Brady 12th edition. Chapters 1-20 & 27
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| Protocols | Lists of steps, such as assessments and interventions, to be taken in different situations.
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| Who develops protocols? |
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| Standing Orders | A policy or protocol issued by a Medical Director that authorizes EMTs and others to perform particular skills in certian situations.
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| Medical Director | A physician who assumes ultimate responsibility for the patient-care aspect of the EMS system.
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| Medical DIRECTION | Oversight of the patent-care aspects of an EMS system by the Medical Director.
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| 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.
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| On-line Medical Direction | Consists of orders given directly by the on-duty physician to an EMT in the field by radio or telephone.
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| Quality Improvement | A process of continuous self-review with the purpose of identifying and correcting aspects of the system that require improvement.
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| Scene Safety | Being aware of potential dangers always a priority. Determining scene safety will be the MOST important decision on any call.
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| BSI | Equipment that protects the EMS worker from infection and/or exposure to the dangers of rescue operations. Gloves, Mask, eye protection.
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| Pathogens | The organisms that cause infection, such as a viruses and bacteria.
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| Standard percautions | A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious.
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| Stress | A state of physical and/or psychological arousal to a stimulus.
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| Contamination | The introduction of dangerous chemicals, disease, or infectious materials.
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| 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)
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| Emergency Move (Life-threatening) | -Hazardeous scene. -Repositioning required to care for life threatening conditions. -Must reach other patents in more critical condition.
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| Emergency Move Techniques | -clothes drag -head first drag -firefighters drag -firefighters carry -one-rescuer assist -two-rescue asist
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| 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
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| 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.
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| 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.
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| Assult & Battery | Assult-placing a person in fear of bodily harm Battery-causing bodily harm to or restraining a person.
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| 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.
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| Expressed consent | Must be implied (inform patient on the procedures you are planning on doing before you do them)
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| Implied consent | -assume consent (patient is unconscious) -follow local laws and protocols -pertains to mental health patients, drugs, alcohol, and minors
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| Patient consent | Permission from patient to assess, treat, and transport.
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| Consent from Children | -minors not permitted to provide consent for treatment. -obtain from parent or gardian.
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| 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
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| 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.
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| 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.
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| DNR Order | DO NOT RESUSCITATE ORDER.
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| 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
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| 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.
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| 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.
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| 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)
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| 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.
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| Aerobic Metabolism | Cellular functions using oxygen
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| Anearobic Metabolism | Cellular functions not using oxygen -Creates much less eneryg and much more waste. -Body becomes acedic, impacts body function.
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| 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
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| Stroke volume | The amount of blood ejected form the heart in 1 contraction.
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| Edema | Swelling associated with the movement of water into the interstitial space.
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| Dehydration | And abnormally low amount of water in the body.
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| Hypoperfusion | Inability of the body to adequately circulate blood into the body's cells to supply them with oxygen and nutrients. Also called SHOCK!
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| Minute Volume | The amount of air breathed in during each respiration multiplied by the number of breaths per minute.
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| 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.
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| Tidal Volume | The volume of air moved in 1 cycle of breathing.
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| 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.
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| Lower airway | -Begins at glottic opening (vocal cords) -Trachea (smooth muscle) -Bronchial passages -Alveoli
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| Bronchoconstriction (Affects Carina to Alveoli) | -Disorder of lower airway -Smooth muscle constricts internal diameter of airway.
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| Gag reflex | Vomiting or retching that results when something is placed in the back of the pharynx. This is tied to the swallow reflex.
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| 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.
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| 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
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| Stridor | A high pitched sound generated from partially obstructed air flowin the UPPER AIRWAY.
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| Cyanosis | A blue or gray color resulting form lack of oxygen in the body
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| Deffusion | A process by which molecules move from an area of high concentration to an area of low concentration.
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| Hypoxia | An insufficiency of oxygen in the body's tissue..
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| Artificial Ventilation | Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation.
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| 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.
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| Respiratory arrest | When breathing completely stops
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| Respiratory Failure | The reduction of breathing to the point where oxygen intake is not sufficient to support life
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| Stoma | A permanent surgical opening in the neck through which a patient breathes.
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| Lung sounds |
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| Respiratory rate |
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| Skin color |
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