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EMD > MPDS Test > Flashcards

MPDS Test Flashcards

1
Q

Priority Symptoms (ACDS)

A
  • abnormal breathing
  • chest pain/discomfort if any
  • DLOC
  • serious Hemorrhaging
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2
Q

Ineffective breathing descriptors

when mentioned use breathing verification diagnostic

EXCEPT UNCONSCIOUS

A

can’t breath at all
not breathing
barely breathing
gasping for air
fighting for air
making funny noises
just a little
turning blue or purple

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3
Q

if mentioned go to 10 (chest pain/ discomfort non traumatic)

heart attack symptoms

also found in arms, jaws, neck, upper back , this is how women perceive

women are also less likely to call in for heart attacks due to higher pain tolerance and the pain are not neccesarily on chest but the ones mentioned above

A
  • aching pain
  • constricting band
  • chest pain/discomfort (now gone)
  • crushing discomfort
  • heaviness
  • numbness
  • pressure
  • tightness

equivalent fo chest pain and handle on 10

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4
Q

Stroke (CVA)/ TIA symptoms

keywords are sudden and onset

A
  • speech problems
  • weakness, numbness, paralysis of face arm or leg on one side of body
  • loss of balance or coordination
  • trouble seeing in one or both eyes
  • severe headache with no known cause

numbness on hand only is NOT a stroke symptoms

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5
Q

review legend of symbols

A

see last page of pilot guide

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6
Q

axioms/ use key words below to rephrase

UNCERTAIN BREATHING
2nd party
considered NOT BREATHING
until proven otherwise

A

UNCERTAIN BREATHING status indicated a 2nd party caller who has seen the patient and is still unsure. this is considered NOT BREATHING until proven otherwise.

because we are leveling up the response “just in case”, and if patient is UNCONS, do not use breathing verification diagnostic

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7
Q

axioms/ use key words below to rephrase

unknown breathing
3rd/4th party

A

unknown breathing status indicates a 3rd or 4th party caller who cannot personally verify the patient’s status.

due to lack of info/ not at scene

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8
Q

axioms/ use key words below to rephrase

ECHO
completing all case entry and CC KQ
safety issues

A

after an ECHO response, completing all Case Entry and CC key questions ensures that the proper knowledge regarding safety issues and the appropriate warnings and/or advice are immediately and always passed on the responders and potential scene helpers.

send ECHO first to help patient, then gather scene safety info/warning/advices to protect crew/bystanders/volunteers.
relating to “scene safety” CC selection rule

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9
Q

axioms/ use key words below to rephrase

prompt recognition
AGONAL BREATHING
MEDICAL arrest PAIs (aka CPR)
immediately after ECHO send
when unconscious patient
INEFFECTIVE or UNCERTAIN breathing

A

prompt recognition of AGONAL BREATHING is critical to the treatment of cardiac arrest because it reduces time to compressions and defibrillation. MEDICAL arrest PAIs should be instituted immediately after ECHO coding and associated PDIs when an unconscious patient’s breathing status is INEFFECTIVE or UNCERTAIN (Breathing verification diagnostic use is NOT neccesary)

uncons patient DO NOT USE breathing verification diagnostic when breathing is uncertain or ineffective

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10
Q

Pilot Guide rules/ use key words below to rephrase

dynamic and often conflicting priorities
critical safety instructions
further attempt to locate by street,hwy, direction, intersection, or objects

A

the EMD must weight the dynamic and often conflicting priorities of obtaining and verifying a useful location versus helping the caller get to safety. if initial efforts to identify an exact location fail, it is essential that critical safety instructions be provided without further delay. further attempts to locate can then be made to determine the street or highway of travel, direction of travel, and last cross street or identifiable objects seen.

emphasis on “patient safety”
hence on DLS link under Danger “get to safety first then call us back”
also relocate to safe location would mean have to verify exact address anyways.

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11
Q

Pilot Guide rules/ use key words below to rephrase

critical patient care instructions
priori to “send” point
scene safety concerns
must be addressed before instructions

A

some critical patients care instructions may be necessary prior to the “send” point. Any significant scene safety concerns take precedene and must be addressed before the provision of instructions.

eg, run away from animals, assualts, fire, water…etc
before “send” point.

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12
Q

Pilot Guide rules/ use key words below to rephrase

1st party caller
sinking vehicle
should not delay PAIs
attempts to locate can be following/during critical safety instructions

A

for a 1st party caller in a sinking vehicle. obtaining an exact location, when not immediately available, should not delay PAIs, further attempts to locate can be made following/during critical safety instructions as time/circumstance permits.

get patient out of sinking vehicle first then address everything else later.

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13
Q

Pilot Guide rules/ use key words below to rephrase

must complete case entry questions
after “send, PDIs & returning to questioning”

A

case entry questioning must always be completed after PDIs when directed by the “send, PDIs & return to questioning” symbol (hanging, strangulation, suffocation, underwater, choking, person on fire)

review legend of symbols

mentioned above are all ECHO response aka “fast track” in ProQA

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14
Q

Pilot Guide rules/ use key words below to rephrase

NO breathing diagnostic
UNCERTAIN/ INEFFECTIVE BREATHING with uncons

A

use of the breathing verification diagnostic is not neccesary when UNCERTAIN BREATHING or INEFFECTIVE BREATHING is associated with unconsciousness.

EMMA! why do we worry about breathing when patient’s heart stopped pumping/ cardiac arrest. Get started on CPR asap

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15
Q

Pilot Guide rules/ use key words below to rephrase

1st party callers
further assess ability to speak, level of distress or agitation, airway noises.
ranges of breathing effectiveness
when i doubt, err on side of patient safety

A

1st party callers using phrases like “i can’t breathe” or “i can barely breathe” may be further assessed by their ability to speak normally or in complete sentences, their level of apparent distress or agitation, and the presense of airway noises (i.e., stridor, wheezing, gasping, etc.) breathing effectiveness ranges from normal breathing to mild SOB to DIFFICULTY SPEAKING BETWEEN BREATHS to fighting for air (INEFFECTIVE BREATHING) when in doubt, the EMD should err on the side of patient safety.

we take what callers tell us, since we are not doctors and we cannot diagnose over the phone, in case of judgment error from audio cues, choose responses that level up response (err on side of patient safety)

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16
Q

CC selection rule/ use keywords below to rephrase

sudden, unexplained collapse
unconsciousness
even as ground level fall
MEDICAL cardiac arrest

A

a sudden, unexplained collapse resulting in unconsciousness, even with reported as a ground-level fall, should be considered a MEDICAL cardiac arrest until proven otherwise.

could be a MEDICAL cardiac arrest that leads to ground level fall

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17
Q

CC selection rule/ use keywords below to rephrase

cardiac arrest
TRAUMATIC
best fits scene safety &
mechanism of injury

A

when cardiac arrest appears to be TRAUMATIC in nature, choose the Chief Complaint Protocol that best fits scene safety concerns and the mechanism of injury.

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18
Q

CC selection rule/ use keywords below to rephrase

scene safety
best addresses those issues

A

if the complaint description includes a scene safety issues, choose the Chief Complaint Protolcol that best addresses those issues.

e.g Protocol 4,8….etc

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19
Q

CC selection rule/ use keywords below to rephrase

TRAUMA
mechanism of injury

A

If the complaint description suggests TRAUMA, choose the Chief Complaint protocol that best addresses the mechanism of injury.

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20
Q

CC selection rule/ use keywords below to rephrase

MEDICAL
foremost symptom
consideration given to priority symptoms

A

if the complaint description appears to be MEDICAL in nature, choose the CC protocol that best fits the patient’s foremost symptom, with consideration given to priority symptoms.

21
Q

CC selection rule/ use keywords below to rephrase

abdominal pain/ cramping
pregnancy
contractions

A

abdominal pain/cramping anytime during pregnancy should be considered contractions until proven otherwise.

espcially when patient is in denial “baby is too early to be born”

22
Q

CC selection rule/ use keywords below to rephrase

traumatic injury or constriction
non-venomous(unquestionable) snake
go to 3, if not go to 2

3 Animal bites/ attacks

A

if the complaint is traumatic injury or constriction involving a non-venomous (unquestionable) snack, go to protocol 3.
if unkown or unsure, go to protocol 2.

23
Q

CC selection rule/ use keywords below to rephrase

back pain
non traumatic or
non recent trauma

as stated in name of protocol 5

A

back pain should only be selected as CC when it is initially clear on case entry that the cause is NON-RECENT traumatic or NON-TRAUMATIC back pain. if unclear, go to protocol 30.

Protocol 30- Traumatic injuries (specific)

24
Q

CC selection rule/ use keywords below to rephrase

breathing-related tracheostomy
conscious patient
go to 6

A

when the complaint description is breathing-related tracheostomy (trach or stoma) problems in the conscious patient, go to protocol 6.

6 breathing problems

25
Q

CC selection rule/ use keywords below to rephrase

both NON-TRAUMATIC chest pain/ HEART ATTACK symptoms and breathing problems
choose foremost symptom
ECHO takes precedences

A

when the complaint description involves both NON-TRAUMATIC chest pain/ HEART ATTACK symptoms and breathing problems, choose the Chief Complaint protocol that Best fits the patient’s foremost symptom, with ECHO-level condition taking precedence. (>/ 16, alert, not pregnant, no reported stroke symptoms) use the Aspirin Diagnostic & instruction Tool on either protocol as appropriate.

26
Q

Exceptions of using
ASA tool

A
  • > / 16
  • alert
  • not pregnant
  • no reported STROKE symptoms
27
Q

CC selection rule/ use keywords below to rephrase

severe thermal burns to eyes
protocol 7

A

since several thermal burns to the eye almost always affect the face or head, go to protocol 7 for these incidents.

won’t be 16! because most likely it will affect airway

28
Q

CC selection rule/ use keywords below to rephrase

hazardous materials (toxic substances)
threat
protocol 8

A

If the complaint description involves a hazardous materials (toxic substances) that pose a threat to bystanders or responders, go to protocol 8.

example of scene safety rule

29
Q

CC selection rule/ use keywords below to rephrase

both chest pain/ HEART ATTACK symptoms and STROKE symptoms
go to 10
**NO ASA TOOL **

A

if the complaint description involves both chest pain/ HEART ATTACK symptoms AND STROKE symptoms, go to protocol 10 but do not utilize ASA tool.

Protocol 10 is generic and “pure medical”and ProQA will try to filter. do not use ASA because patient report of stroke symptoms which is one of the exceptions.

30
Q

CC selection rule/ use keywords below to rephrase

GENERALIZED seizure
go to 12
if atypical go to 9

A

when the complaint description strongly suggests GENERALIZED seizure, go to protocol 12 regardless of consciousness and breathing status. If the scenario is atypical of GENERALIZED seizure, and is ore typical of sudden cardiac arrest, go to protocol 9.

31
Q

CC selection rule/ use keywords below to rephrase

POSTPARTUM hemorrhage
21

A

for a complaint description of POSTPARTUM hemorrhage only, go to protocol 21 (no complications with baby and placenta has been delivered)

because we are focusing on bleeding rather than baby

32
Q

CC selection rule/ use keywords below to rephrase

DANGEROUS, uncontrolled hemorrhage
excludes scene safety
go to 21

A

for DANGEROUS, uncontrolled hemorrhage (neck armpit, or groin), excluding scene safety complaints, go to protocol 21

DANGEROUS hemorrhage: neck, armpit, groin

33
Q

CC selection rule/ use keywords below to rephrase

  • vomit with coffee grounds appearance
  • unusally dark or black and tar like poop
  • go to 21
  • signs of GI bleeding

very specific signs

A

if the complaint description involves vomit (emesis) with a coffee grounds appearance, or unusually dark or black and tar-like fecal matter (stool), go to protocol 21 as these are signs of gastrointestinal bleeding

34
Q

CC selection rule/ use keywords below to rephrase

suicide attempt
overdose, carbon monoxide, stab or gsw
go to specific protocol

A

if the actual type of suicide attempt is deteremined to be overdose, carbon monoxide, stab or gunshot wound, go to and dispatch from that more specific protocol.

because 8, 23,27 put heavy emphasis of scene safety

35
Q

CC selection rule/ use keywords below to rephrase

recreational inhalation
23

A

for recreational inhalation of potentially harmful substances, go to protocol 23.

eg. hairspray, marijuana, gas fumes…..etc

36
Q

CC selection rule/ use keywords below to rephrase

attempt by jumping from height
INTENDING/IMMINENT/ or already jumped
go to 25

A

when the complaint description involves a suicide attempt by jumping from a height (INTENDING SUICIDE, IMMINENT SUICIDE POTENTIAL, or already jumped), go to protocol 25.

25 put emphasis of “jumper”

37
Q

CC selection rule/ use keywords below to rephrase

pregnant
“illness” as primary complaint
26

A

If pregnant patients have “illness” as primary complaint go to protocol 26 unless the problem concerns vaginal bleeding, labour, miscarriage, or waters broken.

if problem concerning vaginal bleeding, labour, miscarriage, or waters broken. we worry about status of baby which goes to 24

38
Q

CC selection rule/ use keywords below to rephrase

sickle cell crisis….

etc

A

if the complaint description involves sickle cell crisis/thalassemia, automatic dysreflexia/hyperreflexia, or acute adrenal insufficiency/adrenal crisis/ addisonian crisis/ addison’s disease, go to protocol 26.

unusual diseases go to 26

39
Q

CC selection rule/ use keywords below to rephrase

abdominal
thoracic eviscerations
27

A

for abdominal and thoracic eviscerations, go to protocol 27

think of broken stitches after surgery “multiple wounds” and penetrating trauma

40
Q

CC selection rule/ use keywords below to rephrase

insignificant or peripheral
puncture wounds
go to 21or 30

A

protocol 27 should not be used for insignificant or peripheral puncture wounds such as household pins, needles, tacks, or stepping on nails. go to protocol 21 or 30 as appropriate.

go to 21 to control bleeding or 30 to treat specific traumatic injuries

41
Q

CC selection rule/ use keywords below to rephrase

ANY traumatic chest pain
go to 30

A

for chest pain due to trauma (current or non-recent) go to protocol 30.

because non traumatic non recent chest pain we go to 10

42
Q

CC selection rule/ use keywords below to rephrase

ground level fall
fainting,near fainting or dizziness
go to 31

A

for ground-level falls caused by fainting, near fainting or dizziness, go to protocol 31.

43
Q

CC selection rule/ use keywords below to rephrase

consciouness and/or
breathing unknown
initially (3rd party caller)
go to 32

A

if the CC and status of consciousness and/or breathing are unknown initially (3rd party caller), go to protocol 32

due to lack of info we err on patient side of safety.
for example if coded life status questionable we give DELTA code

44
Q

NOT BREATHING SITUATIONS

  • not breathing at all
  • UNCERTAIN BREATHING
  • hanging
  • strangulation
  • suffocation
  • COMPLETE obstruction
  • drowning arrest (out of water)
  • under water (non specialized rescue)
  • narcotic/opioid arrest (obivious)
A
  • not breathing at all 9-E-1
  • UNCERTAIN BREATHING 9-E-2
  • hanging 9-E-3
  • strangulation 9-E-4
  • suffocation 9-E-5
  • COMPLETE obstruction 11-E-1
  • drowning arrest (out of water) 14-E-1
  • under water (non specialized rescue) 14-E-2
  • narcotic/opioid arrest (obivious) 23-E-1
45
Q

OBVIOUS EXTREME RESPIRFATORY DISTRESS
1st party

A

1st party caller including but not limited to
* fighting for each breath, using single words or syllables to express
* expressing extreme desperation
* complete respiratory exhaustion
* thought of impending death

ECHO, 6-E-1, breathing problems

46
Q

Breathing Verification Diagnostic

go SLOW when reading espcially the verbiage of “GO”

A

> / 8 sec. interval
AGONAL

check for maximum of 4 breaths

47
Q

AGONAL BREATHING

A

ineffective, deteriorating breathing
lingers after the heart has essentially stopped pumping blood to brain

literally “taking last breath of air”

48
Q

UNCERTAIN BREATHING

A

2nd party caller
uncertain, unsure, indefinite or ambiguous when asked if patient is breathing

EMD (18 decks)

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