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Special Issues in Emergency Care and Resuscitation > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

1485

A
  • first use of an amblulance

- transport only

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2
Q

1800s

A

-first use of an ambulance/attendant to care for injured on site

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3
Q

1926

A

-service started similar to present day

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4
Q

1940

A
  • EMS turned over to fire and police department
  • no set standard of care
  • police and fire dept were well established and funded
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5
Q

20th century and modern technology

A
  • mad major strides after WW2

- bringing hospital to field have patients a better chance for survival

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6
Q

korean war

A
  • first use of helicopter for transport (not care)
  • helicopters flew to the MASH units were they would give care
  • MAS*H units
  • mobile army surgical hospital -> MASH
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7
Q

1956

A

-mouth to mouth resuscitation developed

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8
Q

late 1950s/early 1960s

A
  • focused shifted to bring hospitals to patients

- mobile ICU developed

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9
Q

1966: White paper released

A
  • finding included:
  • lack of uniform laws and standards
  • sickest people were treated by the newest doctors
  • poor quality equipment
  • lack of communication -> no 911
  • lack of training -> therefore funding
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10
Q

white paper finding outlined 10 critical points for EMS system

A
  • one of the points led to this
  • one of the leading causes of death and disability was traffic accidents -> this led to….
  • led to national highway safety act
  • created US department of transportation
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11
Q

1968

A
  • training standards implemented

- 911 created

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12
Q

1969

A
  • first true paramedic program
  • standards for ambulance design and equipment
  • cardiologist and trauma were the first bc cardiovascular disease and vehicle accidents were the leading causes of death
  • Pittsburgh, Florida, seatile, washington
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13
Q

1970s

A
  • 1971- emergency care and transportation of the sick and injured published by AAOS
  • 1973- emergency medical service act- says that states regulate EMS not federal gov -> some state gave money to counties making it more separated
  • this is how standard precautions become blurry
  • 1977- first national standard curriculum for paramedics developed by US DOT
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14
Q

1970

A
  • NREMT began
  • nation registry of EMT
  • emergency physicians are still not recognized at this time
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15
Q

1980s/1990s

A
  • number of trained personnel grew
  • NHTA developed 10 system elements to help sustain EMS system
  • responsibility for EMS to the states
  • major legislative initiatives
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16
Q

licensure

A
  • granted by a government body
  • by state
  • licensure is overall scope of practice
  • how states control who practice
  • also known as certification or credentialing
  • unlawful to practice without license
  • certification is a standard that you have met with baseline amount of knowledge -> just cause you are certified doesnt mean you can do it
  • your work will credential you to do certain things -> different job, different scope of practice
17
Q

holding a license shows you…

A
  • completed initial education

- met the requirement to achieve the license

18
Q

reciprocity

A
  • licensure between two states
  • each state has different reciprocity requirements
  • certification granted from another state/agency
  • requirements:
  • hold a current state certification
  • be in good standing
  • national registry certification
19
Q

EMTALA

A
  • The Emergency Medical Treatment and Labor Act (EMTALA)
  • unfunded mandate- law said you have to do this
  • no one could stay open if they arnt being paid
  • said that you cant decide to treat someone based off funds and insurance
20
Q

the public needs to be taught how to:

A
  • recognize emergencies
  • activate the EMS system
  • provide basic care
  • bystander CPR significantly increases survival rate
21
Q

patient outcomes are determined by:

A
  • bystander care
  • dispatch
  • response
  • prehospital care
  • transportation
  • emergency department care
  • definitive care and rehabilitation
  • bleeding control (tourniquets)
22
Q

dispatcher

A
  • usually the publics first contact
  • training level varies from state to state
  • scene may differ from what dispatcher relay…how can future tech change this
  • getting information about the patients and situation and then sending specific treatment units -> can you misread the situation or the patient misreads the situation and the wrong unit is sent?
23
Q

levels of education

A
  • EMS system function from a federal to local level
  • federal- national EMS scope of practice model…EMS agenda for 2050
  • state: licensure
  • local- service medical director
  • the national guideline designed to create more consistent delivery of EMS nationally
  • 2009- national EMD education standard -> NREMT provides a national standard for testing and certification
24
Q

EMT

A
  • formerly EMT-basic
  • primary provider level in many systems
  • most populous level in the system
  • what kind of service are EMT the most populous volunteer ambulance services
25
Q

paramedic

A
  • highest level to be nationally certified (outside of hospital)
  • 1999- major revision to curriculum to increase level of training and skill
  • 1,600-2000
  • even if independently licensed you must:
  • function under the guidance of a physician
  • be affiliated with a paramedic level service
26
Q

improving system quality

A
  • goal- evaluating and proving patient care
  • continuous quality improvement
  • quality assurance
27
Q

continuous quality improvement (CQI)

A
  • tools to continually evaluate care
  • process of assessing current practice looking for ways to improve
  • dynamic process
  • mistakes will be made, we are only humans -> we need to limit mistakes and consequences
  • limit hours someone works -> decreases mistakes
  • make sure the system supports making good choices
28
Q

1996 institute of medicine

A
  • launched efforts to improve patient safety and quality of care
  • at least 44,000 and may up to 100,000+people die in hospital each year as result of medical errors
  • better care or more money
29
Q

summary

A
  • ambulance corps were developed in WW2 to transport and rapidly care for solders
  • helicopter evacuation (MEDVAC) implemented during the Korean war
  • 1966 the national academy of sciences and the national research council released the white paper
  • practitioners at all levels must be licensed
30
Q

emergency medical service act

A
  • 1973

- says that states regulate EMS not federal gov -> some state gave money to counties making it more separated

Special Issues in Emergency Care and Resuscitation (15 decks)

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