Document written in 1700 B.C. that spelled out protocols and reimbursements for medical care, including punishment for malpractice.
What is abmulances volantes?
Also known as flying ambulances it was developed in 1790 by Jean Larrey and was the philosophy of bringing care to the patients in the field.
When and where was the first documented ambulance service?
In 1869 in New York City started by the Health Department.
What wars helped develope EMS?
World War I and World War II developed ambulance corps to rapidly care and remove injured patients from the field to hospitals.
The Korean War instituted helicopters and also developed M.A.S.H. units to bring hospitals closer to the front line.
What are the white paper?
Document released in 1966, also known as Accidental Death and Disability, that set out 10 critical points.
From these papers the National Highway Safety Act was developed and set up funding for Basic and Advanced life support.
Regulated by USDOT.
Who is Dr. Eugene Nagel?
In 1969 He set up a training course for EMT in Miami Florida.
He also developed the first Telemetry system that enabled fire fighters to transmit a patients ECG to the hospital.
He is called the Father of Paramedicine.
What are the 15 componets set by the Emergency Medical Services System Act in 1973?
Integration of health services
EMS research
Legislation and regulation
System finance
Human Resources
Medical direction
Education systems
Public education
Prevention
Public access
Communication system
Clinical care
Information systems
Evaluation
What are the 10 system elements set by the National Highway Traffic Safety Administration throughout the 1980's and 90's?
Regulation and Policy
Resource management
Human resources and training
Transportation
Facilities
Communication
Public information and education
Medical direction
Trauma systems
Evaluation
What are the different roles in EMS and their functions?
Dispatcher- They receive and enter all information on the call. They interpret the information and in turn relay it to the appropriate resouces. They can relay simple medical direction like CPR, and bleeding control until EMS arrives.
First Respnders- Not recognized in all states. trained in CPR and First Aid.
EMT-Basic- Considered the backbone of EMS. They are trained in advanced airwaysand limited medication administration.
EMT-Intermediate- Skills include IV therapy, cardiac monitoring, and advanced airways procedure.
EMT-Paramedic- Highest skill level. Function under a medical director.
What are the Roles and Responsibilites of the Paramedic?
Preparation
Response
Scene management
Patient assessment and care
Management and disposition
Patient transfer
Documentation
Return to service
What are the roles of the medical director?
Educating and training personnel.
Participating in the selection of new personnel
Participating in equiptment selection
Developing clinical protocols in cooperation with other EMS personnel who are considered experts in the field.
Developing and assisting in a quality improvement program.
Providing input into patient care.
Interfacing between EMS systems and other health care agencies.
Serving as an EMS advocate to the community.
Serving as the cdeical conscience of the EMS system.
What is a Protocol?
Treatment plan for a specific illness or injury.
What is a Standing Order?
Type of protocol that is a written document signed by the EMS systems medical director that outlines specific directions, permissions and sometimes prohibitions regarding patient care that is rendered prior to contacting medical control.
What is the Fight or Flight syndrome?
Physiologic response to a progound stressor. Featuring increased sympathetic tone and resulting in dilation of the pupils, increased heart rate, dilation of the cronchi, movilization of glucose, shunting blood away from the gastrointestinal tract and increasing it the the cerembrum and skeletal muscles.
It helps you deal with stress.
What is Stress?
Reaction of the body to any agent or situation that requires the individual to adapt.
Has two forms
Eustress- positive stress
Distress- negative stress
What are the stages of the defense mechanisms?
Denial
Regression
Projection
Displacement
What is Burnout?
Exhaustion of physical or emotional strength.
Result of unrelieved stress.
What are the stages of the grieving process?
Denial
Anger
Bargaining
Depression
Acceptance
What is mobidity?
Number of nonfatally injured or disabled people. Usually expressed as a rate, meaning the number of nonfatal injuries in a certain population in a given time period divided by the size of the population.
What is mortality?
Death caused by injuries or diseases.
What is passive Transport diffusion?
Movement of a substance from an area of higher concentration to an area of lower concentration.
What is Faclitated diffusion?
Transport molecule within the membrane helps the movement of a substance from areas of higher concentration to areas of lower concentration.
What is Osmosis?
Movement of a solvent from an area of low solute concentration to one of high concentration through a selectively permeable membrane to equalize concentrations of a solute on both sides of the membrane.
What is Filtration?
Movement of water and a dissolved substance from an area of high pressure to an area of low pressure.
What is Active Transport?
Movement via pumps or transport molecules that require energy and move substances from an area of low concentration to an area of high concentration.
What are the 6 R's?
Right Patient
Right Medication
Right Dose
Right route
Right time
Right documentation and reporting.
What is an Agonist?
Medication that stimulates a response in a receptor site.
List of absorption route from slowest to fastest.
Topical- hours to days
Oral- 30-90 minutes
Rectal- 5-30 minutes
SC Injection- 15-30 minutes
IM Injuection- 10-20 minutes
Sublingual tablet- 3-5 minutes
Sublingual injection- 3 minutes
Inhalation- 3 minutes
Endotracheal- Unknown
IO- 60 seconds
IV- 30-60 seconds
Intracardiac- 15 seconds
What is an Antagonist?
Block the receptor site from being stimulated by other chemical mediators and inhibit the normal response.
What is a half life?
Time it takes the body to eliminate half of the drug.
What are the Alpha and Beta receptors?
Alpha 1- Produce peripheral vasoconstriction are associated with mild bronchoconstriction and speed metabolism.
Alpha 2- Control the release of norepinepherine.
Beta 1- Increase the heart rate, cause cardiac muscle to contract, strengthen cardiac contraction. Produce automaticity and trigger cardiac electrical conduction.
Beta 2- Stimulate vasodilation and bronchodilation.
What percentage of an average male body weight is water?
60%
What is a Bolus?
Medication given all at once.
What is the most common inhailed medication?
Oxygen
What are ptentila complications of IV's?
Infiltration
Thrombophlebitis
Occlusion
Vein irritation
Hematoma
Nerve, tendon or ligament damage
Arterial punture
Allergic reactions
Pyrogenic reactions
Circulatory overload
Air embolus
Vasovagal reactions
Catherter shear
What is Vasovagal reaction?
Anxiety from fear of the IV.
Patients can present anxiety, diaphoresis, nausea, and syncopal episodes.
Treatments inculdes placing patient in shock position, applying high flow oxygen, monitor vital signs, and establish an IV for fluids.
The net effect of osmosis is to?
D) Equalize the concentrations of a solute on both sides of the cell membrane.
All of the following diseases are autoimmune diseases, Except?
C) HIV infection
Ascites is defines as?
D) An abnormal accumulation of fluid in the peritoneal cavity.
Enlargement of the heart due to chronically elevated blood pressure is called?
C) Hypertrophy
Severe prolonged stess?
B) causes the body to lose its ability to fight disease.
The Cardinal sign of overhydration is:
A) edema
What type of shock occurs when blood flow becomes blocked in the heart or great vessels?
A) Obstructive
The movement of water and a dissolved substance from an area of high pressure to an area of low pressure is called?
B) Filtration
Groups of cells form?
C) Tissues
Plasma comprises approximately _% of the blood?
A) 55
Strength of a person's peripheral pulses is related to?
B) Stroke volume and pulse pressure
Homeostasis is most accurately defined as?
D) A constant effort to preserve a degree of stability or equilibrium.
An inflammatory condition of the respiratory system that results in intermittent wheezing and excess mucus production is called?
A) asthma
If a patient is taking Enfuviritide, a protease inhibitor, you should be most suspicious that he or she has?
C) HIV infection
The process of chemical signaling between cells is called?
A) neurotransmission
Medications that are manufactured synthetically?
B) do not use animal, mineral, or vegetable sources.
Minimum storage requirements for a controlled substance include a:
B) securely locked, substantially constructed cabinet with no sign or any other indication that the cabinet contains a controlled substance.
A medication that stimulates a response in a receptor site is said to be:
D) an agonsit
When selecting the most appropriate IV catherter, you should routinely consider all of the following except:
A) the patient's medical history.
The primary buffer used in all circulating body fluids is:
C) bicarbonate
The most common cause of circulatory overload in the prehospital setting is:
A) failure to readjust the drip rate after flushing the IV line immediately after insertion.
The chemical sign for sodium bicarbonate is:
A) NaHCO3
All of the following physical changes occur in school-age children except:
B) vital signs similar to those of adults.
Medication routes, from slowest to fastest rates of absorption are:
The pulse rate of a 16 year old adolescent typically ranges between:
B) 60 and 100 beats/min.
Which of the following factors typicall does not affect the vital signs a 65 year old patient:
D) Living conditions.
Relative to younger adults, older adults generally have a harder time breathing because the:
A) natural elasticity of the lungs decreases.
B) diaphragm ascends much higher into the thorax.
C) ribcage becomes flexible due to hypocalcemia.
D) phrenic nerves send fewer signals to the diaphragm.
A) natural elasticity of the lungs decreases.
In conventional reasoning, school-age children:
D) seek approval from their perrs and society.
The decline in cardiac function associated with aging is largely related to:
D) atherosclerosis.
Which of the following vital signs is not consistent with that of a child between 1 and 3 years of age:
A) heart rate of 80 beats/min.
Infants are referred to as belly breathers because:
B) they rely mostly on their diaphragm to breathe.
Which of the following psychosocial changes is common during adolescence:
C) Fixation on public image and fear of embarrassment.
For the first year of life, an infant has naturally acquired passive immunities because:
C) he or she maintains some of the mothers immunities.
