EMS Systems Flashcards
(99 cards)
1
Q
EMR
A
- Basic Emergency care and operations training
- Manage the emergency scene
- Initiate immediate life-saving care
2
Q
EMT
A
An EMS professional trained in BLS interventions
- Additional depth and breadth of training in basic emergency care and transportation
- Focus on initial stabilization of the scene and fundamental emergency care
- EMTs are the primary link between the emergency scene and the health care system.
3
Q
AEMT
A
An EMS professional trained in some ALS interventions
- Additional prep beyond EMT level
- Training in ALS and intravenous therapy (IV)
- Advanced airway management
- Administration of emergency medications
- The primary focus is on advanced assessment techniques and emergency
Interventions to improve patient outcomes
4
Q
Paramedic
A
An EMS professional with extensive training in ALS skills, such as intubation
- The greatest breadth and depth of education and training in emergency care
providers - Prep focuses on ALS assessment, diagnostic and treatment tools and techniques
-Interpretation of Heart Rhythms - Advanced airway management
- Emergency Pharmacology
- Help extend the reach of he health care system
5
Q
ALS
A
Advanced procedures, such as intravenous therapy, advanced airway management, and administering certain emergency medications.
6
Q
BLS
A
Basic Lifesaving interventions, such as CPR
7
Q
EMS
A
A system to provide prehospital care to the sick and injured
8
Q
Primary Service Area
A
A designated location in which the EMS agency is responsible for providing prehospital care.
9
Q
Medical Director
A
A physician who authorizes the EMT to provide care in the field
10
Q
Americans with disabilities act
A
Legislation that protects disabled individuals from discrimination.
11
Q
Licensure Requirements
A
1 High School diploma
2. Immunization against communicable diseases
3 Successful background check and drug test
4 BLS/CPR Cert
5 State Approved EMT course
6 Completion of NREMT
7 Practical Certification Exam
8 Compliance with other state, local, and employer provisions
12
Q
ADA
A
The ADA of 1990 protects people who have disabilities from being denied access to programs and services that the state or local government provides.
Prohibits employers from failing to provide full and equal employment to the disabled
Title 1 of the ADA protects EMTs with disabilities seeking gainful employment
Employees are required to adjust processes so that a candidate with a disability can be considered for the position.
13
Q
History of EMS Systems When did it begin? What was the publication that started it, and what was it paired with to improve the crisis of prehospital care?
A
- EMS had its origins in 1966 with the publication of “Accidental Death & Disability: The neglected disease of modern society.
This ^ prepared jointly by the committee on trauma and shock of the National Academy of Sciences/National Research Council, revealed to the public and congress the serious inadequacy of prehospital emergency care and transportation.
14
Q
Date that EMS Began?
A
-1966 EMS began
15
Q
When did Emergency Ambulance services start to grow and vary in the US?
A
-1960s/70s emergency ambulance services and care varied widely across the USA
16
Q
What is the Medical Service Act? When was it started? What did it do?
A
-Medical Services Development Act of 1973: Created funding sources and programs to develop improved systems and prehospital care
17
Q
In the 1970’s what did DOT develop and publish?
A
The curriculum that served as a guideline for EMT training.
18
Q
Who created the first EMT Textbook? What was it called? When?
A
The Academy of Orthopaedic Surgeons
Called: “Emergency Care and Transportation of the Sick and Injured”
Still used today, but in a different edition.
1971
19
Q
In the late 1970s, what did DOT develop?
A
Recommended National Standard Curriculum for the education and training of paramedics and identified a part of the course to serve for the EMTs
20
Q
1980s
As each state sought to create a system that would meet the needs of its citizens, the definitions of EMS providers began to _________ from state to state. For example, EMTs were allowed to administer medications in some states, while in other states they were not.
A
Vary
Each state sought to create a system suited to the needs of its citizens.
For example, in some states EMTs were allowed to administer medication,s and in others you couldn’t
21
Q
A
22
Q
KSAs
A
Knowledge, skills, and abilities
23
Q
Credentialing is the process of______ a health care providers qualifications
A
Verifying
24
Q
______ is the legal authority to practice as an EMT in a state
A
Licensure
25
The Americans With Disabilities Act (ADA) of 1990 protects people who have a disability from being denied access to programs and services that are provided by state or local governments and prohibits employers from failing to provide full and equal employment to the disabled.
Title I protects _______ with disabilities seeking gainful employment under many circumstances.
EMT's
26
World War I
In warfare, volunteer ______________ were organized and personnel went overseas to provide care for the wounded in World War I.
Ambulances
27
During World War II, the military _______________ special corpsmen to provide care in the field and bring the casualties to aid stations staffed by nurses and physicians.
Trained
28
In the Korean War, this evolved into the field ________ and rapid helicopter evacuation to nearby Mobile Army Surgical Hospital units, where immediate surgical interventions could be performed.
Many __________ in the immediate care of trauma patients resulted from the casualty experiences in the Korean and Vietnam Wars.
Medic, advances
29
1960s
Except in large urban centers, most _____________ did not have the emergency department (ED) staff available today.
Hospitals
30
As a result of Accidental Death and Disability: The Neglected Disease of Modern Society, Congress mandated that two federal agencies address these issues.
The National Highway Traffic Safety Administration (NHTSA), under the US Department of Transportation (________), was directed to enact the Highway Safety Act of 1966.
The Department of Health, Education, and Welfare (now known as the Department of Health and Human Services [DHHS]) was directed to enact the Emergency Medical Services Development Act of 1973, creating funding sources and programs to develop improved systems of prehospital emergency care. This history is why EMS is administrated at the federal level through the _________ and not the DHHS.
DOT
31
In the 1990s, NHTSA began an examination of EMS from a national perspective. With the counsel of EMS providers, physicians, fire chiefs, nurses, state administrators, educators, and other interested professionals, NHTSA created the EMS Agenda for the Future.
This document established a plan to ________________ the levels of EMS education and EMS providers in an effort to ensure a more seamless delivery of EMS care across the country.
Standardize
32
In 2019, NHTSA revised this document and published the new version as EMS Agenda ____
2050
33
Training EMR
Ventilation:
-Oral Airway
-Bag mask device
-Upper airway suctioning
- Nasal Cannula
Cardiovascular:
-Manual CPR
-Auto/Semiautomatic defibrilation
-Medication admin routes
-Intramuscular auto-injector
-Intranasal Premeasured
34
Training EMT
EMR +
-Ventilation:
-Nasal Airway
-CPAP
-Pulse oximetry
-Oxygen humidifiers
Cardiovascular:
-Mechanical CPR
-Telemetry monitoring devices
Med Admin Route:
-Oral
-Sublingual
35
Training AEMT
EMR,EMT +
Ventilation:
-Supraglottic airway
-Tracheobronchial suctioning
-ETCO2 monitoring
Cardiovascular:
same as EMR and EMT
Med Admin Routes:
-Subcutaneous
-Intravenous
36
Training Paramedic
EMR, EMT, AEMT +
Ventilation:
-Endotracheal Intubation
-Cricothyrometry
-Airway obstruction removal by direct laryngoscopy
-High-Flow nasal cannula
Cardiovascular:
-Cardioversion, electrical
-Manual Defibrilation
Med Admin Route:
-Transdermal
-Rectal
37
CPAP
Continuous Positive Airway Pressure
38
CPR
Cardiopulmonary Resuscitation
39
The EMR course focuses on providing immediate care with limited ______ before the arrival of the _______.
Familiarizes students with the additional ________, ________, and _________ techniques that EMTs may use and that EMRs may be called to assist on.
equipment, ambulance
Procedures, Equiptment, and Packaging
40
Approximately _____-_____ hours to provide the essential knowledge and skills required to provide basic emergency care in the field
You and other EMTs who have responded should assume _____________ for the assessment and care of the patient and follow the proper packaging and transport of the patient to the ED, if appropriate.
150-200 hrs
Responsibility
41
This course ranges from 1000-2000 hours and is divided between classroom and _______ training
Increasingly, this training is offered within the context of an __________ degree or a _________ degree college program
Internship
Associates, Bachelors
42
EMS
Is a team of health care professionals who are responsible for and provide emergency care and transportation to the sick and injured
43
What is a Public safety Access Point
A PSAP is a communication center where trained dispatchers obtain the necessary information from the caller and, following dispatch protocols , dispatch the ambulance crew and other equipment and responders that may be needed.
44
What is EMD and what does it do?
Emergency Medical Dispatch, Assists dispatchers in providing callers with vital instructions to help them deal with a medical emergency until the EMS crews arrive. dispatchers are trained and provided scripts to help them relay relevant instructions to the callers
45
Governmental 1/4
More than half of all EMS support is provided by a _____________ entity such as a fire agency (about 45%) or other nonfire _____________ agency (20%).
Private services deliver about ____ of EMS support. Other models seen less frequently include hospital-based programs and Native American tribal services.
46
What are the 6 guiding Principles of Agenda 2050
1.) Safe and Effective
2.) Integrated and Seamless
3.) Reliable and Prepared
4.) Socially Equitable
5.)Sustainable and Efficient
6.) Adaptable and Innovative
47
Agenda 2050 Principle 1
Safe and Effective:
The entire system start to finish is designed to minimize exposure to injury, infections, illness, or stress
48
Agenda 2050 Principle 2
Integrated and Seamless:
Ems is fully integrated with all other aspects of health care and is engaged with other emergency services and within the communities in which they operate.
49
Agenda 2050 Principle 3
Reliable and Prepared:
Ensuring EMS care is delivered consistently and compassionately and is guided by sound research at all times by all EMS providers, at all levels, or from all agencies.
50
Agenda 2050 Principle 4
Socially Equitable:
Access to care and the quality of care are not determined by a patients age, socioeconomic status, gender, ethnicity or where they live.
51
Agenda 2050 Principle 5
Sustainable and Efficient:
Systems must be fiscally responsible, providing value to the community with minimum of waste and a maximum of accountability
52
Agenda 2050 Principle 6
Adaptable and Innovative:
evolving to meet the changing needs of the people whom they serve by continuously evaluating new tools and techniques, education programs, and system designs
53
What is a med Director and what is his or her role in the EMS system
The Med Director authorizes the EMT's in the service to provide medical care in the field.
In virtually all systems the appropriate care for each injury, condition, or illness is determined by the med director.
Med Dir is the ongoing Liaison between the med community, hospitals, and the EMT's in the service.
if treatment problems arise or different procedures should be considered the med Dir is referred to for decision and action.
54
What is Medical Control
Is providing either Offline indirect or online direct as authorized by med director.
*Each EMT MUST know and follow the protocols developed by the Med Director.
An EMS physician or other designee, usually at a local hospital, who can be reached by radio or telephone, for med control during a call, this is a type of online direct Med Con.
55
Med control Physician
After the Ambulance and the EMT's have arrived they will give their report to the Med control Physician and he or she can either confirm or modify the proposed treatment plan or may prescribe any additional special orders that the EMTs are to follow for that patient.
56
What is a standing order?
It designates what the EMT is required to do for a specific complaint or condition. Providers are not required to consult medical direction before implementing standing orders.
57
What is online med control?
Online Med Control consists of directions given over the phone or radio directly from Med Dir or designated physician such as a base station physician at a receiving hospital
58
What is offline med control?
Offline Med control consists of standing orders, training and supervision authorized by the med director.
59
What is MIH?
Mobile integrated Health Care:
It's a method of delivering health care that utilizes the prehospital spectrum of care resources.
60
What is the Goal of MIH?
The goal is to facilitate improves access to health care at an affordable price. In the MIH model, health care is provided within the community rather than at a physicians office or hospital
61
What is an advantage of MIH
An advantage of MIH is that it offers access to care for patients within communities who may have limited medical resources, and leads to better service for those who are homebound or disabled.
62
What is Comm Paramedicine
Comm Paramedicine involves experienced paramedics who receive advanced education and training to equip them top provide serves within a community.
They would typically provide services provided by community paramedics may include performing
-health evals
-monitor chronic illnesses or conditions
-obtain lab samps
-admin immunizations
-serve as a patient -advocate
63
What is Quality Control?
Quality Control ensures that all staff members meet appropriate medical care standards on each call.3
64
What is Just Culture?
Just Culture is a strategy that promotes a learning culture that holds employees accountable for behavioral choices by balancing Fairness and Accountability
65
What is CQI
Continuous Quality Improvement:
Quality management that encourages team members at every level of the Health care system to ask
"How are we doing now?" and
"What can we do to be better?"
CQI is a proactive process of development capitalizing on strengths and addressing challenges.
Info is gathered about processes, performance, and outcomes. Eval of this info generates ideas to improve performance and efficiency, these ideas are tried and also evaluated and the cycle continues
66
What is an HRO
High Reliability Org.
This means that the organization has a commitment to teamwork, a culture of safety, and a commitment to CQI in an effort to prevent errors.
67
Quality Assurance
Measures care against a predefined standard or benchmark.
68
Quality Improvement
Continuous cycle that measures the behavior and implements actions to improve performance.
69
The Plan-do-study-act
The plan phase involves gathering and analyzing info. Analysis of these data may lead to ideas to improve the level of care, efficiency. or outcomes.
-The do phase enacts these ideas
-The study phase evaluates any significant pos or neg changes that resulted from the previous steps. At every level, CQi is a learning and improvement process rather than simply a way to punish members for identified problems
-if the change is positive, a larger part of the EMS system adopts the change in the act phase
70
Environmental Considerations
E.C can be managed using many approaches:
Reducing environmental factors related to errors requires the right equipment and people in place.
71
Medical Errors
Rules-based failures
Knowledge-based failures
Skills-based failures
any combination of these.
72
Finance Documentation
Proper Documentation of EMS calls can impact an agency's ability to:
Process medical insurance claims
Prove eligibility or financial grants
And provide evidence of competent practices.
73
ET3
As the health care syste, in the US evolves, billing is changing at every level.
In 2020, the centers for medicare and Medicaid services or CMS, implemented a pilot program in a small group of EMS agencies, knowns as emergency Triage, treat, an dtrasnport or ET3
Rather than an EMS system getting paid only for transport to an ED, ET3 strives to reimburse EMS systems for providing the right patient with the right care at the right time. This program allows transport to EDs for patients who need that level of care, but also sets up a payment model for patient transport to alternative destinations like
urgent care centers
doctors offices
or on scene treatment with no trasnport
74
Public Health
Public Health addresses health needs of entire populations, with the goal of preventing health problems.
75
Health care in the US is?
is expensive: health care accounts for more than 17.7% of the US gross domestic product.
may not deliver a better product, people born in the US have an average life expectancy of 79 years There are 29 other countries where people typically live longer
76
Focus of Public Health
PREVENTION
77
Primary Prevention
It focuses on strategies that will prevent the event from ever happening.
Vaccinations are a good example of primary prevention within public health.
78
Secondary Prevention
The vent has already happened The question is , what can we do to decrease the effects of the event?
An example of this is guardrails. This is a good way to prevent car accidents or cars flying off the sides of roads.
Educating the public on: Injury prevention, services EMS provides, performing CPR, helping a choking victim, assisting in delivery.
79
EMT Role in Prevention
EMTs are also involved with:
Surveillance of illnesses and injuries, the PCR's generated by EMS personnel can be used to determine whether a serious, widespread condition exists.
80
What is EBM?
Evidence-Based Medicine:
Focused on procedures that have proven useful in improving patient outcomes.
All aspects of the EMT role are currently being researched within the academic community and in the practitioner community.
81
What are the EMTs roles and responsibilities in the EMS system?
1 Keep vehicle and equipment ready for emergency
2 Ensure the safety of yourself, your partner, the patient, and bystanders
3 Operate the emergency vehicle
4 Be an on scene leader
5 Evaluate the scene
6 Call for additional resources as needed
7 Gain patient access
8 perform patient assessment
9 Give emergency medical care to patient while awaiting the arrival of additional medical resources
10 Give emotional support to the patient, the patient's family, and other responders
11 Maintain continuity of care by working with other medical professionals
12 Resolve emergency incidents
13 Uphold medical and legal standards
14 Ensure and protect patient privacy
15 Give administrative support
16 Constantly continue your professional development
17 Cultivate and sustain community relations
18 Give back to the profession
82
What are the professional attributes of an EMT
1 integrity:
Consistent adherence to a code of honest behavior.
2 Empathy:
Aware of and thoughtful towards the needs of others
3 Self-Motivation:
Able to discover problems and solve them without direction
4 Appearance & Hygiene:
Uses persona to project a sense of trust, professionalism, knowledge, and compassion and deodorant
5 Self-Confidence: A state of being in which you know what you know and know what you don't know able to ask for help
6 Time-management:
Able to perform or delegate multiple tasks, ensuring efficiency and safety
7 Communications:
Able to understand others and they understand you
8 Teamwork and diplomacy:
Able to work with others and know your place within a team; able to communicate while giving respect to the listener.
9 Respect:
Places others in high regard or importance; understands others are more important than self.
10 Patient Advocacy:
Constantly keeps the needs of patient at the center of care
11 Careful delivery of Care:
Pays attention to detail; makes sure what is being done for the patient is done as safely as possible
83
Review 1 Standards and Laws
The standards from prehospital emergency care and the providers who deliver it are governed by the laws in each state and are typically regulated by a state office of EMS
84
Review 2 Ambulance
Ambulances are staffed by EMTs that have been trained to the EMT, AEMT, or paramedic level according to recommended national standards and have been licensed by the state they serve.
85
Review 3 EMT training
An EMT has training in basic emergency care, knowledge, skills, and attitudes, focusing on initial care and transport of patients that includes identification, assessment, and treatment of many emergency and nonemergency conditions.
86
Review 4 AEMT training
AN AEMT has training in specific aspects of ALS care, such as IV therapy and the administration of certain emergency medications.
87
Review 5 Paramedic training
A paramedic has extensive training in ALS including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills
88
Review 6 EMR's
EMRs, such as law enforcement, fire fighters, park rangers, ski patrollers, park rangers, ski patrollers, or other organized rescuers often arrive at the scene before the ambulance and EMT's.
89
Review 7 EMT size up and assessment
After the EMT's size up the scene and assess the patient, they provide the emergency care and transport that is indicated based on their findings and ordered by their medical director in the service's standing orders and protocols or by the physician who is providing inline medical direction.
90
Review 8 First at scene
You will often be the first health care professional to assess and treat the patient; as such you have certain roles and are expected to possess certain attributes
91
Review 9 EMT Attributes
EMT attributes include compassion and motivation to educe suffering, pain, and mortality in those that are injured or acutely ill; a desire to provide each patient with the best possible care; commitment to obtain the knowledge and skills that this position requires; and the drive to continually increase your knowledge skills and ability.
92
Review 10 EMT Current Course
The EMT course that you are now taking will present the information and skills that you will need to pass the required certification examination needed to become a licensed EMT.
93
Review 11 Completion of Course
Once you have completed the course you must assume responsibility for directing your own study through continuing education provided by your service's training officer and medical director or through other opportunities available to you. Your commitment to continued learning is the key to being a good EMT.
94
Review 12 Career
Throughout your career, seek new certifications and roles that will broaden your abilities and experience, Mobile integrated health care, including role of community paramedic, is an example of how EMS roles are evolving.
95
Review 13 Confidentiality
as a health care professional and as someone who functions as a physician extender, you are bound by patient confidentiality
96
* Describe the EMT's role in the EMS system.
* EMT is one of the 4 levels of prehospital care. The EMT provides BLS, including AED, use of airway adjuncts, and assisting patients with certain medications.
97
*What role has the USDOT played in the development of the EMS system?
THE DOT has developed a series of guidelines, curricula, funding resources, and assessment tools that are designed to develop and improve EMS in the US
98
*List 5 roles/responsibilities of being an EMT?
any of the 19 will do
99
* Describe the two basic types of medical direction that help the EMT provide care.
1.) Online medical direction is provided through radio or telephone connections between the medical control facility.
2.) Off-line medical direction is provided through written protocols, training, and standing orders.
