JFRD SOG 430 EMT Exam | Questions and Answers

JFRD SOG 430 EMT Exam | Questions and Answers According to SOG 430, what is the responsibility of all members of the JFRD providing emergency medical services All EMT and paramedics must function under the direction of a ____________________ Medical Director It is the philosophy of the JFRD that the well being of the patient is ____________________. our primary concern What type of assessment consists of general appearance with initial emphasis on airway, breathing and circulation, primary assessment What type of assessment consists of a focal exam of the affected body systems with a detailed history secondary assessment A person who presents with subjective and/or objective signs and/or symptoms or a complaint which results in evaluation and/or treatment is known as what Patient A patient encounter does not require_____________, ______________, or ________________ from the patient treatment, transport or cooperation What is the ability of a patient to understand the benefits and risks or, and the alternatives to, a proposed treatment or intervention (including no treatment) Medical decision making capacity What is the basis of informed consent? Capacity What is a global assessment and legal determination made by a judge in court? Competency A patient with a medical decision making capacity is considered to give informed consent when any of the following occur: Patient give verbal consent Patient gives written consent Patient does not object as you begin assessment To give consent, the patient must be legally allowed ____________________. This means that the patient must be: to act as an adult; 18 or emancipated (less than 18 and married or legally released from custody of a parents or guardians What are 2 informed consent exceptions? -unmarried pregnant minor may consent to or refuse treatment for medical problems related to her pregnancy only; -An unmarried minor mother may consent to or refuse treatment for her child Patients/Parents are not considered to have medical decision making capacity if any of the following are present: significant mental impairment (alcohol, drugs head injury) resident in a memory care unit at risk for self harm, suicide or homicide if medical personnel are concerned for the safety of a minor child and the parent or legal guarding refuses treatment and transport, who should be contacted? rescue district/battalion chief and law enforcement for guidance What do you call an individual authorized to make medical decisions on behalf of an incapacitated patient? What are the 3 types? Health care agent Durable power of attorney Health care surrogate Proxy A designated individual to handle affairs and conduct business on a patient behalf is known as what? durable power of attorney A designated individual authorized to make health care decisions on a patients behalf is known as what? health care surrogate If an individual is incapacitated and did not previously complete an advance directive (durable power of attorney, health care surrogate), decisions regarding the patient's medical treatment are made by whom? a proxy Who can be a proxy? any of the following, in order of priority: -appointed guardian or guardian advocate who has been authorized to consent for medical treatment -patient's spouse Adult child of the patient (or majority of adult children) parent of patient adult sibling (or majority of adult siblings) adult relative a close friend clinical social worker licensed pursuant to chapter 491 An approved health care agent may verbally revoke a __________________ if their signature is listed on yellow DNRO form A health care agent MAY NOT verbally withhold consent for __________ in the absence of a DNRO Do not resuscitate order (DRNO) CPR What is an involuntary mental health commitment by law enforcement when the patient does not have the capacity to make a medical decision Baker Act True or False: JFRD members are legally authorized to execute a BAKER ACT false - law enforcement must be called When restraints are in use, circulation to the extremities shall be evaluated at least every____________________. 5 mins For JFRD personnel, what are the approved methods of restraint? appropriate sedative soft limb restraints stretcher straps/harness wide cloth restraints True or False: a patient can be restrained in the prone or hogtied positiion? False What is the primary purpose of the patient care report? to document the clinical care provided to a patient All PCR's are required to be completed by _______________. the end of shift Define the following (as seen on the PCR) CC HPI PE TX CC- Chief complaint HPI - history of present illness PE - physical exam TX – treatment what is OPQRST? Onset, provocation, quality, radiation, severity and time For AMA refusal and non transport documentation, the patient must be awake, alert and fully oriented to________________________________ person, place, time and event If the patient or parent/legal guardian has the mental capacity to refuse transport, you should emphasize what: -need for treatment/transportation -risks of refusal of care (including death and disability) -willingness of EMS to transport the patient -the patient or parent/legal guardian should call 911 again if there are any changes in their condition Care may be refused for a minor only when all the following criteria are met: -patient exhibits no historical or physical finding of potentially life, limb organ threatening injury or illness -patient is not intoxicated and has no alterations in mental status, LOC or vital signs -responsible parent/legal guardian is present and has mental capacity If patient refuses to sign, document "refuses to sign" and then get printed name and signature of witness with mental capacity. List of appropriate witnesses in order of preference is: spouses, relatives, law enforcement, friends, other fire/rescue personnel (FIRE/RESCUE PERSONNEL ARE AN ABSOLUTE LAST RESORT) To promote practices that will provide the highest quality, prehospital emergency care by utilizing the most well trained, courteous employees for the benefit of all residents and visitors of the Jacksonville area is the purpose of what? Quality Improvement The intention of quality improvement will be to ____________ train The authority for the continuous quality improvement program come from _______________ in addition to the ___________________ Director/fire chief Medical Director Quality Improvement program will be the responsibility of the _________(4) Medical Director Division Chief of Rescue Deputy Division Chief/Rescue Quality Improvement Officer The quality improvement process consists of what 3 aspects? Proactive (prior) Concurrent (during) Retrospective (after) Verify that the clinical care provided to the patient meets the established standards set forth in the EMS SOG is the primary purpose of__________ the patient care report review Review Captains must review _____________ PCRs per month Rescue Battalion/District chiefs must review a minimum of ________PCRs per month 20 30 In addition, rescue Battalion/District chiefs must review all: all cardiac/Trauma all Alerts (trauma/stemi/stroke..etc.) all advanced airway if not already reviewed by a captain What is defined as one who due to their age or disability, may be unable to adequately provide for the own care or protection? vulnerable adult Patients meeting the following criteria shall be considered DOS: -unresponsive -Apneic -Pulseness and at least one of the following -clear signs of body decay/visual decomposition -rigor mortis -open cranium with exposes brain matter -decapitated or severed trunk -full thickness burn to entire body Blunt chest trauma or multi system trauma patients meeting the following criteria shall be considered DOS: -unresponsive -Apneic -Pulseness Acutely hypothermic patients in cardiac arrest shall be treated and transported, including submersion victims______________ 60 minutes Control of death scenes is the responsibility of _________________ law enforcement True or False: A DNRO form may be duplicated True; provided the content of the form is unaltered, reproduction is of good quality and duplicated on yellow paper A DRNO only means that in the event of cardiac or pulmonary arrest, that_________________ CPR will not be initiated True or False: A DRNO may be revoked at any time by the patient? True; provided: -if signed by the patient -health care surrogate -proxy -court appointed guardian or person acting pursuant to a durable power of attorney A patient will be transported by rescue if their systolic B/P is greater than ________mmHg or Diastolic B/P is greater than ____________ mmHg 180 mmHg 110 mmHg A patient will be transported by rescue if their Systolic B/P is less than ___________ 90 mmHg Adults, aged _______________ or older require transport by rescue with proper consent 65 years old Transport of passengers is at the sole discretion of the ________________ of the rescue unit with the following exceptions officer in charge Pediatric patients requiring a parent/guardian school representatives when parent/guardian is not available geriatric patients requiring a guardian or caregiver Patients with language barriers requiring a translator patients with speech disabilities requiring someone proficient in sign language Transport of unstable patients should begin within ________________ mins 10 Most patients can be transported to a stand alone ED with the following exceptions: patients expected to be admitted or require special services Cardiac Arrest (with shockable rhythm or ROSC) Chest Pain All Alerts (STEMI, trauma, stroke COVID etc) pediatric pregnancy Baker Act Trauma Red Air Transport Unit (ATU) should be considered for critically ill or injured patients when ground transport time exceeds _____________mins 20 mins ATU to UF Gainsville Burn Center should be considered for isolated burns without other significant trauma when? 2nd or 3rd degree burns 20%of total body substance area 3rd degree greater than 5% of total body substance area 2nd or 3rd degree burns with threat of functional/cosmetic impairment to face, hands, feet, genitalia, perineum or major joint What patients are not appropriate for an ATU? cardiac or traumatic arrest Dogs that are individually trained to do work or perform tasks for people with disabilities are called what? Service Animal True or False: Dogs whose sole function is to provide comfort or emotional support do not qualify as service animals under the ADA? True Under the ADA, service animals must be _____________________(3) unless these devices interfere with the service animal's work or the individual's disability prevents using these devices harnessed, leashed or tethered What might be considered threatening behavior in which case the service animal may be transported by other means growling When its not obvious what service animal provides, personnel may only ask 2 questions: Is the dog a service animal because of a disability? What work or task has the dog been trained to perform? Miniature horses generally range in height from ___________ to __________ measured to the shoulders and generally weigh between ____________ and __________ lbs 24 to 34 60 and 100 pounds What are the four assessment factors to assist entities in determining whether miniature horses can be accommodated in their facility 1. whether the miniature horse is housebroken 2. whether the miniature horse is under the owner's control 3. whether the facility can accommodate the miniature horse's type, size and weight er or not the miniature horse's presence will compromise legitimate safety requirements necessary for safe operation of the facility Trauma Alert Criteria: If any ONE of the following conditions is identified, the patient will be considered a trauma alert: Airway - patient received active airway assistance beyond O2 Circulation - no radial pulse with a sustained HR 120 BPM BMR - 4 or less on motor assessment of GCS Spinal - presence of paralysis, loss of sensation, suspicion of spinal cord injury Cutaneous - 2nd or 3rd degree burns to 15% or more TBSA amputation proximal to wrist or ankle penetrating injury to head, neck or torso (excluding superficial wounds) Long Bone Fracture: signs/symptoms of two or more long bone fractures (humerous, femur, radius/ulna, tib/fib); radius/ulna, tib/fib count as one Trauma Alert Criteria: If any TWO of the following conditions is identified, the patient will be considered a trauma alert: Airway - Respiration rate or 30 or greater Circulation - sustained heart rate of 120 BPM or greater BMR - 5 on motor assessment of GCS Spinal - presence of paralysis, loss of sensation, suspicion of spinal cord injury Cutaneous - soft tissue lost from either a major degloving injury or major flap avulsion greater than 5" sustained a gunshot wound to the extremities Long Bone Fracture: signs/symptoms of single long bone fractures (humerous, femur, radius/ulna, tib/fib); radius/ulna, tib/fib count as one, resulting from a motor vehicle accident fal from an elevation of 10 feet or greater Age: 55 years or older MOI: ejected from motor vehicle (excluding motorcycle, moped, ATV, bike, or open body of pick-up truck