System finance, data collection and analysis, informed consent Flashcards
Variable cost
Changes w/ each unit production activity (disposable medical supplies)
Marginal cost
Cost of producing or providing one additional unit (i.e ambulance)
Cost per capita
Total EMS cost / population served
Cost/transport
Cost per unit hour divided by Unit hour utilization
Unit hour utilization
Hours staffed ambulance ready / number of tasks
Total cost formula
Direct + Indirect + shared cost
1993 NHTSA uniform prehospital data set did what
First attempt at national standard for patient care reports
4 NEMSIS goals
- Establish a nationwide dataset with definitions for EMS systems
- Establish electronic data collection system for all local EMS systems
- Establish statewide database to assure quality of care
- Establish an aggregate nationwide database based on the 3 goals above
4 components of PCR
Front end - data entered
Database - data points
Exchange or interactive engine - uses health information exchange
Back end - used to generate points and data
First data tool that called for integration of PSAP, EMS, hospital and patient outcome data
Utstein template
Enumerative vs analytic studies
- Enumerative: Data set over fixed timeframe
effect of one action on study population
traditional clinical studies - Analytic: Examine performance in an ongoing manner (CQI)
effect of a provider’s action on studies
Common cause vs special cause variation
Common cause: difference due to natural variation
Special cause: changes in performance due to system changes
Belmont report sets what 3 ethical principals
- Respect for persons - autonomy to consent
- Beneficence - risks should be kept to absolute minimum
- Justice - Risks of study not borne by one population while benefits go to another
Common rule has how many levels of investigation? What are they
- Federal (institutional assurance)
- Institutional (IRV)
- Investigator
Who is responsible for informed consent in a study
Primary investigator
Exempt review for IRB approval should be what
Less than minimal risk
I.e de-intentified records, anonymous surveys
Excepted review for IRB key word
No greater than minimal risk
Ex: retrospective review of clinical data
Waiver of consent vs exception from informed consent
Waiver is a low risk study
EFIC is high risk
Ionizing vs non ionizing radiation
Ionizing - breaks bonds
Non-ionizing - excites bonds
Radiation sickness stages
Prodromal - n/v, anorexia
Latent - dose dependent, can be hours to week
Acute - bone marrow suppression, GI issues, CV and CNS issues
3 things that protect against radiation
Time
Distance - decreases as square of distance (most important)
Shielding
What blocks each level of radiation
Alpha - paper/clothing/skin
Beta - FF turnout gear
Gamma - need lead
Prussian blue treats what radiation
Cesium and Thallium
DTPA treats what radiation
Plutonium, americium and curium
Needs to be given within 24 hours of exposure
General principals of decon
Reduce exposure - remove from source, remove clothing
Reduce absorption - if its dry don’t wet it, if its wet make it more wet
What is SARA Title III
Emergency planning and community right to know act
Provides info to public if chemical hazards are present in their area
Level C respiratory protection
N95
Does not have its own air supply
Not good for oxygen deficient environments
Where should radiation warm zone be?
What should providers wear?
Upwind from hot zone
Wear Level B if exposure unknown
Warm zone for radiation treatment
Where clothing is removed (reduces exposure up to 90%)
Where decon takes place
Dry vs Wet radiation exposure
Dry: Brush off with non abrasive brush or towel
Wet: Large volume, low pressure warm water
Technical vs Emergency decontamination
Technical: Done by hazmat team to safely remove contamination
Emergency: Process to rapidly decontaminated a responder in PPE who has suit breach or becomes ill/injured
What is HAZWOPER
OSHA standard 29
Mandates medical monitoring surveillance for all hazmat response team members
Needs baseline, annual, and exit physical.
Also any follow up exams deemed necessary
