EMS Manual Flashcards
A person becomes a patient the moment the EMS provider has determined __ __________ __ _________ to ensure that no illness or injury is overlooked and to ensure that the individual’s capacity to decline an assessment is not impaired by illness, injury, or intoxication.
an assessment is necessary
Patients demonstrate impaired decision-making capacity __ ____ ___ ______ __ __________ ____ _________ or our recommendations or if they have unreasonable excuses for refusal or transport.
if they are unable to understand their condition
The CURVES Mnemonic may aid the assessment of Decision-Making Capacity
- C ommunicate – Must be able to communicate.
- U nderstand – Must be able to understand the following elements and state them back:
- R eason – Must be able to explain the reasons behind their decision.
- V alues – Their reasons must be based on their values and not clouded by
psychosis or suicidal intent. - E mergent condition – Remember under emergent conditions, consent is implied.
- S urrogate – Remember surrogate decision-makers may make decisions on behalf of the patient such as: descending order spouse, adult child, parents,
adult sibling
If the EMS provider has reason to believe the patient’s decision-making capacity is impaired by psychiatric illness, the ___ __________ should be notified, and ___ ______ should be requested immediately to evaluate the patient.
EMS Supervisor, the police
If the patient is deemed a threat, the officers may take the patient into custody on their own authority for _ _____ (“8-hour rule”) during which providers and officers may coordinate transport to the hospital or other facility.
8 hours
Consent is not required in the presence of life-threatening (or potentially life-threatening) illness or injury, or if the patient is unconscious or unable to communicate due to _______, ______ __ ____________ and may reasonably be presumed to have a life-threatening condition.
illness, injury or intoxication
In Virginia Code §54.1-2969 persons between the ages of __ ___ __ _____ ___may be declared an emancipated minor by court order. Emancipated minors may make medical decisions on their own behalf.
14 and 18 years-old
Minors with intact decision-making capacity, who are __ _____ __ ___ __ _____ and whose parent or legal guardian are unable to be contacted, may refuse assessment, treatment and/or transportation.
14 years of age or older
Preexisting agreements between the schools and parents require students must leave
school any time one of the following medications is given at the clinic:
- Epinephrine autoinjector.
- Glucagon.
- Diastat (Diazepam).
- Solu-Cortef.
– Involves a patient who may need care yet has no primary
physician and/or has limited ability to navigate the health-care system.
Medical isolation
Involves barriers to care due to social circumstances – no phone,
no car, no childcare, etc.
Social isolation
Willful infliction of physical pain, injury, mental anguish, or unreasonable
confinement. Sexual abuse falls into this category as well
Abuse
Nonexistent or insufficient care and support necessary to maintain a
person’s physical and/or mental health to the extent that his/her well-being is
impaired or threatened. Persons who live alone/unaided and are unable to care for themselves can be considered to fall into this category, as can a lack of supervision of young children.
Neglect
The illegal use of an incapacitated adult/child or their resources for
another person’s profit or advantage.
Exploitation
As an EMS provider in Virginia, you are also legally required to
report your suspicions of abuse, neglect, and/or exploitation of members of the following
patient populations:
- Children (all patients under 18 years of age, including physically or mentally
disabled/incapacitated). - The elderly (all patients 60 years of age or greater, including those physically or
mentally disabled/incapacitated). - The physically or mentally disabled/incapacitated from 18-59 years of age.
The CRT focuses on individuals or patients that call 9-1-1 greater ____ _ _____ ______ __ ____ , identified as “Super Utilizers.”
than 6 times within 60 days
Legible copies of the VDDNR or other authorized DNR forms may be honored. There are five key parts of the form:
- The patient’s full legal name.
- A DNR determination.
- Signature of Physician (MD) or Nurse Practitioner (NP).
- Date of issue.
- The patient’s signature or, if applicable, that of the person authorized to consent on the patient’s behalf.
In the rare event providers are unable to contact POLMD, attempts should be made to contact __ ___ through the Department of Public Safety Communications (DPSC) and the ___ __________.
an OMD, EMS Supervisor
FRD providers may be called to assist a patient who is incidentally in possession of a weapon (firearm or edged, concealed or otherwise). Such weapons may present a hazard to providers and in all cases are not permitted in receiving facilities. Upon discovery of such a weapon in the possession of a patient with decision-making capacity, providers should utilize the following strategies:
Preferred: The patient willingly leaves the weapon on scene
Alternative: Request law enforcement to the scene if not already present and ask the patient to turn over the weapon to the officer for safekeeping until it can be retrieved
Contingency: EMS Supervisor keeps weapon and accompanies unit to hospital to determine best course of action at destination
5-5-10-2.
- At patient side to 12 Lead ECG less than 5 minutes.
- STEMI identification to Alert less than 5 minutes.
- STEMI identification to enroute to facility less than 10 minutes.
- Two ALS providers should be at the patient’s side during transport
If the patient is prescribed nitroglycerin and has been instructed to take it for the observed symptoms, assist patient with prescribed Nitroglycerin up to a total of…?
3 doses administered by EMS
- If the patient has a blood glucose level less than __, can protect his or her airway, able to swallow, and can follow commands, assist the patient with self-administration of:
o 1 Instant Glucose tube (15 grams).
▪ Reassess and monitor for signs of clinical improvement. Repeat blood
glucose assessment _ _______ after glucose administration. Instant
Glucose tube can be repeated once, if necessary.
70, 5 minutes
All patients greater than __ ____ pregnant who are having an obstetric (OB)-
related emergency should be transported to an OB-capable facility.
20 weeks
Transport the supine patient in the ____ _______ _________ position if delivery is not imminent.
left lateral recumbent