System design, delivery systems, SOP, Education, Occ health Flashcards

1
Q

Pro all ALS

A

All response types covered
Response time may improve
Incremental cost for established ALS agency is minimal

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2
Q

Pro BLS with some ALS

A

Concentrates procedures for ALS (less skill dilution)
ALS may not have major benefit over ALS most of the time

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3
Q

Public utility model features

A
  1. Single ambulance service designated
  2. Governmental unit does billing
  3. Government unit owns capital equipment
    Medical director preferable to be appointed by third party
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4
Q

What is queuing analysis

A

How many units are required for a given hour

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5
Q

Medical director voice regarding performance standards

A

Voice of the likely effect of response of interval performance
Medical equipment
Certification levels on clinical outcomes

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6
Q

Largest cost to EMS systems

A

75 % Labor
25% infrastructure

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7
Q

3 axis of essential system measures

A
  1. Clinical sophistication
  2. Response time reliability
  3. Economic efficiency
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8
Q

4 feature of effective medical oversight

A
  1. External (vs internal)
  2. Authoritative (vs advisory)
  3. Broad scope of authority (vs narrow)
  4. Funded (vs volunteer)
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9
Q

Features of high performance systems

A
  1. Sole provider
  2. Controls center operations
  3. Accountability
  4. Maximizes revenue
  5. Flexible production strategy
  6. Systems status management
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10
Q

What is system status management

A

Ambulance deployment model based on anticipation of need

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11
Q

EMS assessment system

A

Bladrige healthcare criteria for performance excellence

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12
Q

EMS at crossroads 2007 said what about Air EMS

A

Growth primarily money driven
Needs to be actually clinical beneficial
Needs to be safe

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13
Q

First HEMS program

A

Dr Crowly and Shock Trauma with Maryland state police
1970

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14
Q

First hospital based HEMS

A

1972 - St Anthonys in Denver CO

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15
Q

% of population that needs HEMS to get to trauma center

A

27%

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16
Q

What act increased CMS reimbursement for HEMS transport

A

1997: Balanced budget act

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17
Q

Airline deregulation act

A

States have no jurisdiction over aviation aspects of air EMS programs (stays with FAA) or economics of providing services

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18
Q

Title 14 of federal code

A

FAA responsible for all aviation specific issues: safety inspections, helicopter licensure, air traffic control

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19
Q

Miles for HEMS

A

50-175 miles

20
Q

Fixed wing miles for benefit

A

> 150 miles

21
Q

Visual flight rule standard

A

1 mile visibility
500 ft ceiling

22
Q

Federal tort claims act associated with

A

Sovereign immunity

23
Q

4 things needed for EMS clinician to practice

A

Educate or trained
Certified as competent
Licensed to perform
Credentialed by medical director

24
Q

EMR airway interventions

A

Air adjuncts
Positive pressure (not CPAP)
Suction upper airway
Supplemental O2

25
Q

EMR meds

A

Autoinjectors, intranasal atomizers (naloxone)

26
Q

EMT meds

A

Epi autoinjector
Nebs
SL nitro (patients own)
OTC meds for pain and fever
Oral glucose
ASA

27
Q

AEMT different stuff

A

Waveform capo
IV and IO access
IV meds: parenteral analgesia for pain, nausea, dextrose, epi, glucagon, naloxone
Supraglottic aria but not ETT

28
Q

5 things from EMS education agenda for the future

A
  1. National EMS core content
  2. National EMS scope of practice model
  3. National EMS education standards
  4. National EMS certification
  5. National EMS education program accreditation
29
Q

3 big things in medical directors role in EMS education

A
  1. Approve curriculum
  2. Review student performance and progress/attest to competence
  3. Faculty selection/Curriculum development
30
Q

Education vs training

A

education: more theory based
training: more skill based

31
Q

Conn Ed vs Maintaince of cerficaiton/reeducation

A

Con ed: provision of new information
Maintenance: covering material students have been exposed to in past (required for national registry recertification)

32
Q

Remediation of EMS providers must be

A

Educational and constructive

33
Q

Work force entry should evaluate what for EMS

A

Knowledge and skills

34
Q

What does OSHA part 1904 state

A

Requires employers to keep records and report on work related injuries and keep records for 5 years

35
Q

NFPA 1582

A

Requires fire departs have physician to provide medical oversight
Requires fire departments to establish a comprehensive medical program to address safety

36
Q

Hep C transmission risk

A

0.2% percutaneous
0% risk for mucocutaneous

37
Q

HIV transmission risk

A

0.3% risk for percutaneous (higher for deeper injuries, larger needles)
0.09% for mucutaneous

38
Q

What guides vaccination recs

A

NFPA 1582

39
Q

HAZWOPER governs what

A

Any incident requiring PPE to work in an immediately dangerous to life and health environment

40
Q

Two things that require a transport capable EMS unit at all fireground and hazmat incidents

A

NFPA 1500 and HAZWOPER

41
Q

Structure rest after how many minutes of firefighting

A

20 minutes

42
Q

NFPA 1584 states

A

Rehab for FF
5-10 minute rest after consuming one 30 min SCBA cylinder or 20 minutes of heavy exertion
20 minutes of rehab after two SCBs or 45 minutes heavy exertion

43
Q

Sleep Scales

A

Pittsburg sleep quality index
Epworth Sleepiness Scale
not fatigue scales

44
Q

Greatest source of tort claims for EMS

A

Ambulance crashes

45
Q

Step based approach after traumatic event

A
  1. Does individual feel event was significant?
  2. If so - supervisor led hot wash
  3. If not resolved - 10 question trauma screening questionnaire
  4. If 6 or more positive, referral for a more complete assessment
46
Q
A