Paramedic Practice & Safety
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Questions and Answers

A paramedic is called to assist a patient with suspected tuberculosis (TB). Which of the following personal protective equipment (PPE) would provide the MOST appropriate respiratory protection?

  • N95 respirator (correct)
  • Standard face shield
  • Gloves and gown
  • Surgical mask

During a mass casualty incident, effective communication is crucial for safe patient handling. What is the MOST important aspect of team communication to ensure proper lifting and moving techniques are used?

  • Having each team member announce their lifting capacity.
  • Rotating team members frequently to avoid fatigue.
  • Designating one person to lead with clear verbal commands. (correct)
  • Using a variety of non-verbal cues to signal lifting.

What is the PRIMARY reason for paramedics to consistently practice proper lifting and moving techniques when handling patients, especially during emergency situations?

  • To minimize the risk of injury to themselves and their team. (correct)
  • To comply with hospital protocols.
  • To impress bystanders with their efficiency.
  • To expedite patient transport times.

What is the MOST effective strategy a paramedic can implement to prevent the spread of common communicable diseases in their daily practice?

<p>Consistently practicing proper hand hygiene. (D)</p> Signup and view all the answers

A new paramedic expresses feeling overwhelmed by the high-stress environment of EMS. Which stress management technique would be MOST effective for managing acute stress during calls?

<p>Practicing controlled breathing exercises. (B)</p> Signup and view all the answers

You have a needle stick exposure while starting an IV on a patient that is known to have Hepatitis C; outside of immediate wound care, what is the NEXT step in handling this situation?

<p>Report the exposure to the appropriate supervisor and follow established protocols. (C)</p> Signup and view all the answers

To gain the greatest cardiovascular benefit, paramedics who smoke should be encouraged to participate in what type of program?

<p>Smoking cessation (B)</p> Signup and view all the answers

What is the primary role a paramedic should take in promoting overall wellness?

<p>Actively participating in wellness programs themselves. (B)</p> Signup and view all the answers

Asking an adult patient for permission before assessing and providing care is an example of obtaining:

<p>Expressed consent (C)</p> Signup and view all the answers

Which patient scenario poses the greatest public health threat?

<p>A 24-year-old male who appears very ill and recently returned from West Africa (A)</p> Signup and view all the answers

After successfully treating an unresponsive diabetic patient who then regained consciousness, you arrange ambulance transport at a basic level. The patient now alleges you terminated the provider-patient relationship without consent. Which term BEST applies to this situation?

<p>Abandonment (A)</p> Signup and view all the answers

In which of the following situations is it permissible to treat and transport a minor without express parental consent?

<p>When the minor has a life-threatening injury (B)</p> Signup and view all the answers

What is the MOST important reason for EMS providers to participate in research efforts?

<p>To prove changes in procedures make a positive difference (D)</p> Signup and view all the answers

What is the MOST practical method to prevent cross-contamination between patients?

<p>Using disposable equipment whenever possible (A)</p> Signup and view all the answers

Which of the following BEST indicates that a patient falls into the category of "DNR"?

<p>The family produces a valid document signed by the patient and his or her physician (A)</p> Signup and view all the answers

An EMS team is dispatched to a bar for a 'man down'. Witnesses state that an intoxicated individual had a seizure and is now uncooperative. The patient resists treatment, yelling profanities and kicking. Which action would MOST clearly demonstrate negligence on the part of rescuers?

<p>Leaving the scene without further attempt to provide care (A)</p> Signup and view all the answers

During an EMS call, what is the MOST important consideration when communicating with other medical professionals during a transfer of care?

<p>Clarifying that the person accepting care understands what you are trying to describe (D)</p> Signup and view all the answers

Which of the following is the GREATEST risk associated with variable EMS shift work?

<p>Sleep deprivation (C)</p> Signup and view all the answers

Which action BEST demonstrates professional conduct for an EMS provider:

<p>Wearing a clean, pressed uniform at work. (C)</p> Signup and view all the answers

What is the MOST appropriate strategy for developing the ability to perform well under pressure?

<p>Raising technical skills to the instinctive level. (C)</p> Signup and view all the answers

What is the primary purpose of the Ryan White Act in the context of EMS?

<p>To protect EMS providers exposed to infectious diseases by allowing patient testing. (B)</p> Signup and view all the answers

An alert and oriented patient with a laceration refuses treatment, despite your concerns about potential infection. Before honoring the patient's refusal, you should FIRST:

<p>Ensure the patient is fully informed of the risks of refusal. (D)</p> Signup and view all the answers

An EMS provider failed to recognize a misplaced endotracheal tube, resulting in a negative patient outcome. A new device claims to reduce the likelihood of this occurrence. What is the MOST important consideration BEFORE implementing the new device?

<p>There is ample scientific research to support the claim. (A)</p> Signup and view all the answers

Which of the following best describes the term 'libel' in the context of EMS legal considerations?

<p>Making false statements in writing or on social media with malicious intent. (A)</p> Signup and view all the answers

You are called to a private residence and are treating a patient with confirmed TB. How should you disinfect your stethoscope?

<p>Medium-level disinfectant (B)</p> Signup and view all the answers

Why would the nurse receiving your patient in the Emergency Department ask you to state the last three sets of vital signs for a GI bleed patient?

<p>To identify any positive or negative trending patterns during transport (D)</p> Signup and view all the answers

You are transferring care of a patient to a nurse in the emergency department. Failing to provide a concise and accurate report could be considered:

<p>Abandonment. (B)</p> Signup and view all the answers

Which of the following is an example of implied consent?

<p>Treating an unconscious patient with a GCS of 3. (A)</p> Signup and view all the answers

You are called to a scene where a patient is refusing care. To ensure their refusal is valid, the patient must be:

<p>Alert, aware, and fully informed of the risks. (B)</p> Signup and view all the answers

Which communication technology allows for simultaneous two-way communication?

<p>Duplex radio. (C)</p> Signup and view all the answers

Upon arrival at a scene, you find a patient with a valid DNR order. What is the MOST important action to take?

<p>Ensure the legal directive is present and valid before withholding resuscitation efforts. (B)</p> Signup and view all the answers

Which of the following components must be included to ensure the validity of a DNR order?

<p>Witness and physician signatures. (A)</p> Signup and view all the answers

In the context of EMS, what does 'assault' legally refer to?

<p>Unlawfully placing a person in fear of immediate bodily harm without consent. (C)</p> Signup and view all the answers

Which of the following is the MOST appropriate action when communicating with a patient who speaks a different language?

<p>Utilize a professional interpreter or translation service. (C)</p> Signup and view all the answers

What is the primary goal of evidence-based practice in EMS?

<p>To improve patient outcomes through research. (D)</p> Signup and view all the answers

During a 911 call, an EMD is collecting information from a caller at an apartment complex. What information would be MOST critical?

<p>What happened today? (C)</p> Signup and view all the answers

What type of radio will you MOST likely have installed in your vehicle?

<p>Mobile (D)</p> Signup and view all the answers

You have been called to the scene of a patient with a serious medical emergency and the patient is now refusing treatment and transportation. What would be the MOST difficult to achieve in order for the refusal to be legitimate?

<p>Making certain that the patient is fully informed. (A)</p> Signup and view all the answers

Which of the following best illustrates the 'Act' component of continuous quality improvement (CQI) in EMS?

<p>Adjusting strategies based on monitored outcomes and reinforcing best practices. (B)</p> Signup and view all the answers

An EMS provider is called to a scene where a patient is experiencing a mental health crisis. Which in-hospital resource would be MOST appropriate for the EMS provider to utilize?

<p>Mental Health Provider (D)</p> Signup and view all the answers

What is the primary purpose of the National Registry of Emergency Medical Technicians (NREMT)?

<p>To establish and maintain consistent standards for EMS training and certification nationwide. (D)</p> Signup and view all the answers

How do community paramedicine and mobile integrated healthcare programs primarily benefit the healthcare system?

<p>By promoting wellness, preventing illness/injury, and addressing chronic conditions in out-of-hospital settings. (B)</p> Signup and view all the answers

An EMS provider failed to administer oxygen to a patient experiencing severe respiratory distress, leading to a worsened condition. This is an example of what?

<p>Nonfeasance (B)</p> Signup and view all the answers

An EMT administers the correct dose of medication, but uses an unapproved route, causing harm to the patient. This is an example of:

<p>Misfeasance (B)</p> Signup and view all the answers

Which of the following is the BEST example of how EMS providers can collaborate with public health sectors to enhance community health?

<p>Creating community disaster plans and participating in community education programs. (D)</p> Signup and view all the answers

Which of the following is an example of a 'vector' in the context of epidemiology?

<p>A mosquito transmitting malaria to a human. (B)</p> Signup and view all the answers

What is the primary role of a Medical Director in an EMS system?

<p>To develop and implement EMS protocols and provide medical oversight. (C)</p> Signup and view all the answers

An EMS provider administers a medication to a patient, following the local protocols. Later, research emerges showing this medication is harmful. What protects the provider?

<p>Following established protocols developed under medical oversight. (D)</p> Signup and view all the answers

In the context of EMS professionalism, why is empathy considered essential?

<p>It helps providers understand and respond to a patient's emotional needs, fostering trust and rapport. (D)</p> Signup and view all the answers

What is the MOST important reason for EMS providers to participate in continuing education?

<p>To stay up-to-date with evolving best practices, maintain skills, and improve patient outcomes. (D)</p> Signup and view all the answers

Which of the following describes the primary focus of public health principles in EMS?

<p>Promoting health, preventing disease and injury, and improving community health outcomes. (A)</p> Signup and view all the answers

An EMS provider is at the scene of a motor vehicle accident. What action reflects the FIRST and MOST important responsibility?

<p>Ensuring personal and scene safety. (A)</p> Signup and view all the answers

What is the significance of the 1966 White Paper, 'Accidental Death and Disability: The Neglected Disease of Modern Society', in the development of EMS?

<p>It highlighted critical deficiencies in the existing system of emergency care and prompted significant reforms. (B)</p> Signup and view all the answers

Where might documentation of a person's organ donation intentions be found?

<p>Cards or medic alert tags (D)</p> Signup and view all the answers

Which legal term best describes threatening to immobilize a patient without consent unless they cooperate?

<p>Assault (D)</p> Signup and view all the answers

What is the MOST appropriate response when a protocol for a medical emergency with a traumatic injury places the patient at significant risk?

<p>Synthesize an appropriate response on your own. (B)</p> Signup and view all the answers

Which statement best describes the concept of 'Scope of Practice'?

<p>Treatments you are licensed, authorized, and trained to do. (A)</p> Signup and view all the answers

Why is an effective verbal report at the hospital considered essential?

<p>It is an integral part of the transfer of care. (D)</p> Signup and view all the answers

A patient with a productive cough, night sweats, and breathing difficulties at a homeless shelter requires what precaution?

<p>Covering the patient's mouth with a disposable mask. (D)</p> Signup and view all the answers

Why is efficient and effective radio communication important? (Select all that apply)

<p>To receive orders from medical control. (A), To provide for our safety. (B), To allow the receiving facility to prepare. (C)</p> Signup and view all the answers

Which attribute increases effectiveness and efficiency in verbal communication?

<p>Being genuine, sincere, and honest. (A)</p> Signup and view all the answers

During CPR on a cardiac arrest patient, family states the patient has a DNR but cannot locate the paperwork. How do you proceed?

<p>Continue CPR while obtaining information and contacting medical control. (C)</p> Signup and view all the answers

Which personal protective equipment is most appropriate for a patient presenting with a productive cough, fever, and weakness?

<p>Gloves, eye protection, HEPA respirator (C)</p> Signup and view all the answers

Flashcards

Sharps Container

A puncture-proof container for used needles and other sharp medical instruments.

PPE (Personal Protective Equipment)

Using equipment like gloves, masks, and eye protection to prevent contact with bodily fluids.

Hand Hygiene

Washing hands with soap and water to remove germs.

Proper Lifting Techniques

Keep the load close, use legs, avoid twisting. Designate a team leader.

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Stress Management Techniques

Reframing thoughts, controlled breathing.

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Phases of Stress (Hans Selye)

Alarm (fight or flight), resistance, exhaustion.

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Reducing Employee Injury Risk

Implement a safety driver course

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EMS System Components

Community responders, fire/rescue, law enforcement.

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In-Hospital EMS

Care provided in a hospital setting by RNs, PAs, doctors, mental health providers, and rehab services.

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Technological Advances in EMS

Use of technology like telemedicine and smartphone apps to enhance emergency medical services.

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Responsibilities of EMS

Preparation, Response, Patient Assessment, Patient Management, and Disposition/Documentation.

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Professionalism in EMS

Leadership, Empathy, Integrity, Teamwork, and Time Management.

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Appearance and Ethics in EMS

Clean, pressed uniforms and adherence to a code of ethics.

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Patient-First Attitude

Treating patients as you would want your family treated

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EMS Protocols

Developed by medical directors with EMS input, they define care standards.

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Standing Orders

Specific interventions that can be performed prior to contacting medical command.

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Continuing Education

Ensures continued competency and skill maintenance

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Reason for EMS Research

To see if what we use in the field works before implementing it further

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Role of National Associations

Provides foundation to ensure competency of out-of-hospital EMS personnel.

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Epidemiology

Study of disease incidence and prevalence in populations.

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Duty to Act

Formal or informal obligation to provide care.

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Breach of Duty

Action or inaction violating standard of care.

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Proximate Cause

Action that immediately caused or worsened damage suffered by the patient.

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Good Samaritan Laws

Laws offering legal protection to individuals who assist in an emergency, without expectation of compensation.

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Informed Consent

Consent given by a patient after full disclosure of treatment risks and benefits.

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Expressed Consent

Consent that is verbally or written consent.

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Implied Consent

Type of consent: Patient is unconscious, so consent is assumed (Duty to Act).

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Defamation

False communication harming someone's reputation.

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Libel

Written or social media false statements with malicious intent.

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Slander

Spoken false statements injuring a person's reputation with malicious intent.

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Abandonment

Terminating patient care without ensuring continued care.

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Assault

Unlawfully placing someone in fear of immediate bodily harm without consent.

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Battery

Unlawful touching of an individual without their consent.

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Ryan White Act

Protects EMS when exposed to infectious diseases; allows patient testing request after exposure.

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DNR Orders

Orders signed by patient and physician indicating wishes to withhold certain treatments.

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Simplex Radio

A radio system where only one person can send a message at a time.

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Duplex Radio

A radio system where simultaneous two-way communication is possible.

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Emergency Medical Dispatcher (EMD)

Guides bystander actions before EMS arrival but avoids specific treatment/transport recommendations.

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Organ Donation Documentation

Intentions to donate organs may be documented on cards or medic alert tags.

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Assault (in a medical context)

The act of threatening to physically restrain a patient without their consent.

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Protocol Deviation

Deviation from protocol requires a synthesized, appropriate response based on the situation.

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Scope of Practice

The treatments you are legally permitted to perform; dictated by license, authorization, and training.

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Importance of Verbal Report

Crucial for seamless patient handover, ensuring continued quality care.

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Protecting From a Coughing Patient

Wearing a disposable mask on the patient. Protect yourself and others from potential airborne infection.

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Efficient Radio Communication

Safety, medical direction, and facility preparation.

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Verbal Communication Attribute

Genuine, sincere, and honest communication builds trust.

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CPR with Missing DNR

While searching, continue CPR and contact medical control for direction.

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Critical Incident Stress Sign

Signs or symptoms of critical incident stress response include disorientation.

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Public Health Threat

Greatest threat: sick, returning from outbreak area.

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Treating Minors Without Consent

Treatment allowed when minor has a life-threatening condition.

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EMS Research Importance

Helps ensure treatments are effective.

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Preventing Cross Contamination

Reduces spread of infection between patients.

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DNR Indicators

Valid legal document signed by patient/physician.

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Improve Physical Fitness

Helps improve physical health.

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EMS Communication Advice

Transfer of care, clarify understanding.

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Risks of Shift Work

Can cause impaired judgment and reaction time.

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Thinking Under Pressure

Raise skills to instinctive level.

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Physical Wellness

Maintaining appropriate body weight.

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Public Health Programs

Car seat installation is an example.

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PPE for Endotracheal Intubation

Gloves, mask, and eye protection.

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Favorable qualities of a scene leader

Safety conscious at all times.

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Study Notes

Infection Control & Disease Prevention

  • Sharps go into designated sharps containers.

Contaminated Materials

  • Diapers should be discarded in trash cans.

PPE & BSI

  • An N95 respirator should be used when dealing with tuberculosis (TB) patients.
  • A face shield should be worn during intubations.
  • Hand washing is the #1 way to prevent infection transmission.

Proper Lifting Techniques & Body Mechanics

  • Keep the load close to the body when lifting.
  • Use leg muscles when lifting.
  • Avoid twisting or turning while lifting.
  • Communication with the team is crucial for coordination.
  • Designate one person to lead with verbal commands during lifting.

EMS Wellness & Stress Management

  • Health, wellness, and behavior change programs are important for EMS providers.
  • Education on nutrition and hydration is vital; lack of hydration can lead to kidney stones.
  • Smoking cessation provides the greatest cardiovascular benefit.
  • Reframing thoughts and controlled breathing are techniques to manage acute stress.
  • The phases of stress, according to Hans Selye, are alarm/fight or flight, resistance (coping mechanisms activate), and exhaustion, which diminishes the ability to rest.
  • Driver safety programs are necessary.
  • Injury and illness prevention programs are important.
  • Education and training should include proper hydration and safe lifting techniques.
  • Smoking/behavior changes can be addressed through replacement therapy or quitting cold turkey.

Ethical/Professional Practices

  • Report exposures and use proper medical precautions (BSI/PPE) to protect against communicable diseases.

Week 1 Test Questions

  • High self-expectations increase a paramedic's risk for a stress reaction.
  • Treating a TB patient while wearing a surgical mask is an exposure worth reporting.
  • Implementing a safety driver course reduces the chance of serious injury to an employee.
  • Common health communicable disease prevention tactics include proper hand washing, diaper disposal, and proper cleaning of absorbents.
  • Dispose of needles in sharps containers and bloodied supplies in biohazard bags.
  • A paramedic's principal role in promoting wellness involves participating in wellness programs themselves.
  • Properly lift and move patients during emergency moves to reduce the risk of injury.
  • 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 scene is an AED.

Overview of EMS Systems

  • Out-of-hospital components include community responders, EMS, fire/rescue, hazardous materials services, law enforcement, and utilities.
  • In-hospital components include emergency RNs, advanced PAs, doctors, mental health providers, and rehab services.
  • Technological advances include telemedicine, smartphone apps for emergencies, and virtual consults.

History/Development of EMS

  • Key milestones include the 1966 "White Paper," the 1970 establishment of the National Registry, and the 1973 EMS Systems Act, which outlined 15 components of EMS.

Roles/Responsibilities of EMS

  • Preparation, response (personal/scene safety), patient assessment, patient management (with medical direction as needed), and disposition/documentation are key responsibilities.
  • Honor patient preferences when possible.

Professionalism

  • Leadership, empathy, integrity, teamwork, and time management are important.
  • A clean, pressed uniform is part of maintaining a professional appearance.
  • The EMS Code of Ethics emphasizes a patient-first attitude and quality care, treating patients how you would want your family treated.

EMS Protocols/Medical Oversight

  • Medical directors, with EMS input, develop protocols.
  • Standing orders are utilized.
  • The scope of practice is defined by state regulations and medical director delegation.
  • Local protocols are determined by the medical director.

Education, Certification, Licensure

  • EMR, EMT, AEMT, and Paramedic represent different levels of certification.
  • Continuing education is important for refresher courses, recertification, and skill maintenance.
  • Certification exams are administered by the National Registry to establish competency.

Scene Management/Quality Improvement

  • System-wide care evaluations are conducted.
  • Defined scene roles minimize errors and duplication.
  • The most important piece of equipment to bring to every scene is an AED.

Advanced EMS Concepts

  • EMS research and evidence-based medicine enhance care protocols.
  • Participation in EMS research helps determine if field practices are effective.
  • Evidence-based medicine enhances care protocols.

Generalized Week 2 Exam

  • National associations and a national registry agency ensure the competency of out-of-hospital EMS personnel.
  • Local/state-level agencies define who may function within the system, allocate funds, and enact legislation.
  • Medics benefit the health care system by supporting primary care to patients in out-of-hospital settings; they also promote wellness, prevent illness/injury via community paramedicine/mobile integrated health programs, and educate the public on when to call and how to handle chronic/acute issues.
  • Patient destination is no longer just the ED: urgent care and crisis centers are other options.
  • Examples of local protocols: 1973 Emergency Medical Services System Act with 15 components and 1988 NHTSA 10 system elements.
  • Local protocols are created collaboratively by medical directors, local agencies, state EMS authorities, and advisory councils.
  • Protocols are based on new research, technology, and community needs.
  • The National EMS Scope of Practice Model, AHA, and NREMT standards influence protocols.

Components of Continuous Quality Improvement

  • Plan: Identify areas needing improvement based on data (EPCRs).
  • Do: Implement targeted interventions (training, protocol updates).
  • Check: Monitor outcomes and effectiveness.
  • Act: Adjust strategies and reinforce best practices.

Continuing Education Units (CEUs)

  • Maintaining certification is the medic's responsibility.
  • Develop further knowledge/skills.
  • Keep up with the emergency health care delivery system.

Ethics

  • Ethics are rules or standards that govern the conduct of members of a particular group or profession, not laws.
  • Ethics are standards for honorable behavior.
  • Oath of Geneva-1948.
  • National Association of EMTs adopted EMT Code of Ethics-1978.

Public Health Principles

  • Public Health protects/improving community health/policies through: health promotion, disease surveillance, disaster management, and injury prevention programs
  • Accomplishments in PH: Vaccines, motor vehicle safety (seatbelt usage*), workplace safety, control of infectious diseases, tobacco use reduction.

Epidemiology

  • Epidemiology relates to the study of disease incidence/ prevalence in populations.
  • Epidemic relates to a small/local population, controlled by local health.
  • Pandemic relates to a larger population, controlled by CDC.
  • Carrier is someone who comes in contact with an exposed disease and can unknowingly begin the spread of said disease
  • Host is a the person or living organism that can be infected by an infectious agent under natural conditions.
  • A Vector is described as animate indirect transmission from a reservoir to a susceptible host.
  • Virulence is the proportion of persons with clinical disease that becomes severely ill or die after being infected.

EMS PROVIDERS as Injury Prevention Advocates

  • Collaborates w/ public health sectors- create disaster plans (NIMS), community education, secure funding.
  • Community prevention programs are beneficial for: infant/ child safety (carseats*), geriatric falls, work-related injuries, motor vehicle safety awareness, and med misuse.
  • Ethical responsibilities: treat pts how you would want your family members treated, maintain skills, review performance, maintain HIPPA, work cooperatively w other EMS providers.
  • Constitutional: based on the constitution; protects against government abuse.
  • Common: AKA case law*; society's acceptance of customs/ norms (can change/ evolve)
  • Statutory: created by legislative bodies
  • Regulatory: administrative level (think state/ federal).
  • Tort Law*: civil wrongs
  • Negligence components (malpractice; deviation from accepted standards of care).

Negligence Components

  • Duty to act: formal contractual or informal legal obligation to provide care
  • Breach of Duty: action/ inaction that violates standard of care expected.
  • Malfeasance: wrongful/ unlawful act
  • Nonfeasance: failure to perform a required act of duty
  • Misfeasance: legal act performed in a harmful/ injurious manner
  • Actual damage: res ipsa loquitur- complaintant must prove damages that wasn’t contributed by themselves/ what instruments caused it.
  • Proximate cause: action that immediately caused/ worsened damage suffered by pt.
  • Defenses against negligence: good samaritan laws, government immunity, proper documentation/ education.
  • Informed consent: Full disclosure of treatment risk/ benefits
  • Expressed consent: Verbal/ written consent
  • Implied consent: Think of a pt w/ GCS of 3 & duty to act in situation
  • Withdrawal/ refusal of care: Ensure pts are fully informed of risks; pt has to be alert, awareand informed
  • Confidentiality (HIPPA) relates.
  • Defamation relates to intentional false communication that harms one’s reputation.
  • Libel refers to false statements made in writing/ social media; malicious intent/ reckless disregard for falsity of statements
  • Slander includes the act of injuring person’s character, name, or reputation by malicious statements w malicious intent or reckless disregard.

Provider-Pt Relationship

  • Abandonment relates to the termination of care w/o ensuring continued care (think of providing ALS treatment.
  • Assault: Unlawfully places a person in immediate bodily harm w/o their consent.
  • Battery: Unlawful touching of an individual. w/o their consent (treating a pt w/o their consent).

Focus Areas For Prevention & EMS Practice

  • Ryan white act relates to protect EMS when exposed to infectious diseases (allows pt testing request for communicable diseases after exposure).
  • Patient safety & autonomy: prioritize “do no harm”.
  • DNR orders: Must be signed by patient and physician to be valid.

Generalized Week 3 Exam

  • The value of contribution of effective documentation as one justification for funding.
  • You arrive on scene to an unconscious pt. You discover the pt is hypoglycemic and administer glucose. Pt becomes GCS 15 and is refusing all further care including transport to hospital. Partner informs of all risks and has pt sign AMA: decisionifiable, pt was alert aware and informed of all risks.
  • Treat patient as you would want your family members treated.

Advanced Directives/DNR Orders

  • Should include: Witness/ physician signature, clear description of withheld interventions, have time limit for validity, and does not imply to not treat the patient
  • Ensure legal directives are present before withholding resuscitation efforts.
  • Purpose of research is.to improve patient outcomes, enhance EMS systems & interventions
  • Types of research include: Quantitative (use of numbers), qualitative (use of words- reasons and experiences), mixed-method (combination).
  • Evidence based practice: Relies on strong research (randomized controlled trials).

Ethical Research Considerations

  • Nuremburg code & Helsinki declaration ensure safety of participants w informed consent.
  • Institutional Review Boards (IRBs): Approve and monitor studies.

Week 4 Exam

  • Need for study, research methods used, results encountered is found in the abstract
  • Name a process of evaluating & interpreting research: Confidence interval. - Importance of Research to EMS: It is in the patient’s best interest.
  • Ethics are rules/ standards that govern conduct of memebers of a particular group or profession.

Core Professional Attributes

  • Use of plain language, avoid jargon, discuss sensitive issues in private, genuine communication, respecting scope of practice.

Communication Technologies

  • Simplex: one sender at a time on single frequency.
  • Duplex: Two-way simultaneous communication.
  • Trunked systems: Use available frequencies via computer routing.

Mobile and Portable Radios

  • Portable relates to pt-side communication.
  • Mobile Vehicle-BSED for broader communication.
  • Emergin Tools: LTE, GIS,and Video technology Improve Situational awareness.
  • Cellular/Broadband: For rural/ urban communication.

Emergency Medical Dispatcher (EMD)

  • A critical task for the EMD is to determine MOI/NOI.
  • Critical tasks include providing pre arrival instructions for bystander actions.
  • Avoid recommending specific treatments or transport plans.
  • The EMD collects "What happened today?" during a 911 call for help in an apartment complex.

Verbal Communication & Reporting

  • Verbal reporting includes chief complaint, pertinent negatives, trending vitals, use of unit #.
  • Radio etiquette includes speaking clearly/ professionally, avoid codes, protect pt confidentiality & comply with FCC regs (no offensive language).
  • A mobile radio is the MOST likely to be installed in the vehicle.

Written Communication

  • Includes PCR.
  • You should be Objective, Legible and Thorough when writing your report.
  • All Medical and Legal info should be included.
  • Medical community accepted terminology.

Interpersonal Communication

  • Ensures to have clear concise handoffs to hospital staff, do not leave until formal TOC is complete.
  • Follow medical control’s advice, verify medication doses & protocols w medical direction if uncertain while on scene.

Communication Challenges

  • Misinterpretation, time pressure, unclear semantics can be communication barriers.
  • Confirm receiver understands message (ie “do you copy that/ how do you copy?”), use structured formats for clarity as communication solutions..
  • Making certain that the patient is fully informed is the MOST difficult to achieve in order for the refusal to be legitimate
  • Express Consent is being asked for when you are asking an adult patient if it would be okay for you to assess him and provide care.
  • Maintain HIPAA (discuss only w involved parties: EMS team, medical control).
  • Adhere to FCC regulations & EMS protocols (no offensive language).
  • Preserve evidence at scene.

Tips For EMS Success

  • Stay current with continuing education.
  • Prioritize professionalism/ pt-centered care.
  • Leverage technological tools to enhance communication.
  • Practice self-care.
  • The greatest public health threat is a 24-year-old male who looks very sick and just returned from West Africa.
  • Abandonment applies, if that you terminated the provider patient relationship without his consent.
  • Treatment and transport of a minor without the express consent of the parents will be allowed when the minor has a life-threatening injury
  • Proving changes in procedures make a positive difference is the MOST important reason for EMS providers to participate in research efforts.
  • Using disposable equipment prevents cross contamination of patients.
  • The family produces a valid document signed by the patient and his or her physician indicates "DNR".
  • Stretching will be the BEST to perform daily in order to improve physical fitness.
  • An accident driving home from your EMS shift is the LEAST likely to have a duty to act.
  • Leaving the scene without further treatment will clearly demonstrate negligence on behalf of the rescuers
  • 154 would be an appropriate target heart rate to improve cardiovascular endurance for a 30-year-old with a resting heart rate of 70
  • Clarifying that the person accepting care understands what they are trying to describe is important when communicating with other medical professionals during a transfer of care
  • Sleep deprivation is the greatest risk associated with variable EMS shift work.
  • Wearing a clean, pressed uniform at work demonstrates the BEST professional conduct.
  • Raise your technical skills to the instinctive level is the MOST appropriate strategy for developing the ability to think better under pressure.
  • Emergency department practice greatly influences how we practiced EMS.
  • There must be ample scientific research to support the claim is the MOST important consideration when implementing a new product
  • Components of a physical wellness program include: maintaining an appropriate body weight.
  • A car seat install could participate as a public health program on injury and illness prevention.
  • Medium-level disinfectant is how should you disinfect your stethoscope after treating a patient with confirmed TB
  • Preparing body substance isolation precautions in preparation for childbirth: Gloves, gown, and goggles
  • Teaching a class on the benefits of hydration would demonstrates your commitment to the wellness of EMS .
  • Victims of blunt trauma who have presented with and remain in asystole is considered a criteria for termination of resuscitation.
  • To identify any positive or negative trending patterns during transport is what would the nurse ask to state Gl bleed patient's last 3 sets of signs for the patient you brought in. Gloves, mask, and eye protection are items of personal protective isolation equipment regarding during endotracheal intubation.
  • A Favorable quality of the scene leader for patient care: Safety conscious at all times, Maintains situational awareness, Accountable for team's actions and outcomes, Creates an appropriate list of differential diagnoses.
  • "Accidental Death and Disability: The Neglected Disease of Modern Society", also known as "The White Paper", was published in 1966.
  • Medical Direction: "An on-line physician orders you to perform a procedure you have been trained to perform but is not covered under your protocols."
  • Continuing education or skills verification are often required for license or certification renewal accurately describes licensing or certification of EMS providers within a state.
  • An agency that offers prenatal education referrals would benefit a 17-year-old female who is 3 months pregnant and no prenatal care benefit the MOST.
  • Obtaining the raw data is the MOST common role of the EMS provider in regards to research projects involving EMS
  • Intention of Organ Donating is may be found on cards or medic alert tags.
  • Assault is the threatening to immobilize a patient to a backboard, without his consent, unless he cooperate with you and your crew.
  • Synthesizing an appropriate response would be the response to the medical emergency and the traumatic injury protocol place the patient at significant risk
  • Licensed, authorized, and trained to do best describes the "Scope of Practice.
  • Integral is made during the transfer of care is why the verbal report is important the hospital
  • Covering the patient's mouth with a disposable mask guideline will be MOST important treating a productive cough, fever, and weakness.
  • The reasons for providing efficient and effective radio traffic are: to provide for our safety,To receive orders from medical control, To allow the receiving facility to prepare.
  • Being genuine, sincere, and honest would describe an attribute for increasing effectiveness and efficiency in verbal communication
  • Perform CPR while obtaining additional information from the family and call medical control for direction should you proceed if family members tell you that the patient has terminal cancer, but cannot find his DNR order.
  • Disorientation is the MOST that partner is having a critical stress response if striking a pedestrian.
  • Suspected elder abuse incidents are where rescuers are required to report incident to authority
  • Using gloves Eye protection HEPA respirator on a call for an adult presenting with a productive cough, fever, and weakness are appropriate PPE Educating patients on the symptoms of a heart attack is the greatest impact a paramedic can make in preventing death from a myocardial event.
  • Begin and maintain an exercise program reduces or alleviate stress appropriately.

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A set of questions for paramedics focusing on personal safety, communicable disease prevention, effective communication, and stress management techniques in emergency medical services.

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