How often should you repeat ABC’s?
- Every 10 minutes minimum
* continually monitor and reevaluate
Patient transport: If patient deteriorates in route two originally selected facility you should?
• take patient To the most appropriate hospital in closest proximity
Patient refusal of treatment and or transport: the paramedic will…
- where interventions are deem necessary in the patient refuses treatment or transport, try to explain possible consequences of such a refusal
- confirm patient or SDM has capacity utilizing aid to capacity assessment
- Advise patient to call 911 again if further concerns arise
- obtain appropriate documentation on ACR (signatures from patient, partner, and witnesses)
