EMT Lecture #1

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  1. Roles/Responsibility of EMT
    • Personal Safety
    • Safety of partner(s), pt, and bystanders
    • Pt Assessment and Treatment
    • "First, do no harm"
    • Lifting & Moving Pts safely
    • Transport/Transfer of care
    • Record Keeping/Data Collection
    • Pt Advocacy
  2. Professional Attributes of the EMT
    • Neat, clean, positive image and good physical health
    • maintain skills by OTEP or traditional recert
    • Put Pt needs first (advocacy)
    • maintain knowledge of EMS issues
  3. Types of Medical Direction
    • On-line: contacting ALS or paramedic
    • Off-line: utilizing protocol book
  4. Negligence
    • EMT has a duty to act - emt breaches that duty
    • injury/damages were inflicted
    • actions of the emt caused the damages
  5. "Good Samaritan" Statute
    • RCW 4.24.300
    • "Any person, including...a volunteer provider of emergency or medical services, who without compensation...renders care at the scene of an emergency...shall not be liable for civil damages resulting from any act or omission..."
    • "Any person rendering emergency care diring the course of regular employment  is excluded from the protection of this subsection"
    • (Only covers you if you aren't being paid)
  6. Stages of Grieving
    • Denial
    • Anger
    • Bargaining
    • Depression
    • Acceptance
  7. Different Stress Reactions
    • Acute
    • Delayed
    • Cumulative
  8. Warning Signs of Stress
    • Irritibility
    • Inability to concentrate
    • Sleep disruption
    • Anxiety
    • Indecisiveness
    • Guilt
    • Change in appetite
    • Decreased Libido
    • Isolation
    • Loss of interest in work
  9. Lifestyle Changes to Help Manage Stress
    • Diet Changes: decrease sugar, alcohol, caffeine
    • Avoid fatty foods
    • Increase: complex carbs
    • Exercise and practice relaxation techniques
  10. Comprehensive Stress Management Includes:
    • Pre-incident stress education
    • On-scence peer support
    • One-on-one support
    • Disaster support services
    • Defusings, CISD, follow-up
    • Spouse/family support
  11. Transmission and Effects of Hep A
    • Oral-fecal route
    • incubation is 30 days

    Abdominal symptoms, fever, jaundice
  12. Transmission and Effects of Hep B
    • Bloodborne and other bodily fluids
    • Incubation is 120 days
    • May survive 7 days in dried blood

    Flu-like symptoms: fatigue, fever, aching joints
  13. Transmission and Effects of Hep C
    • Only bloodborne
    • Incubation 6-7 weeks
    • Commonly transmitted by IV drug users or from blood transfusions

    Flu-like symptoms, or asymptomatic
  14. Transmission and Effects of TB
    Airborne via droplets

    Wt Loss, fatigue, night sweats, coughing blood
  15. BSI
    • Body Substance Isolation
    • Assume all substances are infectious
    • Gloves and goggles are minimum
    • Use HEPA/N95 mask and/or splash protection if needed
  16. EMT's Scope of Practice
    • Legal duties to pt, MPD, and public
    • Defined by RWC and WAC
    • Defines permitted interventions
    • MPD defines protocols/standing orders
    • Legal authority to function as an EMT - online or offline medical control
  17. EMT's Ethical Responsibilities
    • make needs of patient a priority
    • practice skills to the point of mastery
    • attend CME/OTEP
    • critically review your own performance
    • honesty in reporting
  18. DNR Orders
    • A Do Not Resuscitate Order in an order used bu healthcare facilities to document whether or not a particular pt should receive resuscitation in the event of cardiopulmonary arrest
    • An EMT may only honor a DNR in a licensed nursing home setting, hospital, or when pt is enrolled in hospice
  19. POLST
    • Physician's Orders on Life-Sustaining Treatment
    • Valid in any setting
    • Turns advanced directives into physician's orders
    • honored by all healthcare providers
  20. Sections on a POLST Form
    • A: CPR - resuscitation or not
    • B: Medical interventions - comfort measures only, limited interventions, or full treatment
    • C: Signatures - both physician and patient
    • D: Additional preferences - antibiotics, medically assisted nutrition
  21. Informed or Expressed Consent
    • must be obtained from every competent pt (done when they called 911)
    • pt proof of legal age
    • pt must be informed of treatment planned and risks
    • pt may agree to some activities and not others
  22. Implied Consent
    • assume an unconscious pt would give consent for emergency care
    • applies when pt is not competent or one that cannot make rational decisions (head injury, drunk, etc)
    • pt who initially refuses care then becomes unresponsive b/c of injury or illness
  23. Consent - Minor
    • Must be obtained from parent/legal guardian
    • Emancipated minor under 18
    • Treat life-threats under implied consent
  24. Assault
    causes bodily harm to pt
  25. Battery
    • touching pt without permission
    • providing care without consent (assuming pt is competent and EMT is not using implied consent)
  26. Abandonment
    • premature termination of pr-provider relationship without ensuring transfer of care to the same or higher-level provider
    • Ex: leaving pt at scene with insufficient exam, leaving pt at hospital w/o properly transferring care to ED staff
    • NOT abandonment if scene becomes unsafe
  27. Special Reporting Situations
    • abuse - consider factors: history vs findings
    • conflicting stories
    • multiple injuries
    • parents who won't allow pt to be examed
    • injuries in shape of object
    • environment of neglect
    • emotional/verbal abuse
    • pt is obviously frightened/reluctant to answer q's
    • obvious discomfort when abuser is present
    • abuser answering for pt
    • consider possibility of pt lying
  28. One-Stop Reporting
    866-END-HARM and Law Enforcement
Card Set:
EMT Lecture #1
2013-03-05 19:04:51
EMT EMS Medic One Thurston County

Chapters 1 and 2, Appendix D, M, and F
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