Chapter 1: EMT

9. Define mobile integrated healthcare and community paramedicine. (p 19)

Mobile integrated healthcare (MIH) - method of delivering health care which involves providing health care within a community rather than at a physicians office or hospital Community paramedicine- a health care model in which experienced paramedics receive advanced training to equip them to provide additional services in the prehospital environment, such as health evaulations, monitoring of chronic illnesses or conditions, and patient advocacy

Which of the following is a specific example of the Mobile Integrated Healthcare (MIH) model?

The paramedic administers a patient's flu vaccination

1973

ems system act. first big act to get funding

The first priority of the EMT on the emergency scene is to

ensure personal safety.

type 3 truck

van chassis. mobile care

3. Describe EMT licensure criteria; including how the Americans with Disabilities Act (ADA) applies to employment as an EMT. (p 8)

- High school diploma or equivalent - Proof of immunization against certain communicable diseases. - Successful completion of a background check and drug screening. - Valid driver's license - Successful completion of a recognized health care provider basic life support (BLS)/cardiopulmonary resuscitation (CPR) course - Successful completion of a state-recognized written and practical certification examination. - Demonstrate the mental and physical ability necessary to safely and properly perform all the tasks and functions described in the defined role of an EMT - Compliance with other state, local, and employer provisions. Title I of the ADA protects EMTs with disabilities seeking gainful employment under many circumstances. Employers with a certain number of employees are required to adjust processes so that a candidate with a disability can be considered for the position, and when possible, modify the work environment or how the job is normally performed. This allows EMTs who can perform the functional job skills the opportunity to pursue a career in EMS.

• History of EMS (pp 9-10) 1966: 1970's 1971: 1980s: 1990s:

-1966: Accidental Death and Disability: The Neglected Disease of Modern Society established EMS -Early 1970's: DOT (Department of Transportation) published the first EMT training curriculum - 1971: AAOS published "The Orange Book" - 1980's: Advanced levels of EMTS - 1990's: NHTSA's EMS Agenda for the Future

12. Describe the roles and responsibilities of the EMT. (p 26)

-Keep vehicles and equipment ready for an emergency. -Ensure the safety of yourself, your partner, the patient, and bystanders. -Emergency vehicle operation. -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.

• Roles/responsibilities/professionalism of EMS personnel (pp 26-27) (18)

-Keep vehicles and equipment ready for an emergency. -Ensure the safety of yourself, your partner, the patient, and bystanders. -Emergency vehicle operation. -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.

EMS systems (pp 15-26) -Public Access: -Clinical care: -Primary service area: -Medical direction: -Integration of health services: -Information systems: -Prevention: -EMS research: -Communication systems: -Human Resources: -Legislation and Regulation: -Evaluation: -System finance: -Public education: -Education systems:

-Public Access: emergency dispatch center by dialing 911 -Clinical care: the various pieces of equipment and scope of practice for using that equipment. -Primary service area: the main area in which an EMS agency operates -Medical direction: authorizes the EMTs in the service to provide medical care in the field. Acts as a liaison. -Integration of health services: the prehospital care you administer is coordinated with the care administered at the hospital. -Information systems: Used of efficiently document the care that has been delivered. -Prevention: Primary/Secondary prevention and educate the public. -EMS research: Helps determine the shape of EMS. -Communication systems: -Human Resources: deals with people. Who delivers the care? How are these people compensated for their time? How do other members of the of the medical community interact and participate within the EMS world? -Legislation and Regulation: Training, protocols and practices follow state legislation (scheduling, personnel, budgets, purchasing and vehicle maintenance) -Evaluation: M.D is responsible for maintaining quality control and Continuous quality improvement (CQI) reviews EMS systems. -System finance: EMTs may be asked to father insurance information, secure signatures and obtain permission from patients to bill insurance. -Public education: Primary/Secondary prevention and educate the public. -Education systems: Most EMS training programs must adhere national standards.

7. Name the 14 components of the EMS system. (pp 15-26)

1. Public Access 2. Clinical Care 3. Medical Direction 4. Integration of Health Services 5. Information Systems 6. Prevention 7. EMS Research 8. Communication Systems 9. Human Resources 10. Legislation and Regulation 11. Evalutaion 12. System Finance 13. Public Education 14. Education Systems

Which of the following descriptions MOST accurately portrays emergency medical services (EMS)?

A team of health care professionals who are responsible for providing emergency care and transportation to the sick and injured

14. Understand the impact of the Health Insurance Portability and Accountability Act (HIPAA) on patient privacy. (p 27)

As a health care professional you are bound by patient confidentiality. Your findings and disclosures should only be discussed with those treating the patient. HIPAA - Is the protection of patient privacy

Which of the following skills would a layperson MOST likely be trained to perform before arrival of EMS?

Bleeding control using a tourniquet

10. Discuss the purpose of the EMS continuous quality improvement (CQI) process. (pp 20-

Continuous quality improvement (CQI) - is a circular system of continuous internal and external reviews and audits of all aspects of an EMS system. -Periodic run review meetings are held with those involved in patient care to review the run reports. -The CQI process is designed to identify areas of improvement and assign remedial training.

Peter Safar

Credited for starting the ABC's of CPR.

Prehospital patient care decisions should be based on

EMS research.

Most EMT courses today are based on models developed by the .

DOT

The level of EMS that involves medical training for those who are usually first on the scene of an emergency is .

EMR

5. Describe the levels of EMT training in terms of skill sets needed for each of the following: EMR, EMT, AEMT, and paramedic. (pp 10-14)

EMR - EMRs include law enforcement officers, firefighters, park rangers, ski patrollers, and other organized rescuers. Initiate immediate care and assist the EMTs on their arrival. They provide immediate BLS and urgent care with limited equipment. EMT - EMT course requires approximately 150 hours. They provide basic emergency care in the field. AEMT - Additional skills include IV therapy, use of advanced airway adjuncts, and the knowledge and skills to administer a limited number of medications. AEMT course ranges between 200 and 400 hours. Paramedic - Extensive course of training that increases knowledge and mastery of basic skills and ALS skills. Paramedic course ranges from 1,000 to more than 1,300 hours. Training can be offered in associates and bachelors degree.

8. Describe how medical direction of an EMS system works, and the EMT's role in the process. (p 18)

Each EMS system has a physician medical director who authorizes the EMTs in the service to provide medical care in the field. The appropriate care provided by the EMT is determined by the medical director written in standing orders or protocols. The medical director determines and approves the education and training for EMTs. Medical control is provided off-line (indirect) or online (direct). The service's protocols will identify an EMS physician, usually by a local hospital, who can be reached by radio or telephone.

The EMT is legally obligated to protect a patient's privacy according to

HPPA

13. Describe the attributes an EMT is expected to possess. (p 27) Integrity - Empathy - Self-motivation - Appearance and hygiene - Self-confidence - Time management - Communications - Teamwork and diplomacy - Respect - Patient advocacy - Careful delivery of care -

Integrity - Consistent actions, a firm adherence to a code of honest behavior. Empathy - Aware of and thoughtful toward the needs of others. Self-motivation - Able to discover problems and solve them without someone directing you. Appearance and hygiene - Uses persona to project a sense of trust, professionalism, knowledge, and compassion. Self-confidence - A state of being where you know, what you know, and know what you not know; able ask for help Time management - Able to perform or delegate multiple tasks ensuring efficiency and safety. Communications - Able to understand others and have them understand you. Teamwork and diplomacy - Able to work with others; to know your place within a team; able to communicate while giving respect to the listener. Respect - Places others in high regard or importance; understands others are more important than self. Patient advocacy - Constantly keeping the needs of he patient at the center of care. Careful delivery of care - Pays attention to detail; makes sure what is being done for the patient is done as safe as possible.

EMT training in nearly every state meets or exceeds the guidelines recommended by the:

National Highway Traffic Safety Administration (NHTSA)

11. Characterize the EMS system's role in disease and injury prevention and public education in the community. (pp 23-24) Public Health:

Public Health - examines the health needs of entire populations with the goal of preventing health problems. Primary Prevention - focuses on strategies that will prevent the event from ever happening. Secondary Prevention - the event has already happened. -Vacinations -Dangers of drinking and tobacco use -Pool safety -Car seat installaion -Helmets -Seat belts -9-1-1 -CPR and choking victims

Which of the following statements regarding the Americans With Disabilities Act (ADA) of 1990 is correct?

The ADA prohibits employers from failing to provide full and equal employment to those who are disabled.

Which of the following statements regarding the NREMT is correct?

The NREMT provides a national standard for EMS testing.

1. Define emergency medical services (EMS) systems. (p 5)

The emergency medical services (EMS) system -consists of a team of health care professionals who, in each area or jurisdiction, are responsible for and provide emergency care and transportation to the sick and injured.

6. Recognize the possible presence of other first responders at a scene with EMR training, some knowledge of first aid, or merely good intentions, and their need for direction. (pp 13-14)

You will encounter Good Samaritans trained in first aid and CPR, physicians and nurses, and other well-meaning people with or without prior training and experience. These people can provide valuable assistance when you are shorthanded. They can interfere with operations and even create problems or danger from themselves or others. In your scene size-up identify the various people on the scene and orchestrate well-meaning attempts to assist.

The aspect of the EMT's job that involves protecting the patient's rights is

advocacy .

According to the National EMS Scope of Practice Model, an EMT should be able to:

assist a patient with certain prescribed medications.

father of modern EMS

baron dominique jean larrey

White Paper

bettering of medicine

type AD truck

bigger high rise ICU

1969

first national conference on ems

freedom house ambulance service

first paramedics basically ever

1966 survey results

got us moving forward. accidental death and disability the neglected disease of modern society. building blocks for ems

type one truck

gville county truck

The system of internal and external reviews and audits for all aspects of an emergency medical system is known as quality

improvement.

Continuing education in EMS serves to:

maintain, update, and expand the EMT's knowledge and skills.

An EMT is operating as a designated agent of the

medical director

An order from an EMS system's on-duty physician given by radio or phone is an example of

on-line medical direction .

The first concern of an EMT always must be ___ safety.

personal

type two truck:

regular van

A policy set by an EMS medical director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a(n)

standing order

The standards for prehospital emergency care and the individuals who provide it are typically regulated by the:

state office of EMS.