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Emergency Medical Technology > Introduction to EMS > Flashcards

Introduction to EMS Flashcards

"To hear is to forget, to see is to remember, to do is to understand" -Chinese Proverb

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

What is an EMS system? What is it part of? How is it governed and regulated?

A
  • An organization (system) of community resources and personnel (e.g. health care professionals) who, in each area or jurisdiction, are responsible for and provide rapid medical care to the sick and injured.
  • Part of a local or regional EMS system
  • Standards of prehospital emergency care are governed by laws in each state (Title 22 for California)
  • Regulated by the specific state office of EMS
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2
Q

What are the two absolutes of Prehospital Care?

A
  • Your safety comes first - always (ensure the scene is safe for you in a variety of environements; scene size up)
  • Do no harm to your patient
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3
Q

What is medical terminology? How does the terminology work?

A
  • Medical terminology is language that is used to accurately describe the human body and associated components, conditions, processes and process in a science-based manner.
  • The words are seperated in to parts…
    1. Prefix
    2. Word-root
    3. Suffix
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4
Q

What is an electrocardiogram? (hint: medical terminology)

A
  • Electro/cardio/gram = prefix/word-root/suffix
  • Electro = electricity
  • Cardio = heart
  • Gram = unit of measurement
  • Electrocardiogram: recording of the electrical activity of the heart
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5
Q

Define the following medical terminology…

  • Periorbital
  • Endotracheal
  • Suprapubic
A
  • Peri / orbital = around the orbit (eye)
  • Endo / tracheal = within the trachea
  • Supra / pubic = above the pubic area
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6
Q

What are the components of the EMS (Emergency Medical Services) system?

A
  • General public: ordinary people, not professionals.
  • Dispatchers: receiver and transmitter of messages to personnel
  • First responders: persons trained/disignated to respond to emergencies (cops, paramedics, EMTs, etc…)
  • Transporting agencies
  • Hospital emergency departments
  • Specialty Centers
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7
Q

What are the components of the EMS system according to the book?

A
  1. Public access
  2. Information systems
  3. Communication systems
  4. Evaluation
  5. Medical direction
  6. Clinical care
  7. integration of health services
  8. prevention
  9. Education systems
  10. Public education
  11. EMS research
  12. human resources
  13. legislation and regulation
  14. system finance
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8
Q

How do the components of the EMS system interact according to the __book?

A
  1. Incident/recognition
  2. access 911
  3. dispatch
  4. first responder
  5. basic life support
  6. advanced life support
  7. transport via air/ground
  8. emergency department/facilities
  9. specialty care
  10. patient rehabilitation
  11. prevention awareness
  12. public education
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9
Q

What is the difference between a hospital and specialty center?

A
  • Hospitals are basic receiving facilities which can usually handle up to 90% of cases.
  • Specialty Centers deal with specific problems such as…
  • Trauma (serious, life-threatening injury)
  • Pediatric (medical care of infants)
  • Perinatal (medical care of, around time of birth)
  • Burn (injuries from exposure to heat/flame)
  • STEMI (heart problems)
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10
Q

Who are the prehospital care providers?

A
  • First responders (i.e. EMR basic training; provides care until ambulance arrives such as police officers, fire fighters, etc)
  • EMT-B (EMT-1): trained in BLS such as usage of an AED, airway adjuncts, and assisting patients with certain medications. (150 hrs+ training)
  • AEMT (EMT-I; EMT - Intermediate): trained in specific aspects of ALS such as intravenous (IV) therapy, advanced airway adjuncts, administration of certain emergency medications. Useful in areas with limitations of paramedics. Help to offer higher skills than an EMT where paramedics are not available.
  • EMT-Paramedic: extensive training in ALS such as with endotracheal intubation, emergency pharamocology, cardiac monitoring, and other advanced assessement and treatment skills. (800-1500 hrs+ training). Has an extensive knowledge and mastery of skills
  • MICN (Mobile Intensive Care Nurse)
  • Physician
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11
Q

What is a hospital diversion status? What are examples that might cause this to happen?

A

A hospital diversion status is a temporary status for a health care facilitiy in which it informs EMS that it cannot take any new patients.

  • ER Saturation (So many people that the hospital cannot accomodate them all)
  • Internal Disaster (Hospital is experiencing a disaster resulting in disfunction either in the form of a flood, fire, earthquake, computer system crash, etc.)
  • CT(computed tomography machines could not be working in which we cannot see anatomic problems in the body that cannot be seen by convential x-rays)
  • Trauma
  • STEMI
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12
Q

What is the difference between EMT-1 and EMT-B?

A
  • Nothing, they’re the same.
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13
Q

What is the department of transportion (DOT)? How are the National Highway Transportation Safety Administration (NHTSA) and DOT related?

A
  • Federal Agency responsible for curriculum development of EMTs, you are transporting people (goods) therefore they are responsible and falls under their jurisdiction.
  • The NHTSA of the DOT through the Highway Safety Act of 1966, and the Department of Health and Human Services, through the EMS Act of 1973, created funding sources and programs to develop improved systems of prehospital emergency care.

The “white paper” was an influencial report that detailed the inadequacy of supplies, ambulances and staff training. this lead to the Highway Safety Act of 1966

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14
Q

What is the job description of an EMT-B?

A
  • Emergency care and transport of the sick and injured.
  • Assist ALS personnel with patient care
  • Provide transport between medical facilities (inter-facility transports)
  • Complete required documentation & patient charting.
  • Always work within the scope of practice
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15
Q

What are the goals of the EMT101A course?

A
  • Prepare student to perform the functions of an EMT-B
  • Prepare student to pass National Registry Examination (NRE)
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16
Q

What are the functions of the EMT?

A
  • Care of vehicle and equipment
  • Control of the scene
  • Prompt and perform efficient care
  • Basic life support
    • automated external defibrilation
    • use of airway adjunct
    • assist patients with certain medications
  • Deliver babies
  • Control bleeding
  • Administration of certain emergency medications
  • Providing oxygenation and emergency medications
  • Assist in Advanced life support (ALS)
  • Assist in Intravenous (IV) therapy (set-up, monitor it, not insert it)
  • Safe transport​
    • transport patient with a variety of illnesses and injuries
  • Calm patient
  • Transfer of patient to staff
  • May be employed in health care setting
  • Communications and record keeping
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17
Q

What are the certification requirements to be an EMT-B? What is it used for?

A
  • Be 18 years old or older
  • Have a valid course completion certificate
  • Apply within 2 years of course completion
  • Submit application and fees
  • Pass a written certification examination
  • Pass the background check

Certification Exams are used to ensure all healthcare providers have the same basic level of knowledge and skill.

18
Q

What is title 22 of the CCR (California Code of Regulations)?

A
  • State law defining the scope of practice for EMT-B’s, however a county can tailor it a bit differently.
19
Q

What are disqualifying convictions in a background check that could prevent you from being an EMT-B?

A
  • Violent crimes
  • Sex related crimes
  • Drug related crimes (including DUI)
20
Q

What must an EMT-B do every 2 years?

A

They must recertify which could be done by…

  • Completing a refresher course or..
  • Obtain 24 hours of approved continuing education
  • Then submit application and fees
21
Q

What is the National EMS Scope of Practice Model? How was it created? What the scope of practice for an EMT-B encompass? How does licensure work into this? Remember, manage all patients within your scope of practice NOT OUTSIDE OF IT.

A

The National EMS Scope of Practice Model is a document that provides overarching guidelines as to what skills each level of EMS provider should be albe to accomplish. This was created by experts around the country to create this national standard. After the national scope, licensure serves as the state’s level to vary EMT practice for that state.

  • Assessment of the sick and injured
  • Obtain Diagnostic Signs
  • Render BLS, Rescue, & First Aid
  • Perform CPR
  • Oropharyngeal & nasopharyngeal airways
  • Oxygen delivery devices
  • Suction devices
  • Use AED - if employed and trained by AED provider
  • Extricate entrapped persons
  • Provide initial prehospital trauma care
  • Perform field triage
  • Use various body immobilzation devices
  • Use various types of stretchers
  • Administer oral glucose
  • Set up ALS procedures
  • Transport patients
22
Q

What is the scope of practice for an EMT according to the book?

A
  1. Airway and breathing:
    a. humidifiers
    b. partial brathing mask
    c. venuri mask
    d. manually triggered ventillators
    e. automatic transport ventillators
    f. oral and nasal airways
  2. Assessment:
    a. pulse oximetry
    b. manual and auto blood pressure
  3. Pharmacological intervention:
    a. assist with patients own prescribed medications including auto injector
    b. may administer via the oral or buccal route
    c. physician approved over the counter medications may be administered(aspririn, oral glucose, etc)
  4. Emergency trauma care:
    a. spinal immobilization
    b. seated spinal immobilization
    c. long board
    d. extremity splinting
    e. traction splinting
    f. mechanical patient restraint
    g. tourniquet
    h. MAST/PASG
    I. cervical collar
    j. rapid extrication
  5. Medical/Cardiac care:
    a. mechanical CPR
    b. assisted delivery of infant
23
Q

What are ALS procedures that fall under an EMT-B’s scope of practice?

A
  • Under IV monitoring
    -Can use peripheral lines only (meaning the limbs)
    -Glucose solutions & balanced salt solutions; no additives like drugs
    >>>Glucose = dextrose (5% dextrone)
    >>>Sodium chloride 0.9% = Normal Saline
    >>>Lactated Ringers = ok
    >>>5% Dextrose in .45% Sodium Chloride
    -Monitor
    -Maintain
    -Adjust
    -Preset rate-of-flow (Can do everything but start it)
24
Q

Which patients can you transfer with a tube connected to them?

A

Patients with…

  • Nasogastric tube
  • Gastronomy tube
  • Heparin locks & saline locks (patient connected to iv w/ nothing running)
  • Foley catheters (urine transfer to a bag)
25
Q

What are the rules for lab sessions?

A
  • Wear comfortable clothing
  • Safety first!
  • Report any injures or hazards
  • Do not handle equipment outside EMT-B scope of practice
  • Take care of the equipment
26
Q

WHat are the levels of training?

A
  1. Federal level: NHTSA created the national EMS scope of practice model
  2. State level: Regulates how EMS providers will operate. These laws are executed by state EMS administration who control licensing.
  3. Local level: local medical directors decide the day to day limits of EMS personel.
    - The medical director may limit the scope of practkice but may not expand beyond state law
27
Q

How is public access important for the EMS system?

A
  • The communication center dipatches fire, police, rescue, and EMS units via 911.
  • These trained dispatchers obtain important info from the caller and dispatch ambulance and other crew and equipment.
  • This communication center is called the public safety access point
  • The Emergency medical dispatch (EMD) provides callers with vital instructions to help them deal with medical emergencies until arrival of EMS
  • the syetm helps dipstachers select appropriately resourced units to respond to a request for assistance
28
Q

How are communication systems important for the EMS system?

A
  • With the info provided by caller the ddispatcher selects the appropriate parts of the emergency system that is need to be activated
29
Q

How is clinical care important for the EMS sytem?

A
  • This component describes the various pieces of equipment and scope of practice for using that equipment
  • An EMT may be needed to drive an ambulance thus you must read the primary service aree (PSA) which is the main area you operate
  • An EMT must check equipment and supplies, and make sure the ambulance is fueld, oiled and has good tires. Also be sure to familiarize oneself with an ambulance and equipment.
30
Q

How are Human resources important for the EMS system?

A
  • To encourage the creation of the EMS system and to provide the enviromnent with talented people.
  • The national scope of practice model is to creat a stable foundation on which each level of EMS provider is grounded. It is their goal to ensure that EMs providers are able to seamlessly able to move from one state to another.
31
Q

How is medical direction important for the EMS system?

A
  • Each EMS system has a phsyician medical director who authorizes the appropriate care for each injury, condition or illness that one will encounter in the field.
  • These are described in standing orders or protocals
  • Protocals can be found in comprehensive guidleines delineating the EMT’s scope of practice
  • *-standing orders** are part of protocals and designate what EMTs are required to do for specific complaints or conditions
  • Medical control can be offline (standing orders, training, and supervision authorized by medical director) or online (over the phone or radio directly from medical director)
32
Q

How is legislation and regulation import for the EMS system?

A
  1. Legislation
    - The protocols, training, and practices must conform to the EMS legislation rules, regulations, and guidelines adopted by each state.
  2. Regulation:
    - at the local level, each EMS operates in a designated primary service area (PSA)
    - EMS services are usually administered by a senior EMS official. They are in charge of administration tasks, daily operations of the ambulances and crews, and operates as the chief of the EMS for the PSA it covers.
33
Q

How is the integration of health services importnt to the EMS system?

A

This means that the prehospital care administer is coordinated with the care administered at the hospital.

34
Q

How is evaluation important to the EMS system?

A
  • The medical director maintains quality control and ensures all staff are meeting the standard of care. they do this by reviewing patient care reports, audit administrative records, and survey the patients.
  • All aspects of the EMS system are continuously reviewed and audited as part of the continuous quality improvement (CQI)
  • information and skills in emergency medical care change constantly. This ensures the best knowledge of skills, use of equipment, illnesses, and training on skills not used often.
  • Evaluation also helps to eliminate or limit human error
  • erros can be broken down into three: rules based failure( not following rules), knowledge based failure(ex. not knowing all info of a medication), or skills based failure(ex: using equipment improperly.
  • to eliminate error use a cheat sheet or carry a copy of your protocol book
35
Q

How is the infromation system important for the EMS system?

A
  • And information center allows EMS providers to document care administered.
  • Data from ambulance logs can help justify hiring more personel
  • examining the types of patients can _help the foundation for purchasing new equipment _
  • Data can be combined from hospitals to ambulances to determine patient outcome
36
Q

How is system finance important for the EMS system?

A
  • Allows them to continue to provide care. EMS departments have paid or volunteer personel or a mix.
  • financial resources are available via taxation, fundreaising, donations, or combinations.
  • you as an EMT will help the department secure finacnial resources
37
Q

How are education systems important for EMS systems?

A
  • the quality of care provided depends on the quality and of training and your ability. Therefore instructors in training programs are key members of th EMS team
  • EMTs are required to continue their education to maintain and update their license. This helps combat skills which may weaken from not being used on a constant basis
38
Q

How is prevention and public education important for the EMS system?

A
  • Public health examines the health needs of entire populations with the goal of preventing health problems. Along with education which pushes for exercising and eating right, it is the goal to creat an environment where the need for EMS is decreased.
  • EMS can work with public health agencies with secondary or primary strategies
  • primary: focuses on strategies that will prevent the event from ever happening. (Ex: vaccinations, education on dangers of drugs and alcohol)
  • secondary: here the event has happened. The goal is working on how to decrease it.
  • EMTs survey illnesses and injuries. Patient care reports can be used to determine if a widespread condition exists
39
Q

How is EMS research important to the EMS system?

A
  • compiling significant amounts of data has been used to creat evidence to ensure the best medical decisons are made.
  • Emts will gather data and record all patient data which will be gathered and analyzed.
  • Research can be done at EMS facilities. Patient care records can be used to determine where the department can improve. It can also be used to help shape education
40
Q

What are the professional attributes of an EMT?

A

Emergency Medical Technology (22 decks)

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