Prehospital Emer Care Ch1, 2, 3

Front 1

modern ems system

Back 1

permits patient care to begin at the scene of the injury and illness, and ems is part of a continuum of patient care that extends from the time of injury or illness until rehab or discharge.

Front 2

ems levels of training

Back 2

1. emergency medical responder
2. emergency medical technician
3. advanced emt
4. paramedic

Front 3

e-911

Back 3

enhanced 911 which provides automatic number identification, and automatic location identification

Front 4

cell phone 911

Back 4

call often delivered to a central location the psap located closest to the triggered call tower

Front 5

special facilities

Back 5

trauma, burn, peds, poison, stroke, cardiac, hyperbaric, spine injury, psychiatric

Front 6

first and most important priority is

Back 6

protect your own safety

Front 7

physical demands

Back 7

must be able to lift and carry 125 lbs
color vision
decent hearing

Front 8

patient advocacy

Back 8

protecting the patients rights
collect and safegaurd valuables
shield privacy as much as possible
honor certain patient request as much as possible

Front 9

whos responsibility to maintain licensure

Back 9

your own!!

Front 10

medical director

Back 10

is a physician who is legally responsible for the patient care aspects of the ems system

Front 11

medical direction

Back 11

policies, procedures, and practices either off line (as protocols or standing orders) or on line (by phone or radio)

Front 12

standing orders

Back 12

subset of protocols that do not require real time physician input

Front 13

quality improvement

Back 13

a system of internal and external reviews and audits of an ems system to ensure a high quality of care
-as a general rule this should not be used as penalty tool

Front 14

high risk activities in patient safety

Back 14

-transfer of care at the scene between emr or at the medical facility
-poor communication that leads to misunderstanding or medical errors
-carrying and moving patients in a manner that risk them being dropped
-ambulance crash while transporting
-lack of spinal immobilization

Front 15

evidence based medicine

Back 15

-formulate a ?
-search medical literature for research data about ? formulated
- appraise the evidence for validity and reliability
-if evidence supports change in practice, change protocols and implement change in prehospital care

Front 16

five emotional stages of death

Back 16

1-denial
2-anger (why me)
3- bargaining ( ok but first let me)
4- depression
5- acceptance

Front 17

stress

Back 17

any change in the bodies internal balance
-occurs when external demands become greater than personal resources

Front 18

3 types of stress reactions

Back 18

1- acute- s/s occur right after incident
2- delayed- days, months or years after
3- cumulative- (burnout) result of constant exposure that builds up over time

Front 19

ways to manage stress

Back 19

1-diet
2- exercise more often
3- learn to relax
4- avoid self medication

Front 20

family and friends response

Back 20

1- lack of understanding
2- fear of seperation
3-worry about on call situations
4- inability to plan
5-frustrated desire to share

Front 21

CISM

Back 21

a process to deal with stress encountered by the emt

Front 22

CISD

Back 22

24 to 72 after incident
-typically includes everyone involved in the incident (dispatch, fire, police, ems, etc)

Front 23

defusing

Back 23

-1 to 4 hrs after incident
-less structured than cisd
-opportunity to vent emotions before cisd

Front 24

pathogens

Back 24

bacteria, viruses, fungi (also protoza, and helminths)
-pathogens can spread by way of blood and other body fluids or through the aire

Front 25

single most effective way to prevent spread of ifection

Back 25

hand washing
10 to 15 seconds
can use alcohol or foam agents if dont have acces to water but wash as soon as have access

Front 26

cleaning

Back 26

process of washing a soiled object with soap and water

Front 27

disinfecting

Back 27

includes cleaning but also uses a hospital grade disinfectant or germicide

Front 28

sterilization

Back 28

kills all microorganisms on surface of object done by superheated steam or chem substance (usually hospital)
-equipment contacts mucous membrane use sterilization

Front 29

ppd test

Back 29

purified protein derivative tuberculin test
-should have one every year

Front 30

hep b

Back 30

flu like symptoms and jaundice, dark urine
-possible to have no symptoms at all
-has a vaccination

Front 31

hep c

Back 31

-80 percent infected have no symptoms
-transmission via needlestick
-no vaccine

Front 32

tb

Back 32

-almost vanished once now coming back
-infected by droplets from cough or patients sputum
-s/s fever, cough, night sweats, weight loss
-wear a hepa or niosh n 95 respirator

Front 33

hiv/ aids

Back 33

-cotract by sexual contact, infected needles, mother child, infected blood or blood products
-many with hiv no s/s
-aids infected by opportunistic infections because of weakened immune system
-not everyone with hiv will develop aids

Front 34

Severe Acute Respiratory Syndrome (SARS)

Back 34

- infection by resp droplets from cough or sneezing
-s/s- high fever over 100 usually, headache and bodyache, resp systems,diarrhea, dry cough
-most with sars develop pneumonia
-wear surgurical mask

Front 35

west nile virus

Back 35

-transmitted via mosquito bite
-80 percent infected will show no symptoms
-problem for young and old

Front 36

ANSI vest and hwy

Back 36

class 2 and 3 vest must be worn on hwy receiving federal funding

Front 37

scope of practice

Back 37

-typically defined by state laws
-the actions and care an EMT is legally allowed to perform

Front 38

standard of care

Back 38

-care expected from any trained emt under similar circumstance
-uses reasonable person standard

Front 39

duty to act

Back 39

obligation to care for patient

Front 40

good samaritan law

Back 40

-CA 1959 first one
-provides liability immunity for emergency acts done in good faith
-doesn't prevent you as emt from being sued

Front 41

best way to avoid legal issues

Back 41

-always work within scope of practice and stan of care -always render care to best of your ability
-always behave professionally

Front 42

sovereign immunity

Back 42

prevents patients from govt opertaed ems fro suing government for civil liability
-doesnt apply to private ems company

Front 43

statute of limitaions

Back 43

certain amount of time to file a negligence claim

Front 44

contributory negligence

Back 44

patient through own negligence caused or contributed to damage done to him

Front 45

informed consent

Back 45

patient must be informed of care to be provided and risk associated with it

Front 46

expressed consent

Back 46

-must be obtained from every conscious, mentally competent patient
-can be verbal or head nod

Front 47

implied consent

Back 47

patient unresponsive
-reasonable person would want care if they were in that situation

Front 48

consent to treat a minor

Back 48

-must be obtained from parent or legal gaurdian
-if parent cannot be reached implied consent applies

Front 49

emancipated minor

Back 49

-do not need consent from parent
-also applies to pregnant woman of any age

Front 50

involuntary consent

Back 50

mentally incompetent or individual in law enforcement custody
-patient doesnt have legal right to determine his own care

Front 51

advance directive

Back 51

instruction written in advance of care

Front 52

DNR

Back 52

legal document that governs resuscitation issues only

Front 53

living will

Back 53

covers more general health care issues

Front 54

durable power of attorney (health care proxy)

Back 54

designates a person who is legally responsible to make health care decisions for the signer of the document

Front 55

physicians orders for life sustaining treatment (POLST)

Back 55

used in terminally ill or seriously ill who are not expected to live longer than 1 yr
-allows patient to choose level of care he desires in case of deterioration prior to resucitation

Front 56

refusing care

Back 56

-adult must be competent
-must be fully informed of risks and consequences of refusal
-

Front 57

Negligence

Back 57

-emt had duty to act
-breached duty to act
-patient suffered injury or harm recognized by law as compensable injury
-the injuries were result of the breach of duty

Front 58

intentional tort

Back 58

an action knowingly committed that is considered to be civilly wrong according to the law

Front 59

abandonement

Back 59

discontinuing care without transferring care to a health care professional with equivalent or better training

Front 60

assault

Back 60

willful threat to inflict harm on a person

Front 61

battery

Back 61

act of touching patient unlawfully without his consent

Front 62

false imprisonment/ kidnapping

Back 62

taking the patient to the hospital against his wishes

Front 63

defamation

Back 63

false communication that injures a persons reputation

Front 64

slander

Back 64

spoken form of defamation

Front 65

libel

Back 65

putting false or damaging statement in written form