EMS: Review Questions for First Quarter Exam Questions And Well Elaborated Answers

list the steps of history taking and secondary assessment - correct answers history: 1. OPQRST 2. SAMPLE secondary ass. : 1. inspection 2. palpation 3. auscultation 4. DECAP BTLS 5. focused assessment 6. respiratory system assessment full body physical examination if the patient appears to have no spinal injury and is unconscious (DECAP BTLS) What organization sets the standards for education and conduct of EMS providers? - correct answers National Highway and Traffic Safety Administration Define standing orders - correct answers Type of written protocol that is signed by the EMS director, outlining specific directions and permissions regarding patient care rendered prior to contacting medical control; standing orders designate what the EMT is required to do for a specific complaint or condition; list of what you can/ can't do regarding patient care; EMT does not need permission from medical director to implement a standing order that they are required to follow. Define protocols - correct answers May include standing orders and/or requirement to contact medical direction o Written approved protocols to establish basis for patient careo Written directions for how to treat patientso Offline or online; Outline of EMT's scope of practice; written plans that detail the nursing activities to be executed in specific situations What is the difference between on line and off line medical direction? - correct answers Online medical direction: direct consists of direction given over the phone or radio directly from the medical director or physician; online medical control physician may either confirm or modify the proposed treatment plan or may prescribe any additional special orders that the EMTs are to follow for that patient. Off-line medical direction: indirect consists of standing orders, training, and supervision authorized by the medical director. An EMT is caring for a patient with cardiac chest pain and wants to administer aspirin to the patient. The EMT must call and consult with a physician before the aspirin can be administered. What describes this? - correct answers Online medical direction What is continuing quality improvement? - correct answers Continuous quality improvement (CQI): system of continuous internal and external reviews and audits of all aspects of an EMS system; the medical director is responsible of maintaining quality control. Why are the guidelines and practices of EMT's sometimes changed? - correct answers Evidence based practice and research; EMS is always evolving? idk ab this one Who is the most important person at any incident? (Hint: Ben's #1 rule!) - correct answers YOU! the EMT/ EMS provider. How do we prevent spread of blood borne diseases? Which of these is the best? - correct answers ** wear gloves + wash your hands!! - follow Occupational Safety and Health Administration (OSHA) guidelines for reducing hazards in workplace - follow CDC standard precautions - apply infection control procedures - notify your designated officer if you are exposed How do we prevent the spread of airborne disease? - correct answers - don't use your hands to cover a cough or sneeze (use tissue) - cough or sneeze into arm What is the difference between blood borne, droplet borne, and airborne diseases? - correct answers - blood borne means carried by the blood/ transmitted through blood - droplet borne means transmitted through/ in droplets - airborne means spreading an infectious agent through mechanism such as droplets or dust What are the 5 stages of the grieving process? Give examples of each. - correct answers 1. denial refusing to accept diagnosis or care, unrealistic demands for miracles, persistent failure to understand why there is no improvement 2. anger/ hostility projecting bad news onto the environment and in all directions, lashing out, someone must be blamed, those who are responsible must be punished, ugly phase that may be inappropriately directed at EMT 3. bargaining attempting to secure a prize for good behavior or promising to change 4. depression internalizing anger, hopelessness, desire to die, patient is usually silent, rarely involves suicidal threats 5. acceptance accepting the impending death of the patient or loved one *stages of grief can occur in any order and for varying amounts of time List all the ways you can protect yourself and your crew at the scene of a motor vehicle crash. - correct answers - conduct a careful scene size up - assess possible hazards to your safety - EMS response should be limited to only the vehicles and manpower required to accomplish the mission - wear proper PPE and reflective clothing - firefighting turnout coat for extrication What are the different kinds of consent? Define each and give an example. - correct answers - expressed consent: patient verbally or otherwise acknowledges that they want you to give them care; may be non verbal; must be informed consent!! - implied consent: when a person is unconscious or otherwise incapable of making an informed rational decision about care, the law assumes that the patient would consent to care and transportation if they could; should never be used unless there is a threat to life or limb - involuntary consent: patients who are mentally ill, developmentally delayed, or in behavioral crisis Who can give consent? Who can refuse consent? Give examples - correct answers - an adult who is conscious, rational, and capable of making informed decisions has the legal right to refuse or accept care even if injured - a minor may not give consent by themselves. they must have a parent or legal guardian make the decision regarding patient care. - emancipated minors may refuse care and have the power to give/ refuse consent emancipated minor - correct answers Person who is not 18 but has the same legal rights as an adult; person who is under 18, married, in the armed forces, or is a parent. must be granted legal emancipation by a court. define and give an example: assault - correct answers unlawfully placing a patient in fear of bodily harm; like a threat ex: threatening to restrain a patient who does not want to be transported define and give an example: battery - correct answers unlawfully touching a person ex: providing emergency care without consent; using a splint on a patient's fractured leg without their consent, etc define and give an example: abandonment - correct answers unilateral termination of care by the EMT w/ out the patient's consent and w/ out making provisions for continuing care ex: transferring care to a provider who is lower than you/ less competent provider (paramedic to emt) define and give an example: slander - correct answers communication of false information that damages the reputation of a person (defamation) through spoken words; talking bad about someone ex: telling a nurse or healthcare provider that a patient is drunk define and give an example: libel - correct answers written form of defamation/ communicating false information to hurt a person or their reputation ex: documenting that a patient is drunk on a patient care report define and give an example: duty to act - correct answers an individual's responsibility to provide patient care ex: you are charged w/ emergency medical response; your department's policy states that you must assist in any emergency; if you are off duty and do decide to provide care, you must continue that care until an equal or higher medical provider assumes care. define and give an example: scope of care/ scope of practice - correct answers defines what you legally can and cannot do; most commonly define by state law, outlines care you are legally able to provide of the patient; your medical director further defines the scope of practice by developing protocols and standing orders. ex: respond to 911 call for cardiac arrest and administer CPR is within an EMT's scope of practice define and give an example: standard fo care - correct answers the manner with which you must act or behave; how a reasonable person with similar training would act under similar circumstances; established by local customs, statutes, protocols, medical literature, administrative regulations, etc. what 4 things are necessary for negligence to occur? - correct answers - duty the EMT has an obligation to provide care and to do so in a manner that is consistent w/ standard of care established by training and local protocols - breach of duty there is a breach of duty when an EMT does not act within an expected and reasonable standard of care - damages there are damages when a patient is physically or psychologically harmed in some noticeable way - causation there must be a reasonable cause and effect relationship btw the breach of duty and the damages suffered by the patient ex: dropping the patient during lifting and hurting their leg. if an EMT has a duty and abuses and causes harm to another person (patient, another EMT, etc) then that could count as negligence referred to as proximate causation How do you communicate with the following (HINT- the answers are NOT all the same). Who else might you speak to when your patient is in any of these groups? *older patients/ geriatric - correct answers Techniques when interviewing a geriatric patient: - identify yourself - be aware of how you present yourself - look directly at the patient at eye level w/ good lighting - speak slowly and distinctly, but not shouting - give the patient time to respond unless the condition appears urgent - listen to the answer the patient gives you - explain what you are going to do before you do it - do not talk about the patient in front of them as if they are not there dress the patient as "sir" or "ma'am" and if you know their last name use "Mr." or "Mrs" don't use casual terms such as "honey" or "dear" *remember: not all older patients are deaf! How do you communicate with the following (HINT- the answers are NOT all the same). Who else might you speak to when your patient is in any of these groups? * young children - correct answers - oftentimes, caring for an infant or child means you must provide