Operations Flashcards
When can BLS units cancel ALS responders according to the Cancellation/Slow-Down Policy?
BLS units may cancel ALS responders when there is nothing found, or the patient(s) require only first aid, such as bandaging or simple splinting. BLS units may not slow or cancel ALS units due to air ambulance activation unless confirmed with flight personnel after the air ambulance lands.
What should EMS personnel do upon entering a crime scene to avoid disturbing evidence?
EMS personnel should select a single route to the victim, avoid disturbing furniture, weapons, or articles, and document any items moved, noting the location and reason. All medical debris except sharps should remain at the scene.
What is the purpose of the Diversion System in the Greater Portland Metropolitan Area EMS network?
The Diversion System provides guidelines for ambulance and hospital coordination during high-capacity times to ensure efficient EMS services and minimize prolonged transport times or prehospital care for unstable patients. Diversion is intended as a last resort.
What information must be included in a Prehospital Care Report for each patient?
The report should include the patient’s presenting problem, vital signs with times, history and physical findings, treatments provided with times, ECG strips if monitored, any condition changes, and OLMC contact details (physician name, time, and orders received).
How does the management of lower acuity EMS calls work under the policy?
BOEC triages calls and places Priority 6 call types in a separate queue managed by American Medical Response (AMR). AMR paramedics manage these calls and must contact the caller within 5 minutes and reassess every 15 minutes. Calls unresolved after 30 minutes are returned to the BOEC Dispatch Queue.
What is the role of the Field Surgical Response Team (FST), and when are they deployed?
The FST provides rapid advanced surgical care on scene when life-saving procedures, such as amputations, are needed. They must be ready to respond within 20 minutes and are activated by the Incident Commander when required for complex extrication or trauma situations.
What are the key guidelines for paramedics first arriving at a hazardous materials scene?
Paramedics should approach cautiously from upwind and upgrade, avoid contaminating themselves or equipment, and stage in an isolated area if contamination is suspected. The Hazardous Materials Paramedic (HMP) will direct care and determine transport methods.
What criteria determine the declaration of an MCI, and what steps are taken upon declaration?
An MCI is declared when additional resources or incident structure are needed due to complexity. The Incident Commander announces it to dispatch. The MCI protocol includes establishing medical roles, coordinating transport, and setting up treatment areas.
What are the criteria for activating HEMS in the “Outer Zone”?
HEMS may be used in the Outer Zone (greater than 15 nautical miles from a hospital) if overall out-of-hospital time will be reduced by more than 10 minutes. This includes trauma entries, unstable medical patients, post-cardiac arrest with ROSC, STEMI, sudden onset CVA, and other operational considerations.
Who assumes the role of Person-In-Charge (PIC) on a medical scene?
The first arriving, highest certified EMS provider assumes the role of PIC. When a higher-level EMS provider arrives, they assume the role after receiving a verbal report. The PIC is responsible for overseeing treatment, operations, communication, and scene efficiency.
What steps are taken when managing multiple asymptomatic victims of hazardous material exposure?
Victims are isolated in a safe, climate-controlled environment after decontamination if necessary. Baseline vitals are recorded, and patients are monitored. Asymptomatic patients may be released with instructions, while symptomatic individuals are treated and transported.
Under what conditions can a patient be transported by fire apparatus?
Patients can be transported by fire apparatus when there are no available ambulances, during a mass casualty event, or under special circumstances approved by the Incident Commander. Proper care must be maintained during transport.
What must be done before transporting a contaminated patient in an ambulance?
The HMP directs ambulance preparation, including removing unnecessary equipment, sealing cabinets, and draping the interior with plastic. Upon hospital arrival, the receiving facility must be contacted, and the ambulance parked away from the emergency department until deemed safe.
What are the key roles outlined in the MCI task cards?
Roles include Medical (overall EMS coordination), Triage (patient categorization), Treatment (stabilization of patients), Transportation (patient loading and movement), and Destination (hospital coordination and patient tracking).
What responsibilities do hospitals have for diversion accountability and improvement?
Hospitals must develop internal policies to avoid diversion, submit annual ED surge plans, and attend monthly leadership meetings to review diversion events. County EMS reports diversion hours and works with the leadership collaborative to recommend improvements.
What are the key considerations for staging during a high-risk response?
Units should stage away from hazards, maintain clear access for emergency vehicles, communicate location and staging updates, and coordinate with the Incident Commander. Staging areas must be secure and provide safe operational zones.
