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Questions and Answers
What significant advancement did Jean Larrey develop in the 1790s?
What significant advancement did Jean Larrey develop in the 1790s?
Which historical period saw the establishment of ambulance corps and field hospitals?
Which historical period saw the establishment of ambulance corps and field hospitals?
Who is often referred to as the 'Father of Paramedicine'?
Who is often referred to as the 'Father of Paramedicine'?
What was a key development in paramedicine during the 1960s?
What was a key development in paramedicine during the 1960s?
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In what year was the first dedicated EMT textbook published in the US?
In what year was the first dedicated EMT textbook published in the US?
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Which historical document established protocols and reimbursements for medical care?
Which historical document established protocols and reimbursements for medical care?
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What innovation was introduced during the Korean War to address war injuries?
What innovation was introduced during the Korean War to address war injuries?
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Which organization is related to the accreditation of Canadian Paramedic education?
Which organization is related to the accreditation of Canadian Paramedic education?
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What significant advancement in prehospital care began in the 1990s?
What significant advancement in prehospital care began in the 1990s?
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In which period did non-physician providers start being trained for advanced medical procedures?
In which period did non-physician providers start being trained for advanced medical procedures?
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How did the Code of Hammurabi contribute to medical practice?
How did the Code of Hammurabi contribute to medical practice?
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What was a key outcome of the development of leadership organizations in paramedicine?
What was a key outcome of the development of leadership organizations in paramedicine?
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What type of medical care was primarily provided in homes during Ancient Times?
What type of medical care was primarily provided in homes during Ancient Times?
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What type of paramedics emerged as a result of increased expansion of services?
What type of paramedics emerged as a result of increased expansion of services?
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Which of the following technological advancements is associated with prehospital care?
Which of the following technological advancements is associated with prehospital care?
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What has seen a significant increase due to advancements in prehospital care research?
What has seen a significant increase due to advancements in prehospital care research?
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What is one key benefit of Continuous Quality Improvement (CQI) in patient care?
What is one key benefit of Continuous Quality Improvement (CQI) in patient care?
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Why is Professional Development crucial in the field of medicine?
Why is Professional Development crucial in the field of medicine?
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Which of the following is NOT a reason cited for the need for Professional Development?
Which of the following is NOT a reason cited for the need for Professional Development?
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What is an expected outcome for patients from Professional Development of paramedics?
What is an expected outcome for patients from Professional Development of paramedics?
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What role does Professional Development play for paramedics in terms of employability?
What role does Professional Development play for paramedics in terms of employability?
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Which group is NOT mentioned as a benefactor of Professional Development?
Which group is NOT mentioned as a benefactor of Professional Development?
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What does the term 'scope of practice' imply in the context of professional development?
What does the term 'scope of practice' imply in the context of professional development?
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What is a misconception about the nature of medicine that highlights the importance of professional development?
What is a misconception about the nature of medicine that highlights the importance of professional development?
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Study Notes
HSPA1000 - Fundamentals of Paramedic Practice
- Course title: Fundamentals of Paramedic Practice
- Course code: HSPA1000
- Semester: Spring 2024
Topics
- What is Paramedicine?
- History of EMS
- Roles & Responsibilities
- Professionalism
- Paramedic Patient Relationship
- Effective Communication
Paramedicine
- Paramedicine is a domain of practice and health profession that specializes across a range of settings, including emergency and primary care.
- Paramedics work in diverse clinical settings such as emergency medical services, ambulance services, hospitals, and clinics, as well as non-clinical roles like education, leadership, public health, and research.
- Paramedics possess complex knowledge and skills, a broad scope of practice, and are essential to the healthcare system.
- Depending on location, paramedics may practice under medical direction or independently, often in unscheduled, unpredictable, or dynamic settings.
History of Paramedicine
- Early medical professionals provided care in homes, with protocols and reimbursements established by the Code of Hammurabi (1700 BC).
- 1790s : Jean Larrey developed "ambulances volantes" for field care.
- World Wars I and II led to the development of ambulance corps for casualty care.
- The US considered roles of non-physician providers performing advanced medical procedures outside hospitals from the 1960s onward.
- The Korean War saw the introduction of field hospitals (MASH units) and helicopter evacuations to enhance war injury survivability.
- Dr. Eugene Nagel, the "Father of Paramedicine", began training firefighters with advanced emergency skills (1969).
- The US DOT created National Standards for paramedics based on work by Nancy Caroline (1971, 1977).
- The first dedicated EMT textbook was published in the US (1977).
- Canadian Paramedic education was accredited by the CMA in the 1990s.
- The Paramedic Association of Canada (PAC) established a national competency profile and professional titles for paramedics (1990s-2000).
EMS Systems
- The modern EMS system is a complex network of coordinated services providing various levels of prehospital care to a community.
- The EMS system involves citizen invovlement and public education to recognize emergencies, activate services, and provide basic bystander care.
- Dispatchers receive and process all information for an EMS call, relay the details to the appropriate resources (often including dispatching emergency medical resources to the scene), some dispatchers provide preliminary treatment advice.
- Paramedics' varying roles include Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP), and Critical Care Paramedic (CCP) (differing by scope of practice / regulations depending on country).
Roles and Responsibilities
- Paramedic Responsibilities : Preparation, response, scene management, patient assessment, prehospital care, management and disposition, patient transfer, documentation, return to service, responding and providing care.
- Workplace Factors : Shift preparedness, pre-shift checks, mental and physical well-being
- The workplace includes 12 hour shifts, pre-shift health and safety procedures and requirements.
Scope of Practice
- The scope of practice for paramedics is defined by laws, regulations, medical protocols, and certifications.
- Protocols are standardized procedures outlining steps for specific situations.
- Clinical Practice Guidelines (CPGs) are evidence-based recommendations developed by medical experts to guide decision-making in patient care.
- Paramedics act under Standing Orders or Directives as pre-approved protocols or instructions given by medical oversight to perform certain interventions or procedures.
- Paramedics must act within the scope of their defined scope of practice in patient care, with legal implications for acting outside it.
Medical Oversight
- Medical Oversight involves physician supervision and guidance, which ensures paramedics deliver safe, effective, and high-quality patient care.
- It includes real-time communication between paramedics and medical professionals, through mechanisms such as online medical control, radio, phone, or video conference to seek guidance or feedback, and to intervene when necessary in emergencies.
- It also involves the development and implementation of protocols, clinical guidelines, standing orders, and quality assurance processes.
Paramedic Clinical Support
- Paramedics support their peers with clinical support by providing guidance, and acting as a peer network for assistance with complex or challenging medical cases.
Documentation
- Detailed records (patient care report / Electronic Patient Care Report - EPCR) are essential for legal protection and patient care.
- Thorough documentation in a patient care report (PCR) provides information for the patient’s medical history, symptoms, assessments, treatments, and vital signs.
- PCR records should include the time of the call, arrival, departure, and hospital arrival, observations from the patient and bystanders.
Continuous Quality Improvement (CQI)
- Paramedic professionals have a responsibility to report near misses (incidents that could have caused harm but were avoided) and adverse events (incidents resulting in harm to the patient/paramedic) to the appropriate authorities.
- CQI in paramedicine is an ongoing process of identifying, analyzing, and enhancing practices to improve patient outcomes and efficiency, utilizing data-driven decision-making.
- Examples include regularly reviewing protocols, auditing procedures, training, feedback and analysis of response times.
Professional Development
- Professional development encompasses the acquisition of skills and knowledge both for personal development and for career advancement. It includes a range of learning opportunities from college degrees to formal coursework, conferences and informal learning.
Paramedic Patient Relationship
- Paramedics have a responsibility to patients in aspects of informed consent, including ensuring patients have the right to receive clear and competent information, privacy and confidentiality, autonomy of decision-making, respect and dignity, safety considerations, and involvement in their care.
- It involves supporting patient rights, interests, and well-being within the healthcare system.
- Paramedics act as advocates, ensuring patients have access to resources, and are treated with dignity.
- It requires respecting autonomy and choices, maintaining privacy and offering compassionate care, treating patients fairly and ethically.
Confidentiality
- Confidentiality is the ethical and legal obligation in healthcare to protect patient information.
- Information is only shared with authorized individuals involved in the patient’s care.
- Paramedics must consider the environment to ensure patient information is not disclosed inadvertently to those outside the circle of care, maintaining confidentiality and trust.
Behaving Ethically
- Ethical behavior within healthcare and paramedicine involves upholding professional standards, respecting patient autonomy, prioritizing patient welfare, and maintaining confidentiality.
- It also involves honesty, transparency, and accountability, in all parts of practice.
- Ethical decisions require careful consideration of the consequences of actions and a commitment to the best interests of patients and the community.
Consent
- Consent for healthcare actions, including procedures, treatment options etc., is voluntary and involves the patient having the capacity to make informed decisions, which can only be made freely, without coercion or influence..
- Consent must be given willingly by a patient who has the legal authority and mental capacity to make decisions about their medical care. Consent needs to be Specific to the treatment being proposed, including purpose, benefits, risks, and alternatives.
Capacity
- Capacity for decision-making refers to an individual’s ability to understand relevant information, assess options, and communicate their decisions consistently.
- Capacity can fluctuate due to physical or mental conditions.
- Paramedics need to assess a patient's capacity when making decisions about their care; this includes evaluating their ability to understand, communicate and make decisions for themselves.
Refusal of Care
- Patients have the right to refuse treatment or transport.
- During the capacity assessment, paramedics must rule out any condition that has the potential to affect a patient's decision-making capabilities.
- Paramedics are responsible for documentation that ensures transparency, accountability, and continuity of care for both the patient and the organization providing the care, and protecting the patient’s autonomy and rights.
Patient Advocacy
- Patient advocacy involves support for patient rights, interests, and well-being.
- It includes ensuring access to resources, dignity, respect, and autonomy.
- Paramedics act as advocates through communication, education, and addressing systemic issues.
- This includes helping patients navigate healthcare systems and ensuring equitable access to care.
Psychosocial Supports
- Psychosocial support focuses on the emotional, social, and psychological needs of patients alongside the medical aspect.
- This includes recognizing patients’ feelings, concerns, and social circumstances.
- Patient-centered care prioritizes patients’ preferences, values and needs when making or providing treatment decisions.
Effective Communication
- Effective communication for paramedics requires encoding, transmitting, receiving, and decoding verbal and non-verbal messages correctly and effectively.
- Internal factors, such as empathy, emotional intelligence, bias and self-awareness, significantly influence communication effectiveness..
- External factors, including the physical environment, cultural context, and technology resources, also affect communication interaction.
- Effective communication strategies, including open-ended, closed-ended, probing/follow-up, and pay off questions, as well as aspects of therapeutic tone and communication techniques (e.g., body language) are used with patients.
Chapter References
- Nancy Caroline Emergency Care in the Streets – 8th Edition, Canadian Edition
- Chapter I - EMS Systems, Roles, and Responsibilities
- Chapter 4 – Medical and Legal Issues
- Chapter 10 - Patient Communication
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Description
This quiz explores the essential concepts in the Fundamentals of Paramedic Practice course. It covers foundational topics such as the history of EMS, roles and responsibilities, and effective communication within the paramedic profession. Prepare to test your understanding of paramedicine and its significance in healthcare.
