Santa Clara EMS Test

Personnel Accountability Report (PAR)

-welfare check to verify safety/security of responders -includes all EMS unit including ride alongs

Hazardous Material Procedure

1) Safety + isolate area/deny entry 2) establish command, identify hazardous materials 3)trained HAZMAT personnel allowed to treat area. EMS coordinate effort to provide hospital with pertinent info

Prehospital Task force/ Strike Team type 1

5 ALS ambulanes, EMT/Paramedic, 1 strike team lead with separate vehicle

Strike Team type 2

5 BLS ambulances with 2 EMT's, 1 strike team elader with separate vehicle

Ambulance Task Force

5 ambulances - 2 must be ALS ambulances. 1 task force leader with separate vehicle.

If a pt with a score of 4/5 on the GFAST scale has not shown any normal signs since _____ hours ago you would transport them to a comprehensive stroke center

6 hours

CAN report

Conditions Actions Needs

Risk Refusal - turn down

EMS crew has determined that because of safety concerns they cannot take care of patient. EMS field supervisor completes system variance report

Hazardous Material Accidental Exposure

EMS crew that may be exposed to hazardous material will stop and notify County that they are exposed. Fire will respond. If on scene, notificy IC. Contaminated crew will not transport until decontaminated

patient transport special circumstances

EMS surge, MCI, diversion

Stroke Comprehensive

El camino, Good Sam, Regional, Stanford

Assessing the scene

If first on scene, one crew member becomes IC, other responsible for overall safety Fire/law enforcement takes over IC once on scene

What channel do you speak through to medical?

Medic 92

Physician on scene

Needs valid CA physicians license, other medical license and business address. physician will remain responsible for care until MD takes over. Must accompany crew to hospital

If patient dies en route to hospital

Return to departure point, transport to closest ED, transport to original destination

Emergent Patient Transportation

Transported to nearest ED with red lights/sirens IF time from on scene to ED is < than 10 min. Contact county for event number

EMS personnel badges expire the same day as their EMS license

True

True or False Chest Compressions are contraindicated in patients with VAD

True

Ventricular Assist Device VAD

VAD supplements cardiac ventricle in pumping blood to body

Routine Medical Care Adult

Vitals, Glasgow Coma scale, BP, RR, Pulse, Pulse Ox, Temp, Glucose, ECG, Capnography

EMS standard ID

all EMS personnel will wear uniforms that identify agencies when attached to 911 calls

Imminent Danger is defined as

any threat or hazard that could reasonably be expected to cause immediate death or serious physical harm to a responder.

Emergent Patient Transportation > 10 min

contact 911 for ALS assistance, if no one is available first arriving paramedic will ride to hospital with BLS crew

LHZ indications

fallen power line, energized electrical equipment, collapsed zones, large unprotected holes/pools/sewer access points, damaged vessel containing pressurized gas/ liquid, ammunition/explosives, suspected or present HAZMAT

Prehospital Transfer of Care information will include

full list of information, patient history, medical assessments, critical changes, treatments provided

Pediatric patient definition

neonate: 0-4 months infant: 1 month-1 year child: >1 year pediatric <15 years

Airborne Transmission of Infectious Disease Control

occurs through inhalation or absorption of air that contains TB, measles, chickenpox. Wear N95/N100 respirator/ impermeable gowns

Droplet transmissions Of Infectious disease control

occurs through inhalation or absorption of bodily fluid/substance droplets (influenza, rhinovirus). Wear surgical mask/face shields, impermeable gowns

Contact transmission of Infectious disease control

occurs through pathogens through skin, vomit, draiing wounds, secretions (saliva, sweat). Wear impermeable gown

Routine patient transport

transported to routine emergency department unless EMS system surge, hospital diversion, or patient needs specialty care

VAD assessment difficulties

unable to palpate pulse, read BP, obtain pulse ox. EMS rely on consciousness, skin sign, cap refil

EMS Protective Gear indicated when...

when directed by IC, public safety personnel, county EMS supervisor, OSHA requirements call for gears

Life Hazard Zone

would likely cause death/ seriour injury if exposed

The Operations Director can during MCI

Change emergency procedures to mitigate the potential threat of the MCI

Spinal Injury Assessment

-Determine if language barrier -Assess for distracting injuries/alch/drug -Determine if cooperative, alert, oriented -Palpate/visualize spinal column -remarkable = SMR -unremarkable = -circulation, motor, sensation -flexion/extension elbows/wrist -finger adduction/abduction -plantor flexion/ dorsiflexion -remarkable = SMR -unremarkable = modified SMR

Requests for Medical-Health Mutual Aid into Santa Clara County:

-Incident command officer makes request -Gives information to EMS duty chief -If not resources available then MHOAC coordinates region II resources to help

Determination of Death

-decapitation -decomposition -incineration -obvious destruction of brain, lungs, heart -rigimortis -no pulse + PCR -elected to end life via end of life agreement

If patient is determined to be deceased EMS personnel will

-discontinue resuscitative efforts -cancel prehospital personnel en route -provide appropriate care to bystanders -complete PCR document reason for determination of death

Emergency Vehicle Positioning

-emergency vehicles will be used as a barrier between scene and traffic -If already protected, additional ambulances will be beyond scene to create safety for crews

In extremis means

-protruding limb -uncontrollable airway -unable to stop bleeding after use of tourniquet

Fire can transport when

-pt needs RLS transport and county EMS is not on scene for at least 18 minutes -pt is in cardiac/respiratory arrest -STEMI/Stroke alert -Major Trauma Criteria -Needs rapid transport -uncontrollable airway

Crew Safety

-situational awareness especially when staging -escape routes established -IC designate safety zone for staging

Turn Down occurs because of...

-violation of safe work practices -Environmental conditions -Individuals lacking qualifications or experience -defective equipment being used -assignment violates law or regulation, policies, or procedures

PAR report

-visualize all personnel assigned to unit -determine that they are safe and present -Unit ID, Has par or does not have PAR, # assigned crew present, # non crew present -last assignment -last known location of personnel present

Hazardous Material Hospital Report

Chemical name, decon method, DOT reference #, appropriate treatment info, routing patient notification report, request ED to have personnel outside door to evaluate patient

STEMI

All except PA, El camino, st, louise

Stroke Primary

All except VA

When staging the drivers side should

Be away from traffic, protected. All EMS vehicles that are safety staging should be empty in case their vehicle is hit

BLS Inter facility Transport

Can transport: hospital to SNF/residence, doctors appointment, or dialysis

Protective Gear Indications

FAA Alert, MPMP activation, HAZMAT events, incident on freeway/roadway, working with aircraft, mutual/automatic aid response, need for clear ID due to multi agency response

A 26 year old male with an arrow through his left fore arm proximal to the elbow would be categorized as a major trauma

False

A patient who is a major trauma patient can ask to go to a hospital that is out of county and the EMT will comply

False

A physician on scene give more information than if they are giving online direction?

False

True or false? When arriving at a scene and giving a PAR report, you should count everyone with you except for ride alongs.

False

You can determine an injury as major trauma or minor trauma on scene by viewing the severity of the trauma

False

Infectious Disease Control

Nitrile Gloves Eye protection hand washing after ever patient waterless hand sanitizer

Physician on scene

PCR Physicians Name CA medical License # Business Phone # Level of patient care involvement All procedures and treatments performed at scene

DNR include

POLST for No CPR, DNR, DNR Medallions, Durable Power of Attorney

Updated EMS policy notifications would be distributed as follows except for which medium?

Paper copy sent to every EMS provider

Hazardous Material pre-treatment procedure

Paramedic + IC must agree patient has been decontaminated. Then patient will be cleared for treatment/ transport

Pediatric Trauma Hospitals

Stanford and Valley Med

Adult Trauma Hospitals

Stanford, Valley Med, Regional

You would transport North trauma pt to _______, central trauma pt to _________, and eastern trauma pt to _________

Stanford, Valley Medical, Regional

EMS directors in an MCI can do all of the following except

Take jurisdiction of the local law enforcement

LHZ marked with...

Tape with 3 horizontal strands of red and white barrier tape with DO NOT ENTER printed. If red not available any area barricaded with 3 horizontal strands of barrier tape

Medical Health Operational Area Coordinator

The Medical Health Operational Area Coordinator (MHOAC) for Santa Clara County is the Public Health Officer and EMS Director. -initial point of contact for all mutual aid requests -delegate available resources for mutual aid

When a patient passes away at their home during intervention what agency or person(s) are responsible for the deposition of the descendent?

The fire department or police (if present)

Spinal Motion Restriction SMR

immobilization + cervical collar + backboard + straps + head support device. SMR applied to pt with significant MCI/abnormal spinal injury assessment

Modified Spinal Motion Restriction

immobilization + rigid cervical collar. Used for para-vertebral pain or soft tissue tenderness/ unremarkable spinal injury assessment

EMS duty chief

liaison between agencies that are requested by IC Commander. -delegate roles to ALS contractor supervisors -Fill in IC system -Delegate county health officer

Emergent Definition

life or limp threatening condition that requires immediate care such as: respiratory distress, airway comp, neuro changes, major trauma criteria