ICEMA FINAL STUDY GUIDE
1. Physician on
Scene
What they can
and cannot do,
what you can and
cannot do
2. Organ Donor In- -adult patient for whom it appears death is imminent; a
formation reasonable search of the
What do you do patient's belonging should be made to determine if the
with this infor- individual carries information
mation? indicating status as an organ donor
- EMS field personnel shall notify the receiving hospital if
organ donor information is
discovered
- Any organ donor document discovered should be trans-
ported to the receiving hospital
with the patient unless the investigating law enforcement
officer requests the
document
- EMS field personnel should briefly note the results of the
search, notification of hospital
and witness name(s) on the patient care report
- No search is to be made by EMS field personnel after
the patient has expired
3. Patient Re- only, when necessary, in situations where the patient is
straints potentially violent and is
exhibiting behavior that is dangerous to self or others
Requirements
for applying aggressive or violent behavior may be a symptom of
restraints? medical conditions such as head
trauma, alcohol, drug-related problems, metabolic disor-
ders, stress and psychiatric
, ICEMA FINAL STUDY GUIDE
disorders
method of restraint used shall allow for adequate monitor-
ing of vital signs and shall not
restrict the ability to protect the patient's airway, breathing,
or compromise
neurological or vascular status
Restraints should be applied by law enforcement when-
ever possible. If applied, an
officer is required to remain available at the scene or
during transport to remove or
adjust the restraints for patient safety
This policy is not intended to negate the need for law
enforcement personnel to use
appropriate restraint equipment that is approved by its
respective agency to establish
scene-management control
4. Patient Refusal - A/O x 4
of Care- Adult - Notified up to death
- Fully informed of situation
What is needed - Base hospital contact
for a refusal? - Signature
5. Treatment and - Treatment for a symptomatic individual who is a con-
Transportation firmed case, or a suspected case of
Recommenda- infectious disease is supportive based upon assessment
tions for patients findings
with Emerging
Infectious Dis- - IV fluids and appropriate medications are to be initiated
eases per established protocols
Treatment for the
patient?
6. Interfacility EMT-Ps may not transport a patient with IV drips that are
Transfer not in the EMT-P scope of
, ICEMA FINAL STUDY GUIDE
Guidelines practice
ALS Do's and - EMT-Ps may not transport patients with blood or blood
Don'ts products.
EMT-Ps may initiate prior to contact protocols if the pa-
tient's condition deteriorates,
then must contact the base hospital
7. Hospital Emer- Definition
gency Response rapid advanced surgical care at the scene, in which a
Team (HERT) higher level of on scene surgical expertise,
physician field response
Definition and
purpose Purpose
utilized in a situation where a life-saving procedure, such
as an amputation, is required due to
the inability to extricate a patient. Life before limb concept
is utilized as a life-saving measure,
not as a time saving measure
- should be assembled and ready to respond within 20
minutes of a request
8. Medical Re- StART Triage
sponse to a Mul- Simple Triage and Rapid Treatment. * START includes
ti-Casualty Inci- rapidly assessing (in less than 1 minute) every patient,
dent determining which of 4 clinical categories the patient
belongs, and visibly identifying the category for rescuers
START Triage who will treat the patient.
Definition of MCI Definition of MCI
An MCI is any incident where personnel on scene have
Care priorities requested additional responses to care
for all victims:
Airship trans- Incident requires five (5) or more ambulances; and/or
portation guide- Incident involves ten (10) or more patients; and/or
lines Requires utilization of triage tags; and/or
May require patient distribution to more than one (1)
, ICEMA FINAL STUDY GUIDE
hospital
Care priorities
Adults shall be triaged according to START as outlined in
Firescope. Pediatric patients shall be
triaged according to JumpSTART
Airship transportation guidelines
The CCC (County Communications Center) shall dis-
patch all air resources for the MCI
9. Trauma Triage Special considerations not related to the injury
Criteria A patient shall be transported to the closest Trauma Cen-
ter if any one (1) physiologic criteria is
present following a traumatic event. Trauma base hospital
contact shall be made:
GCS less than 14
RR less than 10 or more than 29
(RR less than 20 for infant less than 1 year old) or need
for ventilatory support
ADULT: BP less than 90 mm Hg or tachycardia
PEDS: exhibits inadequate tissue perfusion or abnormal
vital signs (according to age)
90+(2xage), 70+(2xage) hypotension, 220-age for heart
rate
10. BHO when and If any Physiologic criteria is met
why for trauma - If any Anatomic criteria is met
criteria Penetrating injuries to head, neck, torso and extremities
proximal to the knee or elbow
Blunt chest trauma resulting in chest wall instability or
deformity (e.g., flail chest or ecchymosis)
Two (2) or more proximal long bone fractures (femur,
humerus)
Crushed, degloved, mangled or pulseless extremity
Amputation proximal to the wrist or ankle
Pelvic fracture
Open or depressed skull fracture
1. Physician on
Scene
What they can
and cannot do,
what you can and
cannot do
2. Organ Donor In- -adult patient for whom it appears death is imminent; a
formation reasonable search of the
What do you do patient's belonging should be made to determine if the
with this infor- individual carries information
mation? indicating status as an organ donor
- EMS field personnel shall notify the receiving hospital if
organ donor information is
discovered
- Any organ donor document discovered should be trans-
ported to the receiving hospital
with the patient unless the investigating law enforcement
officer requests the
document
- EMS field personnel should briefly note the results of the
search, notification of hospital
and witness name(s) on the patient care report
- No search is to be made by EMS field personnel after
the patient has expired
3. Patient Re- only, when necessary, in situations where the patient is
straints potentially violent and is
exhibiting behavior that is dangerous to self or others
Requirements
for applying aggressive or violent behavior may be a symptom of
restraints? medical conditions such as head
trauma, alcohol, drug-related problems, metabolic disor-
ders, stress and psychiatric
, ICEMA FINAL STUDY GUIDE
disorders
method of restraint used shall allow for adequate monitor-
ing of vital signs and shall not
restrict the ability to protect the patient's airway, breathing,
or compromise
neurological or vascular status
Restraints should be applied by law enforcement when-
ever possible. If applied, an
officer is required to remain available at the scene or
during transport to remove or
adjust the restraints for patient safety
This policy is not intended to negate the need for law
enforcement personnel to use
appropriate restraint equipment that is approved by its
respective agency to establish
scene-management control
4. Patient Refusal - A/O x 4
of Care- Adult - Notified up to death
- Fully informed of situation
What is needed - Base hospital contact
for a refusal? - Signature
5. Treatment and - Treatment for a symptomatic individual who is a con-
Transportation firmed case, or a suspected case of
Recommenda- infectious disease is supportive based upon assessment
tions for patients findings
with Emerging
Infectious Dis- - IV fluids and appropriate medications are to be initiated
eases per established protocols
Treatment for the
patient?
6. Interfacility EMT-Ps may not transport a patient with IV drips that are
Transfer not in the EMT-P scope of
, ICEMA FINAL STUDY GUIDE
Guidelines practice
ALS Do's and - EMT-Ps may not transport patients with blood or blood
Don'ts products.
EMT-Ps may initiate prior to contact protocols if the pa-
tient's condition deteriorates,
then must contact the base hospital
7. Hospital Emer- Definition
gency Response rapid advanced surgical care at the scene, in which a
Team (HERT) higher level of on scene surgical expertise,
physician field response
Definition and
purpose Purpose
utilized in a situation where a life-saving procedure, such
as an amputation, is required due to
the inability to extricate a patient. Life before limb concept
is utilized as a life-saving measure,
not as a time saving measure
- should be assembled and ready to respond within 20
minutes of a request
8. Medical Re- StART Triage
sponse to a Mul- Simple Triage and Rapid Treatment. * START includes
ti-Casualty Inci- rapidly assessing (in less than 1 minute) every patient,
dent determining which of 4 clinical categories the patient
belongs, and visibly identifying the category for rescuers
START Triage who will treat the patient.
Definition of MCI Definition of MCI
An MCI is any incident where personnel on scene have
Care priorities requested additional responses to care
for all victims:
Airship trans- Incident requires five (5) or more ambulances; and/or
portation guide- Incident involves ten (10) or more patients; and/or
lines Requires utilization of triage tags; and/or
May require patient distribution to more than one (1)
, ICEMA FINAL STUDY GUIDE
hospital
Care priorities
Adults shall be triaged according to START as outlined in
Firescope. Pediatric patients shall be
triaged according to JumpSTART
Airship transportation guidelines
The CCC (County Communications Center) shall dis-
patch all air resources for the MCI
9. Trauma Triage Special considerations not related to the injury
Criteria A patient shall be transported to the closest Trauma Cen-
ter if any one (1) physiologic criteria is
present following a traumatic event. Trauma base hospital
contact shall be made:
GCS less than 14
RR less than 10 or more than 29
(RR less than 20 for infant less than 1 year old) or need
for ventilatory support
ADULT: BP less than 90 mm Hg or tachycardia
PEDS: exhibits inadequate tissue perfusion or abnormal
vital signs (according to age)
90+(2xage), 70+(2xage) hypotension, 220-age for heart
rate
10. BHO when and If any Physiologic criteria is met
why for trauma - If any Anatomic criteria is met
criteria Penetrating injuries to head, neck, torso and extremities
proximal to the knee or elbow
Blunt chest trauma resulting in chest wall instability or
deformity (e.g., flail chest or ecchymosis)
Two (2) or more proximal long bone fractures (femur,
humerus)
Crushed, degloved, mangled or pulseless extremity
Amputation proximal to the wrist or ankle
Pelvic fracture
Open or depressed skull fracture
