Term
| extension of emergency medical care into the community |
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Definition
| emergency medical services |
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Term
| what/who is EMS regulated by? |
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Definition
| individual state EMS laws and regulations |
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Term
| police officers, firefighters, first aid teams, other community EMS responders |
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Definition
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Term
| individuals who will function as members of an ambulance crew |
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Definition
EMT-Basic
EMT-Intermediate
EMT-Paramedic |
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Term
| trained to priority dispatch and for prearrival intstructions |
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Definition
| Emergency Medical Dispatch (EMD) |
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Term
| who has the authority once communication is established with the recieving hospital? |
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Definition
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Term
| Pt is coding....what hospital? |
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Definition
| nearest facility! whether they are the best equipped or not. |
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Term
| trauma unit, NICU, high risk obstetrics, burns, spinal cord, or cardiac care facilities are all what? |
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Definition
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Term
| passed in 1986, governs when and how a patient may be refused treatment and/or tarnsferred from one hospital to another when he/she is in an unstable condition |
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Definition
| Emergency Medical Treatment and Active Labor Act (EMTALA) |
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Term
| inappropriate transfers should be reported when? |
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Definition
| within 72 hours as an EMTALA violation |
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Term
| is transfer of a stable pt regulated by EMTALA? |
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Definition
| No! Transfer after the pt |
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Term
| is transfer of a stable pt regulated by EMTALA? |
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Definition
| No! Transfer after the pt has become stable is permitted and not restricted by EMTALA in any way. |
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Term
| fail to do something that a reasonable person would have done |
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Definition
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Term
| provide a standard of care that is a good standard of care |
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Definition
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Term
| fail to provide fair and reasonable medicine, given your discipline and knowledge |
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Definition
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Term
| who can push a Baker Act affidavit? Who has the final say? |
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Definition
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Term
| how long is a Baker Act hold good for? |
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Definition
| up to 72 hours, followed by a re-evaluation for conclusion of the case. |
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Term
| EMS providers must be protected against exposure to blood and other body fluids |
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Definition
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Term
| filtered (HEPA, N-95) mask, goggles, gloves, and protective clothing, non-absorbent and puncture-resistant |
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Definition
| personal protective equipment (PPE) |
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Term
| ensure no movement occurs in the cervical, thoracic, or lumbar spine |
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Definition
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Term
| NOT adequate for cervical immobilization (requires lateral support, and spinal board) |
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Definition
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Term
| what helmets should be removed/left? |
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Definition
helmet - remove face mask, helmet with shoulder pads holds the head in position = leave it.
Other athletic helmets (lacrosse, hockey) maintain spinal immobilization = leave it.
Motorcycle helmet = remove it! |
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Term
| adequate for most distal fxs (upper and lower) |
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Definition
| air splints or circumfrential bladders |
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Term
| used for pelvic or femoral shaft fxs |
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Definition
| traction splints (Hare or Sager) |
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Term
| used for tibial shaft fxs (NOT near the knee) |
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Definition
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Term
| Logisitics of air-medical transport, considered on a case-be-case basis (3) |
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Definition
time and distance factors
weather delays in ground transport will affect the pt adversely.
Costly. |
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Term
| precautions to minimize the impact of transport |
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Definition
stabilize pt carefully prior to transport.
anticipate deterioration.
monitor as much as possible (HR, RR, Pulse ox, body temp, CO2, BP, Portable blood analyzer)
prepare the transport vehicle |
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Term
| special problems in the neonate during transport (9) |
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Definition
hypothermia (thoroughly dried, pre-warmed surface, clothed).
Hypoxemia (RDS, should be well ventilated).
Vascular access (<1 wk = umbilical).
Infection (broad spectrum abx).
Viability (24+ wks)
Consent for transport (parent/guardian, auspice of beneficence, referring physician).
Stranger anxiety (sit pt on parents lap).
Respiratory fatigue (good reserve, but when they experience resp. fatigue they quickly become apneic and unconscious) |
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Term
| transport of pts with terminal illness is to what facilty? |
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Definition
| closest appropriate medical facility |
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Term
| a sudden ecologic phenomenon of sufficient magnitude to require external assistance |
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Definition
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Term
| number of pts presenting in a given space of time are such that the emergency department cannot offer even minimal care without external assistance. |
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Definition
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Term
| disasters characterized by the production of large numbers of deaths |
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Definition
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Term
Events that occur physically outside the hospital.
Events that occur within the physical plant of the hospital itself that severely compromise the ability of the hospital. |
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Definition
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Term
| release of a biological agent among a civilian population for the purpose of creating fear, illness, and death. |
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Definition
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Term
| bioterrorism potential based on four general criteria |
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Definition
1. potential for public health impact
2. delivery potential
3. public perception of the agent
4. special requirements for public health preparedness |
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Term
| highest risk to national secruity: Class A agent |
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Definition
| smallpox, anthrax, plague, botulism |
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Term
| moderately easy to dissminiate, less potential for causing widespread illness and death = Class B |
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Definition
| west nile virus, Hep A, Ricin Toxin, Salmonella, E Coli |
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Term
| as technology improves, could emerge as future threats = Class C |
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Definition
| influenza, SARS, Rabies, MDR-TB, yellow fever (arbovirus), tickborne hemorrhagic fever |
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Term
| pathways for presentation of biological agent |
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Definition
1. pt presents with S&S immediately recognized.
2. Pt presents with protean sxs, astute clinician makes dx.
3. Pt not suspected of being a victim (diagnostic results establish dx).
4. Multiple pts present over a defined period.
5. Public health surveillance reveals patterns of S&S or disease in the community.
First are 3 most likely. |
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Term
| ER lockdown for what situations? |
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Definition
| GSW, stab wound cases, terrostic threats, external/internal containment of any process/agent that would harm others. |
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Term
| intentional use of weapens (agents) designed to kill, injure, or incapacitate on the basis of toxic or noxious chemical properties. |
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Definition
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Term
| area of spill or chemical release or the hospital area where arriving pts without decontamination are held. |
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Definition
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Term
| area where thorough decontamination and medical stabilization occur |
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Definition
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Term
| area to which fully contaminated pts are transferred. |
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Definition
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Term
| contaminated pts should/should not be allowed in the ER? |
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Definition
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Term
| always prudent to error on the side of what before tx if unknown situation? |
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Definition
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Term
| what takes precendence in the decontamination procedure? |
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Definition
| ocular exposures (immediate eye irrigation) |
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Term
| how should decon proceed? |
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Definition
| head to toe with copious amounts of water. |
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Term
| decon agent for non-polar, water soluble substances? |
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Definition
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Term
| decon agent for never agents? |
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Definition
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Term
| what substances react violently with water? |
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Definition
| certain metals (sodium, lithium, potassium) |
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Term
| what should be done with the pt after the decontamination process? |
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Definition
| wrapped in a clean blanket and transferred to the cold zone |
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Term
| sudden force and rapid acceleration of body surfaces to high peak velocities, but relatively small amounts of actual dispalcement characterize what? |
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Definition
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Term
| slower application of force, weaker acceleration, and lower peak velocity, but relatively graeter surface displacement are typical of what? |
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Definition
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Term
| what is the one sx that shows up in virtually all body systems after blast injuries??? |
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Definition
| bleeding! (from ears, sinuses, lungs, bowel, lacerations) |
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Term
| what is more likely following blast injury.... external hemorrhage or airway compromise? |
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Definition
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Term
| what position lowers the risk of AAE? |
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Definition
| left side slightly forward prone |
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Term
| suspected ATI's require admission and what? |
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Definition
| IV hydration, serial monitoring of K, CK, myoglobin, close monitoring for compartment syndrome, tx for hyperkalemia, hypercalcemia, hypophosphatemia, and mygloinuria associated with rhabdomyolysis, HBO therapy may be effective. |
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Term
| 3 types of radiation even scenarios |
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Definition
accidental
intentional (Dirty Bomb)
without awareness |
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Term
| radioactive materials deposited on the skin (requires decontamination) |
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Definition
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Term
| all or part of the body is exposed to a penetrating radiation source (locally or diffusely) |
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Definition
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Term
| accidental or intentional ingestion of radioactive source or absorption via wounds, the lungs, etc. |
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Definition
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Term
| uptake of radioactive materials into cells, tissues, organs |
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Definition
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Term
| similar to thermal burns, immediate and excrutiating pain, surgical resection and grafting may be required. |
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Definition
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Term
| predictable signs and symptoms develop when a significant portion of the body is exposed to a high level of penetrating radiation over a short period of time (typically less than 24 hrs) |
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Definition
| acute radiation syndrome (ARS) |
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Term
| at what exposure level does ARS usually occur? |
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Definition
| whole body gamma dose in excess of 2 Gy (200 rad) |
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Term
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Definition
prodromal (tansient period of self-limiting sxs).
latent (symptom free period of 1-3 wks).
manifest illness phase (dose dependent subsyndromes - hematopoeitic, gastrointestinal, cardiovascular, CNS) |
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Term
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Definition
| collect specimens of blood and urine, alleviating sxs of the prodromal phase, serial blood specimens for hematologic and cytogenic dose assessment, hematopoietic growth factors. |
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