Operations Flashcards
Stroke Destinations
Centennial Hills
Desert Springs
Mountain View
Southern Hills
Spring Valley
St. Rose San Martin
St. Rose Siena
Sumerlin Medical Center
Sunrise
UMC
Valley
Pediatric Destinations
St. Rose Siena
Summerlin
Sunrise
UMC
L&D Destinations
Centennial Hills
Henderson
Mesa View
Mike O’Callaghan Federal
Mountain View
Southern Hills
Spring Valley
St. Rose San Martin
St. Rose Siena
Summerlin Medical Center
Sunrise
UMC
Valley
When should you establish telemetry contact?
- All time-sensitive or life-threatening condition transports
- Medical emergency in which EMS judgment suggests consultation with a telemetry physician is necessary
- All trauma pts going to trauma center
- Telemetry contact required per protocol
TFTC telemetry reports should include
ETA
Pt Age
Gender
MOI
Ambulatory at scene
Suspected injuries
Vital signs
Airway statis
Neurological status
Incident identifier if multiple pts involved
What should be included in telemetry for suspected Contact Isolation?
- General type of agent involved (insect, chemical, biological, radiation, nuclear, explosive)
- Type of agent if known
- General type w/ patient symptoms (Unkown chemical substance causing respiratory distress w/ secretions)
What are the minimum requirements for non-traumatic or Contact Isolation telemetry?
“Information Only Telemetry”
Attendant/vehicle identification
Nature of call
Patient information - age, sex, number
Patient condition - stable, full arrest
Hx - cc, pertinent sxs, time of onset, pmh
Objective findings - general status, level of responsiveness, vital signs, pertinent localized findings, working impression of pt’s problem
Treatment- in progress, request for drugs or procedures
ETA - include circumstances that may cause delay
For patients meeting “Code White” or “Code STEMI” criteria…
A preliminary telemetry report should be made to notify the receiving facility of the type of activation, and ETA. “Information Only” telemetry should follow once transport is initiated.
Supportive Care
Suction
Administer oxygen
Position for comfort
Splint
Control bleeding
Pain medication (ALS only)
Emotional support
Contact hospice, home health agency, attending physician or hospital
What is a valid DNR?
Form, wallet card, or medallion issued by SNHD. NV Division of Public and Bhavioral Health, or an identification issued by another state
What is a DNR Order?
Written directive issued by a physician licensed in this state that life-resuscitating treatment is not to be administered to a qualified patient.
What is a POLST?
A physician that records the wishes of the patient and directs a healthcare provider regarding the provision of life-resuscitating treatment and life-sustaining treatment.
The DNR/POLST ORder or Idenfitication can be determined invalid if
at any time the patient indicates that they wish to receive life-resuscitating treatment.
What is considered Life-Resuscitating Treatment?
CPR and its components including:
Chest compressions
Defribrillation
Cardioversion
Assisted ventilation
Airway intubation
Administration of cardiotonic drugs
Protocol if you are unwilling or unable to comply with DNR?
Must take reasonable measures to transfer pt to another provider or facility in which the DNR/POLST will be followed.
A patient is:
Anyone with a complaint or mechanism suggestive of potential illness or injury
Obvious evidence of illness or injury
Individual or informed 2nd/3rd part caller requests evaluation for potential illness or injury
PCRs shall include no less than:
Patient’s name, address, age, and sex
Date and location of call
Time of dispatch, arrival at scene, departure from scene, and arrival at hospital
MOI - cc
Medications sed by pt and allergies
PMG, including current medication and allergies
SXS identified during assessment and changes
Care and tx given at a scene and during transport
Pt destination
Name of attendants
If care is provided as authorized by protocol
File attachments
Trauma score, TFTC status, and injury mitigation devices in cases of trauma
At least one full set of vital signs
What file attachments should be included in PCR?
- Assessing and/or monitoring cardiac rhythm
- Obtaining a 12-lead EKG
- Providing electrical therapy, cardioversion, defibrillation, and/or pacing
- Monitoring ETCo2 levels and/or waveform of an intubated pt
What is included in a full set of vital signs?
BP
HR
RR
Temp as indicated
Oxygen saturation
Reassessment after interventions
Any complications or other relevant information
Definition of Hostile Mass Casualty Incident
Persons under assault require the immediate need for teams to enter the warm zone to provide initial tx and triage.
Patients who appear to have expired will not be resuscitated or transported by EMS if:
Any of the obvious signs of death are present OR all 5 presumptive signs of death and at least one conclusive sign of death
What is required to perform before contacting medical control for a traumatic injury suspected to be incompatible with life?
Perform 2 minutes of CPR
Obvious signs of death
A. body decomposition
b. decapitation
C. transection of thorax (hemicorpectomy)
d. incineration
e. other traumatic injuries suspected to be incompatible with life, medical control must be contacted for medical direction.
Presumptive signs of death
- unresponsiveness
- apnea
- pulselessness
- fixed, dilated pupils
- non-traumatic arrests, asystole in two leads, or “No Shock Advised: prompt from AED