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Key developments in the history of EMS
- Vehicles and attendants used to care for injuries on the battlefield
- 1926 Phx Fire adds service to present day EMS
- EMS turned over to Fire and Police
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5 Main types of service that provide emergency care.
- Fire-based
- Third service(municipalities)
- Private (profit & non-profit)
- Hospital based
- Hybrid or other
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A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.
Certification
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The process whereby a state allows qualified people to perform a regulated act.
Licensure
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The process of granting licensure or certification to a provider from another state or agency
Reciprocity
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A document that provides overarching guidelines as to what skills each level of EMS provider should be able to accomplish
National EMS Scope of Practice Model
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Critical Points for a functioning EMS system
- Strategies to ID community health & safety
- Financial incentives
- Community prevention
- National EMS research
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Required components of an EMS system
- Integration of health services
- EMS research
- Legislation & regulation
- System finance
- HR
- Medical direction
- Education & training
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EMS system elements
- Regulation & policy
- Resource management
- HR and training
- Transportation
- Facilities
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The level known as "first responder", usually trained in CPR and/or first aid
Emergency medical responder
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Primary provider level in most EMS systems
Trained in: Advanced airway intervention
Limited medication administration
Intravenous (IV) fluid therapy
EMT-Basic
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Trained in advanced pathophysiology
IV access
Administering IV fluids
Blood glucose monitoring
Some advanced airway management
Advanced EMT
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The highest level EMS skill level
Paramedic
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Types of speciality centers
- Trauma
- Burns
- Poisoning
- Psychiatric
- Childrens
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Attributes of a health care profesional
- Conforms to the same standards of other health care professionals
- Provides quality patient care
- Instills pride in the profession
- Strives continuously for high standards
- Earns respect from others in profession
- Meets high societal expectations on or off duty
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Attributes of professionalism as a paramedic
- Integrity
- Empathy
- Self-motivation
- Confidence
- Communications
- Teamwork and respect
- Patient advocacy
- Injury prevention
- Careful delivery of service
- Time management
- Adminstration
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Roles and Responsibilities of a Paramedic
- Preparation
- Response
- Scene Management
- Patient Assessment & Care
- Management & Disposition
- Patient Transfer & Report
- Documentation
- Return to Service
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A comprehensive CQI program can help prevent problems such as:
- Medical direction issues
- Education
- Communications
- Prehospital treatment
- Transportation issues
- Financial issues
- Receiving facility review
- Dispatch
- Public information
- Disater planning
- Mutual aid
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The three main sources of errors in the EMS system:
- Rules-based failure
- Knowledge-based failure
- Skills-based failure
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The use of practices that have been proven to be effective in improving patient outcomes
Evidence-based practice
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Who has the authority to issue a license?
State EMS governmental body
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The entity that typically coordinates the entire rescue effort is:
Dispatch
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The EMT paramedic national standards are regulated by the:
Department of Transportation (DOT)
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Reciprocity allows a paramedic to:
become certified by another state or agency.
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Which of the following is necessary when returning to service?
1) Restock your unit.
2) Complete all documentation.
3) Notify the hospital.
4) Assess the situation.
Restock your unit.
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The patient documentation is the responsibility of the:
1) officer on scene.
2) attendant in charge.
3) EMT.
4) paramedic.
attendant in charge.
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The role of an EMS medical director includes:
- developing clinical protocols.
- providing input into patient care.
- participating in equipment selection.
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Off-line medical control allows for the development of:
- standing orders.
- protocols.
- procedures and training
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A tool that is often used to continually evaluate paramedic performance is:
continuous quality improvement. (CQI)
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Research that is based on numerical data is known as
quantitative research
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By definition, retrospective research is:
1) research that is observation only.
2) when a clinical trial is being performed.
3) based on a clearly defined problem.
4) based on currently available data.
based on currently available data.
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Off-line medical control can best be described as:
standing orders or protocols.
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What was established after the publication of the “White Paper”?
1) National Highway Safety Act
2) The first EMT textbook
3) Miami Fire paramedic program
4) Controlled Substance Act
National Highway Safety Act
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What group is responsible for ensuring that a research study is ethically sound?
1) Institutional review board
2) Regional ethics committee
3) Principal investigator
4) Research subjects
Institutional review board
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A treatment plan developed for a specific illness or injury
Protocol
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Critical Points for a functioning EMS system (2)
- State EMS legislation for innovation & integration
- Resources for medical direction
- Systems that link EMS
- Cost & benefits
- Calls have location identifying info
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Required components of an EMS system (2)
- Public access
- Prevention
- Transportation
- Communication system
- Clinical care facilities
- PT. info
- Mutual aidEvaluation
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EMS system elements (2)
- Communication
- Public info & Education
- Medical direction
- Trauma systems
- Evaluation
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Medical direction given in real time to an EMS service or provider
Online medical control
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A research format that uses a hypothesis to prove one finding from another
Inferential
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An early title given to an ambulance-style unit
Mobile intensive care units (MICUs)
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A type of study in which the subjects are advised of all aspects of the study
Unblinded study
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A type of research that gathers information as events occur in real time
Prospective research
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The process used by medical magazines, journals, and other publications to ensure quaility and validity of an article before publishing it, and which involves sending the article to subject matter experts for review of the content and research methods
Peer review
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A type of research in which a single case is investigated and documented over a period of time
Case study
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A type of research that examines patterns of change, a sequence of events, or trends over time within a certain population of study subjects
Cohert research
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Medical direction given through a set of protocols, policies, and/or standards
Off-line medical control
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Direction given to an EMS service or provider by a physician
Medical direction
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The responsibilty of the medical director to ensure that the approriate medical care standards are met by EMS personnel on each call
Quality control
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The collaboration of prehospital and in-hospital medicine that focuses on optimizing the use of resources and assets of each with a primary goal of reducing ther mortality and morbidity of trauma patients
Trauma systems
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