EMT Unit 1 Exam (vocab, quizzes, objectives)
Which of the following suffixes mean "pertaining to"?
"-al" and "-ic"
Which of the following statements is NOT appropriate to document in the narrative section of a PCR
"General impression revealed that the patient was intoxicated"
Which of the following suffixes mean "two"?
"dipl-" and "bi-"
The meaning "around" can have which of the following prefixes?
"peri-" and "circum-"
What is the suffix pertaining to eating or swallowing?
"phagia"
midsagittal plane
(midline) An imaginary vertical line drawn form the middle of the forehead through the nose and the umbilicus to the floor, dividing the body into equal left and right halves.
1. Explain the purpose of medical terminology. (p 153)
- Abbreviated words can lead to communication errors, particularly when you use more obscure or local abbreviations -- and particularly when you use them in written documentation where clarification is more difficult. - Avoid using it when talking to families.
Explain the reporting requirements for special situations including abuse, drug- or felony-related injuries, childbirth, and crime scenes.
- Abuse / neglect of children*, elderly*, and others -Injury during the commission of a felony -Sexual Assault -Mentally incompetent -Drug related injury -Childbirth -Infectious disease exposure -Death >>>Mandatory reporting laws vary by locality<<< * Mandated reporting in Massachusetts
Describe the roles and responsibilities of the EMT in court.
- EMTs may be witnesses or defendants in civil or criminal cases. -If you are subpoenaed, notify your service director and legal counsel. -As a witness, you may be required to review the run report as evidence. - You may be deposed (interviewed) as part of discovery. - Most medical cases do not go to trial but are settled after discovery. -EMTs who are defendants often use statutes of limitations (limits on how much time can pass between an incident and lawsuit), governmental immunity based upon state laws, or contributory negligence (the patient is at least partially to blame for the injury/damages). -Cases that go to trial can award compensatory damages (intended to repay proportionally to the injury) and punitive damages (intended to deter the defendant or others from similar actions).
Understand the special considerations in communicating with older people, children, hearing-impaired patients, visually impaired patients, and non-English speaking patients. Ch.4 #4 Pg.113-117
- Identify yourself. - Be aware of how you present yourself. - Look directly at the patient. - Speak slowly and distinctly. - Explain what you are going to do before you do it. - Listen to the answer the patient gives you. - Show the patient respect. - Do not talk about the patient in front of him or her. - Be patient!
Define consent and how it relates to decision making.
- In the context of EMS, consent is permission to render care - The foundation of consent is decision making capacity. - Decision Making capacity is the ability of a patient to understand the information you are providing, coupled with the ability to process that information and make an informed choice regarding medical care.
Discuss the importance of do not resuscitate (DNR) orders and local protocols as they relate to the EMS environment.
- Patient has the right to refuse resuscitative efforts - In general, requires written physician order - Become familiar with state and local protocols - When in doubt, resuscitate - Massachusetts uses the "Comfort care" form - EMTs in MA require a Comfort Care form or MOLST in order to honor a DNR
5. Break down the meaning of a medical term based on the components of the term. (p 162)
- When defining a term, begin with the suffix and work backwards - If the term also contains a prefix, define the suffix, then the prefix and then the word root
Know the standard precautions used in treating patients to prevent infection. (pp 42-47)
--->1. Infection control should be an important part of your daily routine. --->2. Components of an infection control plan: a.) Determination of exposure risk b.) Education and training c.) Hepatitis B vaccine program d.) Personal protective equipment (PPE) e.) Cleaning and disinfection practices f.) Tuberculin skin testing/fit testing g.) Postexposure management h.) Compliance monitoring i.) Record keeping --->3. Follow the steps in Skill Drill 2-2 to manage potential exposure situations. --->4. Cleaning is an essential part of the prevention and control of communicable diseases, ensuring removal of surface organisms that may remain in the unit. a.) Clean the ambulance after each run and on a daily basis. b.) Use appropriate PPE (personal protective equipment) while cleaning. c.) Remove contaminated linens, and put them in an appropriate bag for handling.
Describe the routes of transmission and the steps to prevent and/or deal with an exposure to hepatitis, tuberculosis, and HIV/AIDS. (pp 41-48)
->1. All EMTs are trained in handling blood-borne pathogens. ->2. The CDC has developed standard precautions concerning: a. Personal protective equipment b. Patient care environment c. Special circumstances ->3. Proper hand hygiene a). This is the simplest, yet most effective way to control disease transmission. b.) Wash hands before and after patient contact, even if you wear gloves. c.) If there is no running water, use a waterless handwashing substitute. ->4. Gloves a.) Wear gloves if there is any possibility for exposure to blood or body fluids. b.) Vinyl, nitrile, and latex gloves are effective protection. Wear heavy-duty gloves when cleaning the ambulance. c.) Change gloves between patients. d.) Removing gloves requires a special technique to avoid contaminating yourself with the materials on the outside of the gloves (see Skill Drill 2-1). ->5. Eye protection and face shields a.) Eye protection protects from blood splatters. b.) Prescription glasses are not adequate. c.) Goggles or face shields are best. ->6. Gowns a.) A gown provides protection from extensive blood splatter. b.) A gown may not be practical in many situations. i. May even pose a risk for injury ->7. Masks, respirators, and barrier devices a.) Wear a standard surgical mask for fluid spatter. b.) Place a surgical mask on the patient with a communicable disease. c.) Use a mask with a particulate air respirator on yourself if the disease is tuberculosis. d.) When performing artificial resuscitation, use a pocket mask or a bag-valve mask. e.) With an infected patient, use: i. Pocket mask ii. Bag-valve mask f.) Dispose of these devices according to local guidelines. ->8. Proper disposal of sharps a.) Do not recap, break, or bend needles. b.) Dispose of used sharp items in an approved, closed, rigid, container. ->9. Employer responsibilities a.) The risk of being exposed to a communicable disease is a hazard of your job. b.) Follow OSHA guidelines and other national guidelines and standards to reduce your risk of exposure to blood-borne pathogens and airborne diseases. c.) Know your department's infection control plan and follow it.
explain the need and use for additional patient-moving equipment (specialized); include examples
-Bariatric stretchers: speciaililzed for overweight or obese patients, wider wheelbase for increased stability, some have tow package w/ a winch, rated to hold 850-900 lb (reg.stretcher 650lb) -pneumatic and electronic powered wheeled strecthers: battery operated w/ electronic controls to raise/lower the undercarriage, inc weight of stretcher, hazardous in uneven terrain -portable/folding stretchers: strong, rectangular tubular metal frame w/ fabric stretched across it, some models have 2 wheels, some can be folded in half, used in difficulty to reach areas, weight less then wheeled stretchers -flexible stretchers: excellent for storage and carrying, conform around patient's side, useful for confined spaces, uncomfortable but provide support and immobilization -short backboards: used to immobilize seated patients (ex: KED vest type device) -vacuum mattresses: alternative to backboards for immobilizing geriatric and pediatric patients, air is removed from the device, allowing it to mold around the patient, provided immobilization, comfort and thermal insulation -basket stretchers: rigid stretcher, AKA stokes litter, used for patient removal in remote locations (water rescues/technical rope rescues) ~if patient has spinal injury, secure patient to backboard and place inside basket stretcher to carry patient out ~when return to ambulance, life backboard out of basket and place on wheeled stretcher -scoop stretchers: AKA orthopaedic stretcher, splits into 2 to 4 pieces, pieces fit around patient who is lying on flat surface, both sides of patient must be accessible, patient must be stabilized and secures on scoop stretcher -neonatal isolette: incubator, can't be transported on wheeled stretcher, keeps neonate wamr, protects child from noise, draft, infection, excess handling, may be secured to a wheeled ambulance stretcher or freestanding
8. explain the difference between direct orders (online) and standing orders (off-line) Ch.7 #8 Pg.228-229
-EMT'S must have an order from medical to administer medication - Orders can be given On-Line (via phone or radio) or Off-Line (written standing orders)
4. Describe the enteral and parenteral routes of medication administration and explain how they differ. Ch.7 #4 Pg.222-223
-Enteral Medications: enter the body through the digestive system. Typically in the form of a pill or liquid. -Parenteral Medications: enter the body by any route other than the digestive tract, the skin, or mucous membranes. Usually in liquid form and administered with syringes and needles
describe specific situations in which an urgent move or rapid extrication may be necessary to move a patient, include how each one is performed
-Fires, explosives, hazardous materials -use when you can't properly asses the patient or provide immediate care -alone: use a drag to pull the patient along the long axis of body; clothes drag/blanket/arm/arm to arm drag -remove unconscious patient from vehicle alone: move patient's legs clear of pedals, rotate patient so back is toward the open car door, place arms through armpits and support head against body, drag patient from seat to safe location -necessary to move patient: w/ altered level of consciousness, w/ inadequate ventilation, in shock, in extreme weather conditions -rapid extrication technique -the patient can be moved within 1minute -technique increases risk of damage if patient has spinal injury
3. Discuss the differences between a generic medication and a trade name medication and provide an example of each. Ch.7 #3 Pg.222
-Generic Medication: (such as ibuprofen) is a simple clear non-proprietary name. The Generic name is never capitalized. -Trade Name: is a brand name that a manufacturer gives to a medication such as Tylenol. Trade Names are capitalized.
11. Describe the medication administration considerations that must be applied to special populations including pediatric, geriatric, and pregnant patients. Ch.7 #11 Pg.229,236,238
-Geriatric Pt's may often take and hoard medications so precautions must be taken to ensure what they have actually taken -Adult pt's must be asked about ED drugs when considering nitro -Pediatric Pt's and Geriatric Pt's have a slower rate of absorption and elimination times and may require modification of the dose administered -Children are NOT small adults and must be given special considerations
Compare expressed consent, implied consent, and involuntary consent.
-Informed Consent: Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained. - Expressed Consent: type of consent given when the patient verbally or otherwise acknowledges that he or she wants you to provide care or transport. Can be verbal or nonverbal. -Implied Consent: type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment. - Involuntary Consent: type of consent in which a patient is in some way incapacitated and care is given against their will. This is consent given by a guardian or conservator for patients who are in a behavioral crisis/emergency or developmentally delayed
2. Explain and give examples of medication contradictions and define: -Side effects -Unintended effects -Untoward effects Ch.7 #2 Pg.222
-Medication Contradictions: a medication is contraindicated when it would harm the patient or have no positive effect on the patients condition -Side Effects: are any actions of a medication other than the desired ones -Unintended Effects: effects that are undesirable but pose little risk to the patient -Untoward Effects: are the effects that can be harmful to the patient
1. Define the terms: -Pharmacodynamics -Intended Effects -Indications Ch.7 # Pg.221-222
-Medications are chemical substances used to treat or prevent disease or relieve pain -Pharmacodynamics: is the process by which a medication works on the body -Intended Effects: the action or therapeutic effect that a medication is expected to have on the body -indications: are the reasons or conditions for which a particular medication is given
9. Discuss the administration circumstances surrounding the administration of medication including: -peer-assisted medication -patient-assisted medication -EMT administered medication Ch.7 #9 Pg.229
-Peer-Assisted Medication: you are administering the medication to your self or your partner. (in the event of exposure to a toxic agent) -Patient-Assisted Medication:You are assisting the patient with his or her own personal medication (i.e. if the pt has nitro, epi-pen, or an inhaler and needs assistance in using it.) -EMT Administered Medication: EMT is directly administering the medication to the Patient (i.e. oxygen, oral glucose, and aspirin)
7. Describe the "six rights" of medication administration and describe how each one relates to EMS Ch.7 #7 Pg.227-228
-Right Patient -Right Medication -Right Dose -Right Time -Right Documentation -Right Route
know the importance of decontaminating equipment in the prevention of disease transmission
-decontaminate equipment after use for your safety, safety of crew/patient, prevent spread of disease
discuss situations that may require the use of medical restraints on a patient
-evaulate for correctible causes of combativeness -follow local protocals -require five personnel -restrain the patient in a supine position (positional asphyxia may develop in the prone position)
explain the power grip and sheet or blanket method for lifting a patient
-power grip: gets maximum force from hands, palms up, hands about 10in apart, all fingers same angle, fully support handle on curved palm -drag patient across bed: kneel on bed to avoid reaching beyond the recommended distance, drag the patient within 15-20 inches, complete drag while standing at side of bed, use the sheet/blanket under the patient rather than dragging patient by clothing -in hospital, transfer patient from stretcher to a bed with a body drag: stretcher should be the same height or slightly higher than bed, you & partner should kneel on bed and drag in increments -log roll patient onto his/her back to place patient on backboard, kneel as close to patients side as possible, keep back straight and lean solely from hips, roll patient w/o stopping until patient is resting on his/her side and braced against thighs, pulling toward you allows your legs to prevent the patient from rolling over completely
define the term bariatric
-refers to management of obesity -76 million US adults are obese (30-40% adults, 17%children) -back injuries account for largest number of missed work days
describe specific situations in which a nonurgent move may be necessary to move a patient; include how each one is performed
-scene and patient are stable -carefully plan to move the patient -team leader should plan the move: personnel, obstacles identified, equipment, procedure and path -direct ground lift: for patients w/ no suspect spinal injury who are supine, patients who need to be carried over some distance, EMTs stands side by side to lift and carry patients -extremity lift: for those patients w/ no suspected spinal injury who are supine or sitting, patient in small space. one EMT is at patient's head and one at feet, coordinate moves verbally -transfer moves: ~direct carry: move supine patient from bed to stretcher using a direct carry method ~draw sheet method: move patient from bed to stretcher using a sheet or blanket ~scoop stretcher
explain the special considerations and guidelines related to moving and transporting geriatric patients
-skeletal changes may cause brittle bones, rigidity, and spinal curvatures that present special challenges, -allay the patients fear w/ a sympathetic and compassionate approach
discuss the guidelines for lifting and moving bariatic patients
-stretchers and equipment are being produced w/ higher capacities -does not address danger to users of that equipment -mechanical ambulance lifts are uncommon in the US
explain how to carry patients safely on stairs, including the selection of appropriate equipment to aid in the process
-use stair chair to carry a conscious patient up or down a flight of stairs -this lightweight, wheeling folding chair had a molded seat, adjustable safety straps, and foldout handles at both the head and feet -moving patient on stairs w/ stretcher: backboard should be used instead for a patient who is unresponsive, must be moved in supine position, must be immobilized; carry the patient on backboard down to the prepared stretcher, place strongest EMT at head and foot ends w/ taller person at the foot end, place both the backboard and patient on stretcher (secure both to stretcher w/ additional straps) -loaded wheeled stretcher into ambulance: ensure frame is held firmly b/w 2 hands and it does not tip, newer models are self loading (allowing you to push stretcher into ambulance), other models need to be lowered and lifted to height of floow of ambulance, clamps in ambulance hold stretcher in place
identify how to avoid common mistakes when lifting and carrying a patient
-when directly lifting patient, tightly grip the patient in a place and manner that will ensure that you will
explain the general considerations required of EMTs to safely move patients without causing the patients further harm and while protecting themselves from injury
-whenever possible, use device that can roll -when wheel chair not available, follow guidelines for carrying patient on stretcher -patient weight: estimate patient's weight before lifting (adults 120-220), two EMTs should safely life, try to use four providers to life for more stability and require less strength, do not attempt to lift patient who eights more than 250lb w/ fewer than 4 providers, know weight limits of equipment -lifting and carrying on backboard/stretcher: more patient weight rests on head half of device than on foot, diamond carry and 1-handed carry use one EMT at head and foot, one on each side of patient's torso, use 4 providers, when rolling the stretcher, make sure it is fully elevated position; partner control head end and assist you by pushing w/ his or her arms held w/ elbow bent
Children of which age group are considered toddlers?
1-3 years
Explain proper hand-washing techniques. (pp 43-44)
1. Always wash hand before and after contact with patient, even if you wear gloves. - Rinse your hands using warm water. -If running water is unavailable, you may use waterless hand-washing substitutes. If you use waterless substitutes in the field, make sure you wash your hands using soap and water at the hospital. -Dry your hands with paper towels, and use the paper towel to turn off the faucet.
Describe the steps to take for personal protection from airborne and bloodborne pathogens. (pp 42-47)
1. Gloves - for touching blood, body fluids, secretions, excretions, or contaminated items. - for touching mucous membranes and non-intact skin 2. Gown -during procedures and patient care activities when the contact of the EMT's clothing/exposed skin to blood, body fluids, secretions, excretions, or contaminated items is anticipated. 3. Mask, eye protection, face shield - during procedures and patient care activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions, excretions. Examples include suctioning or endotracheal intubation.
12. Describe the steps that an EMT should follow when dispensing epinephrine to a patient using an auto injector Ch.7 #12 Pg.236
1. Grasp Unit with tip pointing down 2. Form a fist around the unit 3. With the other hand remove the activation cap 4.Hold the tip near the outer part of the PT's thigh 5.Swing and jab firmly into the outer thigh so that the unit is perpendicular (at a 90 degree angle) to the thigh. Do NOT allow to bounce 6. Hold firmly into the thigh for several seconds 7. Dispose of in a sharps container (be sure of your epi-pen some units are different)
Explain postexposure management of exposure to patient blood or body fluids, including completing a postexposure report. (p 52)
1. If you are exposed to a patient's blood or bodily fluids: a.) Turn over patient care to another EMS provider. b.) Clean the exposed area with soap and water. c.) If your eyes were exposed, rinse your eyes for 20 minutes. d.) Activate your department's infection control plan. 2. You will have to complete an exposure report. 3. Time is important! Some infectious agents will act quickly and others will lay dormant. a. Early activation of a plan is critical
List the ways immunity to infectious diseases is acquired. (pp 50-51)
1. Immunizations and Vaccinations. - vaccinations have almost eliminated some childhood diseases, such as measles and polio. 2. Able to recover from an infection from that germ. Gaining partial immunity protect the body against new infections.
State the steps that contribute to wellness and their importance in managing stress. (pp 35-40)
1. Prolonged physical stress can drain the body of its reserves. a.) Depleted of key nutrients b.) Weakened c.) More susceptible to illness 2. Understanding how stress affects you physiologically, physically, and psychologically can help you: a.) Control your reactions b.) Minimize the effect of stress
List the correct radio procedures in the following phases of a typical call initial receipt of call, en route to call, on scene, arrival at the hospital, (or point of transfer), and return to service. Ch.4 #12 Pg.130-136
1. Your unit identification and level of services. 2. The receiving hospital and your estimated time of arrival. 3. The patient's age and gender. 4. The patient's chief complaint or your perception of the problem. 5. A brief history of the patient's current problem. 6. A brief report of physical findings. 7. A brief summary of the care given and any patient responses.
describe the proper positioning for the following conditions: 1.unresponsive patients w/o suspected spine injury 2.patients w/ chest pain, discomfort, difficulty breathing 3.patients w/ suspected spine injury 4.pregnant patients w/ hypotension 5.patients who are nauseated or vomiting
1.recovery position 2. Fowler or semi-Fowler 3. backboard 4. positioned and ransported on their left side 5. transported in a position of comfort
What is the normal respiratory rate for an adult?
12-20 breaths/min
When pulling a patient, you should extend your arms no more than ________ in front of your torso.
15 to 20 inches
The human body should be functioning at its optimal level between the ages of:
19 and 25 years.
Describe the major physical and psychosocial characteristics of Early Adults
19-25yrs body functioning at its peak, Lifelong positive or negative habits are solidified, disk in spine settle, muscle strength decrease, reflexes slow
Describe the major physical and psychosocial characteristics of an infant's life
6 Fontanels, Head is 25% of the body, Nose Breathers, Large Tongue, Weak Neck, Flexible Trachea, Horizontal Rib Cage, Underdeveloped Lungs, Belly Breathers
The average pulse rate of persons between 19 and 60 years of age is typically:
70 beats/min.
A normal systolic blood pressure for a 30-year-old is between:
90 and 140 mm Hg.
hypoxic drive
A "backup system" to control respiration; senses drops in the oxygen level in the blood.
ligament
A band of fibrous tissue that connects bones to bones. It supports and strengthens a joint.
Bilateral
A body part of condition that appears on both sides of the midline
greater trochanter
A bony prominence on the proximal lateral side of the thigh, just below the hip joint.
bariatrics
A branch of medicine concerned with the management (prevention or control) of obesity and allied diseases.
Public safety access point
A call center, staffed by trained personnel who are responsible for managing requests for police, firefighting, and ambulance services
In which of the following situations does a legal duty to act clearly exist?
A call is received 15 minutes prior to shift change
diamond carry
A carrying technique in which one provider is located at the head end of the stretcher or backboard, one at the foot end, and one at each side of the patient; each of the two providers at the sides uses one hand to support the stretcher or backboard so that all are able to face forward as they walk.
preschooler
A child age 3 to 6 years.
Morality
A code of conduct that can be defined by society, religion, or a person, affecting character conduct, and conscience
esophagus
A collapsible tube that extends from the pharynx to the stomach; muscle contractions propel food and liquids through it to the stomach.
Interoperable Communications System
A communication system that uses voice-over-Internet-protocal (VoIP) technology to allow multiple agencies to communicate and trasmit data
Posttraumatic Stress Disorder
A delayed stress reaction to a prior incident. Often the result of one or more unresolved issues concerning the incident, and may relate to an incident that involved physical harm or the threat of physical harm
intranasal
A delivery route in which a medication is pushed through a specialized atomizer device called a mucosal atomizer device into the naris.
Automated external defibrillator (AED)
A device that detects treatable life-threatening cardiac arrhythmias (Ventricular fibrillation and ventricular tachycardia) and delivers the appropriate electrical shock to the patient
mucosal atomizer device
A device that is used to change a liquid medication into a spray and push it into a nostril.
Communicable Disease
A disease that can be spread from one person or species to another
atherosclerosis
A disorder in which cholesterol and calcium build up inside the walls of the blood vessels, forming plaque, which eventually leads to a partial or complete blockage of blood flow.
National EMS Scope of Practice Model
A document created by the national highway traffic administration (NHSTA) that outlines the skills performed by various EMS providers
Which of the following gives surrogates the right to make decisions for patients regarding their health care in the event that the patient is incapacitated and unable to make such decisions?
A durable power of attorney for health care
Adam's apple
A firm prominence of cartilage that forms the upper part of the larynx. It is more prominent in men than women. Also called the thyroid cartilage.
cricoid cartilage
A firm ridge of cartilage that forms the lower part of the larynx.
pancreas
A flat, solid organ that lies below the liver and the stomach; it is a major source of digestive enzymes and produces the hormone insulin.
oxygen
A gas that all cells need for metabolism; the heart and brain, especially, cannot function without it.
pubic symphysis
A hard, bony, and cartilaginous prominence found at the midline in the lowermost portion of the abdomen where the two halves of the pelvic ring are joined by cartilage at a joint with minimal motion.
heart
A hollow muscular organ that pumps blood throughout the body.
epinephrine
A hormone produced by the adrenal medulla that has a vital role in the function of the sympathetic nervous system.
ball-and-socket joint
A joint that allows internal and external rotation, as well as bending.
foramen magnum
A large opening at the base of the skull through which the brain connects to the spinal cord.
liver
A large, solid organ that lies in the right upper quadrant immediately below the diaphragm; it produces bile, stores glucose for immediate use by the body, and produces many substances that help regulate immune responses.
Contributory Negligence
A legal defense that may be raised when the defendant feels that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff
power lift
A lifting technique in which the EMT's back is held upright, with legs bent, and the patient is lifted when the EMT straightens the legs to raise the upper body and arms.
direct ground lift
A lifting technique that is used for patients who are found lying supine on the ground with no suspected spinal injury.
extremity lift
A lifting technique that is used for patients who are supine or in a sitting position with no suspected extremity or spinal injuries.
stair chair
A lightweight folding device that is used to carry a conscious, seated patient up or down stairs.
solution
A liquid mixture that cannot be separated by filtering or allowing the mixture to stand.
backboard
A long, flat board made of rigid, rectangular material that is used to provide support to a patient who is suspected of having a hip, pelvic, spinal, or lower extremity injury; also called a spine board, trauma board, and longboard.
Cellular Telephone
A low-power portable radio that communicates through an interconnected series of repeater stations all "cells"
cardiac output
A measure of the volume of blood circulated by the heart in 1 minute, calculated by multiplying the stroke volume by the heart rate.
Infectious Disease
A medical condition cause by the growth and spread of small, harmful organisms within the body
antagonist
A medication that binds to a receptor and blocks other medications.
agonist
A medication that causes stimulation of receptors.
nitroglycerin
A medication that increases cardiac perfusion by causing blood vessels to dilate; EMTs may be allowed to assist the patient to self-administer the medication.
aspirin
A medication that is an antipyretic, analgesic, anti-inflammatory, and a potent inhibitor of platelet aggregation.
Duty to Act
A medicolegal term relating to certain perosnnel who either by statute or by function have a respnsibility to provide care
Which of the following statements regarding a patient refusal is correct?
A mentally competent adult has the legal right to refuse EMS care and transport
lactic acid
A metabolic by-product of the breakdown of glucose that accumulates when metabolism proceeds in the absence of oxygen.
Pathogen
A microorganism that is capable of causing disease in a susceptible host
metered-dose inhaler
A miniature spray canister through which droplets or particles of medication can be inhaled.
suspension
A mixture of ground particles that are distributed evenly throughout a liquid but do not dissolve.
emergency move
A move in which the patient is dragged or pulled from a dangerous scene before assessment and care are provided.
Emergency medical services (EMS)
A multidisciplinary system that represents the combined efforts of several professionals and agencies to provide pre-hospital care to the sick and injured
diaphragm
A muscular dome that forms the undersurface of the thorax, separating the chest from the abdominal cavity. Contraction of this brings air into the lungs. Relaxation allows air to be expelled from the lungs.
norepinephrine
A neurotransmitter and drug sometimes used in the treatment of shock; produces vasoconstriction through its alpha-stimulator properties.
neonate
A newborn age birth to 1 month.
Which of the following general statements regarding consent is correct
A patient can consent to transport but can legally refuse to be treated
articular cartilage
A pearly layer of specialized cartilage covering the articular surfaces of bones in synovial joints.
school age
A person who is 6 to 12 years of age.
Emancipated Minors
A person who is under the legal age in a given state but, because of other circumstances, is legally considered an adult
To help protect patients, EMS agencies are required to have
A privacy offer to answer question
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
Telemetry
A process in which electronic signals are converted into coded, audible signals, these signals can then be transmitted by radio or telephone to a receiver with a decoder at the hospital
Critical Incident Stress Management
A process that confronts the responses to critical incidents and defuses them, directing the emergency services personnel toward physical and emotional equilibrium
Scanner
A radio receiver that searches or "scans" across several frequencies until the message is completed; the process is then repeated
basket stretcher
A rigid stretcher commonly used in technical and water rescues that surrounds and supports the patient yet allows water to drain through holes in the bottom; also called a Stokes litter.
gallbladder
A sac on the undersurface of the liver that collects bile from the liver and discharges it into the duodenum through the common bile duct.
gel
A semiliquid substance that is administered orally in capsule form or through plastic tubes.
Emergency
A serious situtation, such as injury or illness that threatens the life or welfare of a person or group of people and requires immediate intervention
oral glucose
A simple sugar that is readily absorbed by the bloodstream; it is carried on the EMS unit.
Exposure
A situation in which a person had had contact with blood, body fluids, tissues, or airborne particles in a manner that suggests disease transmission may occur
Mobile Data Terminal
A small computer terminal inside the ambulance that direclty receives data from the dispatch center
prostate gland
A small gland that surrounds the male urethra where it emerges form the urinary bladder; it secretes a fluid that is part of the ejaculatory fluid.
appendix
A small, tubular structure that is attached to the lower border of the cecum in the lower right quadrant of the abdomen.
Repeater
A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency
Dedicated Line
A special telephone line that is used for specific point-to-point communications; also known as a hotline
wheeled ambulance stretcher
A specially designed stretcher that can be rolled along the ground. A collapsible undercarriage allows it to be loaded into the ambulance; also called an ambulance stretcher.
plasma
A sticky, yellow fluid that carries the blood cells and nutrients and transports cellular waste material to the organs of excretion.
flexible stretcher
A stretcher that is a rigid carrying device when secured around a patient but can be folded or rolled when not in use.
scoop stretcher
A stretcher that is designed to be split into two or four sections that can be fitted around a patient who is lying on the ground or other relatively flat surface; also called an orthopedic stretcher.
portable stretcher
A stretcher with a strong, rectangular, tubular metal frame and rigid fabric stretched across it.
parasympathetic nervous system
A subdivision of the autonomic nervous system, involved in control of involuntary functions, mediated largely by the vagus nerve through the chemical acetylcholine.
medication
A substance that is used to treat or prevent disease or relieve pain.
Continuous Quality improvement (CQI)
A system of internal and external reviews and audits of all aspects of an EMS system
Emergency Medical Dispatch (EMD)
A system that assists dispatches in selecting appropriate units to respond to a particular call fr assistance and in providing callers with vital instructions until the arrival of EMS crews.
Which of the following depictions MOST accurately portrays emergency medical services (EMS)?
A team of health care professional who are responsible responsible for providing emergency care and transportation to the sick and injured
power grip
A technique in which the stretcher or backboard is gripped by inserting each hand under the handle with the palm facing up and the thumb extended, fully supporting the underside of the handle on the curved palm with the fingers and thumb.
rapid extrication technique
A technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than 1 minute when conditions do not allow for standard immobilization.
Medicolegal
A term realting to medical jurisprudence (law) or forensic medicine
Negligence Per Se
A theory that may be used when the conduct of the person being sued is alleged to have occurred in clear violation of a statute
cricothyroid membrane
A thin sheet of fascia that connects the thyroid and cricoid cartilages that make up the larynx.
epiglottis
A thin, leaf-shaped valve that allows air to pass into the trachea but prevents food and liquid from entering.
lymph
A thin, straw-colored fluid that carries oxygen, nutrients, and hormones to the cells and carries waste products of metabolism away from the cells and back into the capillaries so that they may be excreted.
Rapport
A trusting relationship that you build with your patient
oropharynx
A tubular structure that extends vertically from the back of the mouth to the esophagus and trachea.
Health Care Proxies
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf in the event that the person making the appointment loses decison making capacity. Also known as a durable power of attorney for health care
Durable Power of Attorney for Health Care
A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on his or her behalf, in the event that the person making the appointment loses decision-making capacity
Expressed Consent
A type of consent in which a patient gives verbal or nonverbal authorization for provision of care or transport
preconventional reasoning
A type of reasoning in which a child acts almost purely to avoid punishment to get what he or she wants.
postconventional reasoning
A type of reasoning in which a child bases decision on his or her conscience.
conventional reasoning
A type of reasoning in which a child looks for approval from peers and society.
Health Care Directive
A written documnet that specifies medical treatment for a competent patient, should he or she become unable to make decisions. Also know as an advanced directive or living will.
Tort
A wrongful act that gives rise to a civil lawsuit
early adult
A young adult age 19-40 years.
infant
A young child age 1 month to 1 year.
toddler
A young child age 1 to 3 years.
adolescent
A young person age 12-18 years.
Define infectious disease and communicable disease. (pp 50-51)
A. An infectious disease is caused by harmful organisms within the body. B. A communicable disease can be spread: 1.) From person to person 2.) From one species to another
Describe issues concerning care of the dying patient, death, and the grieving process of family members. (pp 65-67)
A. Death may occur: --->1. Quite suddenly --->2. After a prolonged, terminal illness B. The EMT will sometimes face death. C. The grieving process: --->1. Denial --->2. Anger, hostility --->3. Bargaining --->4. Depression --->5. Acceptance
Know the physiologic, physical, and psychological responses to stress. (pp 67-69)
A. EMS is a high-stress job. B. It is important to know the causes of stress and how to deal with stress. C. General adaptation syndrome: --->1. Alarm response to stress --->2. Reaction and resistance to stress --->3. Recovery—or exhaustion from stress D. Physiologic manifestations of stress: --->1. Increased respirations and heart rate --->2. Increased blood pressure --->3. Dilated venous vessels near the skin surface (causes cool, clammy skin) --->4. Dilated pupils --->5. Tensed muscles --->6. Increased blood glucose levels --->7. Perspiration --->8. Decreased blood flow to the gastrointestinal tract E. Situations that are stressful for EMS providers: --->1. Dangerous situations --->2. Physical and psychological demands --->3. Critically ill or injured patients --->4. Dead and dying patients --->5. Overpowering sights, smells, and sounds --->6. Multiple-patient situations --->7. Angry or upset patients, family, bystanders --->8. Unpredictability and demands of EMS F. Stress reactions --->1. Acute stress reactions a.) Occur during a stressful situation --->2. Delayed stress reactions a.) Manifest after a stressful event --->3. Cumulative stress reactions a.) Prolonged or excessive stress --->4. PTSD can develop. a.) Characterized by reexperiencing the event and overresponding to the stimuli that recall the event b.) Critical incident stress management was developed to decrease likelihood of PTSD. G. CISM is used to help providers relieve stress. --->1. CISM can occur formally. a.) Trained CISM professionals facilitate. *i. Defusing sessions are held during or immediately after the event. *ii. Debriefing sessions are held 24-72 hours after the incident. --->2. If CISM is not an option, private counseling by a mental health professional may be preferable. H. Warning signs of cumulative stress: --->1. Irritability toward coworkers, family, and friends --->2. Inability to concentrate --->3. Difficulty sleeping, increased sleeping, or nightmares --->4. Feelings of sadness, anxiety, or guilt --->5. Indecisiveness --->6. Loss of appetite (gastrointestinal disturbances) --->7. Loss of interest in sexual activities --->8. Isolation --->9. Loss of interest in work --->10. Increased use of alcohol --->11. Recreational drug use --->12. Physical symptoms such as chronic pain (headache, backache) --->13. Feelings of hopelessness I. Stressful situations --->1. Many situations are stressful for everyone involved. --->2. Exercise extreme care in your words and actions. --->3. Bring a sense of order and stability to the terrifying chaos that the patient is experiencing. --->4. Give patients the opportunity to express their fears and concerns. --->5. It is usually best to transport parents with their children. --->6. Violent situations a.) Potentially violent situations: *i. Civil disturbances *ii. Large gatherings of potentially hostile people *iii. Domestic disputes *iv. Crime scenes b.) When multiple agencies respond, it is important to know who is in command and will be issuing orders. c.) You and your partner must be protected from dangers at the scene to provide care. *i. Law enforcement should secure the scene before your entry. d.) Do not disturb crime scene evidence unless necessary to care for the patient. --->7. Behavioral emergencies a.) Emergencies that do not have a clear physical cause *i. The cause may turn out to be physical (eg, hypoglycemia, head trauma, hypoxia, toxic ingestion). b.) These emergencies result in aberrant behavior. c.) Most behavioral emergencies do not pose a threat, but some do, and you must use caution in such cases.
explain guidelines and safety considerations for the use of medical restraints
A. First evaluate the patient for correctible causes of combativeness. 1. These include head injury, hypoxia, and hypoglycemia. B. Follow local protocols. Obtain medical control authorization if necessary. 1. There may be consequences for either applying the restraints or failing to restrain a patient who should have been restrained. C. If the patient poses a danger to you, your team members, himself or herself, or bystanders, the application of physical restraints needs to be considered. 1. Before you take action to restrain the patient, attempt to speak to the patient in a calming manner, and de-escalate the situation. D. Restraint requires a minimum of five personnel. 1. One for each extremity of the patient, and one for his or her head 2. One EMT should be the established team leader. 3. Develop a plan to restrain the patient together. 4. A patient who is caught off guard is less likely to cause injury to responders. E. The patient should be in the supine position. 1. A patient in the prone position can develop positional asphyxia. F. Each extremity should have a restraint applied to it. G. The patient should be restrained on a backboard with one arm above his or her head and the other arm by his or her side. H. Assess the patient's ABCs, mental status, and distal circulation after restraints are applied. I. Document all information.
Describe post traumatic stress disorder (PTSD) and steps that can be taken, including critical incident stress management, to decrease the likelihood that PTSD will develop. (pp 69-70)
A. PTSD can develop. a.) Characterized by reexperiencing the event and overresponding to the stimuli that recall the event b.) Critical incident stress management was developed to decrease likelihood of PTSD. B. CISM is used to help providers relieve stress. --->1. CISM can occur formally. a.) Trained CISM professionals facilitate. *i. Defusing sessions are held during or immediately after the event. *ii. Debriefing sessions are held 24-72 hours after the incident. --->2. If CISM is not an option, private counseling by a mental health professional may be preferable.
Explain the care of critically ill and injured patients. (pp 61-64)
A. The patient needs to know who you are and what you are doing --->1. Let the patient know that you are attending to his or her immediate needs. --->2. Avoid making unprofessional comments during resuscitation. --->3. Treat all patients with dignity and respect. B. Responses of the critical patient --->1. Anxiety --->2. Pain and fear --->3. Anger and hostility --->4. Depression --->5. Dependency --->6. Guilt --->7. Mental health problems --->8. Receiving unrelated bad news C. Techniques for communicating with the critical patient --->1. Avoid sad and grim comments. a.) Remarks about a patient's condition may increase the patient's anxiety or compromise recovery. --->2. Orient the patient to his or her surroundings. --->3. Be honest. a.) Decide how much information the patient can understand and accept. b.) Allow the patient to be part of the care being given. --->4. Allow for hope. a.) If there is the slightest chance of hope remaining, transmit that message to the patient. D. Locate and notify family members. --->1. Assure the patient that you will take care of notifying the appropriate people. E. Injured and critically ill children --->1. Children should be cared for as any adult would be. --->2. It is important that a family member or responsible adult accompany the child to relieve anxiety and assist in care as appropriate. F. Dealing with death of a child --->1. The death of a child is a tragic and dreaded event. --->2. Help the family through the initial period after the death. G. Helping the family --->1. Acknowledge the death in a private place. --->2. Shock, denial, and disbelief are common emotions and reactions to a child's death. --->3. If circumstances allow, let the parents hold the child. Use your best judgment to determine if this is appropriate. --->4. Let the family's actions be your guide. --->5. The family may want to see the child, and you should allow them to do so. --->6. Prepare the parents for what they will see.
Describe the steps necessary to determine scene safety and to prevent work-related injuries at the scene. (pp 52-58)
A. The personal safety of all those involved in an emergency situation is very important. --->1. Begin protecting yourself as soon as you are dispatched. a.) Wear seat belts. b.) Don appropriate PPE. --->2. Continue to protect yourself once on scene. a.) Make sure the scene is well marked. b.) Place warning devices to alert other motorists to the scene. c.) Park at a safe distance from the scene. d.) Make sure there is plenty of light if it is dark. e. Wear reflective clothing if it is dark. B. Scene hazards --->1. Hazardous materials a.) Upon arrival, look at the scene and try to read any labels, placards, and identification numbers from a distance, perhaps using binoculars. b.) A specially trained and equipped hazardous materials team will be called to the scene to handle disposal of materials and removal of patients. c.) You should not begin caring for patients until they have been moved away from the scene and are decontaminated or the scene is safe for you to enter. d.) Do not enter the scene unless it is safe to do so. --->2. Electricity a.) Dealing with downed power lines is beyond the scope of EMT training. b.) Mark off a danger zone around the downed lines using utility poles as landmarks. The safety zone is one span of the power pole's distance. c.) Lightning is a threat: *i. A direct hit *ii. Ground current d.) A repeat strike in the same area can occur. e.) Avoid high ground to minimize risk of a direct lightning strike. f.) To avoid being injured by ground current, stay away from drainage ditches, moist areas, small depressions, and wet ropes. g.) Make yourself the smallest target possible and drop all equipment. --->3. Fire a.) Common hazards: *i. Smoke *ii. Oxygen deficiency *iii. High ambient temperatures *iv. Toxic gases *v. Building collapse *vi. Equipment *vii. Explosions --->4. Vehicle crashes a.) Vehicle crashes are common events for EMS providers. b.) Vehicle collision hazards include traffic, an unstable vehicle, downed power lines, risk of violence, airbags, and sharp objects. c.) Use sufficient protective gear to reduce the risk of injury.
Describe the different types of protective clothing worn to prevent injury. (pp 58-61)
A. Wearing protective clothing and other appropriate gear is critical to your personal safety. B. Become familiar with the protective equipment available to you. C. Inspect your clothing and gear regularly, ideally before you reach the scene. D. Types --->1. Cold-weather clothing (consists of three layers) a.) A thin inner layer that pulls moisture away from the skin b.) A thermal middle layer that serves as insulation c.) An outer layer that resists wind, rain, sleet, or snow --->2. Turnout gear a.) Protects from heat, fire, sparks, and flash-over b.) Also called bunker gear --->3. Gloves a.) Protect from heat, cold, and cuts b.) May reduce dexterity in a rescue situation. --->4. Helmets a.) Helmets should be worn to protect the EMT from falling objects. b.) Helmets should provide top and side impact protection. c.) Secure chin straps are needed. --->5. Boots a.) Should be water resistant and fit well, and be flexible. b.) Steel-toed boots are preferred. c.) Traction is important for rescue situations. --->6. Eye protection a.) Wear protective glasses with side shields during routine patient care. b.) When tools are in use, use a face shield and goggles. --->7. Ear protection a.) Soft foam industrial-type earplugs --->8. Skin protection a.) Protect against sunburn during outside work. b.) Use a sunscreen with a minimum SPF rating of 15. --->9. Body armor a.) Bulletproof vests b.) Range from lightweight and flexible to heavy and bulky c.) Vests may not be practical for daily use. --->10. Long/loose hair, rings, jewelry a.) Many EMS services have restrictive policies regarding hair, rings, and jewelry. b.) You should tie hair up neatly, limit the number of rings worn, and wear only a watch on the wrist
While evaluating a noncritical patient in the field, you receive a call from dispatch regarding a serious four-car accident. You inform the patient you are treating to have someone take him to his doctor to get checked out before leaving to attend to the more seriously injured people. This is an example of what?
Abandonment
Decision-making Capacity
Ability to understand and process information and make a choice regarding appropriate medical care
Competent
Able to make rational decisions about personal well-being
agonal gasps
Abnormal breathing pattern characterized by slow, gasping breaths, sometimes seen in patients with cardiac arrest.
Which of the following conditions or situations presents the MOST unique challenge to the EMT when immobilizing an elderly patient on a long backboard?
Abnormal spinal curvature
Superior
Above a body part or nearer to the head
Human Immunodeficiency Virus
Acquired immunodeficiency syndrome (AIDS) is caused by HIV, which damages the cells in the body's immune system so that the body is unable to fight infection or certain cancers
unintended effects
Actions that are undesirable but pose little risk to the patient.
untoward effects
Actions that can be harmful to the patient.
EMT-administered medication
Administration of medication by the EMT directly to the patient.
Discuss an EMT's role and obligations if patient refuses treatment or transport.
Adults who are conscious, alert, and appear to have decision making capacity have the right to refuse treatment or withdraw from treatment at any time. A patient's decision to either accept or refuse treatment should be based on information that you provide. This information should include: - Your assessment of what might be wrong with the patient - A description of the treatment that you feel is necessary - Any possible risks of the treatment - The ability of alternative treatments - Possible consequences of refusing treatment Assure the patient understands everything you say. Encourage the patient to ask questions. You should involve online medical control and document the consultation. Everything you say should be included in the patient care report. Have a witness sign form to help protect you from a later claim for negligence or abandonment.
Advanced Life Support (ALS)
Advanced life saving procedures, some of which are now being provided by the EMT
Discuss the state and/or local special reporting requirements such as for gunshot wounds, dog bites, and abuse. Ch.4 #9 Pg.125
Always report to local law enforcement
You are treating a patient who tells you he was prescribed alprazolam (Xanax) for his anxiety. What would anxiety be considered?
An Indication
hypoglycemia
An abnormally low blood glucose level.
middle adult
An adult age 41-60 years.
older adult
An adult age 61 years or older.
Channel
An assigned frequency or frequencies that are used to carry voice and/or data communications
Which of the following statements regarding an emergency patient move is correct?
An emergency move is performed before the primary assessment and treatment.
What program, often available for EMS personnel, involves contracted agencies that provide a wide array of mental health, substance abuse, crisis management, and counseling services?
An employee assistant program
Credentialing
An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization
coronal plane
An imaginary line where the body is divided into front and back parts.
Fowler Position
An inclined position in which the head of the bed is raised
Paramedic
An individual who has extensive training in advanced life support, including in advanced life support, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills.
Emergency Medical Technician (EMT)
An individual who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications
sucking reflex
An infant reflex in which the infant starts sucking when his or her lips are stoked.
Moro reflex
An infant reflex in which, when an infant is caught off guard, the infant opens his or her arms wide, spreads the fingers, and seems to grab at things.
palmar grasp
An infant reflex that occurs when something is placed in the infant's palm; the infant grasps at the object.
rooting reflex
An infant reflex that occurs when something touches an infant's cheek, and the infant instinctively turns his or her head toward the touch.
intravenous injection
An injection directly into a vein; a medication delivery route.
intramuscular injection
An injection into a muscle; a medication delivery route.
intraosseous injection
An injection into the bone; a medication delivery route.
activated charcoal
An oral medication that binds and adsorbs ingested toxins in the gastrointestinal tract for treatment of some poisonings and medication overdoses. It's ground into a very fine powder that provides the greatest possible surface area for binding medication that have been taken by mouth; it is carried on the EMS unit.
pons
An organ that lies below the midbrain and above the medulla and contains numerous important nerve fibers, including those for sleep, respiration, and the medullary respiratory center.
Explain the following directional terms: anterior (ventral), posterior (dorsal), right, left, superior,inferior, proximal, distal, medial, lateral, superficial, and deep. Ch 5 #2 Pg.144-145
Anterior (ventral)- the front surface of the body Posterior (dorsal)- the back surface of the patient Right- the patient's right Left- the patient's left Superior- closest to the head Inferior- closest to the feet Proximal- closest to the point of attachment Distal- farthest from the point of attachment Medial- closest to the midline Lateral- farthest to the midline Superficial- closest to the surface of the skin Deep- furthest from the surface of the skin
side effects
Any effects of a medication other than the desired ones.
Protected Health Information
Any information about health status, provision of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a piatient's medical record or payment history
dead space
Any portion of the airway that does contain air and cannot participate in gas exchange, such as the trachea and bronchi.
Base Station
Any radio hardware containing a transmitter and receiver that is located in a fixed place
Noise
Anything that dampens or obscures the true meaning of a message
fontanelles
Areas where the neonate's or infant's skull has not fused together; usually disappear at approximately 18 months of age.
A 4-year-old boy had an apparent seizure. He is conscious and calm and is sitting on his mother's lap. His father is sitting in a nearby chair. The child's mother suddenly begins crying uncontrollably, which causes the child to start crying. You should
Ask the father to hold the child so you can assess him while your partner tries to calm the mother
A 62-year-old male is seen with crushing chest pain, which he describes as being the same kind of pain that he had with a previous heart attack. He has prescribed nitroglycerin but states that he has not taken any. After administering supplemental oxygen if needed and contacting medical control, you should:
Assist him with taking his nitro unless his systolic blood pressure is less than 100
Which of the following interventions is used by all levels of EMS providers?
Automated external defibrillator
Understand the basic principals of the various types of communications equipment used in EMS. Ch.4 #10 Pg. 127-130
Base Station-Any radio hardware containing a transmitter and receiver that is located in a fixed place. Channel -An assigned frequency or frequencies used to carry voice and/or data communications. Dedicated Line- A special telephone line that is used for specific point-to-point communications; also known as a "hot line." Repeater A special base station radio that receives messages and signals on one frequency and then automatically retransmits them on a second frequency. Cellular Telephone
Radio hardware containing a transmitter and receiver that are located in a fixed place is known as what?
Base station
Identify the emotional aspects of emergency care. (pp 69-70)
Be calm and act responsibly (keep emotions under control). Realize that these emotions are normal.
Interior
Below a body part or nearer to the feet
Dependent Lividity
Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death
What structure of the brain is responsible for the level of consciousness and maintenance of vital signs?
Brain stem
inhalation
Breathing into the lungs; a medication delivery route.
Recognize the stress inherent in many situations, such as mass-casualty scenes. (pp 70- 71)
Briefly explain your plan of action to assist the patient in the crisis. Inform the patient that you need his or her help and the assistance of family members or bystanders to carry out your plan of action. Asses the situation and patient who is having stress and high emotion to help you gain confidence and cooperation from everyone at the scene. Be calm and compassionate to inspire confidence in everyone else. But your professional judgment is more important than compassion.
oral
By mouth; a medication delivery route.
Which of the following substances is the main element that the bone cells use to create a hard and resilient structure?
Calcium
What blocks the ability of the hemoglobin to transport oxygen to body tissues?
Carbon monoxide
Which of the following incidents does NOT require a report to be filled with local authorities?
Cardiac arrest
Describe the major physical and psychosocial characteristics of Older Adult
Cardiac function declines calcium build up inside blood vessels, Size of airway increases surface area of alveoli decreases, lungs vital capacity 50%, Endocrine system declines insulin production drops metabolism slows, Saliva secretion decreases blood flow drops 50%, Kidney filtration declines by 50% size decreases 20%, Nervous system changes are most debilitating brain shrink 10-20%,
The root word "sinus" in sinusitis pertains to which of the following?
Cavity, channel or hollow space
Which of the following is the process in which a person, institution, or program is evaluated and recognized as meeting predetermined standards to provide safe and ethical care?
Certification
Your partner makes the following symbol in a PCR: Δ What does this mean?
Change
Superficial
Closer to or on the skin
Proximal
Closer to the trunk
Describe the relationship between patient communications, confidentiality, and the Health Insurance Portability and Accountability Act (HIPAA).
Communication between you and the patient is considered confidential and generally cannot be disclosed without permission from the patient or a court order. Confidential information includes: - The patient history - Assessment Findings - Treatment provided HIPAA aims to strengthen laws for the protection of the privacy of health information and to safeguard patient confidentiality. Protected health information (PHI)
American with Disabilities Act (ADA)
Comprehensive legislation that is designed to protect individuals with disabilities against discrimination
contraindications
Conditions that make a particular medication or treatment inappropriate because it would not help, or may actually harm, a patient.
Gross Negligence
Conduct that constitutes a willful or reckless disregard for duty or standard of care
You are called to attend to an elderly patient with an extensive medical history who is now in cardiac arrest. The patient's family tells you that the patient has a DNR order. There is no paperwork available but the patient does have a MedicAlert bracelet indicating Do Not Resuscitate. You should:
Confirm the patient identity and then confirm the DNR by calling the MedicAlert Foundation number on the bracelet
Discuss the techniques of effective verbal communication Ch.4 #2 Pg.110-118
Consider the Following strategies - Age - Body language - Clothing - Culture - Educational background - Environment - Eye contact - Facial expression - Gender - Posture - Voice tempo - Volume 1. Make and keep eye contact with your patient at all times. 2. Provide your name and use the patient's proper name. 3. Tell the patient the truth. 4. Use language that the patient can understand. 5. Be careful what you say about the patient to others. 6. Be aware of your body language. 7. Always speak slowly, clearly, and distinctly. 8. If the patient is hearing-impaired, face the person so that he or she can read your lips. 9. Allow time for the patient to answer or respond to your questions. 10. Act and speak in a calm, confident manner while caring for the patient.
What should you do if a patient refuses treatment or transport?
Contact Medical Control
You belong to a small volunteer EMS company and are treating a patient with chest pain, and you feel that the administration of aspirin is indicated. You ask the patient if he is allergic to aspirin and he says no. Shortly after you administer the aspirin, the patient develops signs and symptoms of a severe allergic reaction. Later in the hospital, the doctor advises you that the patient's medical history indicates that the patient has an allergy to aspirin. The patient later sues you. Which of the following is your best defense strategy?
Contributory negligence
The tactical use of an impenetrable barrier for protection that law enforcement agents use is called what?
Cover
Recently you started noticing that a coworker is disinterested in his work. He has started coming in late and has taken to sitting alone and not socializing with other members of the team. The job has been stressful lately. Call volume has increased and you rarely have any downtime between calls. What is your coworker most likely experiencing?
Cumulative stress reaction
Which organization developed and published the first curriculum that served as the guideline for EMT training?
DOT
Compensatory Damages
Damages awarded in a civil lawsuit that are intended to restore the plaintiff to the same condition that he or she was in prior to the incident
Punitive Damages
Damages that are sometimes awarded in a civil lawsuit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public
Putrefaction
Decomposition of body tissues; a definitive sign of death
Putrefaction is defined as
Decomposition of the body's tissues
An obvious sign of death caused by discoloration of the body from pooling of the blood to the lower parts of the body is called what?
Dependent lividity
Quadrants
Describes the sections of the abdominal cavity, in which two imaginary lines intersect at the umbilicus, dividing the abdomen into four equal areas
Breach of Confidentiality
Disclosure of information without proper authorization
Understand how to document refusal of care, including the legal implications Ch.4 #8 Pg.124-125
Document refusal of care with detailed quotes and witness signatures
What information should you include on your PCR related to a patient's medications?
Document the medications names and dosages
If you discover an error as you are writing your PCR, what should you do?
Draw a single horizontal line through the error, initial it, and write the correct information next to it.
Where would you MOST likely find information regarding a patient's wishes to be an organ donor?
Driver's license
Once your ambulance is dispatched to an emergency, you have an obligation to respond. What is this called?
Duty to act
Describe the EMT's legal duty to act.
Duty to act is an individual's responsibility to provide patient care. There may be a duty to act in certain instances, including the following: - You are charged with emergency medical response - Your service or department's policy states that you must assist in any emergency
Which of the following components are needed to prove negligence?
Duty to act, breach of duty, injury/damages, and causation
Prehospital patient care decisions should be based on
EMS research
The determination that prompt surgical care in the hospital is more important than performing time-consuming procedures in the field on a major trauma patient is based MOSTLY on
EMS research
At what level is an individual who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications?
EMT
Which of the following courses requires about 150 hours of training?
EMT
Secondary Prevention
Efforts to limit the effects of an injury or illness that you cannot completely prevent
Primary prevention
Efforts to prevent an injury or illness from ever occurring
Communicating with patients who are deaf or hard-of-hearing can be facilitated by doing all of the following EXCEPT
Elevating the tone of your voice and exaggerating word pronounciation
adrenal glands
Endocrine glands located on top of the kidneys that release adrenaline when stimulated by the sympathetic nervous system.
5. Describe (the following routes of medication administration and disscuss their individual rates of absorption:) -Rectal -Oral -intravenious -intraosseous -Subcutanious -intramuscular -inhalation -sublingual -transcutaneous Ch.7 #5 Pg.222-224
Enteral -Per Rectum (PR) {anal administration}: Rapid -Ingestion {by mouth}: Slow Parenteral -Intravenous (IV){by IV}: Immediate -Intraosseous (IO){Bone Drill}: Immediate -Subcutaneous (SC){TB Test}: Slow -Intramuscular(IM){EPI Pen}: Moderate -Inhalation {Inhaler}: Rapid -Sublingual (SL) {Under the tounge}: Rapid -Transcutaneous {patches}: Slow
Define ethics and morality and their implications for the EMT.
Ethics: The philosophy of right and wrong, of moral duties, and of ideal professional behavior. Morality: code of conduct that can be defined by society, religion, or a person, affecting character, conduct, or conscience.
When a person considers his or her own cultural values as more important when interacting with people of a different culture, what is this referred to?
Ethnocentrism
American Heart Association protocols are based on
Evidence-based research
When performing his or her duties, the EMT is generally expected to
Exercise reasonable care and act prudently
Direct Contact
Exposure or transmission of a communicable disease from one person to another by physical contact
Indirect Contact
Exposure or transmission of disease from one person to another by contact with a contaminated object
Which type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital
Expressed
Which type of consent is involved when a 39-year-old mentally competent female with a severe headache asks you to take her to the hospital?
Expressed
You arrive at the scene of a call to find an elderly man complaining of chest pain. You introduce yourself and ask permission to examine him. He nods and extends his arm. Which type of consent is this?
Expressed consent
Encouraging this patient to provide more information about his injury is an example of which therapeutic communication technique?
Facilitation
Negligence
Failure to provide the same care that a person with similar training would provide
Slander
False and damaging information about a person that is communicated by the spoken word
Libel
False and damaging infromation about a perosn that is communicated in writing
You have responded to a vehicle accident call. Initially, the male patient allows you to splint his broken arm and complete a primary assessment. However, he rescinds consent during transport and demands to be let out of the ambulance. If you refuse, which of the following might you be charged with?
False imprisonment
Deep
Farther inside the body and away from the skin
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
ovaries
Female glands that produces sex hormones and ova (eggs).
cerebrospinal fluid
Fluid produced in the ventricles of the brain that flows in the subarachnoid space and bathes the meninges.
Public Health
Focused on examining the health needs of entire populations with the goal of preventing health problems
What should an EMT do to limit errors in the field?
Follow the agency's written protocols
After you submit the electronic PCR for a call, you realize that you accidentally documented the wrong vital signs. What should you do?
Follow your agencies directions and make an amendment to the PCR
Distal
Further from the trunk or nearer to the free end of the extremity
Which of the following statements regarding glucose is correct?
Glucose is a simple sugar that is readily absorbed by the bloodstream.
The EMT is legally obligated to protect a patient's privacy according to
HIPAA
You are transporting a 54-year-old male in respiratory arrest. An EMR is driving the ambulance as you and your partner are caring for the patient. Which of the following is the MOST logical way of notifying the hospital?
Have the driver contact dispatch and relay the patient information to the hospital
Which of the following statements about health care in the United States is true?
Health care in the United States is expensive but does not necessarily provide better health outcomes.
What is the medical term for coughing up blood?
Hemoptysis
The elbow is an example of what type of joint?
Hinge
You are treating a patient who has lost a significant amount of blood. Which type of shock is this patient most likely to experience?
Hypovolemic shock
Advil, Nuprin, and Motrin are trade names for the generic medication:
Ibuprofen
Emergency Medical Care
Immediate care or treatment
medication error
Inappropriate use of a medication that could lead to a patient harm.
Which of the following is NOT a common factor that would affect a 75-year-old patient's vital signs?
Increased weight
Hepatitis
Inflammations of the liver, usually caused by a viral infection that causes fever, loss of appetite, jaundice, fatigue, and altered liver function
subcutaneous injection
Injection into the fatty tissue between the skin and muscle; a medication delivery route.
barotrauma
Injury caused by pressure to enclosed body surfaces, for example from too much pressure in the lungs.
What is the route of administration for the Epi Pen auto-injector?
Intramascular
Describe the physiology of the musculoskeletal system. Ch 5 #5 Pg. 154-155
It has several functions- movement- whose byproduct is heat. Shivering is an essential function to maintain homeostasis.
What was the focus of Dr. Elisabeth Kübler-Ross's On Death and Dying?
It introduced the stages of grief.
Which of the following statements regarding a "dedicated line" is correct?
It is a constantly open line of communication that cannot be accessed by outside users
Which of the following is not true with regard to simplex mode?
It is called a "pair of frequencies"
As an EMT, the standards of emergency care are often partially based on
It is difficult to prove actions were performed if they are not included on the report
Which of the following statements about the patient care report is correct?
It is difficult to prove actions were performed if they are not included on the report
What is the primary feature of the Health Insurance Portability and Accountability Act (HIPAA)?
It limits the availability of a patient's health care information
Which of the following is NOT true of the lymphatic system?
It's vessels closely parallel the major arteries in the body
hinge joints
Joints that can bend and straighten but cannot rotate; they restrict motion to one plane.
During your treatment of a patient having a stroke whose breathing is normal and oxygen saturation is 96%, you administer oxygen via a nonrebreathing mask at 10 to 15 L/min. This is an example of what?
Knowledge-based error
Governmnetal Immunity
Legal doctrine that can protect an EMS provider from being sued or which may limit the amount of the monetary judgment that the plaintiff may recover; generally applies only to EMS systems that are operated by municipalities or other governmental entities
Discuss the life support chain, aerobic metabolism and anaerobic metabolism. Ch 5 # 14 Pg. 186-188
Life support chain- the links within the chain of survival include early access to an emergency response system early access to CPR, early access to defibrillation (if necessary), and early advanced care. aerobic metabolism- the process of making ATP that uses oxygen. Waste products are CO2 and H2O. anaerobic metabolism- any time that available oxygen is limited to portions of the body, cells will switch to anaerobic metabolism. This is when we create ATP without oxygen. byproduct/waste product is lactic acid
In general, which of the following does a prefix describe?
Location and intensity
Which of the following is the MOST appropriate device to use when immobilizing a patient with a suspected spinal injury?
Long backboard
fallopian tubes
Long, slender tubes that extend from the uterus to the region of the ovary on the same side and through which the ovum passes from the ovary to the uterus.
topical medications
Lotions, creams, and ointments that are applied to the surface of the skin and affect only that area, a medication delivery route.
Prone
Lying face down
Supine
Lying face up
Which of the following is required for an EMT to administer a drug to a patient?
Medical direction approval
The EMT's scope of practice within his or her local response area is defined by the
Medical director
prescription medications
Medications that are distributed to patients only by pharmacists according to a physician's order.
parenteral medications
Medications that enter the body by a route other than the digestive tract, skin, or mucous membranes.
enteral medications
Medications that enter the body through the digestive system.
over-the-counter medications
Medications that may be purchased directly by a patient without a prescription.
aerobic metabolism
Metabolism that can proceed only in the presence of oxygen.
Discuss consent by minors for treatment or transport.
Minors require a parent or guardian's expressed consent. If in a life threatening emergency in the absence of a parent/guardian, implied consent applies. If a minor is injured and requires medical treatment in a school or camp setting, teachers and school officials may act in loco parentis, which means in the position or place of a parent, and can legally give consent for treatment of the minor if a parent or guardian is not available.
Which of the following describes a code of conduct that can be defined by society, religion, or a person, affecting character and conscience?
Morality
Scope of Practice
Most commonly defined by state law; outlines the care that the EMT is able to provide for the patient
Abduction
Motion of a limb away from the midline
Adduction
Motion of a limb towards the midline
diffusion
Movement of gas from an area of higher concentration to an area of lower concentration.
How would you identify a patient who does not have any apparent allergies?
NKA
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?
National Highway Traffic Safety Administration (NHTSA)
Discuss the issues of negligence, abandonment, assault, and battery, and kidnapping and their implications for the EMT.
Negligence is the failure to provide the same care that a person with similar training would provide in the same or similar situation.Determined based on the following four factors: 1. Duty. 2. Breach of duty. 3. Damages. 4. Causation. Abandonment is unilateral termination of care by the EMT without the patient's consent and without making any provisions for continuing care by a medical professional who is competent to provide care for the patient. Assault is defined as unlawfully placing a person in fear of immediate bodily harm. Battery is defined as unlawfully touching a person; this includes providing emergency care without consent. Kidnapping is the seizing, confining, abducting, or carrying away of a person by force.
medulla oblongata
Nerve tissue that is continuous inferiorly with the spinal cord; serves as a conduction pathway for ascending and descending nerve tracts; coordinates heart rate, blood vessel diameter, breathing, swallowing, vomiting, coughing, and sneezing.
motor nerves
Nerves that carry information from the central nervous system to the muscles of the body.
Maintaining the chain of evidence at the scene of a crime should include
Not cutting through holes in clothing
cerebellum
One of the three major subdivisions of the brain, sometimes called the little brain; coordinates the various activities of the brain, particularly fine body movements.
inferior vena cava
One of the two largest veins in the body; carries blood from the lowest extremities and the pelvic and the abdominal organs to the heart.
atrium
One of the two upper chambers of the heart.
illium
One of three bones that fuse to form the pelvic ring.
ishium
One of three bones that fuse to form the pelvic ring.
pubis
One of three bones that fuse to form the pelvic ring.
Which of the following types of questions allow for the most detailed response?
Open-ended questions
Depositions
Oral questions asked of parties and witnesses under oath
Which of the following statements regarding parenteral medications is correct?
Parenteral medications are absorbed more quickly than enteral medications
Prefix
Part of a term that appears before a word root, changing the meaning of the term
Medial
Parts of the body that lie closer to the midline; also called inner structures
Lateral
Parts of the body that lie farther from the midline; also called outer structures
Bloodborne Pathogens
Pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus and human immunodeficiency (HIV)
Give the proper sequence of information to communicate in radio delivery of a patient report. Ch.4 #13 Pg. 131-136
Patient Report should follow a standard format: 1. Your unit identification and level of services. 2. The receiving hospital and your estimated time of arrival. 3. The patient's age and gender. 4. The patient's chief complaint or your perception of the problem. 5. A brief history of the patient's current problem. 6. A brief report of physical findings. 7. A brief summary of the care given and any patient responses.
You are encouraging a patient to go to the hospital by ambulance. You know that a transport will keep you on duty several hours after your regular quitting time. This is an example of
Patient advocacy
The right of a patient to make decisions concerning his or her health is called what?
Patient autonomy
Explain the legal implications of the Patient care report Ch.4 #7 Pg.119,123-125
Patient reports can be called to court at any point in time they are always to be treated with the utmost care
Recognize the importance of medical identification devices in treating the patient.
Patients may carry important medical information and identification in the form of: - A bracelet - Necklace - Key chain - ID card May include DNR order or information related to meds taken, allergies, diabetes, epilepsy, or some other serious condition. Some have USB flash with PDF files containing pertinent information.
Which of the following patient populations typically require a modified drug dose?
Pediatric patients
You are treating a 4-year-old who has been vomiting for 2 days. Which route should you use to deliver anti-nausea medication?
Per rectum
Describe the major physical and psychosocial characteristics of School Age Children
Permanent teeth, 4lb & 2.5in growth per year, learn various types of reasoning
Informed Consent
Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives to treatment have been explained
Consent
Permission to render care
adrenergic
Pertaining to nerves that release the neurotransmitter norepinephrine, or noradrenaline; also pertains to the receptors acted on by norepinephrine.
The suffix "-centesis" means
Pertaining to puncturing an organ or body cavity
Medical Control
Physician instructions that are given directly by radio or cell phone (online/direct) or indirectly by protocol/guidelines (offline/indirect), as authorized by the medical director of the program
beta-adrenergic receptors
Portion of the nervous system that, when stimulated, can cause an increase in the force of contraction of the heart, an increased heart rate, and bronchial dilation.
alpha-adrenergic receptors
Portions of the nervous system that, when stimulated, can cause constriction of blood vessels.
Public health examines the health needs of entire populations. In the United States, public health focuses on education and what else?
Prevention
Cumulative Stress Reations
Prolonged or excessive stress
You are dispatched to a motor vehicle crash involving a motorcycle. Upon your arrival, you find a 17-year-old male patient lying face down on the ground. What is the term for the position in which you found the patient?
Prone
Describe the prone, supine, Fowler's, Trendelenburg's, and shock positions of the body. Ch 5 #3 Pg. 147
Prone-the body is lying face down Supine- the body is lying face up The Fowler's position- named after Dr. Fowler who placed his patients in supine position on an incline with their feet higher than than their head to keep blood in the core of the body. Trendelenburg's position- is exactly the same as Fowler's except the feet are 6 to 12 inches higher than the head and the patient is on a backboard or stretcher. Shock position/modified Trendelenburg's position- the head and torso are supine, and the lower extremities are elevated 6 to 2 inches to help increase the blood flow to the brain.
Which aspect of the Health Insurance Portability and Accountability Act (HIPAA) MOST affects EMS personnel?
Protecting patient privacy
Personal Protective Equipment
Protective equipment that blocks exposure to a pathogen or a hazardous material
Standard Precautions
Protective measures that have traditionally been developed by the CDC for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable diesease
Describe the use of radio communications, including methods of initiating and terminating a radio call Ch.4 #11 Pg.130-136
Provides an effective means of communications for EMS personnel Initiate with you unit number and conclude with over
Which of the following is an example of secondary prevention?
Providing cervical spinal immobilization
The responsibility of the medical director to ensure the appropriate medical care standards are met by EMTs on each call is called what?
Quality Control
Open-ended Questions
Questions for which the patient must provide detail to give an answer
Closed-ended Questions
Questions that can be answered in short or single word responses
VHF (Very High Frequencies)
Radio frequencies beetween 30 and 300 MHz; the VHF spectrum is further divided into "high" and "low" bands
UHF (Ultra-high Frequencies)
Radio frequencies between 300 and 3,000 MHz
Delayed Stress Reactions
Reactions to stress that occur after a stressful situation
Acute Stress Reactions
Reactions to stress that occur during a stressful situation
In Loco Parentis
Refers ot the legal responsibility of a person or organization to take on some of the funcions and responsibilities of a parent
trust and mistrust
Refers to a stage of development from birth to approximately 18 months of age, during which the infants gain trust of their parents or caregivers if their world is planned, organized, and routine.
Which of the following is included in the narrative section in a PCR?
Refusal of care
As you radio the hospital to give a report on your patient, which of the following should you do?
Remain objective and impartial
While treating a patient with a high fever and cough, you accidentally expose yourself to the illness. What should you do?
Report it to the infection control officer
Which of the following is a physical change that typically occurs in the adolescent age group?
Secondary sexual development begins.
10. Give the generic and trade names, actions, indications, contradictions, routes of administration, side effects, interactions, and doses of ten medications that may be administered by an EMT in an emergency as dictated bu state protocols and local medical direction. Ch.7 #10 Pg.229-239
See Chart 7-4 Page 230-231 (way too much to type on here)
Simplex
Single-frequency radio; transmissions can occur in either direction but not simultaneously in both; when on party transmits, the other can only receive; and the party that is transmitting is unable to receive
You could be sued for _____________ if your radio report to the hospital describes the patient in a manner that injures his or her reputation
Slander
Which of the following clinical signs would necessitate the administration of naloxone (Narcan)?
Slow respirations
6. Explain the solid, liquid, and gas forms of medication, provide examples of each, and discuss how the form of medication dictates its route of administration Ch.7 #6 Pg.224-227
Solid: -Pills, Tablets, Capsules (slower route of route of delivery) Liquid: -Solution( liquid mixture of one or more substances that cannot be separated bu filtering or allowing the mixture to stand), Suspension (fine particles evenly distributed through liquid that can be separated by settling), Metered-Dose Inhalers, Topical Medications, Transcutaneous medications, Gels Gas: -Gasses for inhalation (oxygen) -Manufacturers choose the form to ensure the proper route of administration, the timing of release into the blood stream, and its effects on the target organs or body systems.
Which organ lies in the lateral and posterior portion of the left upper quadrant of the abdomen?
Spleen
Good Samaritan Laws
Statutory provisions encated by many states to protect citizens from liability for erros and omissions in giving good faith emergency medical care, unless there is wanton, gross, or willful negligence
Rigor Mortis
Stiffening of the body muscles; a definitive sign of death
If your patient takes nitroglycerin for a heart condition, which of the following routes of administration might he use?
Sublingual
enzymes
Substances designed to speed up the rate of specific biochemical reactions.
hormones
Substances formed in specialized organs or glands and carried to another organ or group of cells in the same organism; they regulate many body functions, including metabolism, growth, and body temperature.
The suffix "-ectomy" means
Surgical removal of
Activated charcoal comes in which medication form?
Suspension
Describe the physical, presumptive, and definitive signs of death.
TRAUMA INCONSISTENT WITH LIFE: -Decapitation -Transection of the torso -Complete destruction of the brain or heart -Incineration -Cardiac arrest clearly and unequivocally caused by significant blunt or penetrating trauma (Exception: Penetrating chest trauma with short transport time to definitive care) Presumptive Signs of Death: - Unresponsiveness to painful stimuli - Lack of a carotid pulse or heart beat - Absence of chest rise and fall - No deep tendon or corneal reflexes - Absence of pupillary reactivity - No systolic blood pressure - Profound cyanosis - Lowered or decreased body temperature Definitive signs of Death: - Obvious mortal damage, such as decapitation - Dependent lividity: Blood settling to the lowest point of the body, causing discoloration of the skin. - Rigor mortis: the stiffening of the body muscles caused by chemical changes w/i the muscle tissue. Occurs sometime between 2-12 hours after death. - Putrefaction (decomposition of body tissues): Depending on temperature conditions, this occurs sometime between 40-96 hours after death.
Trunking
Telecommunication systems that allow a computer to maximize utilizations of a group of frequencies
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
You are responding to an accident scene involving an overturned semi truck carrying diesel fuel. Which reference source will be most helpful in this case?
The DOT Emergency Response Guidebook
Which of the following is an example of a rules-based medication error?
The EMT administers a drug that is not approved by the medical director.
Which of the following is an advantage of MDI drug administration over SVN drug administration?
The MDI route does not require an external oxygen source.
Which of the following statements regarding the NREMT is correct?
The NREMT provides a national standard for EMS testing
Duplex
The ability to transmit and receive simultaneously
Multiplex
The ability to transmit audio and data signals through the use of more than one communications channel
Forcible Restraint
The act of physically preventing an individual from initiating any physical action
alveoli
The air sacs of the lungs in which the exchange of oxygen and carbon dioxide takes place.
expiratory reserve volume
The amount of air that can be exhaled following a normal exhalation; average volume is about 1,200 mL in the average adult man.
inspiratory reserve volume
The amount of air that can be inhaled after a normal inhalation, the amount of air that can be inhaled in addition to the normal tidal volume.
dose
The amount of medication given on the basis of the patient's size and age.
Discuss the anatomy and physiology of the circulatory system. Ch 5 # 7 Pg. 163-173
The anatomy of the circulatory system consists of the heart, arteries, arterioles, veins, venules, capillaries, blood, and the lungs. The heart- is a hollow muscular organ made of cardiac muscle or myocardium. it works as two pumps , the left side being more muscular. A wall called the septum divides the heart into right and left sides. The left side is a high pressure pump and pumps blood to the rest of the body. The right side provides blood to the lungs to be oxygenated and is a low pressure pump. Each side is divided into upper (atrium) and lower (ventricle) chambers. The heart is an involuntary muscle under the control of the autonomic nervous system, but has its own electrical system and can continue to function without central nervous system control. Circulation: de-oxygenated blood goes through the superior and inferior vena cava to the right atrium through the tricuspid valve to the right ventricle through the pulmonary valve to the pulmonary artery to the lungs (where it becomes oxygenated) to the left atrium to the left ventricle to the aorta and then to the rest of the body. Electrical conduction system- a network of specialized tissue that is capable of conducting electrical currents runs throughout the heart. the flow of electrical current through this network causes smooth, coordinated contractions of the heart that cause the heart to pump. Each mechanical contraction of the heart is associated with two electrical processes depolarization (the electrical charges on the surface of the muscle cell change from positive to negative) and repolarization (the heart returns back to its resting state and the positive charge is restored to the surface.
Ventral
The anterior surface of the body
brain stem
The area of the brain between the spinal cord and cerebrum, surrounded by the cerebellum; controls functions that are necessary for life, such as respiration.
cranium
The area of the head above the ears and eyes; the skull. The cranium contains the brain.
What happens when blood volume is lost from the body?
The arteries contract to increase the blood pressure
posterior tibial artery
The artery just behind the medial malleolus; supplies blood to the foot.
dorsalis pedis artery
The artery on the anterior surface of the foot between the first and second metatarsals.
life expectancy
The average number of years a person can be expected to live.
Posterior
The back surface of the body; the side away from you in the standard anatomic postiton
nephrons
The basic filtering units in the kidney.
Flexion
The bending of a joint
flexion
The bending of a joint.
metabolism
The biochemical processes that result in production of energy from nutrients within cells. (Cellular Respiration)
abdomen
The body cavity that contains the major organs of digestion and excretion. It is located below the diaphragm and above the pelvis.
Immune
The body's ability to protect itself from acquiring a disease
General Adaptation Syndrome
The body's response to stress that begins with an alarm response, followed by a stage of reaction and resistance, and then recovery or, if the stress is prolonged, exhaustion
mandible
The bone of the lower jaw.
musculoskeletal system
The bones and voluntary muscles of the body.
parietal bones
The bones that lie between the temporal and occipital regions of the cranium.
Plantar
The bottom surface of the foot
central nervous system
The brain and spinal cord.
trade name
The brand name that a manufacturer gives a medication; the name is capitalized.
perfusion
The circulation of oxygenated blood within an organ or tissue in adequate amounts to meet the cells' current needs.
clavicle
The collar bone; it is lateral to the sternum and anterior to the scapula.
Defamation
The communication of false infromation about a person that is damaging to that person's reputation or standing in the community
circulatory system
The complex arrangement of connected tubes, including the arteries, arterioles, capillaries, venules, and veins, that moves blood, oxygen, nutrients, carbon dioxide, and cellular waste throughout the body.
endocrine system
The complex message and control system that integrates many body functions including the release of hormones.
False Imprisonment
The confinement of a person without legal authority or the person's consent
Foodborne Transmission
The contamination of food or water with an organism than can cause disease
brain
The controlling organ of the body and center of consciousness; functions include perception, control of reaction to the environment, emotional responses, and judgement.
germinal layer
The deepest layer of the epidermis where new skin cells are formed.
Intravenous (IV) Therapy
The delivery of medication directly into a vein
acetabulum
The depression on the lateral pelvis where its three component bones join, in which the femoral head fits snugly.
Primary service area (PSA)
The designated area in which the EMS service is responsible for the provisions of prehospital emergency emergency care and transportation to the hospital
therapeutic effect
The desired or intended effect a medication is expected to have on the body.
bile ducts
The ducts that convey bile between the liver and the intestine.
Discuss the anatomy and physiology of the endocrine system. Ch 5 # 11 Pg. 183-184
The endocrine system is a complex message and control system that integrates many body functions. Endocrine glands release their hormones directly into the bloodstream. Each endocrine gland produces one or more hormones. Each hormone has a specific effect on some organ,tissue, or process. The brain controls the release of hormones by the endocrine glands.
orbit
The eye socket, made up of the maxilla and zygoma.
Federal Communications System
The federal agency that has jurisdiction over interstate and international telphone and telegraph services and satellite communications, all of which may involve EMS activity
Occupational Safety and Health Administration
The federal regulatory compliance agency that develops, publishes, and enforces guidelines concerning safety in the workplace
joint capsule
The fibrous sac that encloses a joint.
cecum
The first part of the large intestine, into which the ileum opens.
Emergency medical responder (EMR)
The first trained individual, such as a police officer, firefighter, lifeguard, or other rescuer, to arrive on scene of an emergency to provide initial medical assistance
Palmar
The forward facing part of the hand in the anatomic position
Anterior
The front surface of the body; the side facing you in the standard anatomic position
cardiac muscle
The heart muscle.
myocardium
The heart muscle.
Designated Officer
The individual in the department who is charged with the responsibility of managing exposures and infection control issues
dermis
The inner layer of the skin, containing hair follicles, sweat glands, nerve endings, and blood vessels.
patella
The knee cap; a specialized bone that lies within the tendon of the quadriceps muscle.
biceps
The large muscle that covers the front of the humerus.
cerebrum
The largest part of the three subdivisions of the brain, sometimes called the gray matter; made up of several lobes that control movement, hearing, balance, speech, visual perception, emotions, and personality.
coccyx
The last three or four vertebrae of the spine; the tail bone.
Identify the information required in a patient care report Ch.4 #6 Pg.119-123
The legal document used to record all patient care activities, from initial dispatch to arrival at the hospital. This report has direct patient care functions but also administrative and quality control functions. PCRs are also known as prehospital care reports. - Chief complaint - Level of consciousness (according to the AVPU scale) or mental status - Vital signs - Initial assessment - Patient demographics (age, gender, ethnic background)
Patient Care Report
The legal document used to record all patient care activities. This report has direct patient care functions but also adminstrative and quality control functions. PCRs are also known as prehospital care reports
mucous membranes
The lining of body cavities and passages that communicated directly or indirectly with the environment outside the body.
lumbar spine
The lower part of the back, formed by the lowest five non-fused vertebrae; also called the dorsal spine.
aorta
The main artery leaving the left side of the heart and carrying freshly oxygenated blood to the body.
Word Root
The main part of a term that contains the primary meaning
femoral artery
The major artery of the thigh, a continuation of the external iliac artery. It supplies blood to the lower abdominal wall, external genitalia, and legs. It can be palpated in the groin area.
carotid artery
The major artery that supplies blood to the head and brain.
brachial artery
The major vessel in the upper extremities that supplies blood to the arm.
Which of the following statements regarding patient weight distribution is correct?
The majority of a horizontal patient's weight is in the torso
Applied Ethics
The manner in which principles of ethics are incorporated into professional conduct
anaerobic metabolism
The metabolism that takes place in the absence of oxygen; the main by-product is lactic acid.
occiput
The most posterior portion of the cranium.
involuntary muscle
The muscle over which a person has no conscious control. It is found in many automatic regulating system of the body.
Which of the following describes the Moro reflex?
The neonate opens his or her arms wide, spreads his or her fingers, and seems to grasp at something after being startled.
Discuss the anatomy and physiology of the nervous system. Ch 5 # 8 Pg. 173-177
The nervous system consists of the brain, the spinal cord, and the nerves). It is divided into two main systems the central nervous system (CNS) and the peripheral nervous system (the somatic nervous system is a part of the peripheral nervous system that regulates voluntary control activities- the autonomic nervous system regulates involuntary actions). The nervous system is divided anatomically by the CNS and peripheral nervous system and divided by function with the somatic and autonomic nervous systems. Central Nervous system - Brain- occipital lobe: vision and storage of visual memories parietal lobe: sense of touch and texture; storage of those memories temporal lobe: Hearing, smell, and language; storage of sound and odor memories Frontal lobe: voluntary muscle control and storage of those memories Prefrontal area: judgement and predicting consequences of actions, abstract intellectual functions Limbic system: basic emotions, basic reflexes (chewing, swallowing,etc.) Diencephalon (hypothalamus): emotions, temperature control, interface with endocrine system (hormone control) Brainstem- midbrain: level of consciousness, reticular activating system, muscle tone, and posture' Pons: respiratory patterning and depth Medulla Oblongata: heart rate, BP, resp. rate, Spinal Cord- reflexes, relays info to and from the body Peripheral nervous system- Cranial nerves: brain to body part; special peripheral nerves that connect directly to body parts. Peripheral nerves: brain to spinal cord to body part; receive stimulus from body, send commands to body
adenosine triphosphate
The nucleotide involved in energy metabolism; used to store energy.
heart rate
The number of heartbeats during a specific time; usually 1 minute.
Host
The organism or individual that is attacked by the infecting agent
generic name
The original chemical name of a medication (in contrast with one of it proprietary or "trade" names); the name is not capitalized.
epidermis
The outer layer of skin, which is made up of cells that are sealed together to form a water-tight protective covering for the body.
Which of the following is a specific example of the Mobile Integrated Healthcare (MIH) model?
The paramedic administers a patient's flu vaccination
Suffix
The part of a term that comes after the root word, at the end of the term
midbrain
The part of the brain that is responsible for helping to regulate the level of consciousness.
peripheral nervous system
The part of the nervous system that consists of 31 pairs of spinal nerves and 12 pairs of cranial nerves; these may be sensory nerves, motor nerves, or connecting nerves.
autonomic nervous system
The part of the nervous system that regulates functions, such as digestion and sweating, that are not controlled voluntarily.
nasopharynx
The part of the pharynx that lies above the level of the roof of the mouth, or palate.
axial skeleton
The part of the skeleton comprising the skull, spinal column, and rib cage.
In which of the following circumstances can the EMT legally release confidential patient information?
The patient is competent and signs a release form
Discovery
The phase of a civil lawsuit where the plaintiff and defense obtain information from each other that will enable the attorneys to have a better understanding of the case and which will assist in negotiating a possible settlement or in preparing for trial. Discorery includes depositions, interrogatories, and demands for production of records
Ethics
The philosphy of right and wrong, of moral duties, and of ideal professional behavior
Medical director
The physician who authorizes or delegates to the EMT the authority to provide medical care in the field
joint
The place where two bones come into contact.
Apex
The pointed extremity of a conical structure
frontal bone
The portion of the cranium that forms the forehead.
large intestine
The portion of the digestive tube that encircles the abdomen around the small bowel, consisting of the cecum, the colon, and the rectum. It helps regulate water balance and eliminate solid waster.
appendicular skeleton
The portion of the skeletal system that comprises the arms, legs, pelvis, and shoulder girdle.
cervical spine
The portion of the spinal column consisting of the first seven vertebrae that lie in the neck.
anatomic postition
The position of reference in which the patient stands facing forward, arms at the side, with the palms of the hands facing forward.
Dorsal
The posterior surface of the body, including the back of the hand
pleural space
The potential space between the parietal pleura and the visceral pleura; described as "potential" because under normal conditions, the space does not exist.
Contamination
The presence of infectious organisms on or in objects such as dressings, water, food, needles, wounds, or a patient's body.
hydrostatic pressure
The pressure of water against the walls of its container.
oncotic pressure
The pressure of water to remove, typically into the capillary, as the result of the presence of plasma proteins.
blood pressure
The pressure that the blood exerts against the walls of the arteries as it passes through them.
Centers for Disease Control and Prevention
The primary federal agency that conducts and supports public health activities in the United States. The CDC is part of the US Department of Health and Human Services.
Emergency Doctrine
The principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs, or alcohol, or the patient's age
pharmacodynamics
The process by which a medication works on the body.
absorption
The process by which medications travel through body tissues until they reach the bloodstream.
adsorption
The process of binding or sticking to a surface.
Licensure
The process of whereby a state allows individuals to perform a regulated act.
digestion
The processing of food that nourishes the individual cells of the body.
lesser trochanter
The projection on the medial/superior portion of the femur.
femoral head
The proximal end of the femur, articulating with the acetabulum to form the hip joint..
You are caring for a driver who struck a light pole. She admits to drinking alcohol but orders you not to tell anyone. You should report the information to ____________.
The receiving nurse or doctor
Documentation
The recorded portion of the EMT's patient interaction, either written or electornic. This becomes part of the patient's permanent medical record
body mechanics
The relationship between the body's anatomical structures and the physical forces associated with lifting, moving and carrying; the ways in which the body moves to achieve a specific action.
diastole
The relaxation, or period of relaxation, of the heart, especially the ventricles.
genital system
The reproductive system in men and women.
Quality Control
The responsibility of the medical director to ensure that the appropriate medical care standards are met by EMT's on each call
Patient Autonomy
The right of a patient to make informed choices regarding his or her health care
Discuss the scope of practice and standards of care.
The scope of practice, which is most commonly defined by state law, outlines the care you are legally able to provide for the patient. Your medical director defines the scope of practice by developing protocols and standing orders. The manner in which you must act or behave is called a standard of care.
Kidnapping
The seizing, confining, abducting, or carrying away of a person by force, including transporting a competent adult for medical treatment wihout his or her consent
pleura
The serous membrane covering the lungs and lining the thorax, completely enclosing a potential space known as the pleural space.
Identify the anatomy and physiology of the skeletal system. Ch 5 #4 Pg. 147-153
The skeleton gives us our human form, allows movement, and protects our vital internal organs. The skeletal system is divided into two main portions the axial and appendicular skeletons. The axial skeleton- is composed of the skull, the face, vertebral column, and the thoracic cage The appendicular skeleton- is composed of the arms and legs, their connection points, and the pelvis Supporting structures within the skeletal system and their functions- ligament:connects bone to bone, tendon: connects muscle to bone, and cartilage: cushion between bones The skull- is composed of two groups of bones, the cranium and the facial bones. The cranium protects the brain and the facial bones protect the face. The cranium had four major bones that fuse together. Occiput, temporal regions, parietal regions, frontal region. the brain connects to the spinal cord through a large opening at the base of the skull called the foramen magnum. The face is composed of 14 bones. maxillae (upper non-movable jawbones), zygomas (cheekbones), mandible (lower movable portion of the jaw), orbit (eye socket which is made up of the maxilla and zygoma and the frontal bone), and the nasal bones. The spinal column- central supporting structure of the body composed of 33 bones each called vertebrae. Vertebrae are named according to the section of the spine in which they lie and are numbered top to bottom. The vertebrae are connected by ligaments and between each vertebrae is cushion called the intervertebral disk Cervical spine: first 7 vertebrae C1-C7. Thoracic spine: the next 12 vertebrae T1-T12. one pair of ribs is attached to each of the thoracic vertebrae. Lumbar spine: the next 5 vertebrae L1-L5. Sacrum: the 5 sacral vertebrae are fused together to form one bone called the sacrum which is joined with the illac bones to form the pelvis. Coccyx: the last 4 vertebrae all fused together form the coccyx/tailbone. The thoracic cavity-contains the heart, lungs, esophagus, and great vessels. It is formed by the 12 thoracic vertebrae and their 12 pairs of ribs. Also involves the sternum which is in the midline of the chest and has three components, the manubrium, the body, and the xiphoid process. The upper extremity- extends from the shoulder girdle to the fingertips and is composed of the arm, forearm, hand, and fingers. Shoulder girdle: is where the bones come together allowing the arm to be moved the three bones are the clavicle, the scapula, and the humerus. Arm: the supporting bone of the arm is the humerus. The forearm are is composed of the radius (on the thumb side) and the ulna. Wrist and hand: wrist is a modified ball-and-socket joint formed by the ends of the radius and ulna and several small wrist bones. There are eight bones in the wrist called carpal bones extending from that are metacarpals and then phalanges. The pelvis- consists of three bones : the sacrum and the two pelvic bones. each pelvic bone is formed by the fusion of three separate bones called the illium, the ischium, and the pubis. The bones are joined posteriorly by the sacrum. The lower extremity- consists of the femur and tibia and fibia and ankle and foot -which has tarsals metatarsals and phalanges. The skeletal system physiology- stores calcium and helps with the creation of various blood cells.
Discuss the anatomy and the physiology of the integumentary system. Ch 5 # 9 Pg. 177-179
The skin is divided into two layers- the superficial epidermis (composed of several layers of cells) and the deeper dermis (specialized skin structures). epidermis layers- starting from bottom to top germinal layer (produces new cells), and then the stratum corneal layer (dead cell layer). under the germinal layer is the ----------Dermis parts- within the dermis is sweat glands, sebaceous glands, hair follicles, blood vessels, and specialized nerve endings. Under the dermis is the Subcutaneous tissue which is mostly fat-insulator. Skin (largest organ in body) serves three functions, to protect the body from the environment and keep fluids in, regulate temperature, and transmit information from the environment to the brain.
hair follicles
The small organs that produce hair.
arterioles
The smallest branches of arteries leading to the vast network of capillaries.
cartilage
The smooth connective tissue that forms the support structure of the skeletal system and provides cushioning between bones; also forms the nasal septum and portions of the outer ear.
interstitial space
The space in between the cells.
Airborne Transmission
The spread of an organism via droplets or dust
Which of the following entities controls licensure of EMTS
The state in which the EMT practices
Extension
The straightening of a joint
extension
The straightening of a joint.
Bioethics
The study of ethics related to issues that arise in health care
pathophysiology
The study of how normal physiologic processes are affected by disease.
pharmacology
The study of the properties and effects of medications.
chyme
The substance that leaves the stomach. It is a combination of all of the eaten foods with added stomach acids.
humerus
The supporting bone of the upper arm.
nervous system
The system that controls virtually all activities of the body, both voluntary and involuntary.
Cover
The tactical use of an impenetrable barrier for protection
action
The therapeutic effect of a medication on the body.
indications
The therapeutic uses for a specific medication.
femur
The thighbone; the longest and one of the strongest bone in the body.
Statute of Limitations
The time within which a case must be commenced
capillary vessels
The tiny blood vessels between the arterioles and venules that permit transfer of oxygen, carbon dioxide, nutrients, and waste between body tissues and the blood.
Communication
The transmission of informatioin to another person--verbally or through body language
maxillae
The upper jawbones that assist in the formation of the orbit, the nasal cavity, and the palate and hold the upper teeth.
manubrium
The upper quarter of the sternum.
Discuss the anatomy and physiology of the urinary system. Ch 5 # 12 Pg. 184-185
The urinary system controls the discharge of certain waste materials filtered from the blood by the kidneys. The main functions are to filter and eliminate wastes, regulate fluid balance in the body, and to control pH balance. The urinary system is composed of the kidneys, ureters, bladder, and urethra. Kidneys ate solid organs that rid the blood of toxic waste products and control its balance of water and salt. Waste products and water are constantly filtered from the blood to create urine. Each kidney drains its urine into one ureter. The ureter leads the urine to the bladder. They are hollow muscular tubes. The urinary bladder is composed of smooth muscle and a specialized lining membrane. The bladder empties to the outside of the body through the urethra.
Paging
The use of a radio signal and a voice or digital message that is transmitted to pagers ("beepers") or desktop monitor radios
Vector-borne Transmission
The use of an animal to spread an organism from one person or place to another
polypharmacy
The use of multiple medications on a regular basis.
labored breathing
The use of muscles of the chest, back, and abdomen to assist in expanding the chest; occurs when air movement is impaired.
Concealment
The use of objects to limit a person's visibility of you
minute volume
The volume of air that moves in and out of the lungs per minute; calculated by multiplying the tidal volume and respiratory rate; also called minute ventilation.
Combining Vowel
The vowel used to combine two word roots or a word root and suffix
mucus
The watery secretion of the mucous membranes that lubricates the body openings.
peristalsis
The wavelike contraction of smooth muscle by which the ureters or other tubular organs propel their contents.
Transmission
The way in which an infectious disease is spread: contact, airborne, by vehicles, or by vectors
Describe the use of written communication and documentation Ch.4 #5 Pg.119-126
The written portion of the EMT's patient care interaction that becomes part of the patient's permanent medical record. It serves many purposes, including demonstrating that the care delivered was appropriate and within the scope and practice of the providers involved. Also provides an opportunity to communicate the patient's story to others who may participate in the patient's care in the future.
Why should you not use an oral route to deliver medication in a patient with an altered LOC?
There is a potential for airway compromise
Why do middle adults commonly experience financial concerns?
They are preparing for retirement but must still manage everyday financial demands.
chordae tendineae
Thin bands of fibrous tissue that attach to the valves in the heart and prevent them from inverting.
13. Explain why determining what prescription and OTC medications a patient is taking is critical aspect of a patient assessment during an emergency Ch.7 #13 Pg.239
This information may provide vital clues to your patients condition that may help guide your treatment or be extremely useful to the ER staff.
per os
Through the mouth; a medication delivery route; same as oral.
per rectum
Through the rectum; a medication delivery route.
transcutaneous
Through the skin; a medication delivery route.
What do you call the amount of air that is moved into or out of the lungs during a single breath?
Tidal volume
platelets
Tiny, disc-shaped elements that are much smaller than the cells; they are essential in the initial formation of a blood clot, the mechanism that stops bleeding.
lymph nodes
Tiny, oval-shaped structures located in various places along the lymph vessels that filter lymph.
Understand the body's topographic anatomy, including the anatomic position and the planes of the body. Ch 5 #1 Pg. 143-144
Topographic anatomy- the superficial landmarks of the body Anatomic position- this a position of reference in which the patient stands facing you, arms at the side, with the palms of the hands forward. Use the patients left and right as the reference point Planes of the Body: Coronal-front and back, Transverse- top and bottom, Sagittal-left and right, Midsaggittal (midline)-left and right-equal halves.
Tylenol is an example of what?
Trade name
You arrive at the scene of a motor vehicle versus pedestrian accident. The patient, a 13-year-old male, is unconscious and had multiple injuries. As you are treating the child, a law enforcement officer advises you that the child's parents will be at the scene is approximately 15 minutes. What should you do?
Transport the child immediately and have the parents meet you at the hospital
kidneys
Two retroperitoneal organs that excrete the end products of metabolism as urine and regulate the body's salt and water content.
Implied Consent
Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment
Describe local EMS system protocols for using forcible restraint.
Typically, you should consult medical control for authorization to restrain or contact law enforcement personnel who have the authority to restrain people. Restraint may only be used in circumstances of risk to the patient or others. MGL Chapter 111 Section 18 says "an emergency medical technician may restrain a patient who presents an immediate or serious threat of bodily harm to himself or others," which must be documented.
sublingual
Under the tongue; a medication delivery route.
Describe the major physical and psychosocial characteristics of a toddler and preschooler's life
Underdeveloped Lung Musculature, Loss of Passive Immunity, Fine Motor Skills, Bladder Control, Sensory Development, Brain Weighs 90% of final weight
Abandonment
Unilateral termination of care by the EMT without the patien's consent and without makng provisions for transferring care to another medical professional with the skills and training necessry to meet the needs of the patient
Assault
Unlawfully placing a patient in fear of bodily harm
Battery
Unlawfully touching a patient or providing emergency care without consent
Explain the Skills that should be used to communicate with family members, bystanders, people from other agencies, and hospital personnel Ch.4 #3 Pg.110,112,113,115-118
Use care and caution not to violate hippa when speaking with anyone other than the patient
You are providing care to a 61-year-old female complaining of chest pain that is cardiac in origin. Your service utilizes a multiplex communication system. You wish to transmit the patient's electrocardiogram to the hospital. In order to accomplish this, you must
Use the multiplex system to transmit the information
MED channels
VHF and UHF channels that the Federal Communications Commission has designated exclusively for EMS use
Which of the following involves the spread of infection by animals or insects that carry an organism from one person or place to another?
Vector-borne transmission
Effective therapeutic communication skills require
Verbal and nonverbal communication techniques
Therapeutic Communication
Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship
Describe Factors and strategies to consider for therapeutic communication with patients. Ch.4 #1 Pg.107-118
Verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.
Describe the major physical and psychosocial characteristics of Middle Adults
Vision & Hearing loss, Cardiovascular issues, Menopause, Greater risk of cancer, diabetes, hypertension
Describe the major physical and psychosocial characteristics of Adolescents
Vitals within adult ranges, 2-3 year growth spurt, Maturation of the reproduction system, Menstruation begins, Acne, Rebellious behavior
What type of mode does an interoperable communications system use?
Voice-over-internet-protocol
History of EMS System
WWI (volunteer ambulances), WWII (in-field care), Korea (MASH), pre-1970 (emergency ambulance service varied), modern EMS (White Paper revealed inadequacy so NHTSA and DOT got funding), 1970s (DOT developed Orange Book curriculum), 1980s (advanced training), 1990s (NHTSA standardizes EMS education)
Which of the following will help improve radio communications?
Wait 1 second after pressing the transmit button before speaking
What does asthenia mean?
Weakness
explain the need and use of the most common patient-moving equipment, the stretcher and backboard
Wheeled ambulance stretcher: (AKA ambulance stretcher or Gurney; most common) weighs 40-145 lb, generally not taken up or down the stairs, moving patient by rolling allows and helps prevent injuries from carrying -Stretcher features: head end & foot end, strong metal frame all parts attach to, hinges at center for elevation of head/back, guardrails to prevent patient from rolling out, undercarriage frame allows adjustment to any height, mattress=fluid resistant, patient is secured w/ straps -Backboards: long, flat, rigid rectangular material, mostly plastic, used to carry and immobilizr patients w/ suspected spinal injury, commonly used for patients found lying down, used to move patients out of awkward places, 6-7 feet long, holes serve as handles and to secure straps
Ethnocentrism
When a person considers his or her own cultural values as more important when interacting with people of a different culture
Proximate Causation
When a person who has a duty abuses it, and causes harm to another individual, the EMT, the agency, and/or the medical dierctor may be sued for negligence
Cultural Imposition
When one person imposes his or her beliefs, values, and practices on another because he or she believe his or her ideals are superior
peer-assisted medication
When the EMT administers medication to him or herself or to a partner.
patient-assisted medications
When the EMT assists the patient with the administration of his or her own medication.
Res Ipsa Loquitor
When the EMT or an EMS system is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred
When is forcible restraint permitted?
When the patient poses a significant threat to self or others
2. Identify the four components that comprise a medical term. (p 153)
Word Root - The foundation of the word Prefix - What occurs before the word root Suffix - What occurs after the word root Combining Vowels - Vowels that join one or more word roots to other components of a term
Do Not Resuscitate Orders
Written documentatioin by a physician giving permission to medical personnel not to attempt resuscitation in the even of cardiac arrest
Advance Directive
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will orheal care directive
Standing Orders
Written documents, signed by the EMS system's medical director, that outline specific directions, permissions, and sometimes prohibitions regarding patient care; also called protocols
Interrogatories
Written questions that the defense and plaintiff send to one another
Standard of Care
Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm
Which of the following should you do when lifting something heavy?
You should bend your legs, not try to lift from the waist.
Explain how to manage patients who are identified as organ donors.
You should treat a potential organ donor in the same way that you would any other patient needing treatment. Use all means necessary to keep that patient alive. You must give oxygen to keep organs viable.
What is the proper name for the cheekbone?
Zygoma
The patient report commonly includes all of the following except
a list of the patients medications
Describe the routes of disease transmission. (pp 41-42)
a. Direct contact (eg, blood-borne pathogens) b. Indirect contact (eg, needle sticks) c. Airborne transmission (eg, sneezing) d. Foodborne transmission (eg, contaminated food) e. Vector-borne transmission (eg, fleas)
Describe how to handle behavioral emergencies. (pp 73-74)
a.) Emergencies that do not have a clear physical cause *i. The cause may turn out to be physical (eg, hypoglycemia, head trauma, hypoxia, toxic ingestion). b.) These emergencies result in aberrant behavior. c.) Most behavioral emergencies do not pose a threat, but some do, and you must use caution in such cases. Use observation and assess the patient with a series of questions and asses their overall condition to determine their state.
Recognize the possibility of violent situations and the steps to take to deal with them. (pp 72-73)
a.) Potentially violent situations: *i. Civil disturbances *ii. Large gatherings of potentially hostile people *iii. Domestic disputes *iv. Crime scenes
You are transporting a 67-year-old female patient to the hospital for investigation of abdominal pain. The patient care record indicates that the patient has a history of AAA. Based on this information, the patient care record includes an abbreviation for:
abdominal aortic aneurysm
In preconventional reasoning, children:
act almost purely to avoid punishment and to get what they want.
While assisting a paramedic in the attempted resuscitation of a 55-year-old male in cardiac arrest, you should expect the paramedic to:
administer drugs via the IV route to achieve the fastest effect
You are dispatched to a state park for a young female experiencing an allergic reaction. Your assessment reveals that her breathing is severely labored and her blood pressure is very low. You carry epinephrine auto-injectors on your ambulance and have been trained and approved by your medical director to administer them. As your partner gives the patient supplemental oxygen, you attempt to contact medical control but do not have a signal from your cell phone. You should:
administer epinephrine to the patient, begin immediate transport, and attempt to contact medical control en route to the hospital.
The process of binding or sticking to a surface is called:
adsorption.
Medical control gives you an order that seems inappropriate for the patient's condition. After confirming that you heard the physician correctly, you should
advise the physician that the order is unclear and ask for clarification
When you are communicating with an older patient, it is important to remember that:
age-related changes diminish the effectiveness of the eyes and ears
What is the root word for pain?
alges
Standard radio operating procedures are designed to
all of the above (keep transmissions brief, develop effective radio discipline)
During your assessment of a 20-year-old man with a severe headache and nausea, you ask him where his headache began, but he does not answer your question immediately. You should
allow him time to think about the question and respond to it
What are the three stages of general adaptation syndrome?
an alarm response, reaction and resistance, and recovery/exhaustion.
Advanced EMT (AEMT)
an individual who has training in specific aspects of advanced life support, such as intravenous therapy, and the administration of certain emergency medications
The ___________ of the heart is the inferior portion of the ventricles.
apex
During your monthly internal quality(QI) improvement meeting, you review several patient care reports(PCRs) with the staff of your EMS system. You identify the patient's name, age, and sex, and then discuss the treatment that was provided by the EMTs in the field. By taking this approach to the QI process, you:
are in violation of HIPPA because you did not remove from the PCR beforehand
AF, VF, and AED stand for
atrial fibrillation, ventricular fibrillation, automated external defibrillator
An EMT may injure his or her back, even if it is straight, if the
back is bent forward at the hips.
You respond to the home of a 59-year-old man who is unconscious, has slow, shallow breathing, and has weak pulse. The family states that the patient has terminal brain cancer and does not wish to be resuscitated. They further state that there is a DNR order for this patient; however, they are unable to locate it. You should:
begin treatment and contact medical control as needed
A patient has fractured both femurs. Anatomically, these injuries would be described as being:
bilateral
The root "melan/o" means:
black
An infant's blood pressure typically increases with age because:
blood pressure directly corresponds to body weight.
The CNS is composed of the
brain and spinal cord
When relaying patient information via radio, communications should be
brief and easily understood
Medications encased in a gelatin shell that are taken by mouth are called:
capsules.
The waste products of aerobic metabolism include
carbon dioxide and water
When assessing an elderly male who complains of nausea and generalized weakness, you find that he takes atorvastatin (Lipitor) and amlodipine (Norvasc). These medications suggest a history of:
cardiovascular disease.
After opening a patient's airway and confirming spontaneous respirations, you check for a pulse on his neck just lateral to the trachea. What artery are you palpating?
carotid
"Chondro" in the word chondritis means:
cartilage
EMTs should have a strong working knowledge of medical terminology in order to:
communicate effectively with other members of the health care team
Ethnocentrism is defined as
considering your own cultural values to be more important when interacting with people of a different culture
You arrive at the scene of an accident and observe the patient lying face-up on the ground. As you look at the front side of his body, which plane of the body are you observing?
coronal
It is essential that you ____________ your equipment to prevent the spread of disease.
decontaminate
What should you do when trying to define the term dysuria?
define the suffix, then the prefix, and then the word root.
The ___________ is a muscular dome that forms the interior boundary of the thorax
diapragm
Upon arriving at the scene of a motor vehicle crash, you find a single patient still seated in his car. There are no scene hazards. As you approach the vehicle, you note that the patient is semiconscious and has a large laceration to his forehead. You should:
direct your partner to apply manual in-line support of the patient's head
The suffix "-pathy" means:
disease
pathophysiology is the study of the functional changes that occur when the body reacts to a particular
disease
A 5-year-old boy has fallen and has a severe deformity of the forearm near the wrist. He has possibly sustained a fracture of the ____________ forearm.
distal
The amount of medication that is given is known as the _________.
dose
What is the best way to care for your patient once he tells you he does not want to go to the hospital?
encourage him to call 9-1-1 again if his condition worsens.
Which of the following systems is responsible for releasing hormones that regulate body activities?
endocrine
When performing his or her duties, the EMT is generally expected to:
exercise reasonable care and act prudently.
digital signals are used in some kinds of paging and tone-alerting systems because they transmit ___________ and allow for more choices and flexibility
faster
The areas of the infant's skull that have not yet fused together are called ________.
fontanelles
The brain connects to the spinal cord through a large opening at the base of the skull called the
foramen magnum
EMR, EMT, AEMT, paramedic
four levels of EMT training and licensure
bile is produced by the liver and concentrated and stored in the
gallbladder
You and your partner arrive at the scene of a motor vehicle crash. The driver, a young male, is severely entrapped in his car. He has an open head injury and massive facial trauma. He is unresponsive, is not breathing, and does not have a palpable carotid pulse. You should:
have your partner check for a pulse to confirm that the patient is deceased
Community Paramedicine
health care model in which experienced paramedics receive advanced training to equip them to provide more services to prehospital environment (ie health evals, monitoring chronic illnesses, patient advocacy)
A by-product of involuntary muscle contraction and relaxation is
heat
After applying a tourniquet, the injury from a patient's leg stops bleeding. This is called:
hemostasis
EMT licensure criteria
high school diploma, immunization against certain communicable diseases, completion of background check/drug screening, valid driver's license, BLS/CPR course, EMT course, state written/practical exam, mental/physical ability, compliance with state provisions
Physical changes that typically occur in early adults include an:
increase in fatty tissue, which leads to weight gain.
You are attending to a 34-year-old male patient who requires transport to the hospital for assessment of his chronic back pain. The patient weighs over 750 pounds. Your bariatric stretcher has a wider surface area to allow for:
increased patient comfort and dignity.
In contrast to typical wheeled ambulance stretchers, features of a bariatric stretcher include
increased stability from a wider wheelbase.
Terms used to designate the following stages of life: infants, toddlers and preschoolers, school-age children, Adolescents (teenagers), early adults, middle adults, and older adults.
infants 0-12 Months, toddlers 1-3yrs, preschoolers 3-6yrs, school-age children 6-12yrs, adolescents 13-18yrs, early adults 19-40yrs, middle adults 40-60yrs, older adults 60+years
The MOST serious consequence of a poorly planned or rushed patient move is:
injury to you or your patient.
A 16-year-old female complains of vaginal bleeding and abdominal cramping that began several hours ago. During your assessment interview, you should:
inquire about the possibility of pregnancy in private, if possible
A diabetic patient has polydipsia. This means that she:
is excessively thirsty
Define pathophysiology. Ch 5 # 15 Pg. 188-190
is the study of the functional changes that occur when the body reacts to a particular disease.
To minimize the risk of injuring yourself when lifting or moving a patient, you should:
keep the weight as close to your body as possible
The proper technique for using the power grip is to:
lift with your palms up.
discuss how following proper patients lifting and carrying a patient
lifting patients: shoulder girdle should be aligned over pelvis, hands should be held close to legs, force then goes straight down spinal column, very little strain occurs -lifting technique: legs should be spread about 15in apart (shoulder width), place feet so center of gravity id balanced, w/ back held upright-bring upper body down by bending legs, grasp patient and stretcher, lift patient by raising upper body and arms and straightening your legs until standing, keep weight close to body, keep arms the same distance apart not lose your grasp on the patient
As an EMT, the standards of emergency care are often partially based on:
locally accepted protocols.
The topographic term used to describe the location of body parts that are closer toward the midline of the body is:
medial
The EMT's scope of practice within his or her local response area is defined by the:
medical director
As an EMT, you may be authorized to administer aspirin to a patient with chest pain based on
medical director approval
Which of the following is NOT a function of the skin?
metabolic coordination
Mobile Integrated Healthcare (MIH)
method of delivering health care which involves providing health care within the community rather than at an office/hospital
If a patient's chest barely moves during inhalation, even if the patients respiratory rate is normal, you should suspect that
minute volume is decreased
When you are communicating with an older patient, it is important to remember that
most older people think clearly and are capable of answering questions
What is adduction?
motion of a limb toward the midline.
explain the technical skills and general considerations, requires of EMTs during patient packaging and patient handling
moving patient: make sure injury does not occur to you, your team, and patient; -using proper body mechanics and maintaining physical fitness greatly reduce chance of injury -repeat training
"Myo" in the word myocarditis means:
muscle
The respiratory rate of 30 breaths per minute in an infant is ________.
normal
When providing a patient report via radio, you should protect the patient's privacy by
not disclosing his or her name
a patient has a large accumulation of blood in the sac surrounding the heart. Which type of shock would this condition cause?
obstructive
When administering a medication you are unfamiliar with, what is the first thing you should do?
obtain an order from medical control.
You are attending to a 26-year-old female who is 34 weeks pregnant with her first child. Your patient has been having lower abdominal pains and cramping for the past two hours. In placing your patient on the stretcher and preparing for transport, you should place her:
on her left side
To protect a restrained patient and prevent him from using leverage to break free, the EMT should secure __________.
one arm above the head
The _____ is made up of the maxilla and zygoma, as well as the frontal bone of the cranium
orbit
In ___________ administration, you are administering medication to yourself or your partner.
peer-assisted
Online medical control requires ______________
phone or radio contact with the medical director
When moving a conscious, weak patient down a flight of stairs, you should:
place the wheeled stretcher at the bottom of the stairs and carry the patient down the stairs with a stair chair
In relation to the chest, the back is:
posterior
An intoxicated 40-year-old male is found lying face down. How would you document his body's position?
prone
National guidelines for EMS care are intended to
provide more consistent delivery of EMS care across the United States
EMS System (14)
public access, clinical care, 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
A 31-year-old female is experiencing an acute asthma attack. She is conscious and alert, but in obvious respiratory distress. After assisting her with her prescribed MDI, you should:
reassess the patient and document her response to the medication.
As you are wheeling your patient through the emergency department doors, you receive another call for a major motor vehicle crash. You should
respond only after giving a verbal patient report to a nurse or physician
The _________ is both the mechanical weight-bearing base of the spinal column and the fused central posterior section of the pelvic girdle
sacrum
You are attending to a 22-year-old female patient who has overdosed. The patient is unresponsive in an upstairs bedroom. The most appropriate way to bring the patient downstairs is:
secured to a fracture board with the strongest provider at the head end.
The ability to take appropriate action with little direction is known as
self-motivation
The risk of bleeding in the skull, which increases with age, is MOST directly related to:
shrinkage of the brain.
After taking diphenhydramine (Benadryl) for an allergic reaction, a person begins experiencing drowsiness and a dry mouth. These findings are an example of a(n):
side effect.
Which of the following structures does not contain smooth muscle?
skeletal system
You are dispatched to a call for a 4-month-old infant with respiratory distress. While you prepare to take care of this child, you must remember that:
small infants are nose breathers and require clear nasal passages at all times.
What type of muscle is involved when you hear your stomach growling?
smooth muscle
"Gastro" in the word "gastroenteritis" means:
stomach
As you and your partner are carrying a stable patient down a flight of stairs in a stair chair, you feel a sudden, sharp pain in your lower back. You should:
stop the move and request additional lifting assistance.
Activated charcoal is an example of a(n):
suspension.
Your patient's initial pulse rate was 89 beats/min and now it is 116 beats/min. What part of the nervous system is responsible for this increase?
sympathetic
Older adults frequently ___________.
take multiple medications
Atherosclerosis is defined as ________.
the blockage of a coronary artery
large amounts of ATP are generated when
the cells function with adequate oxygen
Discuss the anatomy and physiology of the digestive system. Ch 5 # 10 Pg. 179-183
the digestive system is composed of the gastrointestinal tract (stomach and intestines), mouth, salivary glands, pharynx, esophagus, liver, gallbladder, pancreas, rectum, and anus. The function of this system is digestion - the processing of food that nourishes the individual cells of the body. The digestive system lies within the abdomen or abdominal cavity which is composed of four quadrants. right upper, right lower, left upper, and left lower. The liver is primarily in the right upper quadrant (extends to the left upper quadrant). The gallbladder is in the right upper quadrant. The appendix is in the right lower quadrant. The small and large intestines are partially in all of the quadrants. The rectum is partially in the left and right lower quadrants. The spleen is in the left upper quadrant. The stomach is primarily in the left upper quadrant. The mouth consists of the lips, cheeks,gums, and tongue. There are two salivary glands located under the tongue, one on each side of the lower jaw and one inside each cheek. The oropharynx is a tubular structure that extends vertically from the back of the mouth to the esophagus and trachea. the esophagus is s collapsible tube that extends from the end of the pharynx to the stomach. The muscular contractions in the wall of the stomach and gastric juice convert ingested food to a thoroughly mixed semisolid mass called chyme. it's propelled by muscular contractions into the small intestine. The pancreas is a solid organ contains two kinds of glands, one is exocrine and secretes pancreatic juice- which includes enzymes that aid in the digestion of fat, starch, and protein. The other portion is endocrine, called the islets of langerhans which is where insulin is produced. The liver is a solid organ where poisonous substances produced through digestion are brought and rendered harmless, factors necessary for blood clotting and plasma production are found there, bile is also made here to assist in the digestion of fat, sugar and starch to be used immediately for energy is stored here,and produces many factors that are involved in the regulation of immune responses. Because the liver is so big and venous it is easily susceptible to injury. the liver is connected to the intestine with bile ducts. The gallbladder is an outpouching from the bile ducts that serves as a reservoir for that bile. The small intestine is the major hollow organ of the abdomen. The cells lining the small intestine produce enzymes and mucus to aid in digestion. enzymes from the small intestine or pancreas carry out the final processes of digestion. more than 90% of the products of digestion are absorbed across the wall of the intestines into the veins to be transported to the liver (through the portal vein). The liver then processes these nutrients further and then stores or transports them to the heart through veins draining to the liver. The heart pumps that blood filled with nutrients through the arteries to the capillaries where nutrients can pass through the capillary walls to nourish the body's individual cells. The small intestine is composed of the duodenum, jejunum, and ileum. The large intestine is another major hollow organ and consists of the cecum, colon, and the rectum. The major function of the colon is to absorb the final 5 to 10% of digested food and water from the small intestine to form solid stool which is stored in the rectum and passed through the anus. The appendix is a tube that opens up onto the cecum in the right lower quadrant of the abdomen.
You are caring for a 56-year-old male patient complaining of abdominal pain. Your service has recently switched to an electronic PCR system (ePCR). When completing the ePCR, it is important to be aware that
the ePCR allows patient information to be transmitted directly to the receiving hospital's computers
Discuss the anatomy and physiology of the genital system. Ch 5 # 13 Pg. 185-186
the genital system controls the reproductive processes by which life is created =. the male genitals except for the prostate gland and the seminal vesicles lie outside of the pelvic cavity. The female genitalia with the exception of the clitoris and the labia lie within the pelvic cavity. Male reproductive system: consists of the testicles, epididymis, vasa deferentia, prostate gland, seminal vesicles, and penis. Each testicle contains specialized cells and ducts and some of these produce male hormones and others develop sperm. During ejaculation the sperm are carried through the vas deferentia (vas deferens) to the urethra and deposited by the penis. The function of the reproductive system is to reproduce and is also responsible for the production of sex hormones. The penis is also involved in the male's urinary system. Female reproductive system: consists of the ovaries, fallopian tubes, uterus, cervix, and vagina. The ovaries produce sex hormones and specialized cells for reproduction. A specialized ovum, or egg ell, matures and is released regularly approximately every 28 days. this egg travels through the fallopian tubes where fertilization normally occurs. the fallopian tubes connect with the uterus and carry the ovum into the cavity of this organ. The uterus is pear-shaped and hollow with muscular walls. the narrow opening from the uterus to the vagina is called the cervix. The vagina is a muscular distensible tube that connects the uterus with the vulva. The functions include reproduction and hormone balance.
What is an EMT's primary service area?
the main area in which the EMS agency operates
You are transporting to a 66-year-old patient with a history of heart problems. The patient chart indicates that he has hepatomegaly. The root of the term indicates that:
the problem is with the patient's liver
The ability to understand others and have them understand you is known as
the receiving nurse or doctor
define the term body mechanics
the relationship b/w body's anatomic structures and physical forces associated w/ lifting, moving, and carrying
The term "pericardiocentesis" means:
the removal of fluid from around the heart.
Discuss the anatomy and physiology of the respiratory system. Ch 5 # 6 Pg. 155-163
the respiratory system consists of all the structures of the body that contribute to respiration or the process of breathing. It includes the nose, mouth, throat, larynx, trachea, bronchi, and bronchioles which are all air passages or airways. It also includes the lungs, diaphragm, and the muscles of the chest wall. The upper airway consists of the nose, mouth, tongue, jaw, oral cavity, larynx (dividing line), and pharynx. The lower airway consists of the trachea, lungs, and diaphragm. physiology of the respiratory system: function of the respiratory system is to provide the body with oxygen and eliminate carbon dioxide. the exchange of oxygen and carbon dioxide takes place in the lungs in the alveoli. Respiration:the process of gas exchange vs. Ventilation: is the simple movement of air between the lungs and the environment
The term "pharmacology" is MOST accurately defined as:
the study of drugs and their actions on the body.
The ability to handle mutiple tasks based on their priority is called
time management
What is the function of the fallopian tubes
to transport a mature egg to the uterus
What term describes when only one lung is expanding with inhalation?
unilateral chest expansion
Urine is transported from the kidneys to the urinary bladder via the
ureters
To facilitate a safe and coordinated move, the team leader should:
use preparatory commands to initiate any moves
A patient has a blood pressure of 130/70 mm Hg. The "130" in this measurement represents
ventricular contraction
What is therapeutic communication?
verbal and nonverbal communication techniques that encourage patients to express their feelings and to achieve a positive relationship.
3. Describe the following directional terms: anterior (ventral), posterior (dorsal), right, left, superior, inferior, proximal, distal, medial, lateral, superficial, and deep. (pp 158-161)
• Anterior: Front surface of the body • Ventral: Belly side of the body • Posterior: Back surface of the body • Dorsal: Spinal side of the body • Right/Left: The patient's right and left sides • Superior: Nearer the head • Inferior: Away from the head • Proximal: Structures that are closer to the trunk • Distal: Structures that are further away from the trunk or nearer to the free end of the extremity • Medial: Towards the midline • Lateral: Away from the midline • Superficial: Closer or on the skin • Deep: Further inside the body or tissue
4. Describe the prone, supine, Fowler, and semi-Fowler positions of the body. (p 161)
• Prone: Lying face down • Supine: Lying face up • Fowler: Semi-reclined position • Semi-Fowler: Sitting with the back of the stretcher at a 45-degree angle