High Yield Bullet Points Flashcards
(112 cards)
1
Q
UHU formula
A
of transports / fully staffed ambulance hours
2
Q
Cardiac arrest rate
A
0.5-1 per 1,000 people
3
Q
Gas law responsible for decompression sickness
A
Henrys law
4
Q
BLS termination rule
A
Unwitnessed arrest
3 cycles (epi x 3)
No ROSC
5
Q
System status management
A
Term used to describe fluid deployment of ambulances to meet the changing demands in specific geographic areas
6
Q
Gas with garlic odor
A
Blistering agents
Organophosphates
7
Q
Gases with mothball odor
A
Naphthalene
Camphos
8
Q
Gas with pear odor
A
Chloral hydrate
9
Q
Gas with rotten egg odor
A
Hydrogen sulfide
10
Q
Freshly mown hay gas odor
A
Phosgene
11
Q
Gas with geranium odor
A
Lewisite
12
Q
What can an EMR do for airway
A
Airway adjuncts, BVM, O2 and suction, AEDs
13
Q
Lowest level that can give IN narcan
A
EMR
14
Q
What can EMR do with auto injectors
A
Give to themselves or peers (not to general public)
15
Q
What meds can an EMT give
A
IM Epi
ASA
Oral glucose
Duonebs
Assist patients in taking own nitro
16
Q
AEMT Meds
A
Nitro
Epi
Glucagon
D50
Albuterol
Naloxone
NO
17
Q
Lowest level that can obtain IV access
A
A-EMT
18
Q
AEMT Airway unique abilities
A
Advanced airway device placement (supraglottic, not ETT)
Suctioning of an already intubated patient
Waveform capnography
19
Q
3 tests EMT can do
A
12 lead acquisition
Blood glucose
Telemetry
20
Q
AEMT purpose
A
High benefit, low risk advanced skills for systems that cannot support or justify paramedic care
21
Q
What is Part 91
A
general operating fight rules, applies to all aircraft
22
Q
What is part 135
A
Air carrier certificates, commuter and on demand operations, and rules governing persons on board
23
Q
What is title 14?
What does it say?
A
Federal code for flying
FAA and part 135 holder responsible for for all aviation specific issues, (safety inspections, helicopter license, air traffic control)
24
Q
“Traditional model” for air EMS
A
Hospital owns aircraft
Another company holds part 135z
25
What does the airline deregulation act state
States have no jurisdiction over aviation aspects of EMS programs or economics of providing services
26
Cost effective analysis measures
Natural units such as years life gained or healthcare resources consumed
Reports as effect per unity cost
27
Cost utility analysis
Measures in quality adjusted life years
28
Cost benefit analysis
Measures effect of intervention in dollars
29
QA vs QI
QA: Emphasis on individuals performance, monitors and measures against a standard, reactive
QI: Emphasis on process, systems approach, proactive
30
Half of sea level barometric pressure at
18k feet or
5500 meters
31
Temperature decrease at altitude
3.5 degrees F or 2 degrees C for every 1k feet of elevation
32
TASER facts
50k voltes
0.36 J
19 pulses for 5 seconds
Operator can terminate/repeat
33
Most important factor determine outcome from OHCA
Systems of community care
34
AIRWAYS trial
No difference in survival or favorable outcome between Igel and ETI
35
PART trial
King LT vs ETI: favor king but overall very low success rate
36
PARAMEDIC 2 trial
epi had higher rate of 30 day survival over placeboes but excess severe neurological impairment in epi group
37
Smallpox clinical course
10-14 days of asymptomatic incubation
2-4 days of prodrome
Exanthem
38
Smallpox rash timing and distribution
Mucus membranes 24 hours before rash
Starts on face/hands/forearms
Spreads to lower extremities then trunk
39
Smallpox rash description
Firm, deep seated vesicles or pustules in the same stage of development without other apparent cause
Macules --> Vesicles --> Pustules --> Scabs
40
Smallpox vs chicken pox rash
Smallpox: centrifugal
Chickenpox: centripetal
41
Test for continuous data between two groups
Students T test
42
Test for continuous data between 3 or more groups
ANOVA
43
Test for ordinal data between 2 groups
Wilcoxon Rank-Sum test
44
Test for ordinal data between 3 or more groups
Kruskall-Wallis test
45
Test for categorical or binary data?
If less than 5 differences?
Chi square test
Fishers exact test for when <5 occurrences are measured in each category
46
What does a chi square test measure
Whether there is significant differences between treatment and outcomes when hypothesis is true
47
What test compares data from matched pairs
Wilcoxon-signed rank test
48
Highway safety act of 1966
Authorized funds to develop EMS standards and implement programs to improve ambulance service
49
EMS at crossroads
Reflected a very detailed evaluation of EMS, including current organization structure, service delivery, and finance
50
EMS act of 1973
Carved up EMS into regions
Gave 300 million
Defined 15 essential components
No focus on patient care
51
Omnibus reconciliation act of 1981
Comprehensive cost containment act that converted 25 DHHS funding programs into 7 consolidated block grants
52
EMS agenda for the future (1996)
goal to improve quality of community health
First document to emphasize clinical care and integration of EMS into healthcare system
53
EMS agenda for future considered EMS at junction of what 3 things
Public health
Public safety
Health care
54
First document to add role of medical director as essential
EMS agenda for the future (1996)
55
5 facets of 1996 EMS education agenda for the future
All national:
Core content, scope of practice, EMS education standards, EMS education accreditation, EMS certification
56
2 national standards for ambulance design
KKK-A-1822 and NFPA 1917
57
3 main components of essential system measures
1. Clinical sophistication
2. Response time reliability
3. Economic efficiency
58
What is business logic
Used in PCR to conform to defined parameters (can't put GCS 0 or male pregnant)
59
What is service quality
Experiences and perceptions of patients and other stakeholders
60
3 things associated with increased survival in traumatic cardiac arrest
Isolated stab wound to chest
Signs of life with EMS
Thoracotomy within 15 minutes
61
When to withhold CPR in blunt traumatic arrest
1. Apneic
2. Pulesless
3. No organized electrical activity
62
When to withhold CPR in penetrating traumatic arrest
1. Apneic
2. Pulseless
3. No other signs of life (pupillary response, movement, electrical activity)
63
What is regionalization
coordinated statewide system of care that combines out of hospital and in hospital components with public health
64
What is categorization
review against standards to classify facility capabilities
65
What is designation
formal selection for patient referral and transfer by an organizing body that has been given governmental authority to do so
66
What is accreditation
Process in which certification of competency or authority is presented
67
Non combustable source of CO
Methylene chloride
68
3 learning domains
Affective - understanding importance of skill
Cognitive - concepts of skill
Psychomotor - practicing skill
69
What is a CERT
Training civilian public in self sufficient disaster preparedness and response
Part of PPD8
70
Cerebral perfusion pressure formula
MAP - ICP
71
TBI severity
Mild: 14-15
Moderate: 9-13
Severe: 3-8
72
4 R's for treating intimate partner violence
Recognize
Response
Refer
Record
73
4 R's for trauma informed approach
Realization
Recognition
Response
Resist retraumatization
74
O2 L and FiO2 for NC
1-6 L
0.24-0.44 FiO2
75
O2L and FiO2 for simple facemask
5-8 L
0.4 - 0.6 FiO2
76
O2L and Fio2 for nonrebreather
10-15 L
0.9 - 100% FiO2
77
Malcom Bridge quality act
1987 - focused on quality standards
Response to ISO 9000
78
How long for DMAT to be self sufficient
72 hours
79
What does the national association of state EMS officials do
Facilitates interstate cooporation in areas such as patio transfer and reciprocity of EMS personell
80
What does OSHA 1910 state
requires departments to have medical screening programs and maintain records for 30 years after resignation
81
Peds ETT measurements
Size: 4 + (age/4) - uncuffed
Depth: 12 + (age/2)
82
Peds BP cuff measure
2/3 length of upper arm or 2/3 length of thigh
83
Ideal BW meds
Morphine, Ketamine, Roc and Vec,, Levo, Lidocaine, procainamide (Ideally MK Rocs PLeLi)
84
Total body weight meds
Fentanyl, Etomidate, Diltiazem, Succinylcholine, Benzos, Propofol (Total FEDS BP)
85
Determinant code vs response assignment
DC: Static, allowing for comparison among locals
RA: Response to present codes, varies on local EMS agency
86
Prussian blue antidote for
Cesium, rubidium, thallium
87
Hep B exposure and no vaccinaton
HBIG and begin series
88
Hep Exposure and vaccinated
Test: if not responding HBIG x1 and booster
If already known not responder: HBIG x1 and repeat series
89
LAPSS
Unilateral findings with facial droop, grip strength (drift), arm strength
Criteria:Over 45 years old, no hx seizures, not bedridden, symptoms < 24 hours, BG between 60-400s
90
Military echelons of care
1: scene to aid station
2: aid station to division level facility (forward surgical teams)
3: Transport to higher level of care (initial delivery of hospital care)
4: communications zone-level health service support (general hospital)
5: continental US hospital
91
OSHA part 1904
requires employers to keep records and report on work related injuries
Records must be kept for 5 years
92
ESAR-VHP
Emergency system for advance registration of volunteer health professionals
Network that pre-verifies credentials of volunteers who agree to serve during disaster
93
Medical reserve coops
federally funded network of medical and non medical volunteers who respond to disaster in local jurisdiction
94
Enumerative vs analytical study
Enumerative: data set over fixed period, traditional clinical study, clinical data
Analytical: on-going manner, evaluates providers actions on process, performance improvement
95
Types of IRB review
Not human subject: database, metaanalysis
Exempt: Less than minimal risk (de identified data, anonymous survey)
Expedited: No greater than minimal risk (retrospective review of clinincal data)
Full review: More than minimal risk
96
Driver diagram used for
Identify possible areas for change that may result in performance improvement
97
Levels of evidence in studies
I – well designed RCT
IIa – not randomized , well designed
IIb – case control/cohort, well designed
IIc – multiple or overwhelming data from less well designed trials
III – expert opinion
98
Evidence class recommendations
A – good evidence, service outweighs risks
B – Fair evidence (NR and R)
C – fair evidence, risks and benefits equivocal (most EMS lit) (LD)
D – fair, risk outweighs benefit
I – Insufficient evidence
99
What act funded NIMS
Homeland security presidential directive 5
100
PPD 8 recognizes what
recognizes the shared responsibility of government, the business community, and individual citizens in fostering a secure and resilient nation
101
Who grants CLIA
Centers for medicare and medicaid services
102
Operational level HAZMAT
Trained to protect nearby persons and the environment, and control the scene from a safe distance.
They are typically trained in initial containment, possibly vapor suppression and absorption, but do not enter the hot zone and do not don PPE.
103
Technician level in HAZMAT
Trained to control the substance release. They are trained and equipped with whatever level of PPE is needed (A through D). They also have extensive training in substance properties and appropriate tools needed to contain releases
104
Entity that has primary responsibility to coordinate state public health agencies in education the public on issues related to EMS
State EMS office
105
Lead agency for NDMS
Dept of health and human services
106
What agency manages the Strategic national stockpile
Dept of health and human services
107
What does the national medical response team do (NMRT)
provides decontamination and specialized care for victims of weapons of mass destruction events
108
Kinetic energy formula
(1/2 Mass ) x Velocity(squared)
109
3 essentail components of EMS integration with public health
1. Assessment
2. Policy development
3. Assurance
110
Decon vs Disinfection
Decon: removal of microorganisms to leave an item safe for handling
Disinfection: inactivation of disease producing microorganisms
111
Degredation vs Adsorption vs Absorption vs Neutralization
Degradation: Using one chemical to destroy the hazards of another
Adsorption: Uses a substance that binds the dangerous chemical and allows it to be removed
Neutralization: uses weak acids to neutralize bases and vice versa
Absorption: decreases the amount of the chemical by using towels, pads, etc.
112
