Fisdap Final Paramedic Study Guide latest update 2022
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)
Fisdap Final Paramedic Study Guide latest update 2022
,Fisdap Final Paramedic Study Guide latest update 2022
• 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
Fisdap Final Paramedic Study Guide latest update 2022
,Fisdap Final Paramedic Study Guide latest update 2022
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
Fisdap Final Paramedic Study Guide latest update 2022
, Fisdap Final Paramedic Study Guide latest update 2022
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.
Fisdap Final Paramedic Study Guide latest update 2022
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)
Fisdap Final Paramedic Study Guide latest update 2022
,Fisdap Final Paramedic Study Guide latest update 2022
• 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
Fisdap Final Paramedic Study Guide latest update 2022
,Fisdap Final Paramedic Study Guide latest update 2022
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
Fisdap Final Paramedic Study Guide latest update 2022
, Fisdap Final Paramedic Study Guide latest update 2022
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.
Fisdap Final Paramedic Study Guide latest update 2022
