NJ EMD Exam
BLS
system including 1st responders or EMT's
EMD
-advanced form of dispatch -requires specific medical training -serves as part of the EMS system
respiratory distress
-anxiety/distress -cyanotic -tachypnea -noisy respiration -labored appearance -diaphoretic
Heart
4 chamber pump that pumps blood through the body
anaphylactic shock
"allergic shock" difficulty breathing, swelling of face/tongue, chest tightness, etc.
psychogenic shock
"fainting" occurs when blood vessels dialate
Tier 3 response
ALS
Tier 4 response
Aeromedical
Levels of Consciousness
Alert Verbal Painful Unresponsive
3 protocol types
All caller interrogation Medical/traumatic injury Time life critical event
Traumatic Incident Types
Animal bites, assault/domestic violence, bleeding/laceration, burns, eye problems/injury, fall victim, heat/cold exposure, industrial accident, stabbing/gunshot victim, traumatic injury, vehicular related injuries
Trauma
Any injury caused by accident or violence
Damages
Anything awarded to plaintiffs
Tier 2 response
BLS
time-life controlled complaints
CO poisoning/inhalation, cardiac arrest/DOA, choking, drowning (possible), electrocution, pregnancy/childbirth, unconscious/fainting
Veins
Carries unoxygenated blood back to the heart
Ligaments
Connect bone to bone
Tendons
Connect muscle to bone
peripheral nervous system
Contains motor and sensory nerves
Central nervous system
Contains the brain and spinal cord
DOT
Department of Transportation
4 factors of negligence
Duty Breech of duty Proximate cause Damage
EMD
Emergency Medical Dispatch
Detrimental reliance
Expecting a certain action to be taken based on the fact it was reposted in the media
Negligence
Failure to act or perform in a particular situation as any other reasonable person with similar training would under similar circumstances
Breech of duty
Failure to perform your duty by acting accordingly to standard of care
Response modes
Hot Cold Full
7
How many anatomical systems are there in the human body?
Shock
Inadequate tissue perfusion
Negligent retention
Keeping someone employed that in unable or incapable of doing the job
Abandonment
Leaving a patient in a known life-threatening condition; leaving someone in the care of someone else with less training than you
Hot response mode
Lights and sirens response
autonomic nervous system
Made up of and uses motor nerves
NHTSA
National Highway Traffic Safety Administration
Gross negligence
Negligent action that that was undertaken with malicious intent and willful disregard for safety of said person or property
Simple negligence
Negligent conduct that wasn't purposeful or wasn't due to malicious intent
7 anatomical systems of the body
Nervous system Circulatory system Respiratory system Digestive system Musculoskeletal system Genito-urinary system Skin
NJDOH
New Jersey department of health
Cold response mode
No lights or sirens response
Liability
Obligation or debt of office
Emergency rule
One faced with emergency CA t be held to the same standard of conduct he/she would otherwise be held to when not faced with such situation
Consent
Permission to treat the sick/injured
Principle of reasonableness
Refers to what a reasonable person would do in the same situation
Full response mode
Response with multiple agents of the EMS system, with lights and sirens
Duty
Responsibility to act of perform according to established standard of care
Forseeability
Solely relying on information you receive from callers
Blood
Substance made of plasma, red blood cells, white blood cells, and platelets
Capillaries
Thin walled vessels; exchange oxygenated and unoxygenated blood; u turn
4 incident types
Traumatic Incident, medical chief complaint, time-life critical event, miscellaneous
False
True/false: 911 laws provide exemption in some cases of liability
False
True/false: BLS & EMD are the only part of the EMS system
True
True/false: It is your responsibility to gather and provide info without making a diagnosis
True
True/false: The good samaritan law does apply some exemption of liability
True
True/false: The good samaritan law does not protect EMDs while on duty
Agency methods and individual methods
What are the 2 methods of avoiding liability?
BLS
What do all calls require at a minimum?
Roles during Phase 2
-goes to proper protocol -protocols give appropriate response mode -EMD dispatches response personnel in proper mode configuration
EMS
-is a system (that includes EMD) -requires specific medical training -includes all aspects of medical service to the community -includes call-takers through rehab of the patient
Tier 1 response
First responders
BLS
basic life support
hemorrhagic shock
body loses large amounts of blood through internal or external bleeding
hypovolemic shock
loses large amounts of bodily fluids
digestive system
mouth > pharynx > epiglottis > esophagus > stomach > small intestine > large intestine > liver > gallblader > pancreas > spleen > rectum > anus
neurogenic shock
occurs with spinal cord damage
OETS
office of emergency telecommunications system
respiratory system
pharynx, epiglottis, larynx, trachea, brochi, lungs, alveoli, diaphragm, pleura
male reproductive system
prostate, testes, scrotum, penis
septic shock
severe infections
TLCE
time life critical event
2 unconscious/fainting instructions
unconscious airway control (trauma) unconscious airway control (non-trauma)
involuntary muscle
unconsciously controlled muscles (i.e. breathing)
muscles
voluntary muscles, involuntary muscles, cardiac muscles
voluntary muscle
consciously controlled muscles (i.e. walking)
Appropriate concerns
-failure to send resources when requested -subjective judgement of caller credibility -subjective judgement of chief complaint -argumentative or combative EMD behavior -allowing prejudices to influence decisions -giving medical instructions without EMSPRD -failure to train/be certified as an EMD -not giving instructions when they are needed and you have a protocol for it
Attributes and behaviors
-helpful and compassionate -handles stress -master skills of EMD -effectively gather info -assist responders in locating patients -determine nature of medical situation without diagnosing -react passively to hostile callers -maintain confidentiality
dealing with shock
-keep airway clear -control bleeding -calm/reassure patient -keep patient warm -no food/drink unless indicated -comfortable position
Roles during Phase 3
-prepares caller for responding personnel -EMD provides medical instructions as directed by the EMSPRD
responsibilities of EMD
-receive and process calls for EMS assistance -determine the nature and severity of medical incidents -gives emergency medical assistance via approved EMSPRD -relay pertinent info to responding personnel -attempt to ensure safety of patients, bystanders, and personnel -gives instructions to callers (using EMDPRS) and helping them prepare for responder arrival -coordinate with other public safety and EMS services
Symptoms of Shock
-sense of impending doom -weakness -nausea -dizziness -coolness to their skin -restlessness/anxiety -thready pulse -fluid loss -skin moist to touch -shallow/rapid breathing "guppy breathing" -lackluster/dialated eyes -decreasing consciousness -steady BP drop
Roles during Phase 1
-take incoming calls -engage caller in initial survey sequence -goes to proper EMSPRD protocol for further info
4 tiers of EMS
1. First responders 2. BLS 3. ALS 4. Aeromedical
medical cheif complaints
abdominal pain, allergies/stings, back pain, breathing problems, chest pain/heart problems, diabetic problems, headache, OD/poisoning/ingestions, psychiatric/behavioral problems, seizures/convulsions, sick person, stroke/CVA, unknown/person down
3 cardiac arrest/choking instructions
adult child infant
ALS
advanced life support
miscellaneous
air medical dispatch, aircraft/terrorism, hazmat, vehicle in water
AED
automatic external defibrillator
Major dispatch criteria
blood loss respiratory distress shock
2 most common EMD misconceptions
callers are too upset to provide useful and accurate info callers unable to provide EMD with information necessary to dispatch EMS
CPR
cardiopulmonary resuscitation
Arteries
carries oxygenated blood away from the heart
nervous system
central nervous system, peripheral nervous system, and autonomic nervous system
EMDPRS
emergency medical dispatch protocol reference system
EMS-S
emergency medical service system
EMS
emergency medical services
female reproductive system
fallopian tubes, ovaries, uterus, vagina
musculoskeletal system
head, vertebral column, chest, upper extremities, pelvis, and lower extremities
cardiac muscle
heart muscles
cardiogenic shock
heart unable to develop enough pressure to circulate properly
circulatory system
heart, arteries, veins, capillaries, blood
Genito-urinary system
kidneys, ureters, urinary bladder, urethra, genetalia