Final Paramedic Fisdap Study Guide.
Ems Operations - Page 1
OB/Gynecology - Page 11
Pediatrics - Page 20
Airway - Page 30
Medical Emergencies - Page 39
Trauma - Page
Cardiology - Page - Page 54
EMS OPERATIONS
1. Airbags Safety During Extrication (2228)
• Un-deployed airbags may deploy during extrication and cause harm to the patients and
rescuers.
• Look for airbag badging or labeling system
• A vehicles airbags system comes equipped with an energy capacitor that can store power for
up to 30 mins in some models
• Remove key from ignition
4. Criteria for Transferring Care of Patient (154)
• In your documentation of care, it is important that you were able to show in whose care you
left the patient with, otherwise you could face allegations of abandonment. some agencies
have begun to require physician or nurse signatures to verify that the patient was left with a
medical professional of a higher level of training. Another situation that may require you to
document a transfer of care is when you hand over your patient to another agency such as a
paramedic transport crew or an air medical team.
5. Decontamination of Airway Equipment
• Sanitize and disinfect everything after a call
• Any piece of equipment that is intended for single use should be discarded in an appropriate
hazardous materials bag. For any reusable piece of equipment that has had direct contact
with the patient or patients bodily fluids, use a commercial disinfecting agent for
decontamination. Bleach diluted in water (1:10) can also be used as disinfecting agent.
6. Documenting Medication Administration (471)
• Documentation is everything, if you did not document it, you didn’t do it. Always document
your actions and the patients response on the on the patient care report after administering a
medication. This includes...
- Name
- Dose
- Time
- Route
- Persons name who administered it
- Patients response to the medication, whether positive or negative
7. Indications for N95 Mask
• 95 (Heppa) Mask on you, surgical or normal mask on patient
8. Indications for Rapid Extrication (1677-1699) (2226)
,• Patient can be moved from sitting in a car to laying supine on a backboard in 2 mins.
Indications listed below
- The vehicle or scene is unsafe
- The patient cannot be properly assessed before being removed from the car
- The patient needs immediate intervention that requires a supine position
- The patients condition requires immediate transport to the hospital
- The patient blocks your access to another seriously injured patient
• A team member should remain with the patient to direct the rescuers who are preforming the
disentanglement. For example, unless there is an immediate threat to fire, explosion, or other
danger, you should preform a primary assessment and perform and critical interventions
before disentanglement begins. This may include providing c-spine immobilization, opening
airway, providing O2, ventilations, or controlling significant bleeding. Once life threats have
been treated, disentanglement can begin. Sometimes a patient must be removed quickly
(Rapid extrication) because his or her general condition is deteriorating and time does not
permit meticulous splinting and dressing procedures. Quick removal may also occur if hazards
are present, such as as spilled gas or other materials that could endanger the patient or
rescue personnel. The only time the patient should be moved prior to completion of initial
care, assessment, stabilization, and treatment is when the patient’s or emergency responders
life is in immediate danger.
10. Making Decisions Regarding a Patients Request to Refuse Care (96-99)
• Patients with decision-making capacity have the right to refuse all or part of the emergency
medical care offered to them
• Refusing care - Needs to be informed consent.
• Need to use your “People skills” and just talk to the patient
· Ensure your pt is fully informed about their current situation, his or her right to
receive or refuse medical care, and the consequences of a refusal of care
· Unresponsive patients may be treated under implied consent
· Involve online medical control if pt have severe injuries but refusing care
· Document carefully and have pt sign AMA
Minors - Because minors have no legal status, they can neither refuse no consent to medical
care. In the case of children and adults who have legal guardians, consent must be obtained, if
possible, from a parent or legal guardian of the patient. If the parent or guardian is not available,
emergency treatment to sustain life may be undertaken without direct consent under the
doctrine of implied consent. You should also be aware of the legal principle known as “In loco
parentis”. This term literally means “In place of the parent”. This principle may apply in school,
day care, or summer camp situations if a parent is unavailable. The school administrator or day
care director may make treatment and transportation decisions on behalf of the minor.
A particularly difficult circumstance can arise if a parent or legal guardian refuses to grant
consent to treat a minor who clearly requires lifesaving or limb-saving treatment. Although adults
clearly have the right to refuse treatment for themselves, state laws generally do not permit a
parent or guardian to deny treatment to a minor child. In fact, the failure of a parent to allow
such treatment may constitute neglect. When confronted with such a circumstance, the
paramedic should notify law enforcement and medical control. State law may permit the state to
,assume custody of the child for purpose of ensuring that necessary emergency treatment be
provided.
Emancipated Minors - are under legal age in a given state but can be treated as legal adults
because certain circumstances. By court order. Marriage, pregnancy, or active military service.
They can accept or deny care.
12. Operations within a HazMat Scene
Responding to Hazmat incidents
· Look for warning signs such as patient S/S, placards, labels, etc.
· Placards or labels may be found on building, trucks/railway cars, drums/storage
vessels
· Intentional ingestion of chemicals and activities occurring at illicit labs or potential
terrorist activities may have no obvious signs
· Some chemicals are odorized (propane, methane) where other dangerous
substances are odorless (carbon monoxide)
· If you approach a scene where more than one person has collapsed due to
respiratory distress, suspect the presence had a hazardous material
· When arriving, you should stop at a safe distance, uphill and upwind from the scene
· Items to report include:
o Exact location
o Atmosphereic conditions
o Size/shape of containers
o Chemical ID number or symbols
o # of victims with S/S
o Type and number of additional resources
18. Stress Management (42-43)
• Fight or flight mode S/S - heart palpitations, rapid breathing, chest tightness, sweating, rapid
breathing, unnecessary shouting.
1. Control breathing
2. Progressive Relaxation - tighten/relax muscle groups to initiate muscle relaxation throughout
the body. Stupid.
3. Professional Assistance - Seek therapist
• Focus on immediate situations while on duty, remind yourself “I will do my very best, but what i
can do may not be enough”
• Avoid excessive amounts of stimulants such as caffeine or alcohol, cigs, or sleeping aids after
a stressful event.
• Stages of Stress
· Acute reaction – occurs during stressful situations
· Delayed reaction – manifests after stressful situations
· Cumulative reaction – when you are exposed to prolonged/excessive stress
19. Treating a Patient with Advance Directives
An advance directive is usually a written document (but can be also an oral statement) that
expresses the wants, needs, and desires of a patient in reference to his o her future medical
care. Advance directives state what medical care the patient wants or does not want when the
, patient is unable to express his or her wishes. Living wills, DNR’s, and organ donation orders
are all advance directives. DNR’s can also be called Resuscitation Directive
Living Wills and Health Care Power of Attorney are types of advance directives in which a
patient can express wishes regarding end-of-life medical care. These directives are sometimes
called health care “durable” power of attorneys because they remain in effect once a patient
loses “decision making capacity”. The person who carries the Health Care Power of Attorney is
often called the “Surrogate Decision Maker”. They are legally obligated to make decisions as the
patient would want, and has presumably discussed these decisions with the patient. It is
important to keep in mind that the “Surrogate Decision Maker” has no authority until the patient
becomes incapable of making decisions. If the “Surrogate Decision Maker” is attempting to
make decisions that conflict with a competent patients decisions, the patients decisions are
always the ones to be followed.
20. Treating a Violent Patient (99/100)
• May restrain a violent patient to protect you/crew and as well as the patient
• Under the law, you are only able to use force if the patient attacks you. You may defend
yourself.
• Contact Law Enforcement if patient becomes uncooperative and or has weapons.
• Violence can be the result of hypoxia, hypoglycemia, mental illness, brain injury, drug abuse/
OD, or alcohol use, and psych problems.
• Protocol dependent - however, some agencies let EMS personal use “Chemical Restraints”
such a benzodiazepines or antipsychotics to calm patients who are violent and need
transportation to hospital.
• If scene is not safe - contact Law enforcement and go back to ambulance like a lil bitch boy
you are
• Bullet proof vests?
• Always be aware of your surrounding
• Soft restraints while transporting if needed
•
OB/GYNECOLOGY
1. Complications Associated with Pregnancy Induced Hypotension (1931)
• When a Pregnant females uterus compresses the Inferior Vena Cava, venous blood return to
the heart is diminished or occluded.
• Occurs when the women is Supine, or sometimes when she is sitting
• Usually in the 3rd Trimester
• Can lead to fetal distress
• Generally takes 3-7 minutes of Compression before S/S occur
• Early S/S - Nausea, Dizziness, Tachycardia, Claustrophobia
• Late S/S - Diff Breathing, Syncopal Episodes, Hypovolemia from either blood loss or
dehydration.
• Treatment - Placing patient in the left lateral recumbent position - tilting backboard and
treating underlying causes (Fluids if hypovolemic) and monitoring VS such as BP/EKG
2. Complications associated with pregnancy induced hypertension (PIH): (1931)
Chronic HTN: BP that is equal to or Greater than 140/90mm Hg prior to 20th week.
Ems Operations - Page 1
OB/Gynecology - Page 11
Pediatrics - Page 20
Airway - Page 30
Medical Emergencies - Page 39
Trauma - Page
Cardiology - Page - Page 54
EMS OPERATIONS
1. Airbags Safety During Extrication (2228)
• Un-deployed airbags may deploy during extrication and cause harm to the patients and
rescuers.
• Look for airbag badging or labeling system
• A vehicles airbags system comes equipped with an energy capacitor that can store power for
up to 30 mins in some models
• Remove key from ignition
4. Criteria for Transferring Care of Patient (154)
• In your documentation of care, it is important that you were able to show in whose care you
left the patient with, otherwise you could face allegations of abandonment. some agencies
have begun to require physician or nurse signatures to verify that the patient was left with a
medical professional of a higher level of training. Another situation that may require you to
document a transfer of care is when you hand over your patient to another agency such as a
paramedic transport crew or an air medical team.
5. Decontamination of Airway Equipment
• Sanitize and disinfect everything after a call
• Any piece of equipment that is intended for single use should be discarded in an appropriate
hazardous materials bag. For any reusable piece of equipment that has had direct contact
with the patient or patients bodily fluids, use a commercial disinfecting agent for
decontamination. Bleach diluted in water (1:10) can also be used as disinfecting agent.
6. Documenting Medication Administration (471)
• Documentation is everything, if you did not document it, you didn’t do it. Always document
your actions and the patients response on the on the patient care report after administering a
medication. This includes...
- Name
- Dose
- Time
- Route
- Persons name who administered it
- Patients response to the medication, whether positive or negative
7. Indications for N95 Mask
• 95 (Heppa) Mask on you, surgical or normal mask on patient
8. Indications for Rapid Extrication (1677-1699) (2226)
,• Patient can be moved from sitting in a car to laying supine on a backboard in 2 mins.
Indications listed below
- The vehicle or scene is unsafe
- The patient cannot be properly assessed before being removed from the car
- The patient needs immediate intervention that requires a supine position
- The patients condition requires immediate transport to the hospital
- The patient blocks your access to another seriously injured patient
• A team member should remain with the patient to direct the rescuers who are preforming the
disentanglement. For example, unless there is an immediate threat to fire, explosion, or other
danger, you should preform a primary assessment and perform and critical interventions
before disentanglement begins. This may include providing c-spine immobilization, opening
airway, providing O2, ventilations, or controlling significant bleeding. Once life threats have
been treated, disentanglement can begin. Sometimes a patient must be removed quickly
(Rapid extrication) because his or her general condition is deteriorating and time does not
permit meticulous splinting and dressing procedures. Quick removal may also occur if hazards
are present, such as as spilled gas or other materials that could endanger the patient or
rescue personnel. The only time the patient should be moved prior to completion of initial
care, assessment, stabilization, and treatment is when the patient’s or emergency responders
life is in immediate danger.
10. Making Decisions Regarding a Patients Request to Refuse Care (96-99)
• Patients with decision-making capacity have the right to refuse all or part of the emergency
medical care offered to them
• Refusing care - Needs to be informed consent.
• Need to use your “People skills” and just talk to the patient
· Ensure your pt is fully informed about their current situation, his or her right to
receive or refuse medical care, and the consequences of a refusal of care
· Unresponsive patients may be treated under implied consent
· Involve online medical control if pt have severe injuries but refusing care
· Document carefully and have pt sign AMA
Minors - Because minors have no legal status, they can neither refuse no consent to medical
care. In the case of children and adults who have legal guardians, consent must be obtained, if
possible, from a parent or legal guardian of the patient. If the parent or guardian is not available,
emergency treatment to sustain life may be undertaken without direct consent under the
doctrine of implied consent. You should also be aware of the legal principle known as “In loco
parentis”. This term literally means “In place of the parent”. This principle may apply in school,
day care, or summer camp situations if a parent is unavailable. The school administrator or day
care director may make treatment and transportation decisions on behalf of the minor.
A particularly difficult circumstance can arise if a parent or legal guardian refuses to grant
consent to treat a minor who clearly requires lifesaving or limb-saving treatment. Although adults
clearly have the right to refuse treatment for themselves, state laws generally do not permit a
parent or guardian to deny treatment to a minor child. In fact, the failure of a parent to allow
such treatment may constitute neglect. When confronted with such a circumstance, the
paramedic should notify law enforcement and medical control. State law may permit the state to
,assume custody of the child for purpose of ensuring that necessary emergency treatment be
provided.
Emancipated Minors - are under legal age in a given state but can be treated as legal adults
because certain circumstances. By court order. Marriage, pregnancy, or active military service.
They can accept or deny care.
12. Operations within a HazMat Scene
Responding to Hazmat incidents
· Look for warning signs such as patient S/S, placards, labels, etc.
· Placards or labels may be found on building, trucks/railway cars, drums/storage
vessels
· Intentional ingestion of chemicals and activities occurring at illicit labs or potential
terrorist activities may have no obvious signs
· Some chemicals are odorized (propane, methane) where other dangerous
substances are odorless (carbon monoxide)
· If you approach a scene where more than one person has collapsed due to
respiratory distress, suspect the presence had a hazardous material
· When arriving, you should stop at a safe distance, uphill and upwind from the scene
· Items to report include:
o Exact location
o Atmosphereic conditions
o Size/shape of containers
o Chemical ID number or symbols
o # of victims with S/S
o Type and number of additional resources
18. Stress Management (42-43)
• Fight or flight mode S/S - heart palpitations, rapid breathing, chest tightness, sweating, rapid
breathing, unnecessary shouting.
1. Control breathing
2. Progressive Relaxation - tighten/relax muscle groups to initiate muscle relaxation throughout
the body. Stupid.
3. Professional Assistance - Seek therapist
• Focus on immediate situations while on duty, remind yourself “I will do my very best, but what i
can do may not be enough”
• Avoid excessive amounts of stimulants such as caffeine or alcohol, cigs, or sleeping aids after
a stressful event.
• Stages of Stress
· Acute reaction – occurs during stressful situations
· Delayed reaction – manifests after stressful situations
· Cumulative reaction – when you are exposed to prolonged/excessive stress
19. Treating a Patient with Advance Directives
An advance directive is usually a written document (but can be also an oral statement) that
expresses the wants, needs, and desires of a patient in reference to his o her future medical
care. Advance directives state what medical care the patient wants or does not want when the
, patient is unable to express his or her wishes. Living wills, DNR’s, and organ donation orders
are all advance directives. DNR’s can also be called Resuscitation Directive
Living Wills and Health Care Power of Attorney are types of advance directives in which a
patient can express wishes regarding end-of-life medical care. These directives are sometimes
called health care “durable” power of attorneys because they remain in effect once a patient
loses “decision making capacity”. The person who carries the Health Care Power of Attorney is
often called the “Surrogate Decision Maker”. They are legally obligated to make decisions as the
patient would want, and has presumably discussed these decisions with the patient. It is
important to keep in mind that the “Surrogate Decision Maker” has no authority until the patient
becomes incapable of making decisions. If the “Surrogate Decision Maker” is attempting to
make decisions that conflict with a competent patients decisions, the patients decisions are
always the ones to be followed.
20. Treating a Violent Patient (99/100)
• May restrain a violent patient to protect you/crew and as well as the patient
• Under the law, you are only able to use force if the patient attacks you. You may defend
yourself.
• Contact Law Enforcement if patient becomes uncooperative and or has weapons.
• Violence can be the result of hypoxia, hypoglycemia, mental illness, brain injury, drug abuse/
OD, or alcohol use, and psych problems.
• Protocol dependent - however, some agencies let EMS personal use “Chemical Restraints”
such a benzodiazepines or antipsychotics to calm patients who are violent and need
transportation to hospital.
• If scene is not safe - contact Law enforcement and go back to ambulance like a lil bitch boy
you are
• Bullet proof vests?
• Always be aware of your surrounding
• Soft restraints while transporting if needed
•
OB/GYNECOLOGY
1. Complications Associated with Pregnancy Induced Hypotension (1931)
• When a Pregnant females uterus compresses the Inferior Vena Cava, venous blood return to
the heart is diminished or occluded.
• Occurs when the women is Supine, or sometimes when she is sitting
• Usually in the 3rd Trimester
• Can lead to fetal distress
• Generally takes 3-7 minutes of Compression before S/S occur
• Early S/S - Nausea, Dizziness, Tachycardia, Claustrophobia
• Late S/S - Diff Breathing, Syncopal Episodes, Hypovolemia from either blood loss or
dehydration.
• Treatment - Placing patient in the left lateral recumbent position - tilting backboard and
treating underlying causes (Fluids if hypovolemic) and monitoring VS such as BP/EKG
2. Complications associated with pregnancy induced hypertension (PIH): (1931)
Chronic HTN: BP that is equal to or Greater than 140/90mm Hg prior to 20th week.
