Introduction to EMS Flashcards
"To hear is to forget, to see is to remember, to do is to understand" -Chinese Proverb
What is an EMS system? What is it part of? How is it governed and regulated?
- An organization (system) of community resources and personnel (e.g. health care professionals) who, in each area or jurisdiction, are responsible for and provide rapid medical care to the sick and injured.
- Part of a local or regional EMS system
- Standards of prehospital emergency care are governed by laws in each state (Title 22 for California)
- Regulated by the specific state office of EMS
What are the two absolutes of Prehospital Care?
- Your safety comes first - always (ensure the scene is safe for you in a variety of environements; scene size up)
- Do no harm to your patient
What is medical terminology? How does the terminology work?
- Medical terminology is language that is used to accurately describe the human body and associated components, conditions, processes and process in a science-based manner.
- The words are seperated in to parts…
1. Prefix
2. Word-root
3. Suffix
What is an electrocardiogram? (hint: medical terminology)
- Electro/cardio/gram = prefix/word-root/suffix
- Electro = electricity
- Cardio = heart
- Gram = unit of measurement
- Electrocardiogram: recording of the electrical activity of the heart
Define the following medical terminology…
- Periorbital
- Endotracheal
- Suprapubic
- Peri / orbital = around the orbit (eye)
- Endo / tracheal = within the trachea
- Supra / pubic = above the pubic area
What are the components of the EMS (Emergency Medical Services) system?
- General public: ordinary people, not professionals.
- Dispatchers: receiver and transmitter of messages to personnel
- First responders: persons trained/disignated to respond to emergencies (cops, paramedics, EMTs, etc…)
- Transporting agencies
- Hospital emergency departments
- Specialty Centers
What are the components of the EMS system according to the book?
- Public access
- Information systems
- Communication systems
- Evaluation
- Medical direction
- Clinical care
- integration of health services
- prevention
- Education systems
- Public education
- EMS research
- human resources
- legislation and regulation
- system finance
How do the components of the EMS system interact according to the __book?
- Incident/recognition
- access 911
- dispatch
- first responder
- basic life support
- advanced life support
- transport via air/ground
- emergency department/facilities
- specialty care
- patient rehabilitation
- prevention awareness
- public education
What is the difference between a hospital and specialty center?
- Hospitals are basic receiving facilities which can usually handle up to 90% of cases.
- Specialty Centers deal with specific problems such as…
- Trauma (serious, life-threatening injury)
- Pediatric (medical care of infants)
- Perinatal (medical care of, around time of birth)
- Burn (injuries from exposure to heat/flame)
- STEMI (heart problems)
Who are the prehospital care providers?
- First responders (i.e. EMR basic training; provides care until ambulance arrives such as police officers, fire fighters, etc)
- EMT-B (EMT-1): trained in BLS such as usage of an AED, airway adjuncts, and assisting patients with certain medications. (150 hrs+ training)
- AEMT (EMT-I; EMT - Intermediate): trained in specific aspects of ALS such as intravenous (IV) therapy, advanced airway adjuncts, administration of certain emergency medications. Useful in areas with limitations of paramedics. Help to offer higher skills than an EMT where paramedics are not available.
- EMT-Paramedic: extensive training in ALS such as with endotracheal intubation, emergency pharamocology, cardiac monitoring, and other advanced assessement and treatment skills. (800-1500 hrs+ training). Has an extensive knowledge and mastery of skills
- MICN (Mobile Intensive Care Nurse)
- Physician
What is a hospital diversion status? What are examples that might cause this to happen?
A hospital diversion status is a temporary status for a health care facilitiy in which it informs EMS that it cannot take any new patients.
- ER Saturation (So many people that the hospital cannot accomodate them all)
- Internal Disaster (Hospital is experiencing a disaster resulting in disfunction either in the form of a flood, fire, earthquake, computer system crash, etc.)
- CT(computed tomography machines could not be working in which we cannot see anatomic problems in the body that cannot be seen by convential x-rays)
- Trauma
- STEMI
What is the difference between EMT-1 and EMT-B?
- Nothing, they’re the same.
What is the department of transportion (DOT)? How are the National Highway Transportation Safety Administration (NHTSA) and DOT related?
- Federal Agency responsible for curriculum development of EMTs, you are transporting people (goods) therefore they are responsible and falls under their jurisdiction.
- The NHTSA of the DOT through the Highway Safety Act of 1966, and the Department of Health and Human Services, through the EMS Act of 1973, created funding sources and programs to develop improved systems of prehospital emergency care.
The “white paper” was an influencial report that detailed the inadequacy of supplies, ambulances and staff training. this lead to the Highway Safety Act of 1966
What is the job description of an EMT-B?
- Emergency care and transport of the sick and injured.
- Assist ALS personnel with patient care
- Provide transport between medical facilities (inter-facility transports)
- Complete required documentation & patient charting.
- Always work within the scope of practice
What are the goals of the EMT101A course?
- Prepare student to perform the functions of an EMT-B
- Prepare student to pass National Registry Examination (NRE)
What are the functions of the EMT?
- Care of vehicle and equipment
- Control of the scene
- Prompt and perform efficient care
-
Basic life support
- automated external defibrilation
- use of airway adjunct
- assist patients with certain medications
- Deliver babies
- Control bleeding
- Administration of certain emergency medications
- Providing oxygenation and emergency medications
- Assist in Advanced life support (ALS)
- Assist in Intravenous (IV) therapy (set-up, monitor it, not insert it)
-
Safe transport
- transport patient with a variety of illnesses and injuries
- Calm patient
- Transfer of patient to staff
- May be employed in health care setting
- Communications and record keeping
What are the certification requirements to be an EMT-B? What is it used for?
- Be 18 years old or older
- Have a valid course completion certificate
- Apply within 2 years of course completion
- Submit application and fees
- Pass a written certification examination
- Pass the background check
Certification Exams are used to ensure all healthcare providers have the same basic level of knowledge and skill.
What is title 22 of the CCR (California Code of Regulations)?
- State law defining the scope of practice for EMT-B’s, however a county can tailor it a bit differently.
What are disqualifying convictions in a background check that could prevent you from being an EMT-B?
- Violent crimes
- Sex related crimes
- Drug related crimes (including DUI)
What must an EMT-B do every 2 years?
They must recertify which could be done by…
- Completing a refresher course or..
- Obtain 24 hours of approved continuing education
- Then submit application and fees
What is the National EMS Scope of Practice Model? How was it created? What the scope of practice for an EMT-B encompass? How does licensure work into this? Remember, manage all patients within your scope of practice NOT OUTSIDE OF IT.
The National EMS Scope of Practice Model is a document that provides overarching guidelines as to what skills each level of EMS provider should be albe to accomplish. This was created by experts around the country to create this national standard. After the national scope, licensure serves as the state’s level to vary EMT practice for that state.
- Assessment of the sick and injured
- Obtain Diagnostic Signs
- Render BLS, Rescue, & First Aid
- Perform CPR
- Oropharyngeal & nasopharyngeal airways
- Oxygen delivery devices
- Suction devices
- Use AED - if employed and trained by AED provider
- Extricate entrapped persons
- Provide initial prehospital trauma care
- Perform field triage
- Use various body immobilzation devices
- Use various types of stretchers
- Administer oral glucose
- Set up ALS procedures
- Transport patients
What is the scope of practice for an EMT according to the book?
-
Airway and breathing:
a. humidifiers
b. partial brathing mask
c. venuri mask
d. manually triggered ventillators
e. automatic transport ventillators
f. oral and nasal airways -
Assessment:
a. pulse oximetry
b. manual and auto blood pressure - Pharmacological intervention:
a. assist with patients own prescribed medications including auto injector
b. may administer via the oral or buccal route
c. physician approved over the counter medications may be administered(aspririn, oral glucose, etc) -
Emergency trauma care:
a. spinal immobilization
b. seated spinal immobilization
c. long board
d. extremity splinting
e. traction splinting
f. mechanical patient restraint
g. tourniquet
h. MAST/PASG
I. cervical collar
j. rapid extrication -
Medical/Cardiac care:
a. mechanical CPR
b. assisted delivery of infant
What are ALS procedures that fall under an EMT-B’s scope of practice?
- Under IV monitoring
-Can use peripheral lines only (meaning the limbs)
-Glucose solutions & balanced salt solutions; no additives like drugs
>>>Glucose = dextrose (5% dextrone)
>>>Sodium chloride 0.9% = Normal Saline
>>>Lactated Ringers = ok
>>>5% Dextrose in .45% Sodium Chloride
-Monitor
-Maintain
-Adjust
-Preset rate-of-flow (Can do everything but start it)
Which patients can you transfer with a tube connected to them?
Patients with…
- Nasogastric tube
- Gastronomy tube
- Heparin locks & saline locks (patient connected to iv w/ nothing running)
- Foley catheters (urine transfer to a bag)