Intro To Advanced Prehospital Care Flashcards
What is just as important as acute health care and public safety responsibilities?
Illness and injury prevention
Roles and responsibilities of a paramedic are diverse and encompass the disciplines of what?
Health care
Public health
Public safety
In addition to functioning as a treatment provider, what else might a paramedic function as?
Facilitator of access to care
You will seldom run into problem if you always?
Act in the patients best interest
Paramedic must have 6 characteristics?
Excellent judgement Able to prioritize Develop rapport Safely interview hostile patients Communicate with members of diverse cultures. Able to function independently
A significant advance in EMS was made with w/ what document?
1998 publication by the DOT, of the revised EMT-P:National Standard Curriculum .
Which document calls for 4 levels of EMS providers, and details the essential knowledge base and psycho motor skills for each?
2005; national scope of practice model.
The paramedic must actively participate one what, in regard to reserch?
Design
Development
Evaluation
Publication
For years what was paramedic practice based on?
Anecdotal data
Tradition
5 additional duties a paramedic can apply for under expanded scope of practice?
Critical care Primary care Tactile EMS Industrial medicine Sports mesicine
What’s is EMS?
Comprehensive network of personnel, equipment, and resources established to deliver aid and emergency medical care to the community.
EMS system is comprised of what?
In-hospital services
Out of hospital services
EMS operation begins with what?
Citizen activation when someone calls 911
The dispatcher also provides what?
pre arrival instructions to the caller
First responders role is to?
Stabilize patient until more advanced personnel arrive
“Tiered Response?”
Sending multiple levels of emergency care personnel to the same incident
What is the most striking difference between the first “protocols” and EMS system today?
The absence of a physical exam
Who formed the ambulance volante or “flying ambulance.
Napoleons chief surgeons, jean larrey
During world war 1, high mortality was associated with what?
Average evacuation time of 18hrs
Significant advances in trauma occurred during what
Wartime
In 1966, congresses back what act?
National highway safety act, this stablished department of transportation
What land mark publication set off a series of federal and private initiatives?
Publication of (Accidental Death and Disability: The Negleted disease of modern Society). Aka “the white paper”
What act was passed by congress in 1973, that provided additional funding for a series of projects related to the delivery of trauma care.
Emergency Medical Services Act
What act was passed in 1981 that essentially wiped out federal funding for EMS?
Consolidated Omnibus Budget Reconciliation Act (COBRA)
The four “T’s” of Emergency Care
Triage
Treatment
Transport
Transfer
Protocol
Policies and procedures for all components of an ems system
Certification?
Recognition granted to a person who has met it’s qualifications
Licensure
Permission granted to engage in a given occupation to an applicant who has attained the degree of competency required to ensure the publics protection
Four levels of EMS training/certification
EMR-stabalize patient
BASIC-
INTERMEDIATE/Advanced
Paramedic
Professionalism
Conduct and qualities that characterize a practitioner in a particular field or operation
Rules of evidence?
Developed by Joseph p. ornate.
Guidelines for permitting a new medication, process, or procedure to be used in EMS on the basis of proven efficacy
4 guidelines included in the rules of evidence
- Must be a theoretical basis for the change
- There must be ample research
- It must be clinically important
- Practical, affordable, and teachable
People must be able to take it for granted what?
That EMS will respond quickly to 911 call. And act at the highest level of professionalism.
Another way to accomplish “take it for granted” quality improvement?
Through ongoing education and personnel
Ethics?
Standards that govern the conduct of a group or profession.
What did the federal government establish 2005?
National EMS scope of practice model.
Called for four levels of EMS providers.
What program was established by the NHTSA 1988 that defines the “10 elements” necessary to all EMS systems.
Statewide EMS Technical Assessment Program.
Customer satisfaction can be created or destroyed by what?
With a simple word or deed
Kind of quality that customers get excited about, feel good about, and tell stories about?
Service quality AKA “customer satisfaction”
EMS quality is decided into two categories?
“Take-it-for-granted” quality
Service quality
Paramedics can play a valuable role in data collection, evaluation, and interpretation of research. What is the component of a research project that paramedics play a huge role in?
Begin the study, and collection of raw data
Primary responsibilities of a paramedic
Preparation Response Scene size up Patient assessment Patient management Disposition and transfer Documentation Cleanup, maintenance, and review
Additional responsibilities
Community involvement
Support for primary care
Citizen involvement
Personal and professional development
Whenever possible member of the community should be used in the what? Parts of EMS SYSTEM
Development, evaluation, and regulation
What is essential to the reduction of the long-term disability and accidental death
EMS injury prevention projects
Cardiovascular endurance results from what?
Exercising at least 3 days a week vigorously enough to raise your pulse to its target heart rate
Isometric exercise?
Active exercise against n stable resistance
Isotonic exercise
Active exercise when muscles are worked through their range of motion
Whole grains provide what?
Fiber
What will help prevent both cancer and cardiovascular disease
Exercising and eating well
In regards to back safety and moving objects, how should you position the load you are carrying?
As close to your body and center of gravity as possible
In regards of back safety, and carrying objects. Should your palms be up or down
Up
Always avoid what when carrying
Twisting and turning
Let which muscles do the lifting for you?
Large leg muscles
Do want to exhale or inhale when you lift?
Exhale
Do you want to push or pull if given a option
Push
Should you move forward or backward when carrying an object?
Forward
Incubation period for AIDS
Several months and years
Incubation period for hepatitis b, c
Weeks or months
Tuberculosis incubation period
2 to 6 weeks
Any disease caused by the growth of pathogenic microorganism a, which may be spread from person to person
Infectious disease
Strict form of infection control that is based on the assumption that all blood and other body fluids are infectious
Standard precautions
What is, washing an object with cleaners such as soap and water
Cleaning
What is, use of a chemical or physical method such as pressurized steam to kill all microorganisms.
Sterilizing
Any occurrence of blood or body fluid coming in contact with no intact skin, mucous membrane, or parent real contact
Exposure
Stages of loss
Denial Anger Bargaining Depression Acceptance
What is good stress called?
Eustress
As a person adapts to stress they develop 3 things?
Defensive strategies
Coping
Problem-solving skills
To manage your own stress what should you identify, 3 thjngs?
Your personal stressors
The amount of stress you can take
What stress management techniques work for you
3 phases of stress response?
Stage 1- alarm
Stage 2- resistance
Stage 3-exhaustion
What happens during stage 1 of stress response physiologically?
Epi/Nor-epi from the adrenal glands increase the heart rate, blood pressure, dilate pupils, increase blood Sugar, and slow digestion, and relax the bronchial tree.
When does stage one end?
When the event is recognized is not dangerous
What is the extreme end point in response to excessive stress exposure
Burnout
What are the two groups of defense mechanisms and techniques for managing stress?
Beneficial
Detrimental
What are 3 beneficial techniques when managing stress?
Use controlled breathing
Reframe- mentally reframe thoughts that interfere with your performance (I can’t do this)
Attend to the medical needs of the pt.
For long term well being the best stress management technique is?
Take care of yourself, eating properly, exercise regularly, and take time off
3 types of EMS stressors
Daily stress
Small incidents
Large incident/disaster
The study of factors that influence the frequency, distribution, and causes of injury, disease, and other health-related events in a population.
Epidemiology
providers should assess every scene and situation for injury risk and maintain statistics as part of what program?
Injury-surveillance program
The ongoing systemic collection, analysis, and interpretation of injury data essential to the planning, implantation, and evaluation of public health practice.
Injury-surveillance program
Type of prevention that keeps an injury or illness from ever occurring
Primary prevention
Type of prevention which rehabilitation after an injury or illness that helps to prevent further problems from occurring
Tertiary prevention
Type of prevention that includes medical care after an injury or illness that helps to prevent further problems from occurring
Secondary prevention
How to get your target heart rate
220 minus your resting heart rate
The areas involved in organizational commitment
Protection of EMS providers
Education of EMS providers
Data collection
Financial support
Empowerment of EMS providers
Under EMS provider commitment, there are Written guidelines and policies that should promote wellness and safety among employees, they emphasize which 5 areas
Standard precautions Physical fitness Stress management Professional care and counseling Safe driving
In motor vehicle collisions, young children are what?
Easily thrown on impact
Since a child’s head is large in proportion to his body, if unrestrained they tend to fly?
Head first into the windshield or out of the car when a collision occurs
Which seat is the best for children, and under what age?
Back seat for children under 12
Social, religious, or personal standards of right and wrong
Morals
This word is related to benevolence, which means the desire to do good. But this word actually means doing good?
Beneficence
Areas in need of prevention activities? 11?
Low birth weight
Unrestrained children in motor vehicles
Bicycle related injuries
Household fire and burn injuries
Unintentional firearm-related deaths
Alcohol-related motor vehicle collisions
Fall injuries in elderly
Work place injuries
Sports and recreation injuries
Misuse or mishandling of medication
Early discharge of patients
Obligation not to harm
Nonmaleficence
Under this the paramedic Is obligated to minimize the risk as much as possible. Making the scene safe, and protecting the patient from impaired or unqualified health care providers.
Nonmaleficence
This term defines a patients right to determine what happens to his body
Autonomy
Obligation to treat all patient fairly
Justice
Three steps on solving a ethical problem?
State the action in a universal form
List the implications or consequences of the action
Compare them to relevant values
Three ways to test ethics?
Impartiality test
Universalizability test
Interpersonal justifiability test
This way of testing ethics is whether you would be willing to undergo this procedure or action if you were in the patients place
Impartiality test
This way to test ethics asks whether you would want this action performed in all relevant circumstances, which helps the paramedic to avoid shortsightedness.
Universalizability test
This way to test ethics asks whether you can defend or justify your actions to others.
Interpersonal justifiability test
Citizen involvement in EMS helps give insiders what?
An outside, objective view of quality improvement and problem resolution.
Citizen involvement in EMS helps give insiders what?
An outside, objective view of quality improvement and problem resolution.
