Chapter 1: EMS Systems

mobile integrated health care (MIH)

-An integrated team of health care professionals delivers health care services in the community and connects patients with other valuable resources. -The MIH model offers access to care for patients within communities who may have limited medical resources and leads to better service for those who are homebound or disabled.

EMS Agenda 2050 components of an EMS system

-Comprehensive, quality, convenient care -Evidence-based clinical care -Efficient, well-rounded care -Preventative care -Comprehensive and easily accessible patient records

roles and responsibilities of the EMT

-Keep vehicles and equipment ready for an emergency. -Ensure the safety of yourself, your partner, the patient, and bystanders. -Operate the emergency vehicle. -Be an on-scene leader. Perform an evaluation of the scene. -Call for additional resources as needed. -Gain patient access. -Perform a patient assessment. -Give emergency medical care to the patient while awaiting the arrival of additional medical resources. -Give emotional support to the patient, the patient's family, and other responders. -Maintain continuity of care by working with other medical professionals. -Resolve emergency incidents. -Uphold medical and legal standards. -Ensure and protect patient privacy. -Give administrative support. -Constantly continue your professional development. -Cultivate and sustain community relations. -Give back to the profession.

emergency medical dispatch (EMD)

-System that assists dispatchers in providing callers with instructions to help them deal with a medical emergency until EMS crews arrive. -The system helps dispatchers select appropriately resourced units to respond to the call.

C. medical director.

2.Quality control in an EMS system is the ultimate responsibility of the: A. paramedic. B. lead EMT. C. medical director. D. EMS administrator.

C. retreat to a safe place until the police arrive.

3.Upon arriving at the scene of a domestic dispute, you hear yelling and the sound of breaking glass from inside the residence. You should: A. immediately gain access to the patient. B. carefully enter the house and then call the police. C. retreat to a safe place until the police arrive. D. tell the patient to exit the residence so you can provide care.

C. Negative feedback given to those who make mistakes while on a call

4.Which of the following is NOT a component of continuous quality improvement (CQI)? A. Periodic review of run reports B. Discussion of needs for improvement C. Negative feedback given to those who make mistakes while on a call D. Remedial training as deemed necessary by the medical director

A. evaluating patient insurance information.

5.All of the following are responsibilities of the EMS medical director, EXCEPT: A. evaluating patient insurance information. B. serving as a liaison to the medical community. C. ensuring that the appropriate standards are met by EMTs. D. ensuring appropriate EMT education and continuing training.

medical director

A ___ determines appropriate care by establishing a set of written standing orders and protocols.

public safety access point

A call center, staffed by trained personnel who are responsible for managing requests for police, fire, and ambulance services.

automated emergency defibrillator (AED)

A device that detects treatable life-threatening cardiac dysrhythmias (ventricular fibrillation and ventricular tachycardia) and delivers the appropriate electrical shock to the patient.

national ems scope of practice model

A document created by the National Highway Traffic Safety Administration (NHTSA) that outlines the skills performed by various EMS providers.

C. Paramedic

A patient who requires cardiac monitoring in the field would require, at a minimum, which level of EMS provider? A. EMR B. EMT C. Paramedic D. AEMT

certification

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.

continuous quality improvement (CQI)

A system of internal and external reviews and audits of all aspects of an EMS system aimed at improving outcomes.

True

ALS-level instructors and directors must hold a four-year degree.

credentialing

An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.

B. being able to communicate while giving respect to the listener

An example of teamwork and diplomacy is: A. using your persona to project a sense of personal superiority to patients. B. being able to communicate while giving respect to the listener. C. acknowledging that others are not in high regard or importance. D. delegating multiple tasks only occasionally to ensure efficiency and safety

The standards for prehospital emergency care and the individuals who provide it are typically regulated by the: A. american heart association B. state office of EMS C. national registry of EMTs D. regional trauma center

B. state office of EMS

D.Incident recognition

Emergency patient care occurs in progressive phases. What occurs first? A.Activation of EMS B.Initial prehospital care C.The patient receives definitive care D.Incident recognition

True

Evidence-based research is the primary means to determine if changes need to be made in patient care.

community paramedicine

Experienced paramedics receive advanced education and training to equip them to provide a variety of services within a community: -Performing health evaluations -Monitoring chronic illnesses or conditions -Obtaining laboratory samples -Administering immunizations Serving as a patient advocate

health insurance portability and accountability act (HIPAA)

Federal legislation passed in 1996. Its main effect in EMS is in limiting availability of patients' health care information and penalizing violations of patient privacy.

mobile integrated healthcare (MIH)

In ___, an integrated team of health care professionals delivers health care services and connects patients with other resources.

community paramedicine

In ___, providers receive advanced training in areas including performing health evaluations and administering immunizations.

emt attributes

Integrity: adhering to a code of fair and honest behavior Empathy: being aware of and thoughtful toward the needs of others Self-motivation: discovering problems and solving them without someone directing you Appearance and hygiene: using your persona to project a sense of trust, professionalism, knowledge, and compassion Self-confidence: knowing what you know and knowing what you do not know; being able to ask for help Time management: performing or delegating multiple tasks while ensuring efficiency and safety Communications: understanding others and making yourself understood to others Teamwork and diplomacy: being able to work with others; knowing your place within a team; communicating while giving respect to the listener Respect: placing others in high regard or importance; understanding that others are more important than you Patient advocacy: constantly keeping the needs of the patient at the center of care Careful delivery of care: paying attention to detail; making sure that what is being done for the patient is done as safely as possible

quality control

Oversight by the medical director to ensure the appropriate medical care standards are met by EMTs on each call

C. Honest behavior; a clean, well-groomed persona; respecting others

Professional attributes include which of the following? A. Integrity, relying only on one's self, taking charge B. Blaming others, ignoring team members, lying C. Honest behavior; a clean, well-groomed persona; respecting others D. Placing your needs above the patient's care, listening to your patient, performing multiple tasks safely

paramedic

The ___ completes an extensive course of training that lasts from 1,000 to more than 1,300 hours, which significantly increases knowledge and mastery of basic skills and covers a wide range of ALS skills.

emergency medical technician

The ___ course requires approximately 150 hours (more in some states) and provides the essential knowledge and skills required to provide basic emergency care in the field.

primary service area

The designated area in which the EMS agency is responsible for the provision of prehospital emergency care and transportation to the hospital.

False

The development of airbags in vehicles is an example of primary prevention.

False

The focus of the public health arm of health care is education.

advanced emergency medical technician

The length of the ___ course ranges from 200 to 400 hours; this training teaches skills such as IV therapy, the use of advanced airway adjuncts, and the knowledge and skills necessary to administer a limited number of medications.

licensure

The process whereby a competent authority, usually the state, allows people to perform a regulated act.

C. providing legal advice to patients

The roles and responsibilities of an EMT include all of the following EXCEPT: A. performing a patient assessment. B. upholding medical and legal standards. C. providing legal advice to patients. D. ensuring and protecting patient privacy.

D. Americans with Disabilities Act

This act of legislation protects people with disabilities from being denied access to programs and services that are provided by state or local governments. A. Ryan White Act B. Marchman Act C. Equal Rights Amendment D. Americans with Disabilities Act

Continuous quality improvement is a circular system of continuous internal and external reviews and audits of all aspects of an EMS system. By looking at all the components of an EMS system, the CQI process seeks to identify areas that need improvement and enables the problems to be resolved through remediation and training rather than through punitive measures.

What is continuous quality improvement (CQI) and how is it used to help ensure the safety of patients?

C. Ensure personal safety

What is the primary role of the EMT? A. Provide appropriate medical care B. Diagnose the patient's condition C. Ensure personal safety D. Provide transport to the closest hospital

B. National Highway Traffic Safety Administration

Which of the following agencies is the federal source for the model EMT scope of practice and education standards? A. Department of Health and Human Services B. National Highway Traffic Safety Administration C. Federal Emergency Management Agency D. Department of Transportation

national highway traffic safety administration

Which of the following agencies is the source of the EMS Agenda for the Future, the multidisciplinary national review of all aspects of EMS delivery?

The state in which the EMT practices

Which of the following entities controls licensure of EMTs?

C. Maintaining a professional demeanor in even the most stressful situations

Which of the following is a professional responsibility of the EMT? A. Telling the family of a dying patient that everything will be OK B. Maintaining only the skills that he or she feels uncomfortable with C. Maintaining a professional demeanor in even the most stressful situations D. Advising an emergency department nurse that patient reports are given only to a physician

B. The EMT defibrillates a patient in cardiac arrest, begins CPR, and then contacts medical control.

Which of the following is an example of care that is provided using standing orders? A. Medical control is contacted by the EMT after a patient with chest pain refuses EMS care. B. The EMT defibrillates a patient in cardiac arrest, begins CPR, and then contacts medical control. C. A physician gives the EMT an order via radio to administer oral glucose to a diabetic patient. D. Following an overdose, the EMT contacts the medical director for permission to give activated charcoal.

providing cervical spine immobilization

Which of the following is an example of secondary prevention? a) providing cervical spine immobilization b) administering vaccines c) teaching safety in schools d) legislating the use of seatbelts

C. Teaching pool safety when finding someone who slipped and fell near a pool by running

Which of the following is an example of secondary prevention? A. Cardiac arrest management B. Administering vaccines C. Teaching pool safety when finding someone who slipped and fell near a pool by running D. Teaching safety in schools

D. Ensuring personal safety

Which of the following should be the EMT's highest priority? A. Controlling severe bleeding B. Maintaining a patient's airway C. Ensuring patient safety D. Ensuring personal safety

B. Driving under the influence of alcohol

Which of the following situations would MOST likely disqualify a person for EMS certification? A. A misdemeanor committed at age 17 B. Driving under the influence of alcohol C. Possessing a valid driver's license from another state D. A mild hearing impairment that is corrected with hearing aids

A. Continuing medical education

Which of the phases of being an emergency health care provider is continuous? A. Continuing medical education B. Teaching EMS courses C. Pursuing an advanced degree D. Completing weekly drug screening

department of transportation (DOT)

Which organization developed and published the first curriculum that served as the guideline for EMT training?

Research provides data that identify treatments that are beneficial and/or lifesaving for trauma patients and those that are not. Participation in EMS research empowers the EMT to help shape the future of trauma care.

Why is EMS research a vital part in the evolution of patient management?

public safety access points

___ can be reached by dialing 9-1-1.

emergency medical responder

___ training provides skills necessary to initiate immediate care and focuses on providing immediate BLS and urgent care with limited equipment.

EMS as we know it today had its origins in 1966 with the publication of:

accidental death and disability: the neglected disease of modern society