Flashcards in Exam 1: 1-6 Deck (146):
What is QA/QC?
Quality Assurance Quality Control
What is CQI?
Continuous Quality Improvement
What is the minimum number of compressions needed to get air into the inter-thoracic pressure?
What was the first war EMS was used in?
What is the percentage of HALO cases?
High acuity low observation 10% of babies, infants, small children
What is EMD?
emergency medical dispatch
What is EMR?
emergency medical responder, cops and firefighters no drugs
What is EMT
emergency medical technician can give med and do basic life support
What is advanced life support ?
goes with patients
What is paramedic?
What is medical control?
a physician who assumes the ultimiate responsibility for medical direction or oversight of the patient care aspects of the EMS system they oversee training, develop protocols (lists of steps for assessment and interventioins to be performed in different situations).
• EMT is operating as a designated agent of the position acting under their license.
What is a medical director
the medical director is the person who presides over the entire emergency system as they are under their license.
What is a standing order?
physician issues policy or protocol authirizng EMTs to perform skills in certain situations. off-line medical direction
What do you do on call?
your priorities are your one safety, your partners safety, then the patients safety, then bystander safety. Best to stay calm because it is their emergency and not yours so use common sense. Elicit information from patient and process it try putting tape on leg or index cards to write down information. It is important to detach yourself from the situation while still being compassionate, you must get permission to treat, it is important for communication and reassurance for the patient, partner, and family. Call hospital and medical control and diagnose and treat the patient while staying composed
What occurs after a call?
paperwork, remembering details, if you make a mistake on the report put a single line through it and initial and correct if you haven’t turned it in yet. if you did turn it in write an amendment. PCR- patient care report, a legal document and you can requet a follow up or find up from the doctors about the patient after you filed your report. Keep up your certificate every 2 year. Cant tell anoyne about call or patient including family. It is important ot have integrity, as a legal platform there is always drugs and seeing other people in bad ways and it is important to stay about the board. Taking car eof someone with personal difficulty is difficult as they may seem immoral to you, be an abuser but you must put aside pre-determined judgement and don't become biased.
What is NHTSA?
• National Highway Traffic Safety Administration Technical Assistance Program
What does NHYSA do?
EMS in certain states must have sstandards, regulation and policy, resource management ( so that everyone get equal access to care by a certified license equipped), human resources and training (everyone should be EMT level), transportation, facilities communications, public information and education, medical direction, trauma systems, evaluation.
What is the role and responsibility of the EMT?
personal safety, safety of crew, patient and bystanders, patient assessment, patient care, lifting and moving, transport, transfer of care, and patient advocacy.
What is a designated agent?
an EMT or other person authorized by a medical director to give menedicaitona nd provide emergency car.e the transfer of such authorization to a designated agent is an extension of the medical director’s license to prcctice medicine
What is the 911 system
a system for telephone acces to report emergencies a dispatcher takes the information and alerts EMS or the fire or police department as needed with enhanced 911 having the addiitoinal capability of automatically identifying the caller’s phone number and location.
What is quality improvement?
a process of continuous self-review with the purpose of identifying and correcting aspects of the system that require improvement
What are pathogens?
organisms that cause infection and diseases, such as viruses and bacteria;.
What are the four common modes of transmission of pathogens?
blood borne, droplet, airborne, and contact
What is blood borne transmission?
- transferred through blood or other body fluids to mucous membranes or small exposed breaks
What are airborne pathogens?
spread by tiny droplets sprayed during breathing, coughing, or sneezing spread through eyes or when you inhale.
What are standard precautions?
a strict form of infecition control that is based on the assumption that all blood and other body fluids are infections.
What are things for well-being for EMTs?
maintaining solid personal relationship, exercise, sleep, eating right, limiting alcohol and caffeine intake, seeing your physician regulatarly and keeping up to date on vaccines.
What is PPE?
personal protective equipment. equipment that protects the EMS worker from infection and/or exposure to the dangers of rescue operatons.
What is contamination?
the introduction of dangerous chemicals, disease, or infectious materials
What equipment do you wear then?
• gloves needed when possible contact with bleeding, suctioning, artificial ventilation, and CPR. wear front and side protective eyewear. with blood or fluid splatter wear a surgical type mask, such as tubervulosis which u wear high efficieny particulate air respriator (HEPA). wear gown for spilled or splashed fluids such as spurting bleeding such as childbirth and patients with multiple injuries along with mask, glove, and eye protection. always have personal protective equipment immediately available on person and in kits, carry two sets of glove in case they tear. if you think a patient has any kind of flu make sure to put a mask on them before entering th hospital.
What is hepatitis?
infection cuasing inflammation of liver comes in A, B, and C and other strains. Hepatitis A- food or water contaminated by feces, others are thorugh contact with blood and other body fluid. B can survive in dried blood spills posing a risk of transmission many days later and is deadly but has vaccine. C is the same thing but there is no vaccine
What is tuberculosis?
infection settles in lungs can be fatal, made a comeback 1980s, highly contagious spread through air, especially in nursing homes, drug treatment centers, correctional faciliites, or homeless shelters. productive cough (coughing up mucus or other fluid) and/or coughing up blood, weight loss and loss of appetite, lethargy and weakness, night sweats, and fever.
what is AIDS?
(acquired immune deficiency syndrome)- immune system had been attacked by HIV and is no longer able ti combat infection adequately.
what are the standards for infection control?
infection exposure control plan (possiboility of contact), adequate triaing and education, hepatitis B vaccination, personal protective equipment, methods of control, housekeeping, labeling, and postexposure evaluation and follow-up
What is the Ryan White Care Act?
procedure by which emergency response personnel can seek to find out if they have been exposed to potentially life-threatening disease while providing patient care to firefighters, law enforcement, and EMTs. including Tb, bloodbonrne hep. B HIB/Aids diphtheria and rabies but hospitals do not have to physically test patient just see if they did in the past but through disability EMT can take anti-viral right away to get rid of problem
What is stress?
a state of physical/psychological arousal to a stimulus. response to stress: alarm reaction (fight or flight), stage of resistance (back to normal), exhaustion(can no longer adapt easier to be ill)
What is a critical incident?
any situation that triggers a strong emotional response ex. Catastrophes natural disaster, major injury or death. can affect physical cognitive (ability to think), emotional or behavioral get help if (chest pain, difficulty breathing, or abnormal heart rhythms) or (uncontrollable crying, inappropriate behavior, or disruption in normal rational thinking as long as don't pose immediate threat to health, safety or wellbeing.
what is acute stress incident?
occurs simultaneously with or shortly after critical incident, fight or flight response activating the sympathetic nervous system
What is delayed stress reaction?
(PTSD)- many times over the course of the career occur at any time, days to years following incident. flashbacks, nightmares, feelings of detachment, sleep difficulties, or problems with concentration or interpersonal relationships
What is cumulative stress reaction?
(burnout)- occurs as a result of prolonged recurring stressor in our work or private lives. ex. anxiety, progressing to boredom and apathy and emotional exhaustion. physical complaints headache or stomch, sleep distrubances, lack of emotional control, irritiability, withdrawal from other, and increasing depression. leading to migraines, increased dangerous behavior, poor relationathsip, limited self control and depression. leading to paranoia withdrawal and suicidial thoughts. worse calls multiple casualty, children and infants, sever injuries with deformation, ampuations deep wounds and violent deaths, abuse and neglect and death of a friend.
What is an (MCI)?
multiple-casualty incident with an emergency involving multiple patients
What is SIDS?
sudden infant death syndrome.
What is eustress?
a positive form of stress that helps people work under pressure and respond effectively. productive responses-parasympathetic response food and sex
What is distress?
makes it harder to have a productive response
negative when things become overwheleming and your response making response not effective symptoms: irritability with family, friends, an inability to concentrate, difficult sleeping, loss of appetite, anxiety, indecisiveness, guilt, isolation.
What is CISM?
• critical incident stress management, )- a comprehensive system that includes education and resources to both prevnt stress and to deal with stress appropriately when it occurs usually related to an incident.
What are the stages of dealing with death?
denial “not me,” anger “why me?” (vented at others), bargainaing “ok, but I first let me,” depression “ok, but I haven’t” (unwilling to communicate), and acceptance “ok, im not afraid.”
How do you confront a dying patient?
recognize needs (respect, preserve dignity and sense of control, be tolerant of angry reactions form the patient or family members, listen, do not falsely reassure, offer as much as you can.
What is a hazardous material incident?
release of a harmful substance into the environment
What is decontamination?
removal or cleansing of dangerous chemcials and other dangerous or infectious materils. don't take patient in ambulance or hospital until done so. wait for specialist for things
How do you respond to danger?
plan(wear safe clothing, prepare your equipment so it's not cumbersome, carry a portable radio, decide on safety roles), observe (violence, crime scenes, drug and alcohol use, weapons, family members, bystanders, perpetrators, pets call police if you suspect and if unusual silence), react- retreat, radio, reevaluate(flee- put 2 major obstacles in your way, get rid of any cumbersome equipment, take cover and conceal yourself). if drugs or weapons are found on patients call police and cease care.
What is brucella?
chicken pox contagion to adults who have had it before will get shingles if never had it before its chicken pox.
What is the flu?
mouth open with a stuffy nose (airway problems), pale, nailbeds and lips blue (hypoxic) needing oxygen- contagious.
What is measles?
predominantly raised rash
What is meningitis?
red spotted rashes, swollen neck and trouble swallowing
What are the symptoms of a person with psychological problems?
hands up near face, eyes closed, not wanting to act
What is hepatitis?
liver failure ,yellowing having hepatitis, distended belly
What is the asthma attack?
coffee, grunt, tripodding to open up chest
What are standard precautions?
PPE (personal protective equipment, gloves, goggles, face shield, fully gowned, mask), BSI (body condom gloves), and hand-washing
What is PPE?
personal protective equipment
What is BSI?
body substance isolation
What is a localized infection?
contained to one area
what is a generalized infection?
two or more body systems?
What is the contact route of exposure?
ingestion touch an object or another human
What are some other modes of infection?
insects, water, maternal-fetal, oral, fecal, sexual.
What do you wear when u suspect an airborne infection?
PPE, hand hygiene, wear masks, keep door closed, AIIR (patient actively coughing put a mask on them).
What do you wear when u suspect an droplet infection?
PPE, hand hygiene, wear masks, private room
What do you wear when u suspect a contact infection?
gloves, hand hygiene, gowns, clean patient care equipment
What do you wear when u suspect a blood borne infection?
PPE, hand hygiene, disposal of blood stained items into bio bags, use sharps containers, sterilize blood stained linens.
What is body mechanics?
the proper use of the body to facilitate lifting and moving and prevent injury
What is the power lift?
legs should be spread about 15’ apart (shoulder width), place feet so center of gravity is balanced, with your back held upright, bring your upper body down by bending the legs, grasp the patient/stretcher, lift patient by raising your upper body and arm and straightening your legs until standing, keep the weight close to your body.
What is the power grip?
gripping with as much hand surface as possible in contact with the object being lifted, all fingers bent at the same angle, and palms up (so don't drop it) , hands about 10’ apart, all fingers at same angle, fully support handle on curved palm
What do you do to prevent injury?
position feet properly, use legs, never turn or twist, do not compensate when lifting with one hand, keep the weight as close as possible to your body, use a stair chair when carryin a patient on stairs whenever possible
What do you do when reaching?
keep back in locked position, avoid twisting, avoid reaching more than 20 in, avoid prolonged reaching when strenuous effort is required
What do you do when pushing or pulling?
push rather than pull whenever possible, keep your back locked, keep line of pull through center of body by beiding knees, keep weight close to body, if weight below waist push or pull from kneeling position, avoid pushing or pulling overhead, keep elbows bent and arms close to sides.
What is an emergency move?
patient moved to a safe place before you have time to complete or begin assessment so consider possible spinal injuries. ex: hazardous scene such as uncontrolled traffic, fire or threat of, possible explosions, electrical hazards, toxic gases or radiation. care of life-threatneing conditions requires repositioning- reach bleeding or to do cpr, when u have other patients. move patient in direction of long axis of body. drag by clothes feet or blanket. use when there is potential for danger before assessment and management, repositioning required to care for life-threatening conditions, must reach other patients. must have life threatening element to it with no special precaustions. fire
What is an urgent move?
abbreviated assessment when patient extricated place on spine board or carrying device to perform assessment and patient care. must be moved quickly for treatment of an immediate threat to life with precautions for spinal injury. ex. required treatment performed only if patient is moved if needed to support inadequate breathing or to treat for shock or altered mental status, or factors at the scene cause patient decline such as head or cold or immediate threat to life or suspicion of spine injury. necessary to move patient with altered level of consciousness, inadequate ventilation, shock. with rapid extrication technique requires team of knowledgeable EMTs. little bit of time have to move
What is a non-urgent move?
on scene assessment and care procedures then move onto stretcher. No immediate threat to life, when ready with any on-scene assessment completed first and in order to prevent injury and avoid discomfort and pain. used when both scene and patient are stable
What is a patient carrying device?
a stretcher or other device designed to carry the patient safely to ambulance and/or the hospital. ex. must lock stretcher, move patient closest to the ground. do not lift or move with an odd number of EMTs.
What is a power stretcher?
will lift a patient from the ground level to the loading position or lower a patient from the raised position using batter powered hydraulic system that manufacturers state will lift patients on 20 consecutive runs lifitn patients 700 pounds.
What is a manual stretcher?
lifted by EMTs “self-loading stretcher and standard stretcher. 4 EMTs over rough ground make sure to secure them to the stretcher before them
What is a bariatric stretcher/
having to do with patients who are significantly overweight or obese. 800 pounds
what is a stair chair?
- benefits for moving patients from scene to stretcher excellent, easier to use on tight corners and up or down narrow staircases in a sitting position reducing length of patient and device and can be rolled like wheelchair and tracklike system to roll down staircase. requiring two people. Ideal for patients with difficulty breathing, but isn’t used for patients with neck and spine injury, unresponsive patients, and those with altered mental status or airway care.
What is a spine board?
two types or backboards, short and long. used for patients found lying down or standing and who must be immobilized. short ones- removing patients from vehicles when a neck or spin injury is suspected
What are the kinds of portable stretchers?
scoop, basket, flexible, vacuum
What is a scoop stretcher?
or orthopedic stretcher, splits into two pieces vertically allowing patient to be scooped pushing halves together under him doesn't offer support under spine, not used for patients with spinal injury
What is a basket stretcher?
stokes stretcher, move a patient from one level to another or over rough terrain, lined with blanket
What is a flexible stretch?
Reeves stretcher, canvas or rubberized with wooden slats used in restricted areas or narrow hallways felxibleness.
what is a vacuum mattress?
patient placed on device and air withdrawn, becoming rigid and conforming, padding voids naturally for greater comfort reducimg some of discomfort associated with rigid backboards.
Before beginning a lift?
important to estimate weight, knows own limitations, plan and communicate with partner by protecting yourself with body mechanics.
What is the rules for lifting?
keep weight as close to your body as possible, use power grip, use lower lift, whenever possible, use stair chair when carrying patient on stairs, do not further harm, move the body as a unit, only one rescuer gives commands.
What are some added considerations when lifting ?
geriatric patients- kyphosis (unnatural curvature of thoracic), spondylosis (spinal fusion lack of mobility), lordosis (unnatural curvative of lumbar spine, scoliosis (unnatural curvature of lateral spine) , and anxiety. use a scoop and pad around the dip in scoop,
Patients: head size and weight, equipment size, and fear. Any patient on stretcher in ambulance needs 5 point restraint while on cot
What are some patient moving devices?
heeled stretcher (striker- all terrain power stretchers), stair chair, spine boards (long, short with rigid and vest), portable stretcher, scoop stretcher, rescue medicine: basket stretcher (stoke), flexible stretcher (reeves).
What is supine?
What is prone?
What is fowlers?
need flu patients or heart failure patients
What is lateral recumbent?
lay on side.
What is dyspnea?
What is apnea?
What is hypo perfusion?
shock, physiological condition not suitable to life with an increase in heart rate, respiratory rate, and decrease in blood pressure. if loss of a lot of blood pushes it to the heart put in trendelenburg shock position of feet high but if cushings triad- increasing intercranial pressure, patient with a history of head injury, heart rate going down, respiratory rate drop or develop funky pattern and blood pressure go up can cause death brain pushed out of vault.
What is legal?
(must) is carrying out the msuts based upon the condition agreed upon by a large body, have to prove illegal or not and there are conditions with that proof.
What is ethical?
(should)- collective moral and a decision about something,
what is the scope of practice?
a set of regulations and ethical considerations that define the scope or extent and limits of the EMTs job. anyone at the same level of training is able to do. Assesment, treatment within our scope of practice. C-sections are not within scope of practice.
What is the standard of care?
for an EMT providing care for a specific patient in a specific situation the car ethat would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation
What is consent?
permission from the patient for care or other action by the EMT
What is expressed consent?
consent gven by adults who are of legal age and mentally competent to make a rational decision in regard to their medical well-being. informed consent and the patients must understand risks of care explaining procedures. (not saying no and allowing you to render care not written)/informed- (person knows refusal of competent person needs to be explained and documented three times, this is what we think it is, do u understand if we don't take you, try to get them to sign your own and someone elses and not your partner if possible)- tell them who you are and the level of care you can provide and ask to take care of you. if they go with you but cant understand they are consenting
What is implied consent?
the consent it is presumed a patient or patient’s parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed. unconscious and unresponsive, or under influence cant make rational decision assuming responsibility for this decision. do they know name, where they are. can get section 12 if the person seems a threat to themselves or others calling police and wriitng an order that you need to take them.
what is in loco parentis?
in place of a parent, indicating a parson who may give consent for care of a child when the parents are not present or able to consent. Children are emancipated, in armed forces or have their own children can provide consent for themselves.
what is DNR?
a legal document usually signed by the patient and his physician, which states that the patient has a terminal illness and does not wish to prolong life thorugh resuscitativce efforts. if the family says to ignore the DNR contact medical direction for advice and to speak to the family
What is Supra ventricular?
rapid heart rate originating form above the ventricle
What is intercostal retractions?
in between the ribs the muscles are sucking in
What is hemiplasia?
what is retroperitoneal?
behind the abdominal cavity
What is pericarditis?
inflammation round the heart
What is epistaxis caused by digital rhinectomy?q
bloody nose by picking his nose.
What is refusal?
o patient can refuse care if of a legal age or emancipated minor, awake and oriented not affect by disease impairing judgement, and must sign a form. try talking to them or calling doctors, family (careful) or police) then document everything you tried and call someone to stay if refuses but anything significant should come.
what is assault?
placing a person in fear of bodily harm by subjecting the patient to unwated care and transport
What is battery?
- causing bodily harm to or restraining a person
What is negligence?
finding of failure to act properly in a situation in which there was a duty to act, that needed care as would reasonably be expected of the EMT was not provided and that harm was caused to the patient as a result. could occur if did not provide standard care, filure to act,
What is proximate cause?
- damages to the patient were the result of action or inaction of the EMT and by not providing standard of care they caused harm physically or psychologically does not count If seriously injured and cannot be saved.
What is WNL?
within normal limits
What is ASA?
What is AMI
Acute myocardial infarction
What is CP
What is HA
what is CPR?
What is AED
automatic external defribilator
What is FBAO
Foreign body airway obstruction
What is duty to act?
- an obligation to provide care to a patient
what is abandonment?
leaving a patient after care has been initiated and before the patient has been transferred wto someone with equal or greater medical training
what are the good samaritan laws?
series of laws, varying in each state designed to provide limited elgal protection for citizens and some health care personnel when they are administering emergency care. it is always better ot provide care and less legal problems associated with it than abandoning
What is confidentiality?
the obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient’s care or under subpoena or in a court of law or when the patient has signed a rlease of confidentiality
What is HIPPAA
health insurance portability and accountability act, including privacy rule protecting privacy of patient-soecific health care information and providng patient with control over how this information is used and distributed
what is pathology?
study of disease
What is pathophysiology
study of diseases on body
What is libel?
flase injurious information in written form
what is slander?
flas injurious information stated verbally
What is safe haven law?
a law that permits a person to drop off an infant or child at a police, fire or EMS statin or to deliver the infant or child to any available public safety personnel. the intent of the law it to protect children who may otherwise be abandoned or harmed
What is competence
(conscious, no mind altering things, adult over 18/21, legally consent, are informed)
What is involuntary consent?
court order, physician order of where they need to go because they are a danger to themselves. Emancipated pregnant/when have child- can provide for yourself, place to live and eat,
What are • DNR/CCDNR/MOLST?
Do not recessitate hopeless and inactive- CPR if you witnessed it)/(comfort care do not resuscitate- nothing invasive but can give things for comfort like morphine etc. cant start CPR)/(Medical orders for life sustaining treatment- specifics can start CPR no intubate or shock etc.
What are three kinds of negligence?
misfeasance, nonfeasance, malfeasance
What is misfeasance?
do the right thing but you don't do it right,
what is nonfeasance?
didn't do something you were supposed to do
what is malfeasance?
doing things because you don't like them you didn't need them. can hit back if attacking you
What is mandated to report?
- obligated and must report child abuse or neglect form 51A, document as much as you can fill out report and give to physician in ED. Must file 15A for elder abuse or neglect with equal amount of cases for both. elder abuse hard to see because of skin quality. 55 and above or 65 and above. other things may be mandated by state/