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Questions and Answers
What should be done if permission for treatment cannot be quickly obtained?
What should be done if permission for treatment cannot be quickly obtained?
Which pulse point requires a minimum systolic blood pressure of 70 mm Hg to be palpated?
Which pulse point requires a minimum systolic blood pressure of 70 mm Hg to be palpated?
What does a DNR order signify?
What does a DNR order signify?
What is the appropriate action regarding a person who poses a threat to themselves or others?
What is the appropriate action regarding a person who poses a threat to themselves or others?
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In which situation should law enforcement agencies be involved?
In which situation should law enforcement agencies be involved?
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What should a guardian do if a victim refuses medical treatment?
What should a guardian do if a victim refuses medical treatment?
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What is the minimum systolic blood pressure required for palpating the carotid pulse?
What is the minimum systolic blood pressure required for palpating the carotid pulse?
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What type of document outlines desired medical interventions for individuals who cannot express their wishes?
What type of document outlines desired medical interventions for individuals who cannot express their wishes?
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What does the term 'Duty to Act' refer to in emergency medical practice?
What does the term 'Duty to Act' refer to in emergency medical practice?
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Which of the following describes 'abandonment' in the context of emergency medical services?
Which of the following describes 'abandonment' in the context of emergency medical services?
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What type of consent is given when a patient indicates they are ready for treatment verbally or nonverbally?
What type of consent is given when a patient indicates they are ready for treatment verbally or nonverbally?
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How is 'implied consent' typically applied to patients who are unconscious?
How is 'implied consent' typically applied to patients who are unconscious?
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What is a critical consideration when treating minors in emergency situations?
What is a critical consideration when treating minors in emergency situations?
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Which statement about consent for mentally ill patients is accurate?
Which statement about consent for mentally ill patients is accurate?
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What must occur for 'expressed consent' to be valid in emergency medical situations?
What must occur for 'expressed consent' to be valid in emergency medical situations?
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Which of the following correctly describes the ethical considerations in establishing the scope of practice for EMTs?
Which of the following correctly describes the ethical considerations in establishing the scope of practice for EMTs?
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What is the correct procedure if a foreign object is found in a patient's mouth?
What is the correct procedure if a foreign object is found in a patient's mouth?
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When should an oral airway (OPA) be used for a patient?
When should an oral airway (OPA) be used for a patient?
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How should an OPA be correctly inserted?
How should an OPA be correctly inserted?
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What is the proper measurement technique for a nasal airway (NPA)?
What is the proper measurement technique for a nasal airway (NPA)?
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What is a common characteristic of patients who can use an NPA?
What is a common characteristic of patients who can use an NPA?
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Which of the following airway adjuncts is suitable for conscious patients without a gag reflex?
Which of the following airway adjuncts is suitable for conscious patients without a gag reflex?
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When selecting a king tube for airway management, what must be ensured?
When selecting a king tube for airway management, what must be ensured?
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How can the percent of oxygen being inhaled be expressed?
How can the percent of oxygen being inhaled be expressed?
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What is indicated by a Glasgow Coma Scale (GCS) score below 8?
What is indicated by a Glasgow Coma Scale (GCS) score below 8?
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What sound is characterized as a strained, high-pitched noise during inspiration?
What sound is characterized as a strained, high-pitched noise during inspiration?
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Which lung sound is best described as crackly and caused by fluid in the lungs?
Which lung sound is best described as crackly and caused by fluid in the lungs?
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Which condition is most likely associated with wheezing sounds?
Which condition is most likely associated with wheezing sounds?
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In trauma assessment, when should a primary survey be stopped?
In trauma assessment, when should a primary survey be stopped?
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What is a symptom of upper airway obstruction in the pharynx or larynx?
What is a symptom of upper airway obstruction in the pharynx or larynx?
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What is the lowest score possible on the Glasgow Coma Scale, and what does it signify?
What is the lowest score possible on the Glasgow Coma Scale, and what does it signify?
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What type of lung sound is described as a rattling noise associated with mucus in the lungs?
What type of lung sound is described as a rattling noise associated with mucus in the lungs?
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What does FiO2 represent in the context of oxygen therapy?
What does FiO2 represent in the context of oxygen therapy?
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When does the Golden Hour for trauma patients begin and end?
When does the Golden Hour for trauma patients begin and end?
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Which phase of a blast injury involves the risk of thermal burns?
Which phase of a blast injury involves the risk of thermal burns?
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In the context of trauma assessment, what does the 'A' in XABC stand for?
In the context of trauma assessment, what does the 'A' in XABC stand for?
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What is the purpose of the recovery position in trauma care?
What is the purpose of the recovery position in trauma care?
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Which position is used primarily for patients with respiratory emergencies such as CHF and COPD?
Which position is used primarily for patients with respiratory emergencies such as CHF and COPD?
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What vital sign should be obtained as part of a baseline assessment for trauma patients?
What vital sign should be obtained as part of a baseline assessment for trauma patients?
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What does 'Pupils, GCS, and signs of cerebral herniation' relate to in trauma assessment?
What does 'Pupils, GCS, and signs of cerebral herniation' relate to in trauma assessment?
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In which positioning is a patient lying face down?
In which positioning is a patient lying face down?
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What is the correct definition of the Trendelenburg position?
What is the correct definition of the Trendelenburg position?
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Study Notes
EMT Scope of Practice
- The “scope of practice” refers to the extent and limits of the EMT's or EMS job.
- Legal responsibility to act during emergencies is considered the “Duty to Act.”
- “Abandonment” refers to leaving a patient after initiating care and before transferring them to a medical professional with equal or greater training.
Patient Consent
- Expressed Consent: The patient verbally or nonverbally expresses willingness to receive treatment. The patient must be of legal age and able to make rational decisions.
- Implied Consent: The patient is not able to make a rational decision, but they are of legal age and do not specifically refuse emergency care.
- Consent for Minors: Minors cannot legally express their consent. Medical treatment must wait for consent from a parent or legal guardian. In emergencies, treatment can begin without consent if it cannot be quickly obtained.
- Consent for Mentally Ill Patients: These patients require a specific approach. EMTs should familiarize themselves with state laws on how to handle such cases.
- Refusal of Care: A patient refusal to accept first aid or medical treatment must be documented, along with the refusal of consent from a parent or legal guardian (in the case of minors).
- Advanced Directives: A “living will” documents the patient's desired medical interventions in case of incapacity.
- DNR (Do Not Resuscitate): Orders that instruct medical professionals not to perform CPR.
Pulse Points and Blood Pressure
- Carotid Pulse: Located on either side of the neck near the carotid artery. Palpable at a systolic blood pressure of at least 60 mmHg.
- Femoral Pulse: Located on either side of the groin near the femoral artery. Palpable at a systolic blood pressure of at least 70 mmHg.
- Radial Pulse: Palpable at a systolic blood pressure of at least 80 mmHg.
- Pedal Pulse: Palpable at a systolic blood pressure of at least 90-100 mmHg.
Checking and Removing Obstructions
- Examine the mouth for foreign objects such as candy, food, or dirt.
- Finger sweep or suction: If objects are present, use a finger sweep or suction to remove them. Suctioning should not exceed 15 seconds.
- Yankauer: A suction device used to clear obstructions from the mouth.
- Airway Devices: If the mouth is clear, employ an airway device such as an oral or nasal airway, king tube, or intubation to maintain a clear airway.
Airway Adjuncts
- Oral Airway (OPA): Displaces the tongue, opening the airway. OPA's are generally used in patients without a gag reflex. The appropriately sized OPA is measured from the edge of the mouth to the angle of the jaw. Insert the device with the tip pointing towards the top of the head and rotate 180 degrees to secure placement.
- Nasal Airway (NPA): Suitable for patients with a gag reflex. Use a twisting motion to insert the NPA, which should be lubricated with surgical lube. The right nare is usually the largest.
- King Tube: An advanced airway device.
- Intubation: A procedure to insert a breathing tube into the trachea.
FiO2 and Oxygen Devices
- FiO2 (Fraction of Inspired Oxygen): The percentage of oxygen being inhaled, expressed as a percentage or decimal. This is a critical factor when assessing oxygen levels using devices like a BVM (Bag Valve Mask), non-rebreathing mask, venturi mask, nebulizer, or nasal cannula.
The Golden Hour in Trauma
- The Golden Hour: The 60-minute window following a severe injury during which immediate surgery is crucial for optimal survival. The Golden Hour begins when the injury occurs and ends when the patient reaches the operating room.
-
Phases of a Blast Injury:
- Primary: Air blast, primarily affecting hollow organs.
- Secondary: Penetrating or blunt trauma from flying debris.
- Tertiary: Injuries similar to those of a thrown object.
- Quaternary: Thermal burns, heat, fire exposure.
- Quinary: Chemical, biological, or radiological effects.
-
XABC Assessment:
- X: Exsanguinating hemorrhage
- A: Airway
- B: Breathing
- C: Circulation
Trauma Assessment
-
ITLS Trauma Assessment: An assessment method for trauma patients. It involves:
- Obtaining baseline vital signs
- Performing a brief neurological exam: - Pupillary response - Glasgow Coma Scale (GCS) - Signs of cerebral herniation
- Checking for medical alert tags
- Considering other potential causes of altered mental status.
Patient Positioning
- Recovery Position: For breathing patients, the recovery position protects the airway and prevents aspiration. It does not protect the cervical spine.
- Supine Position: Lying on the back.
- Prone Position: Lying face down.
- Fowlers Position: Head elevated at 30 degrees. Ideal for airway management, especially helpful in patients with head bleeds or cerebrovascular accidents (CVA).
- Trendelenburg Position: Patient on back with feet elevated 10-15 degrees. Used for shock and hypotension.
GCS (Glasgow Coma Scale)
- The GCS score ranges from 3 (worst, indicating coma or death) to 15 (best, indicating full consciousness).
- Eye Opening: Response of the eyes to stimuli.
- Verbal Response: Patient's ability to speak or respond verbally.
- Motor Response: Patient's ability to move in response to stimuli.
Lung Sounds
- Stridor: Strained, high-pitched sound heard during inspiration, indicating obstruction of the upper airway in the pharynx or larynx.
- In: Above the vocal cords
- Out: Below the vocal cords
- Course Rales: Crackling noises that sound like crackling or popping, indicating fluid in the lungs.
- Fine Rales: Similar to course rales but lower-pitched and crackly, indicating fluid in the lungs.
- Wheezes: Continuous, high-pitched whistling sound, usually during expiration. Caused by narrowing in the bronchioles (e.g., asthma, COPD, anaphylaxis).
- Rhonchi: Rattling sound heard in the bronchi, indicating mucous in the lungs or upper airway.
Reasons to Stop a Primary Survey in Trauma
- Cardiac arrest
- Airway obstruction
- Life-threatening arterial hemorrhage
- Severe injuries or conditions requiring immediate attention.
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Description
This quiz covers the essential aspects of EMT scope of practice, including the duty to act, abandonment, and various forms of patient consent. Understand the legal responsibilities and the conditions under which consent is obtained, particularly for minors and mentally ill patients. Test your knowledge on these critical concepts in emergency medical situations.
