Lecture 1 Flashcards
1
Q
1485
A
- first use of an amblulance
- transport only
2
Q
1800s
A
-first use of an ambulance/attendant to care for injured on site
3
Q
1926
A
-service started similar to present day
4
Q
1940
A
- EMS turned over to fire and police department
- no set standard of care
- police and fire dept were well established and funded
5
Q
20th century and modern technology
A
- mad major strides after WW2
- bringing hospital to field have patients a better chance for survival
6
Q
korean war
A
- first use of helicopter for transport (not care)
- helicopters flew to the MASH units were they would give care
- MAS*H units
- mobile army surgical hospital -> MASH
7
Q
1956
A
-mouth to mouth resuscitation developed
8
Q
late 1950s/early 1960s
A
- focused shifted to bring hospitals to patients
- mobile ICU developed
9
Q
1966: White paper released
A
- finding included:
- lack of uniform laws and standards
- sickest people were treated by the newest doctors
- poor quality equipment
- lack of communication -> no 911
- lack of training -> therefore funding
10
Q
white paper finding outlined 10 critical points for EMS system
A
- one of the points led to this
- one of the leading causes of death and disability was traffic accidents -> this led to….
- led to national highway safety act
- created US department of transportation
11
Q
1968
A
- training standards implemented
- 911 created
12
Q
1969
A
- first true paramedic program
- standards for ambulance design and equipment
- cardiologist and trauma were the first bc cardiovascular disease and vehicle accidents were the leading causes of death
- Pittsburgh, Florida, seatile, washington
13
Q
1970s
A
- 1971- emergency care and transportation of the sick and injured published by AAOS
- 1973- emergency medical service act- says that states regulate EMS not federal gov -> some state gave money to counties making it more separated
- this is how standard precautions become blurry
- 1977- first national standard curriculum for paramedics developed by US DOT
14
Q
1970
A
- NREMT began
- nation registry of EMT
- emergency physicians are still not recognized at this time
15
Q
1980s/1990s
A
- number of trained personnel grew
- NHTA developed 10 system elements to help sustain EMS system
- responsibility for EMS to the states
- major legislative initiatives
16
Q
licensure
A
- granted by a government body
- by state
- licensure is overall scope of practice
- how states control who practice
- also known as certification or credentialing
- unlawful to practice without license
- certification is a standard that you have met with baseline amount of knowledge -> just cause you are certified doesnt mean you can do it
- your work will credential you to do certain things -> different job, different scope of practice
17
Q
holding a license shows you…
A
- completed initial education
- met the requirement to achieve the license
18
Q
reciprocity
A
- licensure between two states
- each state has different reciprocity requirements
- certification granted from another state/agency
- requirements:
- hold a current state certification
- be in good standing
- national registry certification
19
Q
EMTALA
A
- The Emergency Medical Treatment and Labor Act (EMTALA)
- unfunded mandate- law said you have to do this
- no one could stay open if they arnt being paid
- said that you cant decide to treat someone based off funds and insurance
20
Q
the public needs to be taught how to:
A
- recognize emergencies
- activate the EMS system
- provide basic care
- bystander CPR significantly increases survival rate
21
Q
patient outcomes are determined by:
A
- bystander care
- dispatch
- response
- prehospital care
- transportation
- emergency department care
- definitive care and rehabilitation
- bleeding control (tourniquets)
22
Q
dispatcher
A
- usually the publics first contact
- training level varies from state to state
- scene may differ from what dispatcher relay…how can future tech change this
- getting information about the patients and situation and then sending specific treatment units -> can you misread the situation or the patient misreads the situation and the wrong unit is sent?
23
Q
levels of education
A
- EMS system function from a federal to local level
- federal- national EMS scope of practice model…EMS agenda for 2050
- state: licensure
- local- service medical director
- the national guideline designed to create more consistent delivery of EMS nationally
- 2009- national EMD education standard -> NREMT provides a national standard for testing and certification
24
Q
EMT
A
- formerly EMT-basic
- primary provider level in many systems
- most populous level in the system
- what kind of service are EMT the most populous volunteer ambulance services
25
Q
paramedic
A
- highest level to be nationally certified (outside of hospital)
- 1999- major revision to curriculum to increase level of training and skill
- 1,600-2000
- even if independently licensed you must:
- function under the guidance of a physician
- be affiliated with a paramedic level service
26
Q
improving system quality
A
- goal- evaluating and proving patient care
- continuous quality improvement
- quality assurance
27
Q
continuous quality improvement (CQI)
A
- tools to continually evaluate care
- process of assessing current practice looking for ways to improve
- dynamic process
- mistakes will be made, we are only humans -> we need to limit mistakes and consequences
- limit hours someone works -> decreases mistakes
- make sure the system supports making good choices
28
Q
1996 institute of medicine
A
- launched efforts to improve patient safety and quality of care
- at least 44,000 and may up to 100,000+people die in hospital each year as result of medical errors
- better care or more money
29
Q
summary
A
- ambulance corps were developed in WW2 to transport and rapidly care for solders
- helicopter evacuation (MEDVAC) implemented during the Korean war
- 1966 the national academy of sciences and the national research council released the white paper
- practitioners at all levels must be licensed
30
Q
emergency medical service act
A
- 1973
- says that states regulate EMS not federal gov -> some state gave money to counties making it more separated
