SPRING 2023 FINAL REVIEW

2-rSPRING 2023 FINAL REVIEW Chapter 1 - EMS Systems (8) • Role & responsibility of medical director [pg.14] Physician who authorizes/delegates EMT the authority to provide medical care in the field. Also writes out Standing orders and protocols. Ongoing “working liaison” between the medical community, hospital and the EMT’s in service. Quality control • Difference between off-line medical control, on-line medical control, & protocols [pg.14] Offline medical control- indirect, consist of standing orders, training, and supervision authorized by medical director without needing to contact. On-line medical control- Direct, Physician directions given over phone or radio . Protocols-Describes appropriate care/Establish medical direction for providers. • Importance of continuous quality improvement [pg.16] Reviews and performs audits of EMS system to identify areas of improvement and/or assign remedial training. • Professional attributes of the EMT [pg.22 TABLE 1-6] Integrity, Empathy, Self-motivation, appearance and hygiene, self-confidence, time management, communications, teamwork and diplomacy, respect, patient advocacy, careful delivery of care. • Roles & responsibilities of the EMT [pg.21 TABLE 1-5] Keep vehicles and equipment ready, ensure safety, be familiar with emergency vehicle operation, provide on- scene leadership, perform scene evaluation, call for additional resources as needed, gain patient access, perform a patient assessment, give emergency medical care while awaiting additional medical resources, give emotional support, maintain continuity of care, resolve emergency incidents, uphold medical/legal standards, ensure and protect patient privacy, give administrative support, constantly continue professional development, cultivate and sustain community relation, give back to the profession • Difference between what the DOT, NREMT, & NHTSA did for EMS [pg.3,8,9] DOT-Department of Transportation; manages and regulates transportation vehicles. NREMT- National registry of EMT; certifies and designates those who are able to become EMT’s NHTSA-National Highway traffic Safety Administration; enforces vehicle performance standards • Define & purpose of continuing education [pg.19] Continuing education serves to maintain, update, and expand the EMT’s knowledge and skills. • What are the components of the EMS system? [pg.12 Table 1-3] 1) Comprehensive, quality, convenient care, 2) Evidence-based clinical care, 3) Efficient, well-rounded care 4)Preventive care 5)comprehensive and easily accessible patient records Chapter 2 - Workforce Safety and Wellness (13) • What is, the importance of, & when critical debriefing occurs [pg. 71] Critical debriefing sessions occur 24-72 hours of major incident. Developed to address acute stress situations and potentially decrease PTSD • Define the different type of stress reactions [pg.70] 1) Acute stress reactions -Occur during a stressful situation 2) Delayed stress reaction - manifest after stressful event 3) Cumulative stress reactions - prolonged or excessive stress • Know & be able to define the stages of the grief process [pg.68] 1) Denial - refusing to accept diagnosis or care 2) Anger/hostility- Projecting bad news onto environment and commonly in all direction 3) Bargaining - Attempting to negotiate a favorable outcome for good behavior or promise to change 4) Depression -Internalized anger, hopelessness, and desire to die, usually silent 5)Acceptance - accepting the impending death of patient or loved one • List the routes of disease transmission [pg.39-40] 1) Direct contact 2) Indirect contact 3) Airborne Transmission 4) Foodborne transmission 5) Vector-borne transmission

• Importance of standard precautions Protective measures that prevent health care workers from coming into contact with germs • Define & purpose of the Ryan White Care Act [Can’t find ☹ ] Law requires a designated officer must respond to requests from an emergency responder for an assessment of whether he or she may have been exposed to one of the listed infectious diseases. The designated officer then collects and evaluates the facts about the potential exposure and determines whether an exposure likely occurred. C.A.R.E (Comprehensive Aids Resources emergency) • Differentiate between infectious disease, communicable disease, pathogen, contamination, & exposure [pg 38] 1) Infectious disease -medical condition caused by growth and spread of harmful organisms within body. 2) communicable disease -disease that can be spread from person or species to another. 3) Infection - Abnormal invasion of a host by organisms such as bacteria, viruses, or parasite. 4) contamination -presence of infectious organisms on or in object such as dressings, water, food, needles, wound or body 5) Exposure - situation in which person has had contact with blood or other infectious materials that suggest disease transmission. • Differentiate between hepatitis A, B, C, & D [pg.617 TABLE 15-2] Type Route of infection Incubation time Chronic? Vaccine Treatment Hep A Fecal-oral, infected food 2-6 wk No Yes/life immunity no specific treatment Hep B Blood, sexual contact, body fluids 4-12 wk 10% of patients Yes minimally effective Hep C Blood, sexual contact 2-10 wk 90% of patients No costly but effective Hep D Blood, sexual contact 4-12 wk common No no specific treatment • Required immunizations [pg.52] Hepatitis B, Influenza, MMR, Varicella (chickenpox) Tetanus, diphtheria, pertussis • Stages of the general adaptation syndrome & define each [pg.69] 1) Alarm response -Beginning to response of stress 2) Reaction and resistance - Reacting or resisting stressful situation 3) recovery/exhaustion- Aftermath of stressful situation • Differentiate between direct & indirect contact with examples for each [pg.39] Direct contact -Exposure of a disease from one person to another by physical contact (Bloodborne pathogens) Indirect contact- Exposure of disease from one person to another by contact w/contaminated object (needlesticks) • Know when to wear an N95 or P100 mask [pg.45] Suspect the patient has an airborne/droplet spread disease, place surgical mask on patient and wear respirator • Common causes of stress [pg.69-70] Dangerous situations, physical and psychological demands, critically ill or injured patients, dead or dying patients, overpowering sights, smells, and sounds. Chapter 3 – Medical, Legal, & Ethical Issues (4) • Define & explain the Good Samaritan Law, battery, assault, expressed consent, implied consent, AMA, negligence, breach of duty, liability, HIPAA, confidentiality, DNR, POLST, & abandonment [pg.113-115] Good Samaritan Law - Law that protects citizens from liability for errors and omissions in giving good-faith emergency medical care, unless there is gross or willful negligence. Battery- Unlawful touching a patient Assault- Unlawfully placing a patient in fear Expressed consent- Type of consent in which a patient gives verbal or nonverbal authorization for care Implied consent- Type of consent when patient is unable to give consent (e.g. passed out)

AMA- Against Medical Advice Negligence- Failure to provide same care that a person with similar training would provide Breach of duty- When the EMT does not act within an expected and reasonable Standard of Care Liability - the state of being responsible for something, especially by law. HIPAA - (Health Insurance Portability and Accountability Act) Protects information that can be used to identify the patient, such as Name Confidentiality- the state of keeping or being kept secret or private. DNR- (Do Not Resuscitate) Written documentation by physician giving permission to medical personnel not to attempt resuscitation in event of cardiac arrest. USUALLY SIGNED BY PATIENT AND PHYSCIAN POLST- Physician orders for Life-Sustaining Treatment. Paper describing acceptable interventions for patient Abandonment- Termination of care without patient consent and transferring of care to another medical professional. • Define mandated reporter & what cases is the EMT obligated to report [pg.92] Situations when you are legally mandated to report your findings. Some cases would be child abuse, elderly abuse, self harm, etc. • List & explain the definitive signs of death [pg.95-96] Obvious mortal damage- For example, decapitation Dependent lividity- Blood settling to the lowest point of the body, causing discoloration of the skin Rigor Mortis- Stiffening of body muscles caused by chemical changes in muscle tissues (2-12 hours) Algor Mortis- Cooling of the body until it matches the ambient temperature Putrefaction- Decomposition of body tissues usually between 40-96 hours • What makes a DNR valid? [pg.93] 1) Clear statement of the patient’s medical problems 2) Signature of the patient or legal guardian 3) Signature of one (or more) physicians or other licensed health care provider 4) SOME STATES, DNR have expiration dates. Must be dated in the preceding 12 months to be valid Chapter 4 – Communications & Documentations (6) • List general guidelines for effective radio communication [pg.153 TABLE 4-10] Far too much to list all, but KEY points would be, 1) Ensure clear frequency before speaking 2) Simplicity 3) Speak in clear calm voice 4) Hold mic 2-3 inches away 5) acknowledge transmission asap, 6) Don’t use names • Radio frequencies are assigned by? [pg. 150] The Federal communications commission (FCC) allocate specific radio frequencies for use by EMS providers • Acceptable forms of documentation [pg.139] Acceptable forms are Patient Care Report (PCR) or ePCR (electronic patient care report) • What dispatch obtains from the caller to relay to EMS [pg.152] 1) Nature and severity of the injury, illness, or incident. 2) Exact location of the incident 3) Number of patients 4) Responses by other public safety agencies 5) Special directions or advisories 6) Time at which the unit or units are dispatched • What should and should not be included in a radio call-in & verbal report [pg.132,154-156] Too much info, but KEY points would be 1) Patient name may be stated in verbal report, but NOT radio call-in 2)Never use codes with medical control call-ins 3) repeat order, word by word, with medical control call-in • How are mistakes on PCRs fixed? [pg.142 FIGURE 4-13] If you make a mistake on a hand written report, the proper way to correct it is to draw a single horizontal line through the error, initial it, and write the correct information next to it. Chapter 5- Medical Terminology (5)

• Differentiate & give examples of word roots, prefixes, suffixes, & combining vowels [pg.165] Word root-The main part of a term that contains the primary meaning; cardi, hepat, neur Prefix-Part of a term that appears before a word root, changing the meaning of the term; Hyper-, Hypo-, Tachy- Suffixes The part of a term that comes after the word root, at the end of the term; -logy, -meter, -ectomy Combining vowels- The vowels used to combine two word roots, or word root and suffix; gastr/o +enter/o+ ology • List & give an example of each directional terms and location term (ex: lateral, inferior, posterior, palmer, adduction, proximal, distal, tripod, prone, etc.) [pg.171-173] • Define anatomical position [pg.171 FIGURE 5-1] Refer to left picture above. • List common abbreviations [pg.180 TABLE 5-12] I am only going to list 5 out of the 250 the table so kindly provided. 1) ABC-Airway breathing Circulation 2) BP- Blood pressure 3) HR- Heart rate 4) JVD- Jugular vein distention 5) OU- both eyes • Define the commonly used terms (epi-, peri-, sub-, infra-, circum-, bi-, -itis) [pg.179,180 TABLE 5-10 & 5-11] 1) Epi- Above, upon, on 2) peri- around 3) sub- Under/below 4) infra- below/under 5) circum- around/about 6) bi- two 7) -itis - inflammation Chapter 6- The Human Body (4) • List the main bones of the body & their locations 1) Axial Bone- forms the longitude axis of the body, from skull to tailbone 2) Thoracic cage- Rib cage 3)Appendicular skeleton- Upper and lower extremities and points they connect with axial skeleton • List the sections of the spine, include the number of vertebrae in each [pg.194 FIGURE 6-7] 1) Cervical vertebrae with seven 2) Thoracic vertebrae with twelve 3) Lumbar vertebrae with five 4) Sacral Vertebrae with five 5) coccygeal vertebrae with four crunchy breakfast at 7 am (7 cervical vertebrae), a tasty lunch at 12 noon (12 thoracic vertebrae), and a light dinner at 5 pm (5 lumbar vertebrae)…5-4 Palmar

• Differentiate between the planes of the body [pg.190-191] Sagittal Transverse Frontal/Coronal • Functions & Components of Main Systems [Basically whole chapter] System Function Components Skeletal Provide structural support, establish framework, & protect vital organs Bones, all of them musculosk eletal facilitates movement Skeletal, smooth, and cardiac muscles respiratory breathing, and exchange of oxygen and carbon dioxide Upper & lower airway circulatory Circulate blood throughout the body Arteries, Veins, capillaries, arterioles, venules, heart, and lungs nervous Control of breathing, heart rate, BP, and so much more!!! Brain, spinal cord, and nerves integument ary protect body from, maintain normal body temp, transmit sensory info Skin digestive Digestion (processing of food) All organs in abdomen lymphatic rid body of toxins and other harmful waste Spleen, lymph nodes, vessels, and thymus gland endocrine Integrates many body functions via hormones into blood streams. Endocrine Glands urinary Controls the discharge of certain waste materials filtered from blood Kidney, bladder, urethra, and genitals genital reproductive process Testicles, ovaries, Penis, Vagina Chapter 7 – Lifespan Development (7) • Differentiate between the four main reflexes [pg.256] Moro reflex: when a neonate is startled, it opens its arms wide, spreads its fingers, and seems to grab at things Palmar grasp: occurs when an object is placed into the neonate’s palm Rooting reflex: when something touches a neonate’s cheek, it will instinctively turn its head toward the touch Sucking reflex: occurs when a neonate’s lips are stroked • Reason for sunken & bulging fontanelles [pg.257]