Module 1 - Introduction Flashcards
what is NHTSA and what does it do?
National Highway Traffic Safety Administration
- provides a set of standards to evaluate effectiveness of states EMS system
What is the TAP?
Technical Assistance Program guidelines given by the government (NHTSA) for all states to follow
what are the recommended standards under TAP?
Evaluation
Trauma Systems
Medical Direction
Communication and Public Information
Transportation and Facilities
Resources, HR, and Training
Regulation and Policy
What are the four level of training?
EMR, EMT, AEMT, paramedic
What is an EMR (emergency medical responder) Do ?
CPR
AED utilization
Basic bleeding control
basic airway
ventilation
O2 therapy
What is the EMT (Emergency Medical Technician) do?
- All skills allowed by EMR and:
- Limited medication administration
- Advanced O2 therapy (Supraglottic airways)
- Monitoring blood glucose levels
What is An AEMT (Advanced emergency medical technician) do?
- EMR, EMT skills and:
- administer a select number of medications
- Initiate IV and/or intraosseous infusions
What does a paramedic do ?
- All EMR, EMT, AEMT skills and
- Adv. patient assessment and management
- 12 lead interpretation
- Drug therapy
what is the 5 centers you can transport patients to?
- Psychiatric center
- Burn Center
- Obstetrics/ pediatric centers
- trauma center
- Cardiac center/PCI (Percutaneous Coronary Intervention Center)
What was the “white paper” in 1966 and what did it do for EMS care?
it was the paper published by National Academy of Sciences National Research council titled “Accidental death and Disability: The Neglected Disease of Modern Society”
- detailed the # of deaths and injuries related to MVA
- identified severe decencies in the delivery of pre-hospital care in US
- Recommended changes to ambulance systems, training req., and preparation of prehospital care
how is the states role and national role defined?
- Each state has control of its EMS system
- NHTSA (National Highway Traffic Safety Administration) provides a set of recommended standards called TAP (Technical Assistance Program)
what is the medical director responsible for?
- Providing Medical oversight For EMS system
- clinical patient care aspects of EMS system
- involved in EMS training and education
- provides guides and protocols
- off-line and on-line medical direction for EMT
(Must be Licensed medical physician)
What is off-line medical direction ?
standing orders that allow EMT’s to use own judgement within predetermined guidelines WITHOUT having to contact a physician
What is EMT role in QIC?
- Documenting carefully
- volunteering on a committee or critiquing other EMTS on scene
- obtaining feedback
- maintaing equipment (preventative maintenance checks)
- Doing CE courses
- Maintaining skills
What is on-line medical direction?
Requires EMT to Gain permission from a physician before administering specific emergency care
What does a QIC (Quality improvement committee) do?
Identify those aspects of the system that can be improved and implement plans and programs that will remedy shortcomings
What is evidence based medicine do?
Uses research to provide clear evidence that certain procedures, medications, and equipment are beneficial to patient outcomes
HIV/AIDS transmission mode and Incubation period?
- Blood, semen, vaginal fluid, blood transfusion, needlestick, transplacental, breast feeding
- Months
PPE needed for HIV/AIDS?
Gloves, eyewear, hand washing
HEP B/C transmission mode and Incubation period?
- Blood, semen, vaginal fluid, needlestick, transplacental, human bite, sexual contact
- Weeks or months
PPE needed for HEP B/C?
Gloves, eyewear, hand washing
Tuberculosis transmission mode and Incubation period?
- Respiratory secretions, airborne or direct contact
- 2-6 weeks
PPE needed for Tuberculosis?
Gloves, eyewear, HEPA or N-95 respirator, hand washing
Influenza transmission mode and Incubation period?
Airborne Droplets, Direct Contact with body fluids
1-3 days
PPE needed for Influenza?
Gloves, surgical mask, hand washing
Chicken Pox (varicella) transmission mode and Incubation period?
Airborne droplets, direct contact with open sores
11-21 days
PPE needed for Chicken pox/Varicella?
Gloves, surgical mask, hand washing
Bacterial Meningitis transmission mode and Incubation period?
oral and nasal secretions
2-10 days
PPE needed for Bacterial Meningitis and chicken pox (varicella)?
Gloves, surgical mask, and hand washing
Pneumonia transmission mode and Incubation period?
Respiratory secretions and droplets
PPE needed for Pneumonia?
Gloves, surgical mask, and hand washing
German Measles (Rubella) transmission mode and Incubation period?
Airborne droplets, Transplacental
10-12 days
PPE needed for German Measles (Rubella)?
Gloves, surgical mask, and hand washing
Whooping cough (Pertussis) transmission mode and Incubation period?
Respiratory secretions and airborne droplets
6-20 days
PPE needed for Whooping cough (Pertussis) ?
Gloves, surgical mask, and hand washing
Staphylococcal Skin Infection (STAPH) transmission mode and incubation period?
Direct contact with open lesion or contaminated object
1-3 days
PPE needed for STAPH?
Gloves, hand washing
Severe acute respiratory syndrome (SARS) and Corona Virus (COVID 19) transmission mode and incubation period ?
Respiratory airborne, direct contact
SARS : 10 days
COVID 19: 3-7 days
PPE for SARS/COVID 19?
Gloves, N-95 Respirator or N100 respirator, hand washing, eye protection
Ebola Virus disease (EVD) transmission mode and incubation period?
Direct contact with blood or contact with body fluids
2-21 days
PPE for Ebola Virus Disease (EVD) ?
Gloves, Hand washing, N-95 respirator, Surgical/Isolation gown, boot covers, Specialized training in Donning/Doffing PPE
Zika Virus Disease (ZVD) transmission mode and incubation period?
Bite from infected Aedes mosquito, from pregnant woman to fetus, sexual contact with an infected person
3-12 days
define communicable disease
Disease that spreads from one person to another
What are the the 5 emotional stages?
Denial
Anger
Bargaining
Depression
Acceptance
What is CISM (Critical Incident stress management)?
Is a process to deal with stress encountered by EMT
What are the 2 types of CISM?
CISD (critical Incident stress debriefing) and Critical Incident debriefing
What is Diffusing?
Version of CISD held within 1-4 hours post incident.
What is Debriefing?
Version of CISD held within 24-72 hours of incident
Good protection saying to go by?
“If its brown, red, yellow, green or sticky and its not yours.. dont touch it”
What are the 5 different pathogens you will encounter?
bacteria, viruses, fungi, protozoa, Helminths
What are possible signs of advanced HIV infection?
- rapid weight loss
- Dry cough
- Recurring fever or night sweats
- profound/unexplained fatigue
- swollen lymph nodes in the neck, armpits or groin
- diarrhea that last more then week
- white spots on tongue, mouth or throat
- Pneumonia
- Red, brown, pink, or purplish blotches under the skin or inside the mouth, nose, or eyelids
- Memory loss, depression or other neurological disorders
What are signs of acute menigitis?
- Fever
- Stiff neck
- photophobia (Light sensitivity)
- Onset in hours to few days
- Altered mental status and seizures
what are the signs of TB infection?
Latent:
- no signs
- not contagious
Active:
- Very infectious
- Weakness
- Weight loss
- Fever
- No appetite
- Chills
- Sweating at night
What are the 3 types of flu and which 2 does the CDC focus on?
Type A, B, C
only A & B cause the most issues
What are the characteristics of the flu?
Type A:
- Flu epidemics
- Most serious outbreaks
- animals and humans
- Most serious symptoms
- Spreads quickly
Type B:
- Flu epidemics
- only human
Type C:
- Very limited and causes minor symptoms
What are the 3 types of stress reactions?
What are the 3 types of stress reactions?
what is cumulative stress and what are the warning signs?
- constant exposure to stressful situations that builds overtime
- initial signs can be anxiety and irritability
- anxiety, irritability with coworkers family and friends, inability to concentrate, difficulty sleeping and nightmares, anxiety, indecisiveness, guilt, loss of appetite, loss of sexual desire or interest, isolation, loss of interest at work
What is acute stress and what are the warning signs?
-Usually happens during or immediately after event.
-can results in cognitive, behavioral, physical or psychological changes
- nausea, tremors, trouble concentrating, and sleep issues
what is delayed stress and what are the warning signs?
stress reaction that results from a exposure but doesn’t show up to days, months, or even years after event
-example: PTSD
-signs: nightmares, irritability, insomnia, inability to concentrate, flashbacks, increased inner personal conflicts, withdrawal from others or inability to relate to others
What is involuntary consent?
Involuntary consent is used for mentally incompetent adults or those in custody of law enforcement.
Consent must be obtained from the entity with the appropriate legal authority.
What is contributory negligence?
When the patient through his own negligence has caused or contributed to the damage that was done to him
What are the 5 types of consent?
Express consent, consent for minors, implied consent, informed consent, involuntary
What is OPIM
Other potentially infectious material
What is consent to treat minors?
Miners under the age of 18 cannot refuse medical treatment on their own
Must be done by parent or responsible adult
What is implied consent?
A.k.a. “emergency doctrine” occurs when the patient is unresponsive, competent, or unable to make rational decision
What is informed consent?
Inform the patient of the possible risk and outcome of a procedure
What is negligence
Any wrongful act, injury, or damage, and where there is no intent to do any harm to the patient
What are the four elements involved in negligence that must be present for negligence to occur?
- Duty to act : obligation of Emt to respond to scene and provide care
- Breach of duty to act: occurs with Emt deviates from standard of care
- Damages: damages that are real and demonstrable and recognizable by law.
- Proximate cause: injuries suffered by patient as a direct result of EMT’s negligence
What are some special reporting situations?
- donor and organ harvesting
- baby safe haven laws
- medical identification insignias
What is the scope of practice?
The duties or services that a EMT is authorized to perform in their state
What is the standard of care?
defined as the practices, treatment, and actions an EMT working in the same situation would consider to be reasonable and prudent.
What is off-line medical direction?
Standing orders issued by the Medical Director that allow EMTs to give certain medications or perform certain procedures without speaking to the Medical Director or another physician.
What is online direction?
orders directly given by the medical director by radio or phone
When can a person refuse care?
- If a person is oriented to “Person, Place, or time” they can refuse care/transport
- Patient cannot have altered mental status, be under the influence of drugs/alcohol, or mentally ill
What are the ways to handle a crime scence?
- Take one way in and out
- Touch and move only what you need to
- Always wear gloves
- Do not cut through gunshot holes or stab wounds
- If rape, patient should not shower, wash, use bathroom, eat or drink anything until they get to the hospital
What is the standard information collected on all PCR’s called?
Minimum Data set
What is the minimum data set that should be on a pcr?
- patient information
- administrative information
- viral signs
- patient narrative
- treatment
What is the abbreviation for vital signs?
V/S
What is the abbreviation for shortness of breath?
SOB
What is the abbreviation for signs and symptoms?
S/S
What is the abbreviation for bag valve mask?
BVM
What is the pneumonic “chart” stand for for alternative documentation methods?
C- chief complaint
H- history
A- assessment
R- RX
T- transport
What does pneumonic “soap” stand for in alternative documentation?
S- subjective
O- objective
A- assessment
P- plan
What is the difference between objective and subjective findings on a call?
Subjective - information Based on individuals, perceptions or interpretations.
Objective - information that is measurable or verifiable in someway
SAMPLE (History):
Symptoms
Allergies
Medications
Past history
Last oral intake
Events preceding
OPQRST stands for :
Onset - Gradually or start suddenly
Provocation- Anything make it better or worse?
Quality- Describe pain
Radiate- pain stay local or travel
Severity- Rate pain 1-10
Time - How long?
AVPU is for ?
Determining patients level of responsiveness and consciousness
AVPU:
Alert
Verbal
Pain
Unresponsive
What are some special situations that requires special documentation?
- exposure to infectious
- child or elderly abuse
- On the job injuries
What information is included in the administrative information of a PCR?
EMS number, names of crewmembers and certification level, address, time incident reported, time arrived to seen and left scene, time of transfer to care
What information is included in patient information for PCR
Chief complaint, level, responsiveness, vital signs, skin, color, temperature, and condition, patient demographics
How do you fix a mistake on a PCR?
- Draw a single horizontal line through the error
- Initial and date by the mistake
Why take two sets of vitals?
- it allows for comparison. One set doesnt really tell much
- It allows for a history of vitals for all those involved in care
