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quizlet scc
| Question | Answer |
|---|---|
| Policy 108 - system variance reporting | Incidents that result in a threat to public safety, patient, by-stander, or responder harm. |
| What types of incidents are considered Level A variances | Any incident that results in a threat to public safety patient or by stander or responder harm |
| What is the maximum time you must report a level a variance | Within 24 hours |
| Who must be notified ASAP of a level A variance | EMS on duty Chief via county Communications |
| What type of incidents are considered Level B variances | Any incident that does not result in patient harm, but is a deviation from EMS agency policies, procedures and protocols |
| What is the maximum ti e you must report a Level B variance | 5 Business days |
| What type of incidents are considered Level C variances | Where the responders provided outstanding performance and went above and beyond the normal expectations of responders |
| What form would you use to file a variance report | 903 |
| Policy 109 Policy development and implementation | stands for create revision and implementation of SCC pre hospital care policy (including plans protocols procedures etc) |
| How will policy implementation be disseminated to you | EMS program manager |
| What other resources do you have to find new polices and updates | -county EMS website -County EMS app -Electronic / social media -hardcopy |
| Which policy addressed allocation and implementation of resources? | Policy 109 |
| Policy 500 - electronic patient care | Minimum standard criteria for the completion and submission of electronic patient care record. (ePCR) |
| When an MCI alert occurs with five or more patients is a PCR required | No the EMS agency my temporarily suspend the requirement to complete an ePCR in certain times of mass causality, incidents, large scale disasters or ems data system failure |
| what would you use in lieu of an ePCR when an MCI alert occurs with five or more patients | Triage tags |
| Policy 501 hospital Radio reports | Standard hospital radio report format for prehospital care providers to inform a hospital of pending arrival and when communicating with the base Hospital |
| What alerts (Hospital report ringdown) require use of the county radio | Major Trauma victim (MTV) -Stemi -Stroke -critical patient transports, transporting with red lights and sirens (RLS code 3) |
| What channel do you use for major alerts via the county raid when cell phone contact is not possible | EMS command 92 |
| For interfacility transports, what form of communication is used for ringdowns | Not to occur on SCC EMS, Communications System frequencies; is the responsibility private ambulance service dispatch center. |
| What information is required when giving a deacon alert ringdown | 1 state decon alert) 2 identify that patient has been decontaminated 3 chemical name 4 decontamination methods used on scene |
| Who should you ask to meet you in the ED bay for a Hazardous Materials incident Decon Alert | An appropriate rep to evaluate the decontaminated patient before entry |
| Who can make base contact | Only paramedics |
| What types of incidents are considered Level A variances Policy 502 - Patient Consent and Refusal for EMS services | When an individual is considered a patient and the information that should be provided prior to a patient decided to receive to refuse care / transport |
| Capacity | ability to understand the nature and consequences of a decision and to make and communicate a decision including in the case of proposed health care, the ability to understand its significant benefits risks and alternatives (A/Ox4) |
| Minor legally authorize to consent to medical treatment | Under 18 was or is legally married, is on active military duty, has a court declared emancipation, is pregnant and seeks or needs medical care. |
| Who is legally authorized to refuse care | an adult 18 who has capacity, a monor legally authorized to concent to medical treatment and who has capacity, 3 legal rep of a patient and has capacity |
| who cannot refuse care | minors, 5150 hold, ALOC (Altered level of con) |
| Policy 600 Field Pronouncement of death | Defines when basic and advanced life support care may be withheld or discontinued by EMS in order to avoid unnecessary or prolonged resuscitation of persons for whom recovery is not possible or probable |
| what are obvious signs of death and EMT can call | decapitation, total incineration decomposition, rigot mortis / post mortem lividity, pulseless with total separation or destruction of heart brain and lungs. pulesless and or apnic patient with vaild DNR. Pulselss and or apneic End life act |
| Policy 601 | a procedure for prehospital personnel and physicians to follow whenever a physician is on the scene of an EMS incident |
| If a physician arrives is on scene what must you do first | Request proper identification to confirm that the person is a California licensed physician |
| what three options does the physician on scene have when assisting in rendering aid while responders are on scene | 1 relinquish patient care (Liability but does not ride along) 2Assist responders in patient care 3Manage patient care (render care and ride until transferred to another doctor) |
| Policy 602 - 911 EMS patient destination | Service areas for each trauma center in SCC |
| When can a patient be taken to a hospital of patients choice | If the requested facility meets the requirements of the policy and regardless of ability to pay |
| What is the patient has no preference about where they go | Closest hospital to incident location as determined by ambulance transport time. -Accepting emergency patients (Open) |
| What may happen during a time of EMS surge | Patients may be assigned to hospital destinations and may not be able to select a specific destination county communications will direct where to take patient |
| What is considered in extremis | 1 a breech or protruding limb (baby) 2 external bleed that cannot be controlled by EMS despite the use of direct pressure and or tourniquet 3 Inability to be ventilated adequately following use of basic and advanced airway adjuncts and procedures |
| where do we transport patients that are deemed in extremis | to the hospital that is the closest to the incident location as determined by EMS transport time not no internal disaster |
| What are the designated trauma centers in santa clara county | RSJ VMC SUH |
| What is the age for pediatric patient | Under 15 years old |
| Where are pediatric patients meeting major trauma victim (MTV) criteria to be taken into consideration when | Closest Ped trauma center determined by EMS transport time that is accepting. VMC SUH |
| Where are burn patients to be taken | the burn center at santa clara valley medical center VMC via the trauma center |
| Where are burn patients to be taken if the primary cneter is not accepting | Closest trauma center determined by EMS transport time that is accepting |
| You have a patient that want to be transported out of the county. is this allowed | No patients my be transported out of county hospitals only for diversion prior to beginning transport |
| where would a patient with ROSC be transported | Closest stemi receiving center determined by EMS transport time that is accepting |
| ROSC | Return of spontaneous circulation |
| What are the stemi receiving centers | - ECH - GSH -KSC OCH -RSJ -VMC -SUH |
| If a patient requested to no longer be transported to the hospital and wishes to leave your ambulance how would you respond | attempt to convince the patient to continue to selected or closest ED. Stop ambulance when safe and permit patient to leave in safe location notify communication center |
| What would you do if you were en route to an ED and the patient decided they wanted to go to an alternative location | Divert patient may change requested destination at any time is ambulance has not arrived on hospital proplerty |
| What would you do if you had just arrived to the initial ED and the patient decided he or she wanted to go to an alternative location | do not divert patient care shall be transferred to the staff of such hospital |
| Policy 604 DNR | Criteria for prehospital care personnel to determine when to with hold resuscitative measures |
| What forms are valid DNRs | A no code no cpr on chart. B California emergency medical services authority - California medical association - Emergency Medical service, prehospital do not resuscitate (DNR) Form c CDNR medallion DDPAHC that clearly states DNR. POLST |
| What happens if no valid form of DNR can be produced | Prehospital personnel shall begin resuscitative measures |
| What if resuscitative efforts have been initiated and an adequate DNR status is confirmed? | efforts shall be discontinued immediately |
| If you are given a DNR what must you enter in your PCR | document presence of a DNR order or a POLST in a medical record or a DNR Form, including: -name of signing physician -date signed if resuscitation is withheld because of valid DNR, document time decision to withhold in PCR |
| Once a patient is found to be deceased, who has jurisdiction over that person? | 1. public place, local public safety agency retains jurisdiction 2. home, local police or fire agency present retain jurisdiction 3. residential care facility (SNF), staff makes arrangements 4. if during transport, transport without BLS or ALS in |
| If your patient expires en route what three options do you have? | Transport to pre arranged dest equip and preped to maintain the decedent including notification of local law enforment nurse can give time of D. 2 return to point of departure 3 transport to closest emergency dept of an acute care hosp. |
| Policy 605 prehospital trauma triage | Criteria for the prohospital triage of trauma and burn patients in SCC |
| What types of penetrating injuries are considered MTV criteria | -head -neck -chest -back -abs -groin - extremities prox to the elbow or knee |
| At what speed for a moto vehicle accident would be an automatic MOI for a MTV | estimated impact speed or more than 40 MPH |
| What types of vehicle deformities would indicate a possible MTV activation | deform greater than 12 inches in occupant site. deform greater than 18" on any other site. Significant structural damage to vehicle caused by contact with patients body. ejection from vehicle. death of another passenger. prolonged extra roll over unrst. |
| At what speed for a motorcycle accident would require a MTV activation | Greater than 20 mph |
| Policy 606 transition of care | the process of the transfer of care from one prehospital care provider to another and or hospital or other medical care facility personnel |
| at any point a medic transfer care to an EMT after evaluating a patient | During declared mass casualty incidents MCIs and disaster situations. |
| Policy 607 non emergency amb util in the 911 system | criteria of the util of non emergency ambulances in the SCC 911 EMS system. |
| If a patient is determined to be emergent you can transport the patient to the closest ED with red lights and sirens if the time from arrival on scene to arrival at hosptial is. | less then 10 mins |
| in reguards to BLS util if on scene to hospital transport time is greater than 10 mins | 911 must be called for als assistance |
| In regards to BLS util if immediate transport is necessary and no paramedic amb is available | First arriving paramedic unit shall accompany the BLS crew using ALS equipment from the first response unit. |
| What is the policy on transporting red lights and sirens (RLS) in accordance with the | immediately advise county communications. request a county EMS event Number. During multiple patient events. Local proclamations of emergency. Unique's circumstances. |
| if you arrive on scene and there is no ALS unit available for an ALS call but there is a fire medic available how would you proceed?> | the 911 paramedic and the ALS equipment from the first response unit shall accompany the patient to the emergency department in the non emergency ambulance |
| Policy 609 EMS sytem Field management | Identifies the roles and responsibilities of public and private emergency service agencies at the scene of an emergency in Santa Clara County |
| what are the task the EMS duty chief over sees | Acts as agency liaison, oversees and regulates contracted providers, allocates county medical resources, authorizes emergency policy changes, delegates system management to ALS Field Supervisors, and may fill an ICS position. |
| Policy 610 Hazardous material incidents ES response and transportation | standards for emergency medical responders who respond to hazardous material incidents |
| during the isolate the area and deny entry portion of an initial action response to a hazardous materials incident how far must you keep everyone away from small incidents | at least 100 ft |
| during the isolate the area and deny entry portion of an intial action response to a hazardous material incident how far must you keep everyone away from large incidents | 500ft |
| Policy 611 EMS Air resource Utilization | Procedures for appropriate use of EMS air resources in the Santa Clara County EMS system |
| Who has the only authorization in santa clara county to send an air ambulance to the scene of an incident? | Dispatches by county communications |
| Policy 617 EMNMS system id badge | Id credentialing the standards and procedures for all Santa Clara County EMS system providers to ensure compliance with policy |
| To operate in Santa Clara county what must you have on your person always while on duty | Carry valid government issued photo id -Display a santa clara county EMS system ID badge that is visible at all times. |
| When does your santa clara badge expire? | on the same date as the individuals professional medical credential EMT cert or two years from the issue date. |
| when you decide to leave your current employer what is the process for handling your santa clara county badge | since badges are the property of the county of santa clara must be surrendered to the EMS agency upon separation from service |
| Policy 618 EMS life safety procedures | procedures to ensure the safety and protection of emergency medical services responders |
| what is a CAN report | A report from the first unit on scene incident commander to county communications |
| what does the C in CAN stand for | Conditions = what is observed |
| What does the a stand for in a CAN report | Actions what the incident commander plans to do |
| What does the N in can stand for | Needs what additional resources are needed, |
| what gear are you requred to wear when dealing with scene calls | All EMS personnel shall wear uniforms that identify the agencies they work for when attached to EMS calls. High visibility jacket and goggles with three company identifier |
| Policy 700 A03 Hypoglycemia | BLA/ALS protocols for treatment of Hypoglycemia |
| For an altered patient what is the glucose policy for administration and follow up dose (BLS) | Oxygen. -if BGL is 8mg/dl or less the patient can swallow while controlling thier own airway admin oral glucose at least 25gm. repeat one after 15 min is no improvement. |
| For an altered patient what is the glucose policy for administration and follow up dose (ALS) | -Vascular access. Dextrose 10% IV. piggback or IV drip. -Repeat boluses as needed. -if no IV access, GLUCAGON 1mg IM |
| Policy 700 - a13 stroke | BLS/ALS protocols for treatment of stroke |
| What is the stroke field screen acronym | GFAST |
| What does GFAST stand for? Gase. Facial droop. Arm drift. Speech abnormalities, Time last seen normal | Facial droop. Arm drift. Speech abnormalities, Time last seen normal |
| Who are the comprehensive stroke centers | If a patient has four points on GFAST stroke screen. ECH. GSH. RSJ. SUH. |
| Policy 700 CPR | establish position assignments. (gear) Use team approach. Place patient supine on rigid surface. Limit interruptions of compressions. Change every 2 mins. give at 110 BPM. AD 2.2.4 inches. CD 2 inches. INF 1.5" vents every 6 or about 10 b per min. |
| Policy 700-S05 Routine med care pediatric | BLS ALS protocols for routine med care of peids |
| Ped patient | Under 15 |
| Neonate patient | 0-4 weeks |
| Infant patient | 1month to 1year |
| Child patient | older than one year but under 15 |
| how ofter are vitals to be completed of a pediatric patient | Baseline except temp every 10 mins on stable. Every 5 minutes on unstable |
| Policy 700 m17 Traumatic hemorrhage control | BLS/ALS protocols for traumatic hemorrhage control |
| what are the indications for use of a mechanical tq | ad or ped patient with uncontrolled EXTREMITY hemorrhage ot major Hemorrhages where wound packing and compression bandaging would be insufficient in controlling bleeding |
| what are the contraindications for usage of a mechanical tq | dey to the locations of non-compressible truncal hemorrhages mechanical hemorrhage control will be difficult to complete. |
| Policy 811- multiple casualty incident plan | A comprehensive ops plan for the management of multi casualty events occurring the county of santa clara |
| # of patient at a level 1 multi casualty event | 5-10 |
| number of patients at a level 2 multi casualty event | 11-20 |
| # of patient at a lvl 3 multi casualty event | 21-100 |
| # of patients at a LVL 4 multi casualty event | 101-1000 |
| # of patients at a lvl 5 multi casualty event | 1000 + |
| Start | Simple triage and rapid treatment |
| At what lvl of a multi casualty event is triage enacted | Lvl 2 |
| what three acronyms are used to help during triage at a multi casualty event | Start, JumpSTART, FOG |
| Policy 811a Annex to the multiple casualty incident plan: field treatment site operation guide | An annex to the multiple casualty incident plan regarding field treatment site ops. |
| what is the min req of personnel to setup a field treatment site | 5 |
| what are some considerations to be take when choosing a field treatments site (gen) | responder safety. Secondary hazard. Upwind or uphill. Secured from hostile crowd. |
| what are some considerations to be take when choosing a field treatments site (site reqs) | Gen 100 x100 access to electrical power, near adequate parking, should not impede wireless access. |
| what are some considerations to be take when choosing a field treatments site (ideal sites) | close to hospitals places capable of sheltering people or equipment. Traffic plan that supports all inbound and out bound, access to water supply and restrooms. |
| where are the mobilization centers in santa clara county | De anza, County fairgrounds, fire station off hwy 101 in Gilroy |
| what are required things you will need to complete when operating out of mobilization center. | T card upon arrival. ICS 214 unit log |
| WHat is the best form of communication on or when dealing with communications | Vehicle mounted mobile raid, hand-held portable radio MDC mobile dispatch computer command channel 92 |
| what are the types of radio tones you would hear over the radio | a sound played over the radio channel to grab attention; played before critical system-wide or incident-specific messages 1. steady alert tone 2. warbler tone |
| What does a steady alert radio tone mean? | used to announce a priority message (i.e. "All points bulletin, "Be on the Lookout," or hospital internal disaster status) |
| What does PAR mean? | Personnel Accountability Reporting -a periodic welfare check to verify safety and security of responders -includes all personnel assigned or in the care of the ems unit (i.e. Ridealongs, trainees/interns, patients, assisted allied responders, etc.) |
| If you accidently press the SOS button, what is the only verbiage you can use to indicate it was an accident? | "NO FURTHER ASSISTANCE NEEDED" |
| What is the required compression rate per Santa Clara County policy? | performed at a rate of 110 per minute |
| What are the three (3) new additions to the BLS scope in Santa Clara County? | -naloxone (Narcan) administration -epinephrine administration -glucometer/glucose level testing |
| At what blood glucose level (BGL) is it indicate to treat hypoglycemia in Santa Clara County? | 80mg/dL or less |
| How much aspirin should be administered if there is a complaint of chest pain? | 324mg PO Chewable |
| How much Naloxone do you administer? bls | Internasal autoinjector, may repeat once (for two total doses) |
| How much Naloxone do you administer? als | Naloxone 1-2 MG IV or IM repeat as needed |
| 100 Series covers | overarching system management and reporting. |
| 300 Series: covers | aspects related to personnel. |
| 400 Series: covers | hospital services and their impact on the EMS system. |
| 500 Series: covers | documentation and communication with hospitals. |
| 600 Series: covers | primarily deals with patient transport, destination, and operational deployments like task forces and strike teams. |
| 700 Series: covers | detailed clinical protocols and specific operational procedures often related to patient care. |
| 800 Series: covers | policies and references for large-scale events, system communications, and logistical/administrative procedures. |
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