Air Medical Crew Standards and Practices
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Questions and Answers

What is the primary goal of a just culture in professional settings?

  • To focus solely on individual staff actions
  • To increase punitive measures against staff failures
  • To maintain high standards of secrecy in operations
  • To enable shared accountability and system improvement (correct)

    • Which organization sets the standards for crew education and safety in air medical transport?

  • HIPAA
  • FAA
  • NHTSA
  • CAMTS (correct)

    • Which of the following crew configurations is NOT recognized in air medical transport?

  • EMT and Paramedic (correct)
  • RN and RN
  • RN and Paramedic
  • RNC-OB and Neonatologist

    • What does HIPAA primarily protect?

    <p>Patient Health Information (PHI) under certain conditions</p> Signup and view all the answers

    Which statement best describes the grieving process after an out-of-hospital cardiac arrest?

    <p>Different types of grief can affect individuals differently</p> Signup and view all the answers

    Which of the following should be included in effective communication with patient families during resuscitation?

    <p>Avoiding difficult language and minimizing fear</p> Signup and view all the answers

    What is one of the common stress signs for first responders?

    <p>Chronic fatigue and irritability</p> Signup and view all the answers

    What does the MOST/MOLST form signify in emergency medical situations?

    <p>It serves as a legal document for end-of-life preferences</p> Signup and view all the answers

    Which pain indicators may be used for paralyzed patients?

    <p>Increased heart rate and blood pressure</p> Signup and view all the answers

    What is the function of the GAMUT Metrics in air medical transport?

    <p>Track and evaluate transport-specific quality metrics</p> Signup and view all the answers

    What shift does a just culture advocate for in professional settings?

    <p>From punitive culture to system improvement</p> Signup and view all the answers

    Which of the following roles is NOT considered an air crew member in medical transport?

    <p>EMT</p> Signup and view all the answers

    Which organization is responsible for revising accreditation standards every 2-3 years in air medical transport?

    <p>CAMTS</p> Signup and view all the answers

    What is a key metric tracked by Ground Air Medical Quality Transport (GAMUT)?

    <p>Airway management performance</p> Signup and view all the answers

    What is the purpose of the DNR (Do Not Resuscitate) document?

    <p>To legally prevent resuscitation efforts</p> Signup and view all the answers

    Which of the following is NOT a stage in the grieving process?

    <p>Rage</p> Signup and view all the answers

    What is a common stress sign that first responders might exhibit?

    <p>Chronic fatigue</p> Signup and view all the answers

    Which of the following is a consideration for communication with families during resuscitation?

    <p>Be honest and direct about the patient's status</p> Signup and view all the answers

    What should not be done with PHI in public settings?

    <p>Share PHI openly with bystanders</p> Signup and view all the answers

    What is an indicator of pain in paralyzed patients?

    <p>Increased pulse rate</p> Signup and view all the answers

    What is the main advantage of a just culture in professional settings?

    <p>Fostering shared accountability and system improvement</p> Signup and view all the answers

    Which of the following roles is typically included in air medical transport crew configurations?

    <p>Physician</p> Signup and view all the answers

    What is the primary focus of the Ground Air Medical Quality Transport (GAMUT) metrics?

    <p>Evaluating performance on transport-specific quality metrics</p> Signup and view all the answers

    What type of document is MOST/MOLST, and when is it typically used?

    <p>Emergency medical intervention orders for scope of treatment</p> Signup and view all the answers

    Which of the following is a legally recognized end-of-life request?

    <p>Do Not Resuscitate (DNR) order</p> Signup and view all the answers

    What is the correct approach for providers when delivering death notifications?

    <p>Communicate honestly and use clear language</p> Signup and view all the answers

    Which stage is NOT recognized in the grieving process?

    <p>Affirmation</p> Signup and view all the answers

    What should be done with Protected Health Information (PHI) in public settings?

    <p>Log off or cover the information</p> Signup and view all the answers

    Which of the following is a sign of chronic fatigue often seen in first responders?

    <p>Emotional detachment</p> Signup and view all the answers

    In the context of pediatric death, what should providers avoid when interacting with families?

    <p>Using fear-based tactics in communication</p> Signup and view all the answers

    What is the primary aim of a just culture in professional environments?

    <p>To shift the focus from punishment to systemic improvement</p> Signup and view all the answers

    What is a critical aspect of the accreditation standards set by CAMTS?

    <p>Standards for crew education and maintenance of equipment</p> Signup and view all the answers

    What is NOT a purpose of Ground Air Medical Quality Transport (GAMUT) metrics?

    <p>Analyzing financial performance annually</p> Signup and view all the answers

    Which of the following statements regarding HIPAA is incorrect?

    <p>PHI can be shared freely on social media.</p> Signup and view all the answers

    Which pain indicators might indicate discomfort in paralyzed patients?

    <p>Increased blood pressure and heart rate</p> Signup and view all the answers

    What type of document is a DNR?

    <p>A legal document specifying end-of-life care preferences</p> Signup and view all the answers

    Which statement is a common misconception about the grieving process after a loss?

    <p>Grieving happens in a linear sequence of stages.</p> Signup and view all the answers

    What is a recognized role that is not considered an air crew member in medical transport?

    <p>EMT</p> Signup and view all the answers

    What is essential to ensure when communicating during resuscitation with patient families?

    <p>Maintaining clear and honest communication about the care plan</p> Signup and view all the answers

    Which of the following is a sign of chronic fatigue commonly seen in first responders?

    <p>Emotional instability and irritability</p> Signup and view all the answers

    Study Notes

    Just Culture

    • A safety supportive system of shared accountability
    • Focus on accountability: systems are in place and staff actions are responded to fairly
    • Focus on system improvement rather than punishment

    Accreditation Standards

    • CAMTS Accreditation:
      • Standards for crew education, ethical standards, business profiles, equipment standardization, crew credentials, safety/weather plans, and maintenance
      • Revised every 2-3 years
      • Valid for 3 years

    Common Crew Configurations

    • RN (CFRN®) and Paramedic (FP-C)
    • RN/RN, RN/MD, RNC-OB/Neonatologist or Neonatal RRT
    • Crew members: pilot, nurse, paramedic, APRN/PA, physician, respiratory therapist
    • EMT not recognized as air crew member

    Ground Air Medical Quality Transport (GAMUT) Metrics

    • Purpose: Track, report, and evaluate performance on transport-specific quality metrics.
    • Metrics:
      • Airway management
      • Administration of blood products
      • Ventilator management
      • CPR
      • HROB events
      • Safety events

    Privacy Considerations

    • HIPAA: Health Insurance Portability Accountability Act
    • Disclose PHI only for Treatment, Payment, Operations (TPO) purposes
    • Media: Defer to public information officer (PIO)
    • Do not post identifiable information or scene photos on social media
    • Do not use personal devices for PHI
    • Always log off or cover PHI in public settings

    Holistic Patient Care

    • Sedation and Analgesia
      • Paralyzed patients experience pain.
      • Indicators of pain: Vital signs, tearing of eyes, ventilator dyssynchrony.
    • Communication
      • Auditory senses are the last to fade.
      • Verbalize care plans with all patients.
      • Example: "Can you please swallow?" to advance a stuck ETT.

    Death Notification

    • Out-of-Hospital Cardiac Arrest (OHCA) results in death 90% of the time
    • Grief: Natural response to loss
      • Stages of grief: Denial, Anger, Bargaining, Depression, Acceptance
      • Types of grief: Anticipatory, Complicated, Disenfranchised
    • Communication During Resuscitation
      • Provider communication and rapport with family is important.
      • Assure and communicate care plans with family members.

    Do Not Resuscitate (DNR)

    • DNR: Legal document and end-of-life request.
    • Provide comfort to the patient's family.
    • Practice active listening and reassurance.
    • MOST/MOLST Form: Medical Orders for Scope or Treatment.
      • Legal document for emergency medical interventions.
      • Often seen with DNR.

    Pediatric Death

    • Provider Response
      • Avoid fear-based actions.
      • Benefit of parental presence during resuscitation.
    • EMS Role
      • Honest and clear communication with patient family.
      • Use words like "dead" or "died".
      • Allow natural grieving process.

    First Responder Response to Trauma

    • Stress Signs: Chronic fatigue, irritability, negative attitude, declining health, substance abuse, emotional instability.
    • Post-call Debrief
      • Address safety concerns.
      • Review performance and incidents.
      • Improve team dynamics.

    Question

    • One of the top risk factors associated with patients and families initiating malpractice claims is:
      • Poor communication from medical staff

    Just Culture

    • A system of shared accountability that promotes safety
    • Focuses on improving systems rather than punishing individuals
    • Shifts from a punitive culture to a system improvement culture

    Accreditation Standards

    • CAMTS (Commission on Accreditation of Medical Transport Systems) sets standards for air medical services
    • Standards include crew education, ethical standards, business profiles, equipment standardization, crew credentials, safety/weather plans, and maintenance
    • Standards are revised every 2-3 years and valid for 3 years

    Common Crew Configurations

    • RN (CFRN®) and Paramedic (FP-C) are common crew members
    • Other possible crew members include: RN/RN, RN/MD, RNC-OB/Neonatologist or Neonatal RRT, pilot, physician, respiratory therapist
    • EMTs are not recognized as air crew members

    Ground Air Medical Quality Transport (GAMUT) Metrics

    • Used to track, report, and evaluate performance on transport-specific quality metrics
    • Metrics include airway management, administration of blood products, ventilator management, CPR, HROB events, and safety events

    Privacy Considerations

    • HIPAA (Health Insurance Portability Accountability Act) governs the disclosure of Protected Health Information (PHI)
    • PHI can only be disclosed for Treatment, Payment, or Operations (TPO) purposes
    • Do not post identifiable information or scene photos on social media
    • Do not use personal devices for PHI

    Holistic Patient Care

    • Sedated and paralyzed patients still experience pain
    • Indicators of pain include: vital signs, tearing of eyes, and ventilator dyssynchrony
    • Communication is crucial even for sedated patients, as auditory senses are the last to fade
    • Verbalize care plans and provide clear communication with all patients

    Death Notification

    • OHCA (Out-of-Hospital Cardiac Arrest) results in death in 90% of cases
    • Grief is a natural response to loss and can manifest in various stages: Denial, Anger, Bargaining, Depression, Acceptance
    • Types of grief include: Anticipatory, Complicated, Disenfranchised
    • Communication during resuscitation is important for fostering trust and rapport with the family, assuring them of the care plan

    Do Not Resuscitate (DNR)

    • A legal document and end-of-life request
    • Provide comfort and reassurance to the patient's family
    • Practice active listening and reassurance
    • MOST/MOLST (Medical Orders for Scope or Treatment) form is a legal document for emergency medical interventions that often accompanies a DNR

    Pediatric Death

    • Providers should avoid fear-based actions and allow parental presence during resuscitation
    • Honest and clear communication with the patient's family is essential, using words like "dead" or "died" to allow them to grieve naturally

    First Responder Response to Trauma

    • Stress signs include: chronic fatigue, irritability, negative attitude, declining health, substance abuse, and emotional instability
    • Post-call debriefing is crucial for addressing safety concerns, reviewing performance and incidents, and improving team dynamics

    Malpractice Claims

    • Poor communication from medical staff is a major risk factor for patients and families initiating malpractice claims

    Just Culture

    • A safety supportive system of shared accountability
    • Focuses on systems and processes rather than blaming individuals
    • Encourages reporting of errors and near misses without fear of punishment
    • Promotes a culture of continuous improvement

    Accreditation Standards

    • CAMTS (Commission on Accreditation of Medical Transport Systems) accredits air medical transport services
    • CAMTS standards cover crew education, ethical standards, business profiles, equipment standardization, crew credentials, safety/weather plans, and maintenance.
    • Accreditation is valid for 3 years and reviewed every 2-3 years

    Common Crew Configurations

    • Typical crew consists of a pilot, nurse, paramedic, and sometimes an APRN/PA, physician, or respiratory therapist
    • EMTs are not typically recognized as air crew members
    • Common crew configurations include RN (CFRN®)/Paramedic (FP-C), RN/RN, RN/MD, RNC-OB/Neonatologist or Neonatal RRT

    Ground Air Medical Quality Transport (GAMUT) Metrics

    • Used to track, report, and evaluate transport specific quality metrics
    • Metrics include airway management, administration of blood products, ventilator management, CPR, HROB (High Risk Obstetric Births) events, and safety events

    Privacy Considerations

    • HIPAA (Health Insurance Portability and Accountability Act) protects patient privacy
    • Only disclose protected health information (PHI) for treatment, payment, and operations (TPO) purposes
    • Avoid posting identifiable information or scene photos on social media
    • Do not use personal devices to access or store PHI
    • Always log off or cover PHI in public settings

    Holistic Patient Care

    • Paralyzed patients experience pain despite being unable to express it
    • Monitor vital signs, tearing of eyes, and ventilator dyssynchrony to assess pain
    • Remember that auditory senses are the last to fade
    • Communicate care plans verbally to all patients even if they are unconscious
    • Provide clear and concise instructions during procedures

    Death Notification

    • Out-of-Hospital Cardiac Arrest (OHCA) results in death 90% of the time
    • Grief is a natural response to loss and can manifest in various stages: denial, anger, bargaining, depression, and acceptance
    • Types of grief include: anticipatory, complicated, and disenfranchised
    • Communicate with family members during resuscitation, assuring them of care plans and demonstrating empathy

    Do Not Resuscitate (DNR)

    • DNR is a legal document and end-of-life request
    • Provide comfort and reassurance to the patient's family
    • Practice active listening and respect their wishes
    • MOST/MOLST (Medical Orders for Scope or Treatment) is a legal document outlining desired emergency medical interventions, often seen with DNR orders

    Pediatric Death

    • Avoid fear-based actions when dealing with pediatric death
    • Encourage parental presence during resuscitation
    • Communicate honestly and clearly with the patient's family, using words like "dead" or "died"
    • Allow the family to grieve naturally

    First Responder Response to Trauma

    • Stress signs can include chronic fatigue, irritability, negative attitude, declining health, substance abuse, and emotional instability
    • Post-call debriefings are crucial for addressing safety concerns, reviewing performance, and improving team dynamics

    Question

    • The answer is d. Poor communication from medical staff.
    • Malpractice claims are often initiated due to a breakdown in communication between medical staff and patients/families, leading to misunderstandings, lack of trust, and dissatisfaction.

    Just Culture

    • A system of shared accountability built on safety.
    • Involves systems in place and responding to staff actions fairly.
    • Shifting from a culture of punishment to a culture of system improvement.

    Accreditation Standards

    • CAMTS Accreditation: Sets standards for crew education, ethical standards, business profiles, equipment standardization, crew credentials, safety/weather plans, and maintenance.
    • Revised every 2-3 years and valid for 3 years.

    Common Crew Configurations

    • RN (CFRN®) and Paramedic (FP-C) are the most common.
    • Other configurations include: RN/RN, RN/MD, RNC-OB/Neonatologist or Neonatal RRT
    • Crews can include pilots, nurses, paramedics, APRN/PA, physicians, and respiratory therapists.
    • EMTs are not recognized as air crew members.

    Ground Air Medical Quality Transport (GAMUT) Metrics

    • Used to track, report, and evaluate performance on transport-specific quality metrics.
    • Metrics include: airway management, administration of blood products, ventilator management, CPR, HROB events, and safety events.

    Privacy Considerations

    • HIPAA (Health Insurance Portability Accountability Act) is a key focus.
    • Only disclose Protected Health Information (PHI) for Treatment, Payment, Operations (TPO) purposes.
    • Defer to the public information officer (PIO) for media inquiries.
    • Do not post identifiable information or scene photos on social media.
    • Don't use personal devices for PHI.
    • Always log off or cover PHI in public settings.

    Holistic Patient Care

    • Sedation and Analgesia: Recognize that paralyzed patients still experience pain.
    • Use vital signs, tearing of eyes, and ventilator dyssynchrony as indicators.
    • Communication: Focus on verbalizing care plans with all patients, as the sense of hearing is the last to fade.

    Death Notification

    • OHCA: Out-of-Hospital Cardiac Arrest results in death 90% of the time.
    • Grief: Recognize it as a natural response to loss.
    • Stages of Grief: Denial, Anger, Bargaining, Depression, Acceptance.
    • Types of Grief: Anticipatory, Complicated, Disenfranchised.
    • Communication During Resuscitation: Emphasize the importance of provider communication and rapport with the family; assure and communicate care plans with family members.

    Do Not Resuscitate (DNR)

    • A legal document and end-of-life request.
    • Importance of providing comfort to the patient's family.
    • Practice active listening and reassurance.
    • MOST/MOLST Form: Medical Orders for Scope or Treatment.
    • This legal document covers emergency medical interventions and is often seen with DNRs.

    Pediatric Death

    • Provider Response: Avoid actions that may cause fear in the family.
    • The presence of parents during resuscitation can be beneficial.
    • EMS Role: Communicate honestly and clearly with the family, using words like "dead" or "died". Allow the family to grieve naturally.

    First Responder Response to Trauma

    • Stress Signs: Chronic fatigue, irritability, negative attitude, declining health, substance abuse, emotional instability.
    • Post-call Debrief: Address safety concerns, review performance and incidents, and improve team dynamics.

    Question

    • The answer is (d) Poor communication from medical staff. The text highlights communication as a crucial aspect of patient care and a key contributor to malpractice claims.

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    Description

    This quiz covers essential aspects of air medical crew standards, including accreditation requirements, common crew configurations, and the principles of a Just Culture. It emphasizes accountability and system improvement within air medical transport. Test your knowledge on GAMUT metrics and the roles of different crew members in ensuring quality care.

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