l OM oA RcPSD |12 504 245 EMT FISDAP Basic Final Exam Study Guide
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Key Terms Embolism- obstruction of an artery Edema- fluid buildup; swelling PMS- pulse, motor, sensory Ischemia- inadequate blood supply to a part of the body Hematoma- collection of blood outside of a blood vessel Aneurysm- localized enlargement of an artery caused by a weakening in the artery wall Dilation- opening Dyspnea- labored breathing Syncope- temporary loss of consciousness, or fainting Incontinence- lack of voluntary control over urination or defecation EMS Systems
Most states have four training and licensure levels:
-EMR (Emergency Medical Responders) -EMT (Emergency Medical Technicians) -AEMT (Advanced EMT)
-has training in ALS (advanced life support) including:
-IV therapy (Intravenous) -administration of certain emergency medications -Paramedic
History of EMS:
-Origins include: volunteer ambulances in WW1, field care in WW2, field medic and rapid helicopter evacuation in Korean conflict -EMS as we know it originated in 1966 with the publication of Accidental Death and
Disability: The Neglected Disease of Modern Society
-DOT (Department of Transportation) published first EMT training curriculum in early 1970s -EMS care is governed and part of the Department of Transportation -National Highway Traffic Safety Administration (NHTSA) 1 / 4
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EMS Types:
-Anglo-American model (ours) -brings patient to the hospital -Franco-German model (Europe) -brings the hospital to the patient
Levels of training:
-Federal level: National EMS Scope of Practice Model provides guidelines for EMS skills
-State level: Laws regulate EMS provider operations
-Local level: Medical director decides day-to-day limits of EMS personnel
-every 3 years resubmit for recertification (40 hours of continuing educ. required)
Public BLS (basic life support):
-millions of laypeople are trained in BLS/CPR -teachers, coaches. child care providers
Emergency Medical Responders (EMR):
-law enforcement, firefighters, park rangers, ski patrol, etc.-initiate immediate care and assist EMT’s on their arrival -good samaritans trained in first aid and CPR
Emergency Medical Technicians (EMT):
-has knowledge and skills to provide basic emergency care -responsibility for assessment -emergency care -package and transport of patient
Advanced Emergency Medical Technicians (AEMT):
-adds knowledge and skills in specific aspects of ALS -IV therapy -advanced airway adjuncts -medication administration
Paramedics:
-extensive course training -wide range of ALS skills -endotracheal intubation -emergency pharmacology -cardiac monitoring; use of electrocardiogram (EKG) 2 / 4
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Medical Direction:
-physician medical director authorizes EMTs to provide medical care in field -appropriate care is described in standing orders and protocols -medical control can be off-line or online -Online (direct) -directions given over phone or radio -Offline (indirect) -standing orders or protocols
Evaluation:
-medical director maintains quality control -continuous quality improvement (CQI) -reviews and audits EMS system -refresher training or continuing education -minimizing errors is the goal On-Scene Patient Assessment -BSMNHS (Bald Short Men Never Have Sex) -BSI -Scene Safety -Mechanism of Injury/ Nature of Illness -Number of patients -Help (additional resources) -Spine Immobilization -GLCAB5C5D (Girls Love Compliments) -General impression -Level of Consciousness (AVPU) -Chief Complaint -Airways -Breathing (5) -(Y/N), (R,R,Q), oxygen intervention, make sure O2 working, mgt. of injuries -Circulation (5) -(Pulse R,R,Q), major bleeding, (skin color, temp., condition), shock Management (HOTTI) -Decision to Transport -Trauma Pt assessment vs. Medical Pt assesment -Medical Pt then take history -Then VFIT 3 / 4
l OM oA RcPSD |12 504 245 -Vitals -Field impression -Intervention/Treatment -Trauma Pt -Then take vitals and attempt to get SAMPLE history -Begin secondary assessment
-DCAP BTLS
-Eyes check for PEARRL -check extremities for PMS (pulse, motor, sensory) -Manage secondary injuries -Reassessment
-Stable: every 15 mins. take vitals
-Unstable: every 5 mins. take vitals
*Key things to remember: PMS before & after immobilization
*When backboarding, slide the patient down and then up -See Trauma Patients for more details Airway Management Key terms
-Apneic: no longer breathing
-Alveoli: tiny air sacs of the lungs which allow for rapid gaseous exchange
-Capillaries: smallest blood vessels
-Pleural Cavity: thin fluid-filled space between the two pulmonary pleurae (visceral and parietal) of each lung -Visceral pleura- OUTER layer -Parietal pleura- INNER layer -Positive Pressure Ventilation (PPV): process of forcing air into a patient’s lungs (aka artificial ventilation)
-Patent airway: open airway
Respiratory assessment
-Adequate breathing:
-between 12-20 breaths/min -regular pattern -bilateral (both sides) clear and equal lung sounds -equal chest rise and fall -adequate depth (tidal volume)
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