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HISTORY OF EMS PRE-20TH CENTURY
- 1700 BC: CODE OF HAMMURABI
- 1790: AMBULANCES VOLANTES
- 1869: FIRST AMBULANCE SERVICE
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20TH CENTURY EMS
- WW1 &WW2: SOLDIERS TRANSPORTED TO HOSPITALS
- KOREAN WAR: HELICOPTER EVAC, MASH UNITS
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WHAT IS THE WHITE PAPER
- 1966: ACCIDENTAL DEATH AND DISABILITY: THE NEGLECTED DISEASE OF MODERN SOCIETY
- THE US DEPARTMENT OF TRANSPORTATION WAS CREATED
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WHAT ARE THE 14 REQUIREMENTS OF THE EMS SYSTEM ACT OF 1973
- INTEGRATION OF HEALTH SERVICES
- EMS RESEARCH
- LEGISLATION AND REGULATION
- SYSTEM FINANCE
- HUMAN RESOURCES
- MEDICAL DIRECTION
- EDUCATION SYSTEMS
- PUBLIC EDUCATION
- PREVENTION
- PUBLIC ACCESS
- COMMUNICATION SYSTEMS
- CLINICAL CARE
- INFORMATION SYSTEMS
- EVALUATION
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WHAT ARE THE 5 LEVELS OF PROVIDERS IN THE EMS SYSTEM?
- DISPATCHER
- FIRST RESPONDER
- EMT BASIC
- EMT INTERMEDIATE
- EMT PARAMEDIC
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WHAT ARE THE PRIMARY RESPONSES OF A PARAMEDIC?
- PREPERATION
- RESPONSE
- SCENE MANAGEMENT
- PT ASSESMENT AND CARE
- MANAGEMENT AND DISPOSITION
- PT TRANSFER
- DOCUMENTATION
- RETURN TO SERVICE
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WHAT ARE THE DUTIES OF A MEDICAL DIRECTOR?
- DEUCATING AND TRAINING PERSONEL
- PARTICIPATING IN PERSONNEL SELECTION
- EQUIPMENT SELECTION
- DEVELOPING CLINICAL PROTOCOLS
- ASSISTING IN QI
- DIRECT INPUT INTO PATIENT CARE
- INTERFACING BETWEEN EMS AND OTHER AGENCIES
- SERVING AS EMS ADVOCATE
- SERVING AS MEDICAL CONCIENCE
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WHAT ARE THE 5 TYPES OF RESEARCH?
- DESCRIPTIVE
- EXPERIMENTAL
- PROSPECTIVE
- RETROSPECTIVE
- CROSS-SECTIONAL
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WHAT ARE THE 4 COMPONETS OF WELL-BEING
- PHYSICAL
- MENTAL
- EMOTIONAL
- SPIRITUAL
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WHAT IS STRESS
A NONSPECIFIC RESPONSE OF THE BODY TO A DEMAND MADE UPON IT
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WHAT ARE THE 2 TYPES OF STRESS
- EUSTRESS: POSITIVE STRESS
- DISTRESS: NEGATIVE STRESS
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WHAT IS AN ALARM REACTION
- THE FIRST STAGE
- BEGINS WITH A QUICK ALERT RESPONSE
- SUDDEN STIMULATION OF THE SYMPATHETIC NERVOUS SYSTEM
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HOW CAN YOU COPE WITH STRESS?
- CONTROLL BREATHING
- REFRAMING
- PROGRESSIVE RELAXATION
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RESPONSES OF PATIENTS TO STRESS
- FEAR
- ANXIETY
- DEPRESSION
- ANGER
- CONFUSION
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PATIENT DEFENSE MECHANISMS
- DENIAL
- REGRESSION
- PROJECTION
- DISPLACEMENT
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RESPONSE OF FAMILY FRIENDS AND BYSTANDERS TO STRESS
- ANXIOUS
- PANICKY
- ANGRY
- DEMANDING
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RESPONSE IN MULTI CASUALTY INCIDENTS TO STRESS
- ANXIETY
- BLIND PANIC
- DEPRESSION
- OVERREACTION
- CONVERSION HYSTARIA
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SYMPTOMS OF IMPENDING BURNOUT
- CHRONIC FATIGUE AND IRRITABILITY
- CYNICAL, NEGATIVE ATTITUDE
- LACK OF DESIRE TO REPORT TO WORK
- EMOTIONAL INSTABILITY
- CHANGING IN SLEEP PATTERNS
- FEELING OVERWHELMED OR HELPLESS
- LOSS OF INTREST IN HOBBIES
- DECREASE ABILITY TO CONCENTRATE
- DECLINING HEALTH
- TIGHTNESS IN MUSCLES
- OVEREATING OR SMOKING
- ABUSING DRUGS OR ALCOHOL
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5 STEPS OF GRIEVING
- DENIAL
- ANGER
- BARGAINING
- DEPRESSION
- ACCEPTANCE
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The 4 Es of injury prevention
- –Enforcement
- –Education
- –Engineering/environment
- –Economic incentives
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WHAT ARE THE 2 INJURY TYPES
- •Intentional
- –Refer to injuries resulting from purposeful human action, whether directed at oneself or othersAssault and suicide are included in intentional injuries.
- •Unintentional
- –Refers to injuries that were unplanned
- •Injury occurs in a short period of time—seconds to minutes.
- •Harmful outcome was not sought.
- •The outcome was the result of one of the forms of physical energy in the environment or normal body functions being blocked by external means.
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The five steps to developing a prevention program:
- –Conduct a community assessment.
- –Define the injury problem.
- –Set goals and objectives.
- –Plan and test interventions.
- –Implement and evaluate interventions.
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defamation
- •Intentionally making a false statement through written or verbal communication that injures a person’s good name or reputation
- –Libel is making a false statement in writing.
- –Slander is verbally making a false statement.
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hippa
- •Provides stringent privacy requirements for patient information
- –Medical information can be disclosed only if it is necessary for a patient’s treatment or for payment or medical/billing operations.
- •Privacy officer
- –Responsible for ensuring all protected health information (PHI)
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GOOD SAMARITAN LAW
- •Provides immunity from liability to any member of the community who stops and helps at the scene of an emergency
- –Initially passed to encourage the public to help at emergency scenes
- •Provides some protection for EMS personnel who are off duty and assist at an emergency
- •Emergency care must be given free of charge.
- •Requires that persons responding to an emergency do all they can, within their knowledge, to support and sustain life and to prevent further injury
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WHAT ARE ETHICS
: the philosophy of right and wrong
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what is morality?
- •code of conduct defined by
- –Society
- –Religion
- –Person
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what is medical ethics
- •Also called bioethics
- •Discusses and debates the health care of human beings, your patients
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CODE OF ETHICS
- •Oath of Geneva
- –Issued in 1948
- –World Medical Association
- •Code of Ethics for EMTs
- –Issued in 1978National Association of EMTs
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patient autonomy
- •Patients have the right to direct their own care.
- •Patients have the right to decide how their end of life care should be provided.
- •Patients have the right to decide what and when care should be stopped.
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the human body
- –Made up of cells, tissues, and organs
- –Function in a constantly changing microenvironment
- –Biology
- –Pathophysiology
- –Etiology
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what is a cell
- •Basic self-sustaining unit of the human body
- –Differentiation
- •Three main components
- –Cell membrane
- –Cytoplasm
- –Nucleus
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cell membrane
- –Consists of fat and protein
- –Surrounds the cell and protects the internal components within the cytoplasm
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organells
- –Found in the cytoplasm
- –Operate in a cooperative and organized fashion to maintain the life of the cell
- –Ribosomes
- –Endoplasmic reticulum
- –Golgi complex
- –Lysosomes
- –Peroxisomes Mitochondria
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nucleus
- –Contains genetic material and the nucleoli
- –Ribonucleic acid (RNA)
- –Nuclear envelope
- –Embedded in the cytoplasm
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4 types of tissue
- •Epithelial
- •Connective
- •Muscle
- •Nerve
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epithelial
- –Absorption of nutrients in the intestines
- –Secretion of various body substances
- –Endothelial cells
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connective
- –Binds the other types of tissue together
- –Extracellular matrix
- –Collagen
- –Bone and cartilage
- –Adipose tissue
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muscle
- –Characterized by its ability to contract
- –Enclosed by fascia
- –Overlies the framework of the skeleton
- –Classified in terms of structure and function
- –Three types
- •Skeletal muscle
- •Cardiac muscle
- •Smooth muscle
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nerve
- –Characterized by its ability to transmit nerve impulses
- –Peripheral nerves
- –Neurons
- –Dendrites
- –AxonsSynapse
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•Ligands
- •Molecules either produced by the body or given as a drug –Bind any receptor leading to any reaction
- •Hormones
- –Endocrine hormones
- –Exocrine hormones
- –Paracrine hormones
- –Autocrine hormone
- •Neurotransmitters
- •Electrolytes
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•Adaptations in Cells and Tissues
- •Exposed to adverse conditions
- –Process of adaptation in an attempt to protect themselves from injury
- –Atrophy
- –Hypertrophy
- –Hyperplasia
- –Dysplasia
- –Metaplasia
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•Distribution of Body Fluids
- •Environmental changes
- –Due to aging, exercise, pregnancy, medications, disease, and injury
- –Body fluids contain
- •Water
- •Sodium
- •Chloride
- •Potassium
- •Calcium
- •Phosphorus
- •Magnesium
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•Distribution of Body Fluids
•Total body weight
- –Approximately 50% to 70% is fluid.
- –Average male is 60% fluid.
- –Average female is 50% fluid.
- –Intracellular fluid
- –Extracellular fluid
- –Interstitial fluid
- –Intravascular fluid
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