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Paramedic Medicine
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467
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Undergraduate 1
09/12/2013

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Term
Identify the key elements necessary for effective EMS system operations.
Definition
Citizen Activation, Dispatch, Prehospital Care, Hospital Care, Rehab
Term
State EMS Systems are responsible for...
Definition
Managinng the delivery of prehospital care; working with regional and state agencies to create protocols, standards and guidelines; providing collection services; and coordinate mutual aid and disaster planning.
Term
Advisory councils are responsible for...
Definition
Organizing EMS programs/activities and acting as liaison with national agencies.
Term
Advisory councils are made of...
Definition
Medical professionals, paraprofessionals, consumers, public and private agencies.
Term
NEMSIS is responsible for...
Definition
Developing nationwide EMS training curricula; evaluating patient/EMS system outcomes; facilitating research efforts; and addressing resources for disasters/domestic preparedness.
Term
What are the five components of the EMS Education Agenda for the Future: an EMS Approach?
Definition
-National EMS Core Content
-National EMS Scope of Practice Model
-National EMS Education Standards
-National EMS Certification
-National EMS Education Program Accreditation
Term
The National EMS Core Content component of the National EMS Education Agenda...
Definition
Defines entire domain of out-of-hospital practice; identified universal body of knowledge and skills for personnel.
Term
The National EMS Scope of Practice Model component of the NEEA...
Definition
Defined four levels of EMS personnel and minimum skills for each level.
Term
The National EMS Education Standards component of the NEEA...
Definition
Defines competencies, clinical behaviors, and judgments; goal is to meet practicing guidelines.
Term
Refers to the way in which a person follows the standards of a profession.
Definition
Professionalism
Term
Allows a person to engage in a profession or activity that otherwise would be unlawful; granted by govt authority.
Definition
Professional Licensure
Term
Grants authority to a person to take part in an activity; received from a government or nongovernment entity.
Definition
Certification
Term
The act of enrolling one's name in a register or book of record.
Definition
Registration
Term
Local process that allows a paramedic practice in a specific EMS agency, guided by a medical director.
Definition
Credentialing
Term
List the characteristics of the professional paramedic.
Definition
Integrity, Empathy, Self-motivation, Appearance and personal hygiene, self-confidence, communications, time mgmt, teamwork and diplomacy, respect, patient advocacy, and careful delivery of service.
Term
What are the benefits of on-line control?
Definition
Good for when patient care falls outside scope of standing orders; allows specific care; supersedes off-line medical direction.
Term
What are the benefits of off-line control?
Definition
Good for quick directives regarding treatment protocols; enables the paramedic to act more autonomously.
Term
What is the role of Continuous Quality Improvement Programs (CQIP)?
Definition
Ongoing study; improvement of a process, system or organization.
Term
What are the components of an effective CQIP?
Definition
Leadership, Information and analysis, strategic quality planning, human resource development and mgmt, EMS process mgmt, EMS results, and satisfaction of pts and other stakeholders.
Term
What are the phases of comm that occur during a typical EMS event?
Definition
Occurrence of event; detection of need; notification and emergency response; arrival, treatment, preparation and transport; and preparation for next response
Term
What is the role of communication in EMS?
Definition
Allows info delivery between person in need, telecommunicator, and paramedic
Term
3 digit telephone number used to facilitate reporting of an emergency that requires a response by a public safety agency.
Definition
911
Term
The geographical area that has been granted authority by a state or local govt body to provide 911 service.
Definition
911 Service Area
Term
A call placed to 911 in which the caller disconnects before the call can be answered by the public safety answering point (PSAP) telecommunicator.
Definition
Abandoned call
Term
The analog or digital radio interface used in wireless telephone systems.
Definition
Advanced mobile phone service
Term
A PSAP designated to receive calls when the primary PSAP is unavailable.
Definition
Alternate PSAP
Term
System for routing 911 calls to one or more designated alternate locations if all 911 trunks to a primary PSAP are busy or out of service.
Definition
Alternate routing
Term
The encoding of a carrier wave by variation of its amplitude in accordance with an input signal
Definition
Amplitude modulated
Term
The customer premises equipment at which the telecommunicator answers and responds to calls.
Definition
Attendant position
Term
Any automated device that can access the 911 system, but does not provide for two way communication (prohibited in many states).
Definition
Automatic Alarm and Automatic Alerting Device
Term
Equip that automatically distributes incoming calls to available PSAPs in order of receipt
Definition
Automatic call distributor
Term
The automatic display at the PSAP of the caller’s telephone number, the address or location of the telephone, and supplementary emergency services info.
Definition
Automatic Location Identifier
Term
The telephone number associated with the access line from which a call originates.
Definition
Automatic Number Identification (ANI)
Term
Typically, a disaster recovery answering point that serves as a backup to the primary PSAP and is not located at the same location as the primary PSAP.
Definition
Backup PSAP
Term
Does not support ANI or automatic location identification.
Definition
Basic 911
Term
The capability of the PSAP to maintain control of a 911 caller's access line, even if the caller hangs up.
Definition
Calling Party Hold
Term
The callback number associated with a wireless telephone; similar to ANI for cell phones.
Definition
Calling Party's Number
Term
The wireless telecomm antenna serving a specific geographical area.
Definition
Cell
Term
The physical path between two terminal locations.
Definition
Circuit Route
Term
A computer-based system that aids PSAP telecommunicators by automating selected dispatching and record-keeping activities.
Definition
Computer-Aided Dispatch (CAD)
Term
An arrangement in which one or more public safety agencies choose to operate as a single 911 entity.
Definition
Consolidated PSAP
Term
A telephone circuit used for a single purpose, such as transmission of 911 calls.
Definition
Dedicated trunk
Term
The performance of 911 call answering and dispatching by personnel at the primary PSAP.
Definition
Direct dispatch
Term
The practice of routing circuits along different physical paths to prevent total loss of 911 service in the event of a facility failure.
Definition
Diverse routing
Term
The capability of a PSAP telecommunicator to ring the telephone on a held circuit; requires calling party hold.
Definition
Emergency ring back
Term
Message trunks capable of providing ANI, connecting the serving central office of the 911 calling party and the designated enhanced 911 control office.
Definition
Emergency service trunks
Term
An emergency telephone system that includes network switching, database, and customer premises equipment elements capable of providing selective routing, selective transfer, fixed transfer, ANI, and automatic location ID.
Definition
Enhanced 911 (E911)
Term
The capability of a PSAP attendant to disconnect a 911 call even if the calling party remains off the hook; used to prevent overloading of 911 trunks.
Definition
Forced disconnect
Term
Satellite based technology for determining location.
Definition
GPS
Term
A telephone enclosed in a box and placed along a highway that allows a motorist to summon emergency and nonemergency assistance.
Definition
Highway call box
Term
A program that collects, stores and collates data into reports to allow interpretation and evaluation of information such as performance, trends, and traffic capabilities.
Definition
Management info system
Term
A database of street names and house number ranges w/in their associated communities defining emergency service zones and their associated emergency service numbers to enable proper routing of 911 calls.
Definition
Master street address guide
Term
A PSAP to which 911 calls are routed directly from the 911 control office.
Definition
Primary PSAP
Term
A facility equipped and staffed to receive 911 calls; receives the calls directly, and if the call is relayed or transferred, the next receiving PSAP is designated a secondary PSAP.
Definition
Public Safety Answering Point (PSAP)
Term
The routing of a 911 call to the proper PSAP based on the location of the caller; controlled by the emergency service number, which is derived from the customer’s location.
Definition
Selective routing
Term
As used in 911, a person trained and employed in public safety telecommunications.
Definition
Telecommunicator
Term
Typically, a communication path between central office switches or between the 911 control office and the PSAP.
Definition
Trunk
Term
Minimum requirements for radio equip used by ambulance services:
Definition
Self contained desktop transceiver with speaker; microphone; antenna; mobile unit; two-way radio with multiple-frequency capability
Term
Handheld portable radios capable of contact with base station and data recording are elements of a ________ EMS comm system.
Definition
Simple
Term
Remote consoles, high-power transmitters, repeaters, satellite receivers, and high-power multifrequency vehicle radios are elements of a ________ EMS comm system.
Definition
Complex
Term
This communication operation mode requires a transmitter, with a receiver at each end that operate on the same frequency, with only one end operating at a time (preventing interruption.
Definition
Simplex
Term
This EMS comm operation mode uses two frequencies allowing both parties to communicate at the same time. Allows interruption.
Definition
Duplex
Term
This EMS comm ops mode transmits telemetry, voice simultaneously from field; party can interrupt as needed; voice transmission may interfere with transmission data; and is most common mode used today.
Definition
Multiplex
Term
These are comm systems with 5 or more repeaters that work as a group (each repeater with a different channel); is advantageous in major metropolitan areas with heavy radio freqs; locks out all other sharing users and bars interference from other agencies.
Definition
Trunked system
Term
How do trunked systems operate?
Definition
Radio transmissions originate, find available repeater in the system, and computer switches transmission to chosen repeater.
Term
Receiving and processing calls; dispatching and coordinating EMS resources; relaying medical info between entities; and coordinating with public safety agencies are the roles of...
Definition
Dispatching as it applies to pre-hospital emergency medical care
Term
EMS systems use _________ radio communications protocol.
Definition
Standard
Term
General guidelines for radio comm:
Definition
Formulate message so comm is effective; speak into microphone at 2-3 in; speak slowly, clearly; enunciate; speak in normal pitch; be brief, concise; break long messages into shorter ones; avoid codes; avoid dialect or slang; advise receiving party upon completed transmission; confirm message rcvd; always be professional, polite, and calm.
Term
What situations are a paramedic legally required to report?
Definition
-Neglect or child abuse
-Neglect or abuse of seniors
-Spousal abuse
-Rape, sexual assault
-Gunshot wounds
-Stab wounds
-Animal bites
-Certain communicable diseases
Term
Four elements involved in a claim of negligence.
Definition
Duty to act, breach of duty, harm, causation
Term
Describe measures paramedics may take to protect themselves from claims of negligence.
Definition
Education: training, continuing ed, and skills retention; appropriate quality improvement; appropriate medical direction; accurate, thorough documentation; professional demeanor
Term
Patient consent that signifies the individual knows, understands, and agrees to the care rendered.
Definition
Informed
Term
Verbal or written consent to treatment.
Definition
Expressed
Term
This consent presumes that an unconscious person without decisional capacity who needs emergency care would consent to lifesaving care if able to do so.
Definition
Implied
Term
Describe the paramedic's responsibilities regarding patient confidentiality.
Definition
Paramedics have a legal and ethical duty to protect a patient's privacy.
Term
Describe actions to be taken in a refusal-of-care situation.
Definition
Assess LOC/Orientation; explain each procedure why it is needed, and consequences of refusal carefully; answer any Pt questions; contact medical control; document thoroughly.
Term
What are the legal considerations related to Pt transport?
Definition
-Driver must conform to laws, regs, policies, and must operate the vehicle in a manner that safeguards the Pt
Term
What are the right of way privileges granted to EMS drivers?
Definition
-Travel slightly faster than posted speed
-Move safely fm one lane into the opposite lane of traffic
-Safely enter and pass through intersections on a red light
-Use audible and visual warning devices appropriately
-Park in unauthorized areas
Term
What are the legal considerations related to Pt transport specific to hospital choice?
Definition
The hospital to which the Pt is taken should be based on Pt needs and hospital capability, but the Pt's choice should be honored.
Term
What are the legal considerations related to payer protocols?
Definition
In life and limb emergencies, payer protocols should not be a factor in providing care and transporting to the nearest facility.
Term
What are the legal implications related to resuscitation and Pt death?
Definition
Witholding or stopping resuscitation; advance directives; potential organ donation; death in the field
Term
Pts should be resuscitated until one of the following occur:
Definition
-Restoration of effective, spontaneous circulation and ventilation
-transfer of care to senior emergency medical professional
-presence of reliable criteria indicating irreversible death
-healthcare provider is unable to continue
-valid DNR is presented
-Online authorization from medical control or prior medical protocol allows
Term
What should the paramedic do if CPR is requested by family members despite a DNR, or if the order is suspected to be invalid?
Definition
Initiate resuscitation and contact medical direction
Term
These are legal documents executed to inform health care providers of a Pt's wishes in the event the person becomes incapacitated and unable to convey these wishes directly.
Definition
Advance directives
Term
What is the legally accepted order for approaching family about organ donation?
Definition
Spouse
Adult son or daughter
Parents
Siblings
Legal guardian
Term
What role do medics play in organ donation?
Definition
Eval potential donors, establish comm with medical direction, and provide emergency care to maintain viable organs.
Term
What should a medic do when they encounter an apparent death in the field?
Definition
-Contact medical direction and follow protocols
-Document any observations or unusual findings
-Notify appropriate authorities
-Disturb the scene as little as possible
-Provide emotional support
Term
What is the importance of EMS research?
Definition
Essential to continued evolution, and insight on intended effects, cost effectiveness.
Term
Distinguish between professional accountability, legal accountability, and moral accountability.
Definition
Professional--to patient, medical director, EMS system; must meet standard of care
Legal
Moral--personal values and beliefs
Term
The discipline relating to right and wrong, moral duty and obligation, moral principles and values and moral character.
Definition
Ethics
Term
A standard for honorable behavior designed by a group with expected conformity.
Definition
Ethics
Term
The systematic study of moral dimensions, including the moral vision, decisions, conduct and policies of the life sciences and health care.
Definition
Bioethics
Term
Describe the rapid approach strategy used to resolve ethical conflicts in an emergency.
Definition
-Ask if you have experienced a similar problem that can be used for precedent
-If not, see if you can delay to deliberate with co-workers/med direction
-If can't buy time, use the set of three tests (impartiality, universalizability and interpersonal justifiability test)
Term
In this test for resolving an ethical dilemma, you ask if you would accept the action if you were in the patient's place.
Definition
Impartiality
Term
For this test, used to solve an ethical dilemma, ask if you would feel comfortable having the action performed in all relevantly similar circumstances.
Definition
Universalizability Test
Term
In this test, used to solve an ethical dilemma, ask if you are able to provide good reasons to justify and defend your actions to others.
Definition
Interpersonal Justifiability Test
Term
What are the ethical issues related to allocation of resources?
Definition
Health insurance, treatment decisions when resources are inadequate, mutliple-casualty disaster, rationing of care required based on ethically oriented criteria
Term
What are the ethical issues related to decisions surrounding resuscitation?
Definition
Advance directives, living wills, self-determination documents (these make it easier, w/o documents decisions may not be so clear)
Term
What are the ethical issues related to confidentiality?
Definition
-PPI is not to be disclosed by health care professionals w/o consent
-However, in some cases release is mandated by law (HIV, public health benefit, etc.)
Term
What are the ethical issues related to consent
Definition
-Legal right to decide medical care
-Pts who refuse lifesaving care can create legal and ethical conflicts
Term
Factors to consider for ethical dilemmas involving futile situations.
Definition
-May pose dilemma when lack of agreement about treatment goals exists
-Consult medical direction to assist
Term
Laws protecting pts from unethical health care practices, economic triage, and patient dumping are ethical dilemmas relating to...
Definition
Obligations to provide care
Term
Conflict existing between the duty to follow medical control, and the duty to provide for patient needs may cause ethical dilemmas related to...
Definition
Patient advocacy
Term
What are the ethical dilemmas related to care that a paramedic may face?
Definition
Futile situations, obligation to provide care, patient advocacy, and role as physician extender
Term
What are the prehospital ethical dilemmas the paramedic may face?
Definition
Allocation of resources, decisions surrounding resuscitation, confidentiality, and consent
Term
What can be done daily to reduce risk of infectious disease exposure?
Definition
-Be aware of common exposure sources
-Use personal protection
-Know what to do if exposure occurs
Term
What is minimum PPE?
Definition
Gloves, masks, gowns, HEPA filters
Term
Actions to be taken following significant exposure to a patient's body fluids.
Definition
-Immediately wash
-Report to receiving hospital asap
-Immediately document
-Comply with req'd reporting responsibilities/timeframes
-Cooperate with investigation
-Be screened
-Obtain proper immunization boosters
-Obtain full medical follow-up
Term
Health insurance, Rx decisions when resources are inadequate, multiple-casualty disaster, rationing of care required are ethical issues related to...
Definition
Allocation of resources
Term
Advance directives, living wills, and self-determination documents are ethical issues related to...
Definition
Decisions surrounding resuscitation
Term
What should a paramedic do in futile situations?
Definition
Consult medical direction
Term
This law protects patients from unethical health care practices.
Definition
Emergency Medical Treatment Active Labor Act (EMTALA)
Term
Evaluating impact of Pts care based on fiscal aspects important to the hospital.
Definition
Economic Triage
Term
Unstable Pt transfer, discharged for financial reasons.
Definition
Patient dumping
Term
In moments when paramedic accountability conflicts with patient advocacy, what should the medic do?
Definition
Ethical to err on the side of providing for Pt's needs
Term
What daily measures can be taken to reduce the risk of infectious disease exposure?
Definition
Be aware of common exposure sources, use personal protection, and know what to do if exposure occurs
Term
What is minimum PPE?
Definition
Gloves, masks, gowns, HEPA filters (when tuberculosis confirmed)
Term
What measures can be taken to reduce the risk of infectious disease exposure?
Definition
-Practice universal precautions
-Follow engineering, work practices
-Maintain good personal health, hygiene habits
-Maintain immunizations
-Practice BSI
-Use sharps containers
-Properly clean, disinfect, dispose of use material/equipment immediately
Separate and label all soiled laundry and equipment until items can be cleaned and disinfected.
Term
What actions should be taken following a significant exposure to a Pt's blood or other body fluids?
Definition
-Immediately was contact area
-Report asap to rcving hospital and agency designated official
-Immediately document
-Comply with req'd reporting responsibilities
-Cooperate with incident investigation
-Be screened
-Obtain proper immunization boosters
-Obtain full medical follow-up
Term
This anxiety occurs in certain situations or unusual circumstances, and is normal and healthy.
Definition
Normal anxiety
Term
What does normal anxiety do for someone?
Definition
Provides a warning system that protects persons from being overwhelmed by a sudden stimulation.
Term
This is an ongoing state of vigilance or alertness beyond the initial conflict or emergency, and despite resolution.
Definition
Abnormal anxiety
Term
This is a process that involves learning successful ways to deal with stressful situations.
Definition
Adaptation
Term
What occurs during the adaptation process?
Definition
Usually begins with defense mechanisms, then coping skills are developed, followed by problem solving, and finally concluding with mastery.
Term
These are adaptive functions of the personality; assist a person in adjusting to stressful situations and help people avoid dealing with the problems.
Definition
Defense Mechanisms
Term
An active confronting process, involves gathering info and using the info to change or adjust to a new situation.
Definition
Coping
Term
This stress reaction involves analyzing a problem and finding options to deal with the issue now and in the future.
Definition
Problem solving
Term
This is the ability to see multiple options and solutions for challenging situations; results from extensive experience and the use of effective coping mechanisms.
Definition
Mastery
Term
Reframing, controlled breathing, progressive relaxation, and guided imagery are examples of...
Definition
Stress-reduction techniques
Term
This stress reduction technique involves first looking at the situation from a different emotional viewpoint and then placing it in a different frame that fits the facts of another situation equally well.
Definition
Reframing
Term
This is a natural stress control technique where a person concentrates on depth and rate of breathing to achieve a calming effect.
Definition
Controlled breathing
Term
Stress reduction technique in which the person systematically tightens and relaxes particular muscle groups, fooling the brain into initiating muscle relaxation throughout the body.
Definition
Progressive relaxation
Term
This stress-reduction technique involves focusing on an image that helps relieve stress during meditation.
Definition
Guided imagery
Term
Documenting scene situations that affect care, aiding in tracking care skills of paramedic, and documentation of ALS skills for recertificaiton are uses of...
Definition
Patient Care Reports
Term
What is the purpose of the Pt care report?
Definition
Demonstrates continuity of care, provides a legal record of care provided, assists financial reimbursement, and assists quality improvement studies/research.
Term
What are the components of an accurate, thorough PCR?
Definition
-Dates
-Response times
-Difficulties en route
-Comm difficulties
-Scene observations
-Reasons for extended on-scene time
-Previous care provided
-Time of extrication
-Time of Pt transport
-Reason for hospital selection
Term
What are the elements of a properly written EMS document?
Definition
-Accurate and complete
-Legible
-Timely
-Unaltered
-Free of nonprofessional/extraneous info
Term
What are examples of effective systems for documenting the narrative section of a pre-hospital PCR?
Definition
SAMPLE
SOAP
CHART
CHEATED
Head to toe
Chronological
Patient Mgmt Approach
Term
What does SOAP stand for?
Definition
Subjective Data
Objective Data
Assessment Data
Plan Patient Management
Term
This section of SOAP contains all Pt symptoms, the chief complaint, associated symptoms, history, current meds/allergies, and info provided by Pt, family bystanders, etc.
Definition
Subjective Data (S)
Term
This section of SOAP contains pertinent physical exam data, vital signs, LOC, physical exam findings, EKG, Pulse ox, and blood glucose determinations.
Definition
Objective Data (O)
Term
This section of SOAP contains the clinical impression of the Pt (based on subjective and objective data).
Definition
Assessment Data (A)
Term
This section of SOAP contains treatment provided and requests for addn'l Rx.
Definition
Plan (P)
Term
What should be documented when a Pt refusal is involved?
Definition
-Physical assessment findings
-Paramedic's advice
-Advice from medical direction
-Clinical info that suggests Pt able to make the decision to refuse
-Witness' signature
-Complete narrative, including quotations and statements by others
Term
What needs to be documented when care, or transportation is not needed?
Definition
If cancelled en route, document the agency that cancelled the call.
Term
What is the appropriate method to make revisions/corrections to the PCR?
Definition
-Make it as soon as the need is realized
-Note the purpose of the revision
-Note the date and time the revision was made
-Ensure the revision was made by the original author
Term
Research where events are monitored, analyzed w/o attempt to manipulate/alter outcome.
Definition
Descriptive
Term
Research where the intervention is introduced and effects are monitored for outcome.
Definition
Experimental
Term
Research where specific question, hypothesis, and data collection are defined before study begins.
Definition
Prospective
Term
Research where specific question, hypothesis, and data collection are defined after data already exists.
Definition
Retrospective
Term
Research where a group of subjects is studied during specified period of time.
Definition
Cross-sectional
Term
Traditional medical practice based on medical knowledge, intuition, and judgment.
Definition
Evidence-based practice
Term
What criteria should be evaluated when reading a research paper?
Definition
Read critically, review:
-population
-inclusion/exclusion criteria
-data collection
-results
-discussion and conclusion
Term
What are the 10 steps to perform research?
Definition
-Prepare question
-Write hypothesis
-Decide what to measure, and best way to measure it
-Define population
-Identify study limitations
-Seek study approval
-Obtain informed consent
-Gather data after conducting pilot trials
-Analyze data after conducting pilot trials
-Determine what to do with the research
Term
What are the uses of a PCR?
Definition
Medical continuity of care, quality improvement, legal record, supply tracking, performance eval, state reporting, education, and skill tracking.
Term
Inappropriate documentation may result in _________ and ________ consequences.
Definition
Medical and Legal
Term
What situations require special documentation?
Definition
Patient refusal of care or transport, care or transport not provided/needed, and mass casualty incidents
Term
What is the purpose of the PCR?
Definition
To document the key elements of patient assessment, care and transport.
Term
The process by which one person or group transmits meaning to others.
Definition
Communication
Term
What are the four barriers to communication?
Definition
Attributes of the receiver, selective perception, semantic problems, and time pressures
Term
This barrier to successful communication stems from different people reacting in different ways to the same message or idea.
Definition
Attributes of the receiver
Term
This barrier to communication arises from the tendency of people to listen to only a part of an idea or message.
Definition
Selective perception
Term
This barrier to communication is a result of commonly used words having different meanings for different people.
Definition
Semantic problems
Term
This barrier to communication occurs when normal channels of comm are bypassed or shortened due to a time crunch.
Definition
Time pressures
Term
Three elements of that protect against claims of negligence.
Definition
Training, competent Pt care skills, and full documentation
Term
What are the legal issues related to Pt transport?
Definition
Level of care during transport, use of emergency veh. operating privileges, choice of Pt destination, and payer protocols
Term
Legal responsibilities for the Pt continue until...
Definition
Transfer of care or it is clear the Pt no longer requires care
Term
What are two concepts of ethical healthcare?
Definition
Provide Pt benefit, and do no harm.
Term
That all resources should be allocated fairly is an accepted _______ value.
Definition
Bioethical
Term
A health care professional is not allowed to reveal details supplied by the Pt to others w/o the Pt's consent; this is the principle of..
Definition
Confidentiality
Term
Factors that must be considered to ensure appropriate timing of medical and mechanical skills during rescue:
Definition
-Pt access
-Initiation of Tx at the site
-Release of Pt fm entrapment
-Continuous medical care throughout
Term
What are the phases of a rescue operation?
Definition
-Arrival and scene size-up
-Hazard control
-Gaining Pt access
-Medical Tx
-Disentanglement
-Pt packaging
-Transportation
Term
What is the PPE for rescuers?
Definition
-Impact resistant helmet w/ ear protection and chinstrip
-Safety goggles w/ strap and vents
-Turnout gear
-Waterproof slip resistant gloves
-Steel toe/sole boots
-SCBA
Term
What are the hazards that may be present during an EMS Op on the highway?
Definition
-Alternative fuel veh
-Electrical power
-Unstable vehicles
-Undeployed air bags or SRS
Term
How far should a rescuer stay from an airbag?
Definition
Side impact-5 in
Driver-10 in
Passenger-20 in
Term
What are special considerations for pre-hospital assessment?
Definition
-Assessment can be complicated by weather, temp, access, equip limitations, Pt entrapment and PPE (mobility)
-Difficulty exposing Pt
-Restrictive clothing and PPE
-Limited lighting and cramped space
-Difficulty transporting equip to Pt
Term
What are special considerations for mgmt of Pt exposure during rescue ops?
Definition
Protect the Pt from extrication damage, heat, cold, and external elements.
Term
What are special considerations for mgmt of ALS measures in rescue ops?
Definition
BLS is mandatory and ALS should only be provided if necessary
Term
What are the special considerations for mgmt of Pt monitoring during rescue ops?
Definition
LOC and vitals must be monitored thru the rescue
Term
What are the special considerations for mgmt of pain control during rescue ops?
Definition
Provide Pt w/ drugs that will reduce pain during extrication
Term
Which federal law enabled creation of the US DOT and the NHTSA and provided funding for EMS?
Definition
Highway Safety Act
Term
Which component is at the center of the EMS system?
Definition
Consumers
Term
Which component of the EMS Education Agenda for the future is designed primarily to protect the public?
Definition
EMS Certification
Term
This describes the manner in which a paramedic follows the practice, guidelines, and ethical considerations of prehospital emergency care.
Definition
Professionalism
Term
Making sure the ambulance is adequately stocked is within the role of a paramedic as defined by...
Definition
US DOT
Term
The _________ is responsible for monitoring the quality of EMS care.
Definition
EMS Physician Medical Director
Term
What should be done if a man, claiming to be a physician, is attempting to direct care in an inappropriate manner on a cardiac arrest call?
Definition
Contact online medical direction for instructions
Term
"Continuing education programs" demonstrates a prospective method of a _____________ model.
Definition
Continuous Quality Improvement
Term
Which error prevention strategy involves asking yourself, "Am I doing the right thing?"
Definition
Reflection Bias
Term
Applying colored tape to distinguish between look alike medicines is an example of an _________ method to reduce the risk of medication error?
Definition
Environmental
Term
The highest risk activity on an EMS call is...
Definition
Responding lights and sirens
Term
A unit of frequency equal to one cycle per sec
Definition
Hertz
Term
The ability to transmit or receive in one direction at a time.
Definition
Simplex
Term
A grouping of radio equipment that includes a transmitter and receiver.
Definition
Base Station
Term
Radio freqs between 300 and 3000 MHz.
Definition
UHF
Term
The ability to transmit and receive simultaneously through two different freqs.
Definition
Duplex
Term
A unit of frequency equal to 1 million cycles per second.
Definition
MegaHertz
Term
Radio freqs between 30 and 300 MHz.
Definition
VHF
Term
A unit that receives transmissions from a mobile radio and retransmits them at higher power on another freq.
Definition
Repeater
Term
Three common causes of environmental interference with radio transmissions.
Definition
Mountains, Dense foliage, and Tall bldgs
Term
Describe 4 responsibilities of an EMS dispatcher.
Definition
-Rcv calls fro EMS assistance
-Dispatch/coordinate EMS resources
-Relay med info
Coordinate with public safety agencies
Term
3 essential pieces of info a dispatcher must obtain from a bystander who calls in to report a MVC.
Definition
-Name/callback # of caller
-Location of the MVC
-Nature of the emergency scene
Term
What are three ways the FCC directly influences EMS?
Definition
-Licensing and frequencies
-Establishing equipment standards
-Enforcing rules and regs
Term
6 actions a paramedic may take to ensure clear and understandable radio transmissions.
Definition
-Speak 2-3 in away fm the device
-Speak slowly
-Don't use emotion
-Be concise
-Don't use codes
-Advise when done transmitting
Term
Manipulation of the intended idea for communication is known as...
Definition
Encoding
Term
A mobile unit is a component of a ________ communication system.
Definition
Simple
Term
A radio receiver circuit used for suppressing the audio portion of unwanted radio noises or signals is called...
Definition
Squelch
Term
The term for the number of repetitive cycles per second completed by a radio wave.
Definition
Frequency
Term
Transmission and reception of electrocardiograms over the radio or telephone.
Definition
Telemetry
Term
How is the strongest signal selected when numerous satellite receivers are used?
Definition
Repeaters
Term
What are dispatch services located away from base stations that facilitate comm with field personnel known as?
Definition
Remote consoles
Term
What is an advantage of comm with cell phones?
Definition
They provide a secure link between EMS and the hospital.
Term
A function of pre-arrival instructions is to...
Definition
Provide life-saving instructions
Term
What is the role of the FCC?
Definition
To monitor freqs for appropriate usage.
Term
Forcefully restraining the arm of an alert, competent Pt while an IV line is placed is...
Definition
Battery
Term
As a joke, advising the ER staff that the Pt is a prostitute may legally result in...
Definition
Slander
Term
Telling a friend that you treated a nurse you both know for an OD is known as ...
Definition
Invasion of Privacy (libel)
Term
Restraining an alert, conscious adult with an obvious fracture and transporting him against his will is...
Definition
False imprisonment
Term
Documenting that the Pt is homosexual and remarking "Now let's see them get insurance", is...
Definition
Libel
Term
Leaving a Pt in the ER to go on another call before you have an opportunity to give a report to the nurse is...
Definition
Abandonment
Term
Name three effective means by which the paramedic can avoid claims of liability when providing Pt care.
Definition
-Obtain appropriate training
-Deliver competent care
-Ensure thorough documentation
Term
Which branch of law is also referred to as Tort Law?
Definition
Civil law
Term
What is necessary for successful prosecution of a criminal law case?
Definition
Violation of a statute
Term
This act provides protection for the paramedic with regards to infectious disease.
Definition
Ryan White Act
Term
You are caring for an elderly Pt who experienced a syncopal episode, and he now refuses care. What action must you take to ensure legal compliance during this refusal process?
Definition
Tell the Pt that if he changes his mind, he can call you again.
Term
According to the AHA, what criteria must be met to stop CPR in the prehospital setting after you have initiated ALS procedures?
Definition
Persistent asystole or agonal rhythm is present, and no reversible causes are identified.
Term
In an unblinded study when the paramedic is assessing the Pt's response to a new drug that relieves pain, who would know when the study Rx is being given as opposed to the control Rx?
Definition
The Pt, the paramedic, and researcher
Term
You are conducting research for a drug to treat cardiac arrest. Only you and your partner have been trained to gather the data, so the drug will be used only on days that you work. This type of subject selection is called...
Definition
Convenience sampling
Term
Before research is approved by an institutional review board, what must you prove?
Definition
Consent will be obtained
Term
Which section of a research article describes the step-by-step processes to conduct the research?
Definition
Methods
Term
Which type of statistical analysis has findings that suggest the results in the sample could be generalized to the entire population?
Definition
Inferential
Term
What is the primary goal of the institutional review board?
Definition
Pt safety
Term
Which type of consent would be most common when performing cardiac arrest studies?
Definition
Deferred consent
Term
(Defense mech) A rape victim cannot recall anything from the time she was abducted until the police find her.
Definition
Repression
Term
(Defense mech) A paramedic who was passed over for a promotion states that the boss always plays favorites.
Definition
Rationalization
Term
(Defense mech) A paramedic is upset by a violent death and washes all the vehicles in the garage.
Definition
Substitution
Term
(Defense mech) A victim of an auto accident refuses to acknowledge that he cannot move his legs.
Definition
Denial
Term
(Defense mech) An EMT who gave poor care complains about the Pt's hospital Rx.
Definition
Projection
Term
(Defense mech) A 10 yo begins to suck his thumb en route to the hospital after sustaining a fracture from a fall.
Definition
Regression
Term
List three potential symptoms of decompensation fm the effects of long-term stress.
Definition
Irritability, fatigue, withdrawal
Term
T or F, indigestion or change in bowel habits is a warning sign of cancer.
Definition
True
Term
T or F, water is one of the most important nutrients.
Definition
True
Term
Generalized feelings of apprehension are called...
Definition
Anxiety
Term
Critical incident stress debriefing is most helpful for what kinds of situations?
Definition
Ones in which a high degree of stress is perceived.
Term
A child acting as though nothing has happened is a normal response to the death of a close family member, T or F.
Definition
False
Term
School-age children (7-12 yo) believe that death...
Definition
Happens to others, not themselves
Term
Making associations or implying a cause.
Definition
Interpretation
Term
Paraphrasing a Pt's words.
Definition
Reflection
Term
Pausing for several moments.
Definition
Silence
Term
Reviewing and open-ended questions.
Definition
Summary
Term
Having the Pt rephrase a word.
Definition
Clarification
Term
Providing information.
Definition
Explanation
Term
Refocusing on one aspect of the interview.
Definition
Confrontation
Term
List 6 actions the medic can use to convey that he/she is actively listening to the Pt.
Definition
-Face the Pt when he speaks
-Maintain eye contact
-Avoid crossing arms/legs
-Avoid distracting body mvmts
-Nod at appropriate times
-Lean toward the Pt
Term
A planned act to communicate and obtain information is known as...
Definition
Therapeutic Communication
Term
When a message is put into an understandable format, it is considered...
Definition
Encoded
Term
When you try to see the situation from another person's POV, you are demonstrating...
Definition
Empathy
Term
What is the most effective method for communicating with a hearing-impaired Pt in the prehospital setting?
Definition
Whatever method the Pt prefers
Term
What are uses for a PCR?
Definition
Medical continuity of care, quality improvement, legal record, supply tracking, performance eval, state reporting, education, and skill tracking.
Term
What should you document when your response is cancelled en route to the scene?
Definition
Canceling authority and time of cancellation
Term
When correcting a PCR, individual strikeouts are ok. T or F
Definition
False (entire sentence should be re-written)
Term
First few hours of life
Definition
Newborn
Term
Younger than 28 days
Definition
Neonate
Term
28 days to 1 year
Definition
Infant
Term
1-3 y/o
Definition
Toddler
Term
3-5 y/o
Definition
Preschool
Term
6-12
Definition
School Age
Term
Infant Reflex, head turns toward facial stimulation.
Definition
Rooting
Term
Infant Reflex, lips pucker when mouth contacts nipple.
Definition
Sucking
Term
Infant Reflex, toes spread up and out when sole stroked.
Definition
Babinski
Term
Infant Reflex, mouth opens if palm is pressed when supine.
Definition
Babkin
Term
Infant Reflex, infant stretches and then hugs self after loud noise.
Definition
Moro
Term
What are causes of physical and emotional challenges in late adulthood?
Definition
Decreased mobility, disease processes, cognitive loss, and death of a companion
Term
A HR of 140/min at rest would be considered normal for what age group?
Definition
Newborn
Term
What physiological changes occur at birth?
Definition
Pulmonary vascular resistance decreases, SVR increases, ductus venosus contricts, and right ventricular pressure decreases.
Term
T or F, infant's lose body heat and fluid through respirations.
Definition
True
Term
This is a protective survival reflex in infants.
Definition
Rooting
Term
For which type of temperament might low intensity of reactions and a negative mood be observed?
Definition
Slow-to-warm-up
Term
T or F, toddlers hemoglobin approaches adult levels.
Definition
True
Term
Which parenting style tends to produce children who are responsible, assertive, and self-reliant?
Definition
Authoritative
Term
This style of parenting tends to produce children who have low motivation and self-esteem.
Definition
Authoritarian
Term
This style of parenting tends to produce dicontented, distrustful, and self-centered children.
Definition
Permissive
Term
Regarding development of peer relationships in the toddler or preschool age group, they are formed with others at ...
Definition
The same age level
Term
T or F, regarding school aged children, growth rates are slower than infants/toddlers, lymphatic tissue is larger relative to adults, primary teeth are lost and replaced with permananet teeth, and skull growth is 95% complete.
Definition
True
Term
Conventional reasoning is a stage in which phase of the psychosocial development of a child?
Definition
Moral
Term
What stimulates the release of hormones that initiate the physical changes of puberty in girls?
Definition
FSH
Term
Regarding teenagers and psychosocial issues, the number one cause of death in gay teens is...
Definition
Suicide
Term
On which developmental issue do early adults often focus?
Definition
Selecting a mate
Term
Which health-related concern is common in middle-aged adults?
Definition
Hypercholesterolemia
Term
Where do deaths from unintentional causes rank in the US?
Definition
Fifth
Term
Why are EMS providers ideal to assist with an educational plan to reduce a community's incidence of drowning?
Definition
They are welcomed into homes and public places
Term
How can EMS agencies promote the involvement of staff members in community wellness programs?
Definition
Provide a salary for off-duty injury prevention work
Term
What community resources can you use as sources of information to determine whether the makeup of your community is changing?
Definition
Census data
Term
A support group would be an example of what kind of activity?
Definition
Tertiary
Term
A drunk-u-drama is an example of what kind of activity?
Definition
Primary health prevention
Term
A stop smoking campaign is an example of what kind of activity?
Definition
Secondary intervention (they already smoked)
Term
What is the primary goal of public health activities?
Definition
Preventing illness and injury
Term
Infection that produces influenza-like symptoms, dark-colored urine, and light-colored stools.
Definition
Hepatitis
Term
Macular rash that can cause severe birth defects if a susceptible mother is exposed in pregnancy.
Definition
Rubella
Term
Bacterial pulmonary infection spread by airborne droplets.
Definition
TB
Term
Viral infection that impairs the ability of the body to fight other infectious diseases.
Definition
HIV
Term
Sexually transmitted disease characterized in the early stage by a painless chancre.
Definition
Syphilis
Term
Inflammation of the lining of the CNS that may produce headache, stiff neck, seizures, and coma.
Definition
Meningitis
Term
Bacterial infection that produces mucopurulent discharge but rarely causes septicemia.
Definition
Gonorrhea
Term
Generalized illness accompanied by vesicular lesions, fever, and malaise.
Definition
Varicella
Term
What are the 6 elements that must be present for an infectious disease to occur?
Definition
-Pathogenic agent
-Reservoir
-Portal of exit fm reservoir
-Transmission conducive environment
-Portal of entry to new host
-Susceptibility of new host
Term
During this stage of HIV, the Pt may have swollen lymph nodes, fever, and sore throat.
Definition
Acute retroviral infection
Term
During this stage of HIV, the Pt will have enlarged lymph nodes.
Definition
Aysmptomatic infection
Term
During this stage of HIV, the Pt may have oral lesions, bacterial pneumonia, shingles, and pulmonary tuberculosis.
Definition
Early symptomatic infection
Term
During this stage of HIV, the Pt may have diarrhea, tumors, dementia, neurologic symptoms, and opportunistic infections.
Definition
Late symptomatic infection
Term
What are chronic signs or symptoms that may develop in untreated syphilis?
Definition
-Paresis
-Wide gait
-Ataxia
-Psychosis
-Myocardial insufficiency
Term
What agency is responsible for establishing the guidelines for BSI and universal (standard) precautions?
Definition
Centers for Disease Control and Prevention
Term
How can you interrupt the portal of entry in the chain of elements of an infectious disease?
Definition
Wear gloves as defined in BSI guidelines
Term
The internal defense that provides antibodies to destroy invading organisms is produced by...
Definition
Humoral immunity
Term
The infectious disease phase that begins when the agent invades the body and ends when the disease process begins is which period?
Definition
Incubation
Term
This infectious disease phase begins when the latent period ends and continues as long as the agent is present and can spread to others.
Definition
Communicability period
Term
This infectious disease phase begins with invasion of the body and ends when the agent can be shed or communicated.
Definition
Latent Period
Term
This infectious disease phase follows the incubation period and has variable lengths.
Definition
Disease Period
Term
Death caused by hepatitis is most likely to occur from which strain of the virus?
Definition
Hep B
Term
Which sign or symptom can help to distinguish pneumonia from other respiratory illnesses?
Definition
Shaking chills and chest pain
Term
This is a classic sign/symptom of tetanus.
Definition
Trismus
Term
What is the reaction causing muscle spasms that prevents a patient with rabies from drinking called?
Definition
Hydrophobia
Term
What is the primary mode of transmission for rubella, mumps and varicella?
Definition
Respiratory droplets
Term
This is a complication of varicella.
Definition
Reye syndrome
Term
Which childhood disease is characterized by a violent cough that can persist for 1-2 months?
Definition
Pertussis
Term
What secondary complication of influenza often is associated with severe illness or death?
Definition
Pneumonia
Term
Which S&S associated with mononucleosis could produce a life-threatening condition if the patient is not maintained at rest?
Definition
Splenomegaly
Term
Which body system harbors the dormant herpes virus?
Definition
Nervous System
Term
When should assessment of the potential for violence at the scene begin?
Definition
En route to the call
Term
What may indicate that the residence you are about to enter is potentially dangerous?
Definition
Darkened residence
Term
When approaching a single vehicle stopped along the highway, approach should be from the...
Definition
Passenger's side
Term
What is most likely to protect a paramedic from danger during a violent street scene?
Definition
Retreat immediately
Term
How can you learn about gang-related activity in your EMS response area?
Definition
School officials
Term
Why is a response to a meth lab risky?
Definition
May be booby trapped
Term
This should raise suspicion of domestic violence.
Definition
Inconsistent injuries
Term
What is the safest EMS safety strategy in a dangerous situation?
Definition
Avoidance
Term
These are clues that a patient may become violent.
Definition
Verbal abuse, boxer stance, and clenched fists
Term
T or F, an ice pick may easily pass through body armor.
Definition
True
Term
Tactical Paramedic training usually includes...
Definition
Advanced hazard assessment
Term
These standards designate design standards for types I, II, and III ambulances.
Definition
KKK A-1822
Term
Why are routine ambulance equipment checks essential?
Definition
So that essential equipment is available and in working order during Pt care
Term
What should determine emergency vehicle placement in a community?
Definition
Average response times that meet national standards
Term
How can the paramedic promote safety when responding to a vehicle crash on the highway?
Definition
Park 100 ft past the crash
Term
All air medical crew members should receive specialized training in...
Definition
Flight physiology
Term
Aside from ensuring safety, rescue ops should be guided by...
Definition
Medical and physical needs of the Pt
Term
What is the responsibility of the paramedic in any rescue situation?
Definition
Know when it is safe to attempt rescue
Term
What routine safety measure should be used to protect the Pt during a vehicle rescue that does not involve fire/hazmat?
Definition
Blankets
Term
According to OSHA and NFPA standards, rescuers should have ACCESS to what PPE?
Definition
Ear plugs
Term
When responding to swift water rescue, the paramedic should not walk in fast-moving water that is over...
Definition
Knee deep
Term
These factors will contribute to drowning.
Definition
Cool water temp, drugs, and alcohol use
Term
What is the first measure that should be used to attempt rescue for a person in the water?
Definition
Reach
Term
T or F, an oxygen level over 22% would be considered hazardous.
Definition
True
Term
This is a clue that a silo is oxygen limiting.
Definition
Usually blue
Term
A medic may enter a trench collapse w/o specialized equipment when the trench is less than...
Definition
Waist deep
Term
What should the paramedic do to reduce the risk of fire at the scene of a motor vehicle collision?
Definition
Turn off the ignition
Term
With regards to an undeployed airbag, what measure may create a hazard for rescuers?
Definition
Cutting the steering column to disable the system
Term
This is a complication of crush syndrome.
Definition
Myoglobinemia
Term
If a driver side air bag has not deployed, how far away from it will you stay?
Definition
10 inches
Term
Contracts agreeing to interagency exchange of resources when necessary.
Definition
Mutual aid
Term
Pumpers, ladders, rescue trucks.
Definition
Apparatus
Term
Rendezvous location for all arriving EMS, fire and rescue equipment.
Definition
Staging area
Term
Responsible for coordination of major incident situation.
Definition
Command
Term
Which phase of major incident planning involves establishing an inventory of community resources needed for selected disasters?
Definition
The preplan
Term
What are the 5 major components of FEMAs ICS organization?
Definition
-Command
-Finance
-Logistics
-Ops
-Planning
Term
What has the highest priority when the IC is considering whether to expand the ICS organization during an incident?
Definition
Life safety
Term
What is the primary responsibility of the section chiefs in an MCI?
Definition
To make sure that section members are working toward a common goal.
Term
Which section has overall responsibility for the areas that provide care to medical staff?
Definition
Logistics
Term
Is extrication group resource an appropriate role for a physician brought to the scene from a local hospital?
Definition
Yes
Term
The most appropriate radio comm during an MCI would be between...
Definition
Command and section officers
Term
Pt classification during MCI should be based on...
Definition
-Physiologic signs
-Anatomic injury
-Concurrent disease
Term
What information should be included on the patient tracking log?
Definition
Patient's priority
Pt ID
Transporting unit
Hospital destination
Term
In triage, patients are sorted, airways are opened, and...
Definition
Hemorrhage is controlled
Term
What best defines a major incident that requires use of the ICS?
Definition
Rescuers do not have enough help or equipment to manage the scene in a timely manner.
Term
This is any substance or material that is capable of posing an unreasonable risk to health, safety, and property.
Definition
Hazardous Material
Term
Weight of pure vapor compared with the weight of an equal volume of dry air.
Definition
Vapor density
Term
Dose of chemical that will kill 50% of animals.
Definition
LD50
Term
Exposure limit of 15 min.
Definition
TLV-STEL
Term
Gas or vapor concentration that will burn or explode with ignition source.
Definition
Flammable or exposure limits
Term
Safe exposure for a 40 hr work week.
Definition
PEL
Term
Minimum temp to ignite gas without spark or flame.
Definition
Ignition temp
Term
Atmosphere that causes immediate harm.
Definition
IDLH
Term
Vapor's ability to mix with water.
Definition
Vapor solubility
Term
Maximum concentration not to be exceeded even for a moment.
Definition
TLV-C
Term
Temperature at which liquid produces enough vapor to ignite and flash over but not continue to burn without more heat.
Definition
Flash point
Term
Health hazards of arsenic
Definition
Neurotoxin and hemotoxin
Term
Health hazards of halogenated hydrocarbons
Definition
Hepatotoxin and cardiotoxin
Term
Health hazards of hydrochloric acid
Definition
Irritant
Term
Health hazards of hydrogen cyanide
Definition
Asphyxiant
Term
Health hazards of lead
Definition
Neurotoxin and hemotoxin
Term
Health hazards of malathion
Definition
Nerve poison
Term
Health hazards of mercury
Definition
Nephrotoxin, neurotoxin and hemotoxin
Term
What health problems can be encountered when an individual is exposed to irritants?
Definition
Damage to the respiratory tract and eye irritation.
Term
What health problems can be encountered when an individual is exposed to asphyxiants?
Definition
Deprive body tissues of oxygen.
Term
What health problems can be encountered when an individual is exposed to nerve poisons, anesthetics and narcotics?
Definition
Disruption of the nervous system
Term
What health problems can be encountered when an individual is exposed to hepatotoxins?
Definition
Destruction of the liver
Term
What health problems can be encountered when an individual is exposed to cardiotoxins?
Definition
Dysrhythmias and MIs
Term
What health problems can be encountered when an individual is exposed to neurotoxins?
Definition
Neurological and behavioral disruption
Term
What health problems can be encountered when an individual is exposed to hemotoxins?
Definition
Destruction of red blood cells
Term
What health problems can be encountered when an individual is exposed to carcinogens?
Definition
Cancer-causing agents
Term
What term describes the legislation, enacted in 1986, that established requirements for federal, state, and local government and industry regarding emergency planning and the reporting of HazMat?
Definition
Superfund Amendments and Reauthorization Act
Term
According to the HAZWOPER, what are the five categories of individuals who may respond to a Hazmat incident?
Definition
-First responder-awareness
-First responder-operations
-Hazmat Tech
-Hazmat Specialist
-On-scene IC
Term
The United Nations labeling system is a/an (formal/informal) means of identifying hazardous products.
Definition
Formal
Term
T or F, seizure is a general S&S of inhalation exposure to Hazmat.
Definition
True
Term
T or F, external exposure to corrosive materials will generally cause burns.
Definition
True
Term
How should rescuers approach the scene of a hazmat incident?
Definition
Upwind and Uphill
Term
Which of the following is included in the "pre-suit" medical monitoring of an individual who will be entering a hazmat situation:
-End-tidal CO2
-Reflexes
-Blood glucose
-Weight
Definition
Weight
Term
General recommendations for emergency management of contaminated Pts includes cutting off...
Definition
The Pt's clothing
Term
What is performed during the "pre-suit" examination?
Definition
-Baseline vitals
-Rescuer informed of S&S of contamination or exposure
Term
What is performed during the "post-entry" exam?
Definition
-Vital signs
-Monitor rescure for S&S of exposure and heat-related illness
Term
Steps for rescuer decon leaving hot zone:
Definition
-Remove and place outer gloves and boots in receptacle
-Remove SCBA
-Remove protective clothing
-Shower twice
-Put on clean clothes
-Obtain med eval
Term
How may hazardous materials enter the body?
Definition
Ingestion, absorption, injection and inhalation
Term
What are the formal means of identifying hazmat?
Definition
Placards, shipping papers, MSDS
Term
What are the informal means of identifying hazmat?
Definition
Visual indicators (vapor), container characteristics, company name and smell
Term
Illnesses caused by bacteria found in rodents.
Definition
Plague and Tularemia
Term
Nerve agent that has a camphorlike odor.
Definition
Chlorine
Term
Thick, odorless liquid used as a nerve agent.
Definition
VX
Term
Gray, poisonous gas that smells like mown hay.
Definition
Phosgene
Term
Odorless nerve agent.
Definition
Sarin
Term
Bacterial disease spread by rodent fleas.
Definition
Plague
Term
Poisonous cytotoxin from a plant.
Definition
Ricin
Term
Nerve agent that has a fruity odor.
Definition
Tabun
Term
Anthrax, botulism, plauge, ricin, tularemia and smallpox are all...
Definition
Biological agents
Term
Sarin, soman, tabun and VX are all....
Definition
Nerve agents
Term
Nerve agents cause a __________ overdrive.
Definition
Cholinergic
Term
What is the antidote for nerve agent exposure?
Definition
Atropine and 2PAM (pralidoxime chloride)
Term
What are the five categories of WMD?
Definition
BNICE
Biological
Nuclear
Incendiary
Chemical
Explosive
Term
What are the different categories of biological agents?
Definition
Category A-high morbidity and mortality
Category B-moderate morbidity and low mortality
Category C-emerging pathogens
Term
List four agents that could cause sudden onset of difficulty breathing, blurred vision, HA, and weakness.
Definition
Sarin, soman, tabun, and VX
Term
List three factors that would affect the degree of contamination from a dirty bomb.
Definition
-Size of the explosion
-Amount of radioactive material
-Weather
Term
List three special considerations for a paramedic responding to a WMD incident.
Definition
-Secondary devices
-Crowd control
-Crime scene preservation
Term
Which WMD exposure route has the potential for the greatest number of casualties?
Definition
Aerosol
Term
This type of infection can cause severe respiratory distress and sepsis in later stages.
Definition
Anthrax
Term
A large number of Pts who ate at the salad bar are complaining of nausea, blurred vision and dry mouth. Several have difficulty swallowing and complain they are having trouble breathing. What might this be?
Definition
Botulism
Term
You are caring for a Pt suspected to have smallpox. What PPE is indicated?
Definition
Respiratory and contact protection
Term
A large number of Pts have excessive tearing, salivation, severe dyspnea w/ wheezing, weakness, drooling and hypoTN. What Tx should you provide along with O2?
Definition
Atropine and 2PAM
Term
According to the Office for Domestic Preparedness, what are the responsibilities of EMS providers in preparing for and responding to incidents of terrorism involving WMD agents?
Definition
Implement incident operations
Term
Itching, papular lesion that becomes vesicular, black eschar; S&S resembling those of a cold followed by respiratory distress and sepsis are signs of...
Definition
Anthrax
Term
Fever, fainting, SOB, cough, bloody sputum and GI symptoms are signs of...
Definition
Plague
Term
High fever, fatigue, HA and backache; w/in 2-3 days rash and skin lesions that crust and scar, joint deformities and blindness are signs of...
Definition
Smallpox
Term
N, dry mouth, blurred vision, dysphagia, fatigue and dyspnea are signs of...
Definition
Botulism
Term
Fever, HA, chills, malaise, GI illness, DIC, ARF and possible death are signs of...
Definition
Tularemia
Term
Severe respiratory symptoms and/or failure, severe GI symptoms, vascular collapse, and seizures are signs of...
Definition
Ricin
Term
How is botulism treated?
Definition
Antitoxin, mechanical ventilation
Term
How is tularemia treated?
Definition
Antibiotics
Term
Published standards that address competencies for EMS workers at hazmat scenes.
Definition
NFPA
Term
Published rules to govern training requirements, emergency plans, medical checkups, and other safety precautions for workers at uncontrolled hazardous waste sites and those responding to hazardous chemical spills.
Definition
OSHA and EPA (1989)
Term
Medical exams for members of hazmat teams, providing medical care, record keeping and periodic eval of the surveillance program are tasks of a...
Definition
Hazmat medical monitoring program
Term
The first agency to arrive at the scene of a hazmat incident must...
Definition
-Detect and ID the materials
-Assess the risk of exposure
-Consider potential for fire/explosion
-Gather info from onsite personnel/resources
-Confine and control the incident
Term
What are the primary goals of decon?
Definition
-Reduce Pt's dosage of material
-Decrease the threat of secondary contamination
-Reduce the risk of rescuer injury
Term
What are paramedic tactics for safety?
Definition
-Avoidance
-Tactical retreat
-Cover and concealment
-Distraction
-Evasive maneuvers
Term
What are the seven phases of a rescue operation?
Definition
-Arrival and scene size-up
-Hazard control
-Gaining access to the Pt
-Medical Tx
-Disentanglement
-Pt packaging
-Transportation
Term
What are the six major hazards associated with confined spaces?
Definition
-Oxygen-deficient atmospheres
-Chemical or toxic exposure and explosion
-Engulfment
-Machinery entrapment
-Electricity
-Structural concerns
Term
Environments with oxygen concentrations below ______ are considered hazardous.
Definition
19.5%
Term
60 sec assessment that focuses on the patient's ability to walk, respiratory effort, pulse/perfusion and mental status.
Definition
START Triage
Term
You assess a Pt with a RR below 30, capillary refill < 2 sec, and can follow commands, and can walk. What triage category is the Pt?
Definition
Minor
Term
You triage a Pt that meets 30-2-can-do, but cannot walk, what category is the Pt?
Definition
Delayed
Term
You triage a Pt that is unconscious, has rapid breathing, delayed or absent cap refill, or an absent radial pulse. How would this Pt be triaged?
Definition
Immediate
Term
If you triage a Pt that's not breathing, what should you do?
Definition
Open the airway:
-If the Pt spontaneously begins breathing, consider delayed
-If the Pt does not begin breathing, consider dead
Term
Identify the eight factors that influence safe ambulance ops.
Definition
A. Appropriate use of personal restraints
B. Appropriate use of escorts
C. Environmental conditions
D. Appropriate use of warning devices
E. Proceeding safely through intersections
F. Parking at the emergency scene
G. Operating with due regard for safety of others
H. Safely moving a Pt into and out of the ambulance
Term
Identify ambulance types.
Definition
A. Type I—based on the chassis-cabs of light duty pickup trucks
B. Type II—based on modern passenger/cargo vans
C. Type III—based on chassis-cabs of light duty vans
Term
The time after an injury has occurred when the patient and observers remain acutely aware of what has happened and may be more receptive to being taught ways that the event or illness could have been prevented.
Definition
Teachable moment
Term
An assessment of a target community to identify needs and resources required to provide prevention and wellness promotion activities
Definition
Community Health Assessment
Term
Vitals of an infant.
Definition
a. HR avg is 120 BPM
b. RR 25/min
c. BP systolic 90 mm Hg
d. Temp 98-100
Term
Vitals of a toddler.
Definition
1. HR 80-130 BPM
2. RR 20-30/min
3. BP 70-100 mm Hg
4. Temp 96.8-99.9 degrees
Term
Vitals of a preschooler.
Definition
1. HR 80-100 BPM
2. RR 20-30/min
3. BP 80-100 mm Hg
4. Temp 96.8-99.6 degrees
Term
Vitals of a school-aged child.
Definition
a. HR 70-110 BPM
b. RR 20-30/min
c. BP systolic 80-120 mm Hg
d. Temp 98.6
Term
Vitals of an adolescent.
Definition
a. HR 55-105 BPM
b. RR 12-20/min
c. BP systolic 100-120 mm Hg
d. Temp 98.6
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