System finance, data collection and analysis, informed consent Flashcards
Variable cost
Changes w/ each unit production activity (disposable medical supplies)
Marginal cost
Cost of producing or providing one additional unit (i.e ambulance)
Cost per capita
Total EMS cost / population served
Cost/transport
Cost per unit hour divided by Unit hour utilization
Unit hour utilization
Hours staffed ambulance ready / number of tasks
Total cost formula
Direct + Indirect + shared cost
1993 NHTSA uniform prehospital data set did what
First attempt at national standard for patient care reports
4 NEMSIS goals
- Establish a nationwide dataset with definitions for EMS systems
- Establish electronic data collection system for all local EMS systems
- Establish statewide database to assure quality of care
- Establish an aggregate nationwide database based on the 3 goals above
4 components of PCR
Front end - data entered
Database - data points
Exchange or interactive engine - uses health information exchange
Back end - used to generate points and data
First data tool that called for integration of PSAP, EMS, hospital and patient outcome data
Utstein template
Enumerative vs analytic studies
- Enumerative: Data set over fixed timeframe
effect of one action on study population
traditional clinical studies - Analytic: Examine performance in an ongoing manner (CQI)
effect of a provider’s action on studies
Common cause vs special cause variation
Common cause: difference due to natural variation
Special cause: changes in performance due to system changes
Belmont report sets what 3 ethical principals
- Respect for persons - autonomy to consent
- Beneficence - risks should be kept to absolute minimum
- Justice - Risks of study not borne by one population while benefits go to another
Common rule has how many levels of investigation? What are they
- Federal (institutional assurance)
- Institutional (IRV)
- Investigator
Who is responsible for informed consent in a study
Primary investigator
Exempt review for IRB approval should be what
Less than minimal risk
I.e de-intentified records, anonymous surveys
Excepted review for IRB key word
No greater than minimal risk
Ex: retrospective review of clinical data
Waiver of consent vs exception from informed consent
Waiver is a low risk study
EFIC is high risk
Ionizing vs non ionizing radiation
Ionizing - breaks bonds
Non-ionizing - excites bonds
Radiation sickness stages
Prodromal - n/v, anorexia
Latent - dose dependent, can be hours to week
Acute - bone marrow suppression, GI issues, CV and CNS issues
3 things that protect against radiation
Time
Distance - decreases as square of distance (most important)
Shielding
What blocks each level of radiation
Alpha - paper/clothing/skin
Beta - FF turnout gear
Gamma - need lead
Prussian blue treats what radiation
Cesium and Thallium
DTPA treats what radiation
Plutonium, americium and curium
Needs to be given within 24 hours of exposure
