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Midterm 1-20 & 27

Brady 12th edition. Chapters 1-20 & 27

QuestionAnswer
Protocols Lists of steps, such as assessments and interventions, to be taken in different situations.
Who develops protocols?
Standing Orders A policy or protocol issued by a Medical Director that authorizes EMTs and others to perform particular skills in certian situations.
Medical Director A physician who assumes ultimate responsibility for the patient-care aspect of the EMS system.
Medical DIRECTION Oversight of the patent-care aspects of an EMS system by the Medical Director.
Off-line Medical Direction Consists of standing orders issued by the Medical Director that allow EMTs to give certain medications or perform certain procedures without speaking to the Medical Director or another physician.
On-line Medical Direction Consists of orders given directly by the on-duty physician to an EMT in the field by radio or telephone.
Quality Improvement A process of continuous self-review with the purpose of identifying and correcting aspects of the system that require improvement.
Scene Safety Being aware of potential dangers always a priority. Determining scene safety will be the MOST important decision on any call.
BSI Equipment that protects the EMS worker from infection and/or exposure to the dangers of rescue operations. Gloves, Mask, eye protection.
Pathogens The organisms that cause infection, such as a viruses and bacteria.
Standard percautions A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious.
Stress A state of physical and/or psychological arousal to a stimulus.
Contamination The introduction of dangerous chemicals, disease, or infectious materials.
Stages of Stress First Stage: Alarm reaction (fight or flight) Second Stage: Resistance (Coping) Third stage: Exhaustion (loss of ability to resist or adapt to the stressor)
Emergency Move (Life-threatening) -Hazardeous scene. -Repositioning required to care for life threatening conditions. -Must reach other patents in more critical condition.
Emergency Move Techniques -clothes drag -head first drag -firefighters drag -firefighters carry -one-rescuer assist -two-rescue asist
Advanced Directive Legan document expressing patients wishes if patient is unable to speak for self. -DNR order -Living Will -Health care proxy (person to speak for you if you are unable too) -DOES NOT PREVENT EMT FROM PROVIDING COMFORT MEASURES
Urgent Move (take time to assess patient) -required treatment can be performed only if patient is moved. -patient's condition is deteriorating. -performed with precautions for spinal injury.
Abandonment (#2 area of litigation/being sued for) Once care initiated, may not be discontinued until transferred to medical personal of equal or greater training.
Assult & Battery Assult-placing a person in fear of bodily harm Battery-causing bodily harm to or restraining a person.
Confidentiality The obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient's care, or under subpoena, or in a court of law, or when patient has signed a release of confidentiality.
Expressed consent Must be implied (inform patient on the procedures you are planning on doing before you do them)
Implied consent -assume consent (patient is unconscious) -follow local laws and protocols -pertains to mental health patients, drugs, alcohol, and minors
Patient consent Permission from patient to assess, treat, and transport.
Consent from Children -minors not permitted to provide consent for treatment. -obtain from parent or gardian.
Possible exceptions to child consent (check local law) -In loco parentis -Emancipated minors -Life-threatening illness or injury -Minors who have children -Minors serving in armed forces
Consent for mentally incompetent adults -Adult patients incapable of informed decisons about care. -State and local laws and protocols permit transport of such patients under implied consent.
Involuntary Transportation -Patient considered threat to self or others. -Court order. -Usually requires decision by mental health professional or police officer. -If patient restrained,must not risk legal liability.
DNR Order DO NOT RESUSCITATE ORDER.
Duty to act -Obligation to provide care. -While on duty, EMT obligated to provide care if no threat to own safety. -Duty to act not always clear -Off duty -on duty, out of jurisdiction -FOLLOW LOCAL LAWS AND PROTOCOLS -FOLLOW OWN CONSCIENCE
Negligence -Something that was not done, or was done incorrectly. -MUST PROVE -Emt had duty to act -Breach of duty-EMT failed to provide standard of care expected or failed to act. -Proximate causation-patient suffered harm because of EMTs action or inaction.
Scope of practice -Regulation and ethical considerations that define extent or limits of job duties. -May include skills and procedures. -Determined by national, state, local laws, statutes, and protocols.
Standard of Care -Care expected from EMT with similar training for patient in a similar situation. -Meeting standard of care reduces risk of legal action. -SCOPE OF PRACTICE (WHAT YOU CAN DO) -STANDARD OF CARE (HOW YOU SHOULD DO IT)
Refusal of care (#1 area of litigation/being sued for) -Patient may refuse care or transport -Legally able to consent -Mentally competent and oriented -FULLY INFORMED OF RISKS -SIGNS RELEASE FORM -DESPITE ALL PRECAUTIONS, EMT MAY STILL BE HELD LIABLE.
Aerobic Metabolism Cellular functions using oxygen
Anearobic Metabolism Cellular functions not using oxygen -Creates much less eneryg and much more waste. -Body becomes acedic, impacts body function.
Cardiac Output -The amount of blood ejected from the heart in 1 minute (heart rate X stroke volume) -Slowing heart rate or decreasing stroke volume reduces cardiac output. -Rapid heart rates reduces cardiac output
Stroke volume The amount of blood ejected form the heart in 1 contraction.
Edema Swelling associated with the movement of water into the interstitial space.
Dehydration And abnormally low amount of water in the body.
Hypoperfusion Inability of the body to adequately circulate blood into the body's cells to supply them with oxygen and nutrients. Also called SHOCK!
Minute Volume The amount of air breathed in during each respiration multiplied by the number of breaths per minute.
Perfusion The supply of oxygen to, and removal of wastes from, the cells and tissues of the body as a result of the flow of blood through the capillaries.
Tidal Volume The volume of air moved in 1 cycle of breathing.
Upper airway Begins at the mouth and nose -air is warmed and humified in nasal turbinates. -Includes Phyrnx -Orogharynx, nasopharynx, and laryngopharynx -Ends at glottic opening -Vocal cords divide the upper and lower airways.
Lower airway -Begins at glottic opening (vocal cords) -Trachea (smooth muscle) -Bronchial passages -Alveoli
Bronchoconstriction (Affects Carina to Alveoli) -Disorder of lower airway -Smooth muscle constricts internal diameter of airway.
Gag reflex Vomiting or retching that results when something is placed in the back of the pharynx. This is tied to the swallow reflex.
Head-Tilt Chin-Lift -Place one hand on forehead and fingertips of the other hand on under patients lower jaw. -Tilt head -Lift chin -DO NOT ALLOW MOUTH TO CLOSE -USED ON PATIENTS WHO ARE NOT KNOWN OR SUSPECTED TO HAVE A SPINAL INJURY.
Jaw Thrust Maneuver -Place one hand on each side of the patient's lower jaw at angles of jaw below ears. -Use index fingers, push angles of patients lower jaw forward -DO NOT TILT OR ROTATE PATIENTS HEAD -USED IF PATIENT IS KNOWN OR SUSPECTED TO HAVE HEAD OR SPINAL INJURY
Stridor A high pitched sound generated from partially obstructed air flowin the UPPER AIRWAY.
Cyanosis A blue or gray color resulting form lack of oxygen in the body
Deffusion A process by which molecules move from an area of high concentration to an area of low concentration.
Hypoxia An insufficiency of oxygen in the body's tissue..
Artificial Ventilation Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation.
Respiration The diffusion of oxygen and carbon dioxide between the alveoli and the blood (pulmonary respiration) and between the blood and the cells (cellular respiration). Also used to mean, simply, breathing.
Respiratory arrest When breathing completely stops
Respiratory Failure The reduction of breathing to the point where oxygen intake is not sufficient to support life
Stoma A permanent surgical opening in the neck through which a patient breathes.
Lung sounds
Respiratory rate
Skin color
Created by: lyssadegroat
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