Prehospital Emergency Care Ch 4 And 6

Front 1

Functions of a PCR

Back 1

-continuity of medical care
-admin uses
-legal document
-educational and research uses
-evaluation and continuous quality improvement

Front 2

PCR

Back 2

documentation of an emts contact with a patient

Front 3

Does the documentation you provide become part of the patients permanent hospital record?

Back 3

YES

Front 4

continuity of medical care

Back 4

-provides a baseline for other providers
-gives an understanding of events and reasons for call

Front 5

PCR legal

Back 5

-is a legal document
-may be called as a witness
-documentation can be an essential part to your defense

Front 6

PCR formats

Back 6

-written-most traditional format, combines check boxes and write on lines for vitals along with other areas for writing a fuller narrative
-computerized- a.)some have boxed sheets that are then scanned in computer
b.) on others data is directly entered into a PDA or laptop.

Front 7

Can the emts computer be linked to diagnostic equipment, to electronic medical records, to CAD, systems handling fleet management, etc?

Back 7

yes

Front 8

2 basic rules for PCR

Back 8

if it wasnt written down it didnt happen

if it wasnt done dont write it down

Front 9

why does DOT make an effort to standardize care?

Back 9

such general standardization will hopefully lead to a higher level of patient care across nation

Front 10

minimum data set

Back 10

patient info- cheif complaint, loc, bp, skin perfusion, skin color, temperature and condition, pulse rate, resp rate and effort, patient deomgraphics.

admin info-time incident reported, time unit was notified, time of arrival at patient, time the unit left the scene, time unit arrive at destination (hospital) time of transfer of care

Front 11

How many sets of vital signs shall be taken and recorded?

Back 11

ideally atleast two complete sets of vitals should be taken and recorded, also important to note the patients position when taking the vitals. Also critical to record the time which vitals taken.

Front 12

PCR narrative section

Back 12

-brief but thorough picture of the patient for other medical personnel to use
-chief complaint, sample, objective data, subjective data, and pertinent negatives.

Front 13

treatment section of pcr

Back 13

chronological order of treatments given, the time they were administered and the patients response to treatment

Front 14

refusal of treatment highlights

Back 14

-inform patient of why they should go to hospital and consequences of not going
-always make an effort to persuade patient to go before leaving
-discuss situation with medical control, doctor may convince patient or give guidelines for emt for a refusal
-document assesment findings you have done also document patient is alert and a&o x 4
-explain that you can always come back

Front 15

false information may lead to?

Back 15

suspension, or revocation of emt certification or license, and may lead to criminal charges

Front 16

transfer of care report

Back 16

-
-obtain signature from medical professional who is assuming care (if able to)
-leave a copy of report at facility
-a cope of transfer of care report shall be submitted with full pcr

Front 17

mci patients and documentation

Back 17

the needs of patients conflict with the needs of complete documentation
-often just a triage tag used for pcr later

Front 18

special report sitautions

Back 18

abuse of child or elderly
-possible exposure to disease
-injury to ems member
-other sits where emt deems neccessary

Front 19

SOAP

Back 19

alternative method for documentation
S-subjective
O-objective
A-assessment
P-plan

Front 20

CHART

Back 20

C-chief complaint
H-history
A-asessment
R-rx
T-transport

Front 21

CHEATED

Back 21

C-chief complaint
H-history
E-exam
A-assessment
T-treatment
E-evaluated
D-disposition

Front 22

Best way to move a patient?

Back 22

the easiest way that will not cause injury or pain to your patient or yourself

Front 23

Body mechanics

Back 23

safest and most efficient methods of using your body to gain a mechanical advantage

Front 24

4 basic principles

Back 24

-keep weight of object as close to body as possible
-to move a heavy object use legs, hip, and buttocks muscles plus contracted abdominal muscles
-stack-visulaize shoulders tacked on top of hips, hips stacked on top of feet, move them as unit
-reduce height or distance object must be moved

Front 25

lordosis

Back 25

stomach is too anterior and buttocks to posterior

Front 26

kyphosis

Back 26

the shoulders are rolled forward, which results of fatigue of lower back and increases pressure on every region of spine

Front 27

general guidelines for lifting and moving

Back 27

always try to use an even number of rescuers
-two rescuers should carry a heavy load for 1 minute or less
-never lift and twist simultaneously

Front 28

powerlift

Back 28

feet are apart,knees bent, back and abdominal muscles tightened, back as straight as possible, lifting force driven through heels and arches
-a useful technique for rescuers with weak knees and thighs

Front 29

powergrip

Back 29

recommended gripping technique, the alms and fingers come in complete contact with the object and all fingers are bent at same angle

Front 30

squat lift

Back 30

use if you have one weak leg or ankle, or both knees and legs are strong and healthy
-place weaker leg slightly forward, and push yourself upper with your stronger leg

Front 31

one handed carry

Back 31

keep your back locked, and avoid leaning to opposite side too much

Front 32

when it is necessary to reach how far should reach for something?

Back 32

15 to 20 inches, no more than 20

Front 33

pushing

Back 33

whenever possible push rather than pull, keep push area between waist and shoulders

Front 34

pulling

Back 34

avoid when possible, keep load between shoulders and hips

Front 35

emergency move

Back 35

immediate danger to patient or rescuer (fire, expolsives, hazmat, inability to protect patient from hazards at scene, inability to gain access to patients who need care, inability to provide lifesaving care because of the patients location or position.
types-shirt drag, blanket drag, armpit forearm drag

Front 36

urgent moves

Back 36

patient is suffering immediate threat to life
type rapid extrication (loc, inadequate resp, indications of shock, major bleeding, fracture of both femurs

Front 37

nonurgent moves

Back 37

no immediate threat to life, choose best equipment and positioning for moving patient safely.
-direct ground lift, extremity lift, direct carry method, draw sheet method

Front 38

wheeled stretcher

Back 38

-device most commonly used
-rescuer at head pushes and rescuer at feet guides
-two types lift in and roll in, roll in type has specialized wheel at head to simplify loading, it significantly reduces amount of twisting and lifting required
-never leave patient unattended
disadvantage-difficult to maneuver on uneven terrain

Front 39

bariatric stretcher

Back 39

up to 1600 lbs
-larger wheels, wider cot, heavily constructed frames

Front 40

portable stretcher

Back 40

-particularly useful when the patient must be removed from a confined or too narrow space that wheeled stretcher won fit into.
-should not be used when spinal immobilization is needed unless used with a long backboard
-care must be taken when putting patient on rock ground
-three types-basic model, the breakaway, basic with folding wheels and posts
-

Front 41

stair chair

Back 41

-usefull when a wheeled stretcher cannott navigate down narrow corridors and doorways, small elevators, and stairways.
-dont use for altered loc, suspected spinal injury, or injury to lower extremities

Front 42

backboards

Back 42

-protects patient from rocky ground and acts as spinal immobilizer
-if use a short backboard such as a ked then put them on a long backboard after (short backboards good for immobilize patients that are sitting)

Front 43

scoop stretcher

Back 43

-up to 300 lbs, made to be assembled and disassembled around patient, used in confined areas where other conventional stretchers will not fit.
-also good of for pelvic or bilateral femural fractures
-2 or more rescuers required
-note for spinal injuries

Front 44

basket strecther

Back 44

-commonly called stokes basket
-will accommodate a scooped stretcher or ohio backboard
-allows you to completely immobilize a patient who is already in backboard for rough terrain

Front 45

flexible stretcher

Back 45

-special transfer device made of canvas or synthetic materials
-especially usefull for narrow and restricted hallways found in mobile homes

Front 46

position put pregnant women in?

Back 46

-on left side to prevent supine hypotensive
-if there is excess vaginal bleeding place in supine position, if suspect prolapsed cord place woman on back and elevate hips

Front 47

unresponsive patient with no head, neck or, spinal trauma

Back 47

put in left lateral recumbent

Front 48

patient with chest pain or breathing difficulties

Back 48

placed in postion of comfort usually sitting up

Front 49

alert patient who is nauseated placed?

Back 49

in sitting or recovery position