EMS Final Review: Infection Control & Lifting

• Study notes for EMS Final Review, Weeks 1-5:

Infection Control & Disease Prevention

• Sharps must be disposed of in sharps containers.
• Contaminated materials like diapers are to be disposed of in trash cans.
• PPE & BSI (Body Substance Isolation) precautions are critical.
• N95 masks should be used with suspected tuberculosis patients.
• Face shields should be used during intubations.
• Hand hygiene, specifically hand washing, is the number-one method for infection transmission prevention.

Proper Lifting Techniques - Body Mechanics

• Load should be close to body and legs should be used when lifting.
• Avoid twisting or turning when performing lifts.
• Communication with the team is key for coordination through designated verbal commands.

EMS Wellness & Stress Management

• Prioritize health, wellness, and behavior change programs.
• Education on nutrition and hydration is vital; lack of hydration can cause kidney stones.
• Smoking cessation yields the greatest cardiovascular benefits.
• Effective stress management includes reframing thoughts and controlled breathing to manage acute stress.
• The phases of Hans Selye stress response are alarm, fight or flight, and resistance.
• Resistance involves coping mechanisms, and exhaustion leads to diminished ability to rest.
• Safety and Education programs include driver safety, injury and illness prevention, and proper hydration/safe lifting techniques.
• Smoking/behavior changes should involve replacement therapy or cold turkey quitting.

Ethical/Professional Practices

• Handling exposure incidents involves reporting exposures and using proper medical precautions (BSI/PPE) to protect against communicable diseases.

Key Test Questions for Week 1

• High self-expectations can put a paramedic at higher risk for a stress reaction.
• Exposure requires reporting when treating a TB patient while wearing only a surgical mask.
• Implementing a safety driver course reduces an employee's chance of serious injury.
• Prevent communicable diseases through proper hand washing, diaper disposal, cleaning of absorbents.
• Needles should be disposed in sharps containers and bloodied supplies in biohazard bags.
• The principal role of paramedics is to participate in wellness programs.
• Emergency moves should reduce risk of injury when lifting and moving patients.
• Reframing thoughts is a stress management technique.
• Measles can be transmitted through airborne droplets and direct contact.
• The most important piece of equipment to bring on a scene is an AED (Automated External Defibrillator).

Overview of EMS Systems

• Components include out-of-hospital resources (community responders, EMS, fire/rescue, hazardous materials services, law enforcement)
• Components include in-hospital resources (emergency RNs, advanced PAs, doctors, mental health providers, rehab services)
• Technological advances in EMS include telemedicine, smartphone apps for emergencies, and virtual consults.

History/Development of EMS

• Important milestones include: 1966 (The White Paper), 1970 (Establishment of National Registry), and 1973 (EMS Systems Act outlining 15 components of EMS).

Roles/Responsibilities of EMS

• Includes preparation, response (personal/scene safety), patient assessment, patient management (medical direction PRN), disposition, documentation (honoring patient preference if able).

Professionalism

• Requires leadership, empathy, integrity, teamwork, and time management.
• Clean, pressed uniforms are essential.
• Ethics: Adhere to the EMS code of ethics.
• Patient-first attitude and quality care prioritize treating patients as you would want your own family treated.

EMS Protocols/Medical Oversight

• Protocols are developed/created by medical directors with EMS input.
• Standing orders are guidelines.
• Scope of practice is defined by state regulations and medical director delegation.
• Local protocols are set by the medical director.

Education, Certification, Licensure

• Levels include EMR (Emergency Medical Responder), EMT (Emergency Medical Technician), AEMT (Advanced Emergency Medical Technician), and Paramedic.
• Continuing education includes refresher courses for recertification and skill maintenance.
• Certification exams are administered by The National Registry to establish competency

Scene Management/Quality Improvement

• System-wide care evaluations are performed.
• Clearly defined roles minimize errors and duplication.
• The most important piece of equipment on every scene is an AED.

Advanced EMS Concepts

• EMS research and evidence-based medicine enhances patient care protocols.
• A reason for participation in EMS is to validate field practices before further implementation.

Generalized Week 2 Exam

• National associations and national registry agencies ensure the competency of out-of-hospital EMS personnel.
• Local/State-level agencies: Define who may function within system and allocate funds; enact legislation
• Medics supporting primary care in out-of-hospital settings promotes wellness and injury prevention.
• Patient destinations extend beyond the ED to include urgent care and crisis centers; educates public.
• Examples of local protocols: 1973 Emergency Medical Services System Act 15 components and 1988 NHTSA 10 system elements
• Local protocols are made by medical director, EMS agencies in collaborative efforts with state authorities.
• Protocols are based on research, technology, and community needs.
• Influences: The National EMS Scope of Practice Model, AHA (American Heart Association), and NREMT (National Registry of Emergency Medical Technicians) standards.

Components of Continuous Quality Improvement

• Plan: Identify areas needing improvement based on data (ePCRs- electronic Patient Care Reports).
• Do: Implement targeted interventions (training, protocol updates).
• Check: Monitor outcomes and effectiveness.
• Act: Adjust strategies and reinforce best practices.
• CEUs- A medic's professional responsibility to maintain certification, develop knowledge/skills, and keep up w/ emergency healthcare.
• Ethics are rules or standards that govern members' conduct, not law.
• The Oath of Geneva (1948) is a statement of ethics.
• The National Association of EMT adopted the EMT Code of Ethics in 1978.

Public Health Principles

• Aim to protect/improve community health through promotion, disease surveillance, disaster management, and injury prevention programs.
• Accomplishments in public health include vaccines, motor vehicle safety (seatbelt usage), workplace safety, control of infectious diseases, and tobacco use reduction.
• Epidemiology is the incidence/prevalence of disease study in populations.
• An epidemic affects a small/local population and is controlled by local health.
• A pandemic is larger in scale, think COVID-19, and is controlled by the CDC.
• A carrier is someone in contact with an exposed disease who unknowingly spreads it.
• A host is a person or living organism that can be infected under natural conditions.
• A vector is animate and delivers indirect transmission from a animal reservoir to a susceptible host.
• Virulence is the proportion of persons with clinical disease made severely ill or that die after being infected.
• Injury prevention advocates create disaster plans and seek funding.
• Community prevention programs benefit infant/child safety (car seats program), geriatric falls, work-related injuries, motor vehicle safety and medication misuse.

Medical-Legal & Ethical Responsibilities

• Treat patients as you would want your family treated; maintain skills, review performance, maintain HIPPA (Health Insurance Portability and Accountability Act), cooperate.
• Consitutional Law protecrs against government abuse
• Common Law, also known as Case Law, follows society's acceptance of customs/norms (can change/evolve)
• Statutory Law are laws created by Legislative bodies
• Regulatory Law is Administrative, think State/ Federal-ICEMA
• Civil Torts are civil wrongs
• Negligence (Malpractice) is the deviation from acceptable standards of care.
• Duty to act occurs when you have inform legal obligation to provide care.
• Breach of duty happens when action or inaction violates care.
• Malfeasance is a wrongful/unlawful act.
• Nonfeasance is a failure to perform a required act of duty
• Misfeasance is legal act performed in a harmful, injurious manner
• Actual damage: Res Ipsa Loquitur- Complaintant must prove damages
• Proximate Cause- Action that immediately caused/ worsened damages of patient
• Defenses Against Negligence: Good Samaritan Laws, government immunity, documentation and education
• Informed, Expressed and Implied consents can be provided in EMS
• Withdrawal and refusal of care occurs PT has to be alert, aware and informed of the risks.

Confidentiality (HIPAA)

• Defamation, intentional false communication that harms reputation
• Libel, false statements in writing/social media; reckless disregard for false statements
• Slander- Act of injuring person’s character or reputation with intent for reckless diregard
• Abandonment: Termination of care w/o ensuring continued care
• Assault: Unlawfully places a person in immediate bodily Harm
• Battery: Unlawful touching of an individual's consent -Ryan White Act protects EMS in infectious Diseases
• Patient saftey and automony is top priority
• DNRs must be physician signed to be valid.

Generalized Week 3 Exam

• Effective documentation is a valuable justification for funding.

• When a diabetic patient is unresponsive but becomes conscious, alert, oriented, and refuses treatment, discontinue care (Patient was Alert, Aware, Personal Decision.

• When confronting an uncooperative patient, the best course of action is to treat them as you would treat your own family member.

• you disagree with medical control for a treatment the provider must adhere to the "do no harm" satndard.

• Exposing yourself to a communicable disease harms the whole community.

• Data on area illnesses and injuries for funding for various interventions.

• Advanced Directives/DNR Orders should physician sign for medical validity.

• Legal directives should be provided before resuscitation efforts

• An ALS AOS pt would need morphine pump, Call the Hospice agency

• The purpose of research is to ensure to enhance EMS.

• Quanitative is the use of number while Qualitiative os reasons and experiences.

• Evidence based practice is reliablility of strong research trials

• nuremburg Code ensures pt informed and safe

• Institutional Boards Approve studies to advance knowledge.

Generalized Week 4 Exam

• Abstract a research paper for the need to results and confidence level

• IRB oversees the ethics around conduct and research

• Research in EMS is the patients best interest by providiing change

• Ethics are a standard of standards in groups of conduct

• If a restrictive PT needed care respect what is needed to be done and adapt

• Maintain PT confidentiality and protect Legal responsibility .

• Alow and inability to comprehend risks give nurses autonomy -Implied consent, AMA and restraints use for consent.

• Evidence with reasearch is how it will affect treatments and the patients

• Descriptive study is study of the effect on patients

Core professional attributes

• Plain language is clear and effective, while respecting patients scope if private
• Radios are simple and duplex for transmissions
• Use LTE and GIS technology to provide awareness

Communication is an advanced measure

• Critical tasks of emergency is moa and provide transport
• c/c, negg and trending vitals are pertinent in med report.
• Communicate using clear language and proffessionalism.
• PCR is objectove and thorough in written reports
• Report to ensure all info is provided to to verify and avoid confusion.
• Lack of clear time is a barrier of safety.

Solutions

• Confirum recicer knows what is copy that and use strucutre standards to verfy everything
• Legal conciderartions, maintian hippa and protocols at scene
• Stay current with success.

Study notes covering infection control, proper lifting techniques, and EMS wellness. Key topics include sharps disposal, PPE, body mechanics, hydration, and stress management in emergency medical services.