Unitek EMT Midterm Flashcards

Questions and Answers

Who invented EMS?

The French

Who operated the first ambulances?

Funeral homes/the undertaker

When was NREMT founded?

1970

When was NEMSSA passed by Congress?

1973 Signup and view all the answers

When were EMS standards developed and by whom?

1966-DOT Signup and view all the answers

What are NHTSA standards for EMS systems?

<ol> <li>Regulation and Policy 2. Resource Management 3. Human Resources training 4. Transportation 5. Facilities 6. Communications 7. Public Info/Edu 8. Medical Direction 9. Trauma Systems 10. Evaluation (QA/QI)</li> </ol> Signup and view all the answers

What are the components of the EMS system?

Emergency medical dispatcher, EMS responders, Emergency Department/hospital, Specialty Centers (trauma, burn, pediatric, cardiac stroke...) Signup and view all the answers

What does Enhanced 911 provide?

Caller number and location Signup and view all the answers

What role do Emergency Medical Dispatchers play?

Gives instructions to callers on how to provide emergency care until EMS personnel arrive Signup and view all the answers

What are the levels of EMS training?

Emergency Medical Responder (first responder), EMT, AEMT, Paramedic Signup and view all the answers

What are the roles and responsibilities of an EMT?

Personal safety, safety of the crew, patient assessment, patient care, lifting and moving, transport, transfer of care, patient advocacy, good physical/personal traits Signup and view all the answers

What is EMS's role in Public Health?

Injury prevention (geriatric/pediatric), Public Vaccination Programs, Disease Surveillance Signup and view all the answers

What is Mobile Integrated Healthcare?

Preventing future 911 calls by making house calls to frequent callers Signup and view all the answers

What is the difference between scope of practice and standard of care?

What you can do vs. how you should do what you need to Signup and view all the answers

What are exceptions that allow children to refuse care?

Emancipated Minor, Pregnant, In loco parentis Signup and view all the answers

When is involuntary transportation ok?

Patient is a threat to himself/others, court order, decision by mental health professionals/police Signup and view all the answers

A patient may refuse care if they are:

Legally able to consent, awake and oriented, fully informed, sign a release form Signup and view all the answers

What is proximate causation?

Patient suffered harm because of EMT action or inaction Signup and view all the answers

What do Good Samaritan laws provide?

Grant immunity from liability if rescuer acts in good faith, rarely applies to on-duty personnel, does not protect from negligence Signup and view all the answers

What is dependent lividity?

A sign of death in which skin turns purple due to blood leaving capillaries Signup and view all the answers

What is rigor mortis?

Sign of death in which the muscles/joints stiffen Signup and view all the answers

What is putrefaction?

Sign of death in which body decomposes and produces odor Signup and view all the answers

What is libel?

Written defamation of character Signup and view all the answers

What is slander?

Verbal defamation of character Signup and view all the answers

What is an on-line order?

An order given by medical direction over the phone/radio Signup and view all the answers

What is an off-line order?

Standing orders issued by medical direction Signup and view all the answers

What is body mechanics?

Proper use of body to prevent injury and facilitate lifting/moving Signup and view all the answers

What is an emergency move?

A move made when there is an immediate life threat to the patient Signup and view all the answers

What is an urgent move?

Move used if something causes a decline in patient's condition or if the treatment of a patient requires a move Signup and view all the answers

What is a non-urgent move?

No immediate threat to life. You have time to move the patient Signup and view all the answers

Who made the standard precautions?

OSHA Signup and view all the answers

What does the Ryan White CARE Act require?

Notification and assistance to medics who have possibly been exposed to certain diseases Signup and view all the answers

What is an acute stress reaction?

Sudden stress response to a stressful/traumatic situation Signup and view all the answers

What is eustress?

The type of stress that drives you to perform well Signup and view all the answers

What is distress?

Negative form of stress that causes problems to health Signup and view all the answers

What is Critical Incident Stress Management (CISM)?

Comprehensive system that teaches how to prevent/cope with stress Signup and view all the answers

What are the three R's for reacting to danger?

Retreat, Radio, Re-evaluate Signup and view all the answers

What is pathophysiology?

The study of how disease processes affect the function of the body Signup and view all the answers

What is the role of mitochondria?

Converts glucose into ATP Signup and view all the answers

What is aerobic metabolism?

Requires oxygen Signup and view all the answers

What is anaerobic metabolism?

Metabolism in the absence of oxygen that results in the creation of pyruvic/lactic acid, raising the body's acidity Signup and view all the answers

What is tidal volume?

Amount of air taken in per breath Signup and view all the answers

What is minute volume?

Tidal volume x respiratory rate Signup and view all the answers

What does the medulla oblongata control?

Respirations Signup and view all the answers

What is pleural space?

Area between lungs and chest cavity Signup and view all the answers

What is hypercapnia?

High CO2 levels Signup and view all the answers

What is hypoxia?

Low oxygen levels Signup and view all the answers

What is the role of chemoreceptors?

Detect changes in levels of oxygen/CO2 and detect pH (acidity) of the body Signup and view all the answers

What is the function of blood?

Gas transport system Signup and view all the answers

What is plasma oncotic pressure?

Proteins in plasma attract water away from cells and into the bloodstream Signup and view all the answers

What is hydrostatic pressure?

The pressure within a blood vessel that tends to push water out of the vessel toward cells Signup and view all the answers

What is loss of tone?

Vessels lose the ability to constrict and dilate, resulting in low BP Signup and view all the answers

What is hypertension?

High blood pressure Signup and view all the answers

What is the average stroke volume?

~70 ml/beat Signup and view all the answers

What is preload?

Amount of blood returning to the heart Signup and view all the answers

What is contractility?

The ability of the heart to contract Signup and view all the answers

What is afterload?

The force or resistance against which the heart pumps Signup and view all the answers

What is cardiac output?

Heart rate x stroke volume Signup and view all the answers

What is hypoperfusion (shock)?

Inability of the body to adequately circulate blood to the body's cells to supply them with oxygen and nutrients Signup and view all the answers

Where does the upper airway end?

At the glottic opening Signup and view all the answers

What is the role of the nasopharynx?

Warm/humidify oxygen Signup and view all the answers

Where does the lower airway begin?

Below the larynx Signup and view all the answers

What is crowing?

Stridorous sound heard on inhalation and exhalation Signup and view all the answers

What are rails/crackles?

Fluid in alveoli causes this sound Signup and view all the answers

What are contraindications of OPA?

Patient exhibits gag reflex Signup and view all the answers

What are the contraindications of NPA?

Severe head injury with blood draining from the nose, history of fractured nasal bone, cerebrospinal fluid coming from nose/ears Signup and view all the answers

What is the maximum amount of time you should suction for?

10 seconds Signup and view all the answers

What is ventilation?

Process of moving air into/out of the lungs Signup and view all the answers

What is inhalation?

Active process in which muscles expand and chest size increases, creating negative pressure that pulls air into lungs Signup and view all the answers

What is exhalation?

Passive process in which muscles relax and positive pressure pushes air out Signup and view all the answers

What is dead space air?

Air moved in ventilation not reaching alveoli Signup and view all the answers

What is external respiration?

Diffusion of oxygen/CO2 between alveoli and blood Signup and view all the answers

What is internal respiration?

Exchange of gases between cells of the body and the blood Signup and view all the answers

What are signs of hypoxia/hypercapnia?

Shortness of breath, increased respiratory rate/depth, increased heart rate Signup and view all the answers

What is respiratory distress?

Body compensating for a respiratory change and meeting metabolic needs (increased respiration/heart rate) Signup and view all the answers

What is respiratory failure?

When the body can no longer compensate for metabolic needs (precursor to respiratory arrest) Signup and view all the answers

What is respiratory arrest?

No breathing, low heart rate, high CO2, low muscle tone (can lead to cardiac arrest) Signup and view all the answers

What is continuous positive airway pressure (CPAP)?

A form of noninvasive positive pressure ventilation Signup and view all the answers

What flow of oxygen do we use for BVM/NRB?

15 L/min Signup and view all the answers

What flow of oxygen do we use for nasal cannula?

2-6 L/min Signup and view all the answers

What is a tracheostomy mask?

Form of assisted ventilation for patients with stoma Signup and view all the answers

What is the difference between Mechanism of Injury (MOI) and Nature of Illness (NOI)?

Essentially trauma vs. medical Signup and view all the answers

What is low-velocity trauma?

A knife causes this type of trauma Signup and view all the answers

What is medium-velocity trauma?

A gun/shotgun causes this kind of trauma Signup and view all the answers

What is high-velocity trauma?

A rifle causes this kind of trauma Signup and view all the answers

What is blunt force trauma?

Trauma in which the blow doesn't penetrate skin Signup and view all the answers

What does BENAMES stand for?

BSI, Environment, Number of Patients, Additional Resources, MOI/NOI, Extrication, Spinal Precautions Signup and view all the answers

What is the respiratory rate for adequate breathing in adults?

12-20 Signup and view all the answers

What is the respiratory rate for adequate breathing in children?

15-30 Signup and view all the answers

What is the respiratory rate for adequate breathing in infants?

25-50 Signup and view all the answers

What is seesaw breathing?

Form of inadequate breathing seen in pediatrics in which chest goes in as belly comes out Signup and view all the answers

What are signs of inadequate breathing in pediatrics?

Nasal fumeflaring, Grunting, Seesaw breathing Signup and view all the answers

What is the sign of inadequate artificial breathing in adults vs. children?

Adults: increasing pulse rate, Children: decreasing pulse rate Signup and view all the answers

What does OPQRST stand for?

Onset, Provocation, Quality, Radiation, Severity, Time Signup and view all the answers

What are rhonchi?

Low pitched sounds resembling snoring/rattling Signup and view all the answers

What are the contraindications of CPAP?

Severely altered mental status, respiratory arrest, hypotension/shock, nausea and vomiting, penetrating chest trauma, GI bleeding Signup and view all the answers

What is chronic obstructive pulmonary disease (COPD)?

Umbrella term used to describe pulmonary diseases such as emphysema or chronic bronchitis Signup and view all the answers

What is chronic bronchitis?

Cells in bronchioles that clear mucus are unable to do so Signup and view all the answers

What is emphysema?

Alveoli walls break down resulting in CO2 trapped in them Signup and view all the answers

What is asthma?

Chronic airway disease that results in bronchoconstriction Signup and view all the answers

What is pulmonary edema?

Fluid in alveoli, swelling in ankles occurs Signup and view all the answers

What is pneumonia?

Infection of lungs causing inflammation and lots of mucus Signup and view all the answers

Study Notes

EMS Origins and Structure

EMS was invented in France.
The first ambulances were operated by funeral homes/undertakers.
NREMT was established in 1970 to regulate EMS training.
The National Emergency Medical Services Systems Act (NEMSSA) was passed by Congress in 1973.
EMS standards were developed in 1966 by the Department of Transportation (DOT).

NHTSA EMS Standards

The National Highway Traffic Safety Administration (NHTSA) established essential standards including:
- Regulation and Policy
- Resource Management
- Human Resources Training
- Transportation
- Facilities
- Communications
- Public Information/Education
- Medical Direction
- Trauma Systems
- Evaluation (Quality Assurance/Improvement)

Components and Operations of EMS

Key components of an EMS system include:
- Emergency medical dispatcher
- EMS responders
- Emergency Department/hospital
- Specialty centers (trauma, burn, pediatric, cardiac, stroke, etc.)
Enhanced 911 technology provides the caller's number and location for immediate assistance.

Roles and Responsibilities of EMTs

EMTs ensure personal safety and the safety of crew, patient, and bystanders.
Responsibilities include patient assessment, care, lifting/moving, transport, transfer of care, and patient advocacy.
Key qualities for EMTs involve good physical condition and personal traits.

Public Health Role of EMS

EMS plays a vital role in public health through:
- Injury prevention programs targeting geriatric and pediatric populations.
- Public vaccination initiatives.
- Disease surveillance efforts.

Medical Directives and Care

Different levels of EMS training include Emergency Medical Responder, EMT, AEMT, and Paramedic.
On-line orders are provided by medical direction via phone/radio, while off-line orders are standing orders.
Body mechanics emphasize proper use to prevent injury during lifting and moving.

Patient Care Protocols

Emergency and urgent moves are performed when immediate threats to life or decline in conditions are present.
Non-urgent moves occur when there is no immediate threat.
Standards and precautions for patient care stem from OSHA regulations.

Mental Health Considerations

Involuntary transportation is justified if a patient poses a threat to themselves or others based on assessments by mental health professionals or law enforcement.

Patient Rights and Legal Considerations

Patients may refuse care if they are legally competent, alert, informed, and sign a release form.
Good Samaritan Laws offer immunity from liability for those rendering aid in good faith, though they often do not cover on-duty personnel.

Physiological Terms and Concepts

Proximate causation ties harm directly to EMT action or inaction.
Dependent lividity, rigor mortis, and putrefaction are signs indicating death.
Pathophysiology studies how diseases affect body functions, with the mitochondria converting glucose to ATP.
Metabolism can be aerobic (requiring oxygen) or anaerobic (producing lactic acid in the absence of oxygen).

Respiratory Concepts

Tidal volume refers to air volume inhaled/exhaled per breath, while minute volume is calculated as tidal volume multiplied by respiratory rate.
The medulla oblongata controls respiration, and respiratory distress indicates the body is compensating effectively.
Signs of hypoxia include shortness of breath and increased respiratory rates.
Continuous positive airway pressure (CPAP) aids in noninvasive ventilation for respiratory issues.

Trauma and Assessment

Mechanism of Injury (MOI) contrasts with the Nature of Illness (NOI), distinguishing between trauma and medical conditions.
Different types of trauma are categorized by velocity: low (knife), medium (gun), and high (rifle).
Vital signs such as respiratory rates depend on age groups, e.g., adults: 12-20 breaths/min, infants: 25-50 breaths/min.

Pulmonary Conditions

Chronic obstructive pulmonary disease (COPD) encompasses conditions like chronic bronchitis and emphysema.
Asthma results in chronic bronchoconstriction, whereas pulmonary edema involves fluid in alveoli causing swelling.
Pneumonia is characterized by lung infection leading to inflammation and mucus buildup.

Emergency Care Techniques

Ventilation involves the movement of air in and out of the lungs, with oxygen flow rates of 15 L/min for BVM/NRB and 2-6 L/min for nasal cannula.
Signs of inadequate breathing in pediatrics include nasal flaring, grunting, and seesaw breathing.

By understanding these key concepts, EMTs can provide effective care while ensuring safety and compliance within the EMS framework.

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Description

Test your knowledge with these flashcards for the Unitek EMT Midterm. This quiz covers key historical milestones in Emergency Medical Services, such as the founding of NREMT and the development of EMS standards. Perfect for EMT students looking to review essential information.