Chap 1 - Intro to ALS Care.txt
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. What would you like to do?
Who is the highest level of prehospital care provider?
What is the name of the 1998 publication that has improved paramedic education?
EMT-Paramedic: National Standard Curriculum
EMS Agenda for the Future: A Systems Approach (2005); calls for '4' levels of EMS Providers. What are they?
- First Responder = Emergency Medical Responder
- EMT Basic = EMT
- EMT Intermediate = EMT Advanced
- EMT-P = Paramedic
What is the Emergency Medical Services?
Comprehensive network of personnel, equipment & resources established for the purposes of delivering aid & emergency medical care to the community
What is Basic Life Support (BLS)?
basic life-saving procedures (ie. artificial ventilation, & CPR)
What is Advanced Life Support (ALS)?
advanced life saving procedures (ie. IV therapy, drug therapy, intubation & defibrillation)
Who is credited with the development of the 'Triage' concept?
What is Triage?
Method of sorting patients by the severity of their injuries
What publication is commonly referred to as "The White Paper"?
Accidental Death & Disability: The Neglected Disease of Modern Society
What did Congress create in 1966?
National Highway Safety Act - established US Dept. of Transportation - forces States to create EMS systems
What Act did Congress pass in 1973?
Emergency Medical Services Systems Act
What are the 15 Components of the Emergency Medical Services Systems Act (EMSSA)?
- 1) Manpower
- 2) Training
- 3) Communications
- 4) Transportation
- 5) Emergency Facilities
- 6) CCU
- 7) Public Safety Agencies
- 8) Consumer Participation
- 9) Access to Care
- 10) Patient Transfer
- 11) Standardized record keeping
- 12) Public info & education
- 13) Systems review & evaluation
- 14) Disaster management plans
- 15) Mutual Aid
What is Medical Direction?
medical policies, procedures & practices that are available to providers either on-line or off-line
What are the 10 system elements for the 1988 NHTSA?
- 1) Regulation & policy
- 2) Resources mgmt
- 3) HR & training
- 4) Transportation
- 5) Facilities
- 6) Communications
- 7) Trauma Systems
- 8) Public info & education
- 9) Medical Direction
- 10) Evaluation
What is a Trauma Center?
Medical facility that has the capability of caring for the acutely injured person
What is Quality Improvement (QI)?
An evaluation program that emphasizes service & uses customer satisfaction as the ultimate indicator of system performace
In 1996, The EMS Agenda for the Future listed 14 attributes that the EMS system should strive for. What are they?
- 1) Intergration of health services
- 2) EMS research
- 3) Legislation & regulation
- 4) System finance
- 5) HR
- 6) Medical Direction
- 7) Education systems
- 8) Public education
- 9) Prevention
- 10) Public access
- 11) Communications systems
- 12) Clinical care
- 13) Information Systems
- 14) Evaluation
What is a Medical Director?
Physician who is legally responisble for all of the clinical & patient care aspects of the EMS system
What is On-Line Medical Direction?
When a qualified physician gives direct orders to a prehospital provider either by radio or phone
What is an Intervener Physician?
A licensed physician, professionally unrelated to patients on scene, who attempts to assist EMS providers with patient care
What is Off-Line Medical Direction?
Medical policies, procedures & practices that medical direction has set up in advance of a call
What are Protocols?
Policies & procedures for all components of an EMS system
What are the '4' T's of Emergecy Care?
- 1) Triage
- 2) Treatment
- 3) Transport
- 4) Transfer
What should a Communications Plan include?
- 1) Citizen Acess
- 2) Single Control Center
- 3) Operational Communications Capabilities
- 4) Medical Communications Capabilities
- 5) Communications Hardware
- 6) Communications Software
What is an Emergency Medical Dispatcher (EMD)?
EMS person medically & technically trained to assign emergency medical resources to a medical emergency
What is the goal of emergency response?
- BLS = 4 minutes
- ALS = 8 minutes
What is Certification?
The process by which an agency or association grants recognition to an individual who has met its qualifications
What is Licensure?
Process by which a gov't agency grants Permission to engage in a given occupation to a person who has attained the degree of competency required to ensure the public's protection
What is a profession?
Existence of a specialized body of knowledge or skills
What is Reciprocity?
Process by which an agency grants automatic certification or licensure to a person who has comparable certification/licensure from another agency
How many miles is required to transport a patient by fixed wing aircraft?
In 1983 what organization recommended equipment to be carried by BLS services?
American College of Surgeons Committee (ACSC)
In 1988, what organization recommended a list of supplies & equipment for ALS services?
American College of Emergency Physicians (ACEP)
In 1972, GSA developed three basic types of ambulances; what are they?
Type I: conventional cab & chassis on a module ambulance body, no passageway b/t driver & patient compartment
Type II: standard van formed as one unit, must have raised roof
Type III: specialty van with forward cab, passageway b/t driver & patient compartment
What are the '3' levels of Trauma Centers?
- Level 1: highest level of care
- Level 2: may not have specialty peds or neurosurgery on site
- Level 3: Doesn't have immediate surgical facilites available
In 1997, NHTSA released a manual "A Leadership Guide to Quality Improvement for EMS Systems'. What are the '7' components in that guide?
- 1) Leadership
- 2) Information & Analysis
- 3) Strategic quality planning
- 4) HR development & mngmnt
- 5) EMS process mngmnt
- 6) EMS systems results
- 7) Pt satisfaction
What is Quality Assurance (QA)?
Program designed to maintain continuous monitoring & measurement of the quality of clinical care given
What is Continuous Quality Improvement (CQI)?
Program designed to refine & improve an EMS system
Who developed the Rules of Evidence?
Joseph P. Ornato
What are the Rules of Evidence?
Guidelines for permitting a new medication, process, or procedure to be used in EMS on the basis of proven efficacy
What are the '4' Rules of Evidence?
- 1) Theoretical basis for change
- 2) Ample research
- 3) Clinically important
- 4) Practical, affordable, & teachable
What is Pathophysiology?
The study of how disease affects normal body processes
What are the Medic's primary responsibilities?
- 1) Preparation
- 2) Response
- 3) Scene size-up
- 4) Pt assessment
- 5) Pt management
- 6) Disposition & transfer
- 7) Documentation
- 8) Cleanup, maintenance & review
What are the professional attributes of a Medic?
- 1) Leadership
- 2) Integrity
- 3) Empathy
- 4) Self-motivation
- 5) Professional appearance & hygiene
- 6) Self-confidence
- 7) Communication skills
- 8) Time management skills
- 9) Diplomacy in teamwork
- 10) Respect
- 11) Patient advocacy
- 12) Careful delivery of service
What is Isometric Exercise?
Active exercise performed against stable resistence - motionless manner
What is an Isotonic Exercise?
Muscles are worked thru a range of motion
What are the basics of physical fitness?
- 1) Cardio
- 2) Strength & flexibility
- 3) Nutrition & weight control
- 4) Disease prevention
- 5) No harmful habits/addictions
- 6) Back Safety
What is Infectious Disease?
Any disease caused by the growth of pathogenic microorganisms - which may be spread from person-to-person
What are pathogens?
Microorganisms capable of producing disease
What is an Incubation Period?
The time between contact with a disease organism & the appearance of the 1st symptoms
What are standard precautions?
Strict form of infection control that is based on the assumption that all blood & other body fluids are infectious
What is Personal Protective Equipment (PPE)?
Equipment used in EMS personnel to protect against injury & the spread of infectious disease
What are the '5' stages of Grief?
- 1) Denial
- 2) Anger
- 3) Bargaining
- 4) Depression
- 5) Acceptance
What are the phases of Stress?
- 1) Alarm
- 2) Resistance
- 3) Exhaustion
What is the Circadian Rhythm?
Physiological phenomena that occurs approx. 24 hr intervels
What are the '3' types of specific EMS stress?
- 1) Daily
- 2) Small incidents
- 3) Large incidents & disasters
What is Epidemiology?
Study of factors that influence the frequency, distribution & causes of injury, disease & other health-related events in a population
What are the Years of Productive Life?
Age at death minus 65
What is an injury?
Intentional or unintentional damage to a person resulting from exposure to mechanical or any other form of energy or from an absence of essentials such as heat or oxygen
What is an injury risk?
A situation that puts people in danger of injury
What are morals?
Social, religious, or personal standards standards of right & wrong
What are ethics?
Rules & standards that govern the conduct of members of a particular group or profession
What is Beneficence?
The principle of doing good for the patient
What is nonmaleficence?
The obligation not to harm the patient
What is the Latin phrase to mean 'First, do no harm'?
PRIMUM NON NOCERE
What is Automony?
A competent adult patient's right to determine what happens to his own body
What are the '3' steps in solving a ethical problem?
- 1) State the action in a universal form
- 2) List implications/consequences of the action
- 3) Compare them to relevent values
What is an Impartiality Test?
Asks whether you would be willing to undergo this procedure or test if you were in patient's place
What is the Universalizability Test?
Would you want this action performed in ALL circumstances
What is the Interpersonal Justifibility Test?
Asks whether you can defend or justify your actions to others
What would you like to do?
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