EMT Legislation

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EMT Legislation
2010-06-10 14:41:15

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  1. Define jurisprudence.
    Application of provincial legislation, regulations and policies that individuals need to know in order to obtain registration
  2. What is the Health Discinplines Act?
    Governing legislation for EMR/EMT/Paramedics in Alberta. Contains the framework for scope of practice. It contains information on initial registration requirments, anual renewal requirments, and franework for appeals and complaints.
  3. What is the Ambulance Services Act?
    Information for individuals or organizations that operate services in alberta. It outlines how districts are formed, the structure, function, and authority of ambulance district boards, the lisencing of operators, and various rules and regulations
  4. What is the Health Professions Act?
    Provides oversite into the governance, registration, continuing competence, and profesional conduct of numerous health professions in alberta.
  5. What is the relevance of the Traffic Safety Act?
    This act contains information on all aspects of operating a motor vehicle in alberta. It also describes the legal aspects of driving an ambulance; exceeding the speed limit, use of sirens and the use of flashing lights.
  6. What is the relevance of the Child, Youth and Family Enhancment Act
    Oulines the steps, responsibilities and actions that muct be taken if a child is considered in need. All to ensure the safety and well being of the child.
  7. What is the relevance of the Protection of Persons in Care Act?
    Duty of individuals to report abuse or suspected abuse of persons in care.
  8. What is the relevance of the Fatalitles Inquiries Act?
    Procedures for reporting death and the investigative procedures that must occur.
  9. What is the relevance of the Freedon of Information and Protection of Privacy Act
    Allow any person a right of access to public records and outlines the procedure to do so.
  10. What is the relevance of the Emergency Medical Aid Act
    This Act describes how “off-duty” health care professionals who stop and render assistance to a sick or injured person cannot be held liable for damages for injuries to or the death of that person alleged to have been caused by an act or omission on his or her part in rendering medical assistance, unless it is established that the injuries or death were caused by gross negligence.
  11. Describe the relevance of the Limitations Act?
    This act outlines the timelines associated with bringing claim for injury.
  12. Describe the relevance of the Mental Health Act?
    This act describes when a patient can be detained and admitted as a mental health patient.
  13. Describe the relevance of the Personal Directives Act?
    Personal directives are legal documents which allow you to name a decision maker and/or provide written instructions to be followed when, due to illness or injury, you no longer have the capacity to make decisions such as where you will live or the medical treatment you will receive. The Personal Directives Act describes the requirements for a personal directive to be legitimate.
  14. Describe the relevance of the Health and Safety Act?
    This Act describes the responsibilities of employers and workers with regards to ensuring a healthy and safe work environment. This Act also outlines how to conduct workplace related accident investigations, hazard recognition, and how to set up health and safety committees. It also describes the power and authority of an Occupational Health and Safety Officer.
  15. Describe the relevance of teh Health Informations Act?
    The purpose of this Act is to establish mechanisms to protect the privacy of individuals with respect to their health information and to protect the confidentiality of that information and to enable health information to be shared and accessed, where appropriate, to provide health services. The Act also provides information to individuals about their right of access to health information about themselves.
  16. Describe the relevance of the Controled Drug and Substances Act?
    This Act lists all controlled drugs and substances and describes the offenses and punishment for violating the laws regulating these drugs/substances. This Act also describes the authority of the policy to search and seize controlled substances. Some of the listed controlled substances may be used by practicing paramedics as part of their scope of practice.
  17. Describe the relevance of the Transportation of Dangerous Goods Act?
    This Act describes all aspects of safely handling and transporting goods that are deemed to be dangerous. It outlines safety standards and the need for emergency response plans in case of an accident. It discusses confinement in the case of a spill. Offences and punishment are also described. The schedule in the Act defines the classification of dangerous goods.
  18. Describe the relevance of the Charter of Rights and Freedoms?
    • This charter lists fundamental freedoms:
    • Freedom of conscience and religion;
    • Freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication;
    • Freedom of peaceful assembly; and freedom of association.
    • The charter also describes the democratic right to vote, legal rights, and equality rights.
  19. Describe the anatomy of the upper and lower airway.
    • The Upper Airway
    • Nose - Warmed, cleaned, humidified
    • Pharynx - naso (nasal to soft palate), oro (soft palate and eppiglottis) hypo (epiglottis and larynx/esophagus)
    • Epiglottis - Prevents food entry, covers larynx
    • Larynx - vocal cords, thyroid and cricoid cartilage

    • The Lower Airway
    • Trachea - C shaped cartilage rings, divides at level of sternal angle, Right is mroe direct
    • Alveoli - small air sacs where air exchange occurs
  20. Explain the physiology of the respiratory system? (Inhalation/Exhalation/Respiration/Ventilation processes)
    • Inhalation - is an active process where the diaphragm moves down and intercostals life ribs and pull them out. Increase in V equals a decrease in P and air will enter the lungs.
    • Exhalation - Passive process where everything relaxes and air is forced out.
    • Respiration - pulmonary or cellular where there is an exchange of gasses down their gradients.
    • Ventilation - must occur for respiration to occur.
  21. Discuss the components of Suction.
    • Suctioning may last for a duration of 15sec and must continue till the airway is clear.
    • Soft Suction - Advantages that it comes in many sizes, can suction through an OPA or NPA. Disadvantages that it cant move large secretions
    • Rigid Suction - Advantages will not kink or bent, removes large particles. Disadvantages limited to oropharynx and could cause lascerations.
  22. Discuss the Orophayrngeal Airway (OPA)
    Indications: Unconscious with no gag reflex
  23. Insert inverted then rotate 180 degrees to resting place. Do not invert in pediatics, use a tongue depressor.
  24. Discuss the Nasopharyngeal Airway
    Indications: Intact Gag, no skull fracture.

    Diameter should be slightly smaller than the nasal. tip of patients nose to thr trigus of the ear. Lubricate and insert bevel towards septum.
  25. Foreign Body Airway Obstruction
    Conscious - Abdominal thrusts

    Unconscious - Open airway, check breathing, 2 breaths, reallign, 2 breaths, compressions (adult 15, child 5), look, repeat
  26. Tell me about Oxygen Cylinders
    • Full pressure of 2000 to 2200 psi
    • Regulator so it can be administered at 40-70psi
    • 1) Pressure Compensated - gravity affected
    • 2) Bourdon Guage
    • Tank Size
    • D - 0.16 400
    • E - 0.28 660
    • M - 1.56 3450
    • Residual safe is 200psi
    • [Cylinder pressure remaining (psi) – safe residual pressure (200psi)] x Constant _________________________________________________________________ = Time
    • Flow Rate (L/min)
  27. Compare oxygen delivery systems
    • Nasal Canula - 1-6L/min 24-40%
    • Face Mask - 6-10L/min 40-60%
    • NRB - 10-15L/min up to 90%
    • BVM - 10-15L/min 90-95%
  28. Pulse Oximetry
    • Normal - 95-99%
    • Mild Hypoxia - 91-94%
    • Moderate Hypoxia - 86-91%
    • Severe Hypoxia - < 86%

    *Check equipment, nail polish, fake nails, dirt
  29. Capnography and Capnometry
    • Capnography - quantitative measurment of exhaled CO2 where normal ranges are 35-45mmmHg
    • Capnometry - single measure to indicate presence of exchange. Yellow or Purple

    • Displacment of tube
    • Obstruction of tube
    • Pneumothorax
    • Equipment Failure
  30. Esophageal Tracheal Combitube
    Two inflatable cuffs 100mL and 15mL. There is two tubes; the long white tube and the short blue tube.

    • Esophagus placement - breath through the blue tube
    • Tracheal placement - breath through white tube

    • Advantages: secures airway, rapid, well anchored, less chance of vomiting, can be used in trauma pt's
    • Indications: poor compliance, unconscious, unresponsive, long transport
    • Contraindications: gag, esophageal pathology
  31. Laryngeal Mask Airway
    Filled with 20-40mL

    • Advantages: rapid, less damage, easy to use
    • Disadvantages: does not isolate (vomiting)

    Indications: poor compliance, unconcious, long transport
  32. What are the inherent rates of the diffrent parts of the heart?
    • SA - 60-100
    • AV - 40-60
    • Ventricles - 20-40
  33. In an ECG what direction does the curent flow?
    Current flows from a negitive electrode to a positive one.
  34. P Wave
    Contraction of the atria, positive deflection, upright and round.

    PR interval 0.12 - 0.20
  35. QRS Complex
    Depolarization of the ventricles (atril repol hidden)

    Less than 0.12
  36. T Wave
    Ventricular repolarization.
  37. Mechanical CPR Devices
    • Indications: no breathing and no pulse, min90lbs and max 300lbs.
    • Contraindications: Chest deformities and children
  38. What are the common electrolytes in our body?
    • Cations: Sodium, Potassium, Calcium, Magnesium
    • Anions: Chlorine, Bicarbonate
  39. Intracellular fluid
    • Within the cell
    • 40% of body weight
    • Mostly water
  40. Extracellular Fluid
    • Outside the cell
    • 20% of body weight
    • Plasma and tissue fluid
  41. Osmotic Pressure
    Pressure required to stop or change the flow of water across a semipermeable membrane.
  42. Isotonic SOlution
    Solution of equal concentration to the cell
  43. Hypertonic Solution
    Greater concentration than the intracellular concentration in the cell
  44. Hypotonic Solution
    Lower solute concentration than that inside the cell
  45. Average Blood Volumes
    • Adult - 70mL/kg
    • Small Child - 65-70mL/kg
    • Neonate - 90mL/kg
  46. Signs of Shock
    • Thirst
    • Pallor
    • Tachycardia
    • Diaphoresis
    • Tachypnea
    • Decreased Urine
    • Thready Pulses
    • Hypotension
    • Altered LOC
    • Cardiac Arrest
  47. PASG
    • Pnuematic Anti Shock Garmat
    • - Increases BP above suit
    • - Decreases blood flow below suit
    • - Decreases blood loss below suit

    Indications: Neurological shock, splinting for multiple leg fractures, pelvic fractures with hypovolemia, systolic <50mmHg

    Contraindications: Pregnancy, pulmonary edema, hemmorage above suit

    Inflate Legs first then if BP not above 90-100, inflate abdomen.