Term
| emergency medical care is provided in two major ways : |
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Definition
pre-hospital (AKA EMS)
Hospital (ER/trauma centers) |
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Term
| Pre-hospital emergency care is delivered by..... |
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Definition
EMS technicians
(Emergency Medical Services) |
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Term
| EMS is provided by many agencies : |
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Definition
hospitals
fire departments
volunteers
private firms
military |
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Term
| what are the three major levels of EMS certification |
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Definition
EMT - basic
EMT - intermediate
EMT- paramedic |
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Term
| ______ should be locally driven - that is the local community identifies the needs and allocates resources |
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Definition
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Term
| basic 40 hour course covering first aid, AED operation, ambulance operations |
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Definition
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Term
| additional training focused on skills including IV insertion, airway management |
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Definition
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Term
| Recently revamped to include advanced pharmacology, ACLS, AMLS, emergency surgical procedures |
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Definition
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Term
| All levels of certification are regulated and overseen by ..... |
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Definition
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Term
| have explicit laws requiring patients to be medically screen to determine if an amergency actually exists |
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Definition
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Term
| almost all ____ carry some recognized trauma designation (level 1-4) |
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Definition
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Term
| have specific regulations regarding the staffing of medical professionals |
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Definition
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Term
| basic plans in place for stabilization and transfer of trauma patients |
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Definition
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Term
| essentially the same as level IV, but with the advanced designation |
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Definition
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Term
| major trauma designation, able to handle almost all forms of trauma |
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Definition
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Term
| comprehensive. Has complete "in house" 24 hr surgical coverage teams |
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Definition
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Term
| a speciality hospital that has specific expertise in the initial and on-going management of burn victims |
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Definition
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Term
| hospital burn centers are usually associated with level ____ |
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Definition
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Term
| The Emergency Medical Treatment and Active Labor Act (EMTALA) is a statute which governs when and how a patient may be.... |
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Definition
1. refused treatment or
2. transferred from one hospital to another when he is in an unstable medical condition |
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Term
________ was passed as part of the Consolidated Omnibus Budget Reconciliation Act of 1986, and it is sometimes referred to as "the COBRA law". In fact, a number of different laws come under that general name. Another very familiar provision, also referred to under the COBRA name, is the statute governing continuation of medical insurance benefits after termination of employment.
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Definition
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Term
_____ applies only to "participating hospitals" -- i.e., to hospitals which have entered into "provider agreements" under which they will accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program for services provided to beneficiaries of that program. In practical terms, this means that it applies to virtually all hospitals in the U.S., with the exception of the Shriners' Hospital for Crippled Children and many military hospitals. Its provisions apply to all patients, and not just to Medicare patients.
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Definition
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Term
The avowed purpose of the statute is to prevent hospitals from rejecting patients, refusing to treat them, or transferring them to "charity hospitals" or "county hospitals" because they are unable to pay or are covered under the Medicare or Medicaid programs.
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Definition
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Term
________ is primarily but not exclusively a non-discrimination statute. One would cover most of its purpose and effect by characterizing it as providing that no patient who presents with an emergency medical condition and who is unable to pay may be treated differently than patients who are covered by health insurance. That is not the entire scope of EMTALA, however; it imposes affirmative obligations which go beyond non-discrimination. |
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Definition
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Term
| ______ also covers the patient through the transfer process |
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Definition
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Term
| if you transfer a patient, these rules apply and a very specific patient handoff procuedure must be followed |
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Definition
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Term
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Definition
o Triage
o History
o Physical Exam
o Initial Management
o Data Gathering
o Clinical Decision Making
o Treatment/Interventions
o Disposition |
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Term
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Definition
oTriage is the Sorting of Patients
oPresenting complaint, vital Signs, “How they look”
nA fluid and dynamic process
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Term
| determines who gets attention first |
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Definition
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Term
| triage is accomplished at the _____ |
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Definition
| front desk in the ER OR accomplished by the triage team during large scale disasters |
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Term
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Definition
brief to very brief history - condition dependent, pertinent positives/negatives
often an ongoing process |
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Term
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Definition
ABCDEs- primary survey - mmediate life threats, sick vs non-sick
secondary survey |
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Term
| tailor the exam to the complaint |
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Definition
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Term
| the purpose of the primary survey is to detect and look at.... |
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Definition
| life threatening problems |
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Term
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Definition
airway
breathing
circulation
disability
expose/exmaine |
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Term
| step 4 - clinical decision making |
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Definition
Hx + PE = differential diagnosis
may be short but is usually long
what is going to kill my patient? |
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Term
| step 5 - initial management |
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Definition
"safety net"
usually occurring simultaneously to hx/PE
orders should become reflexive - O2, IV access, monitor (ECG and puls ox) |
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Term
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Definition
common ER studies
labs (CBC, CMP, UA)
D-stick (glucose)
EKG
PCXR/CT/US
peak flow
stool guaiac if GI bleed suspected |
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Term
| Step 7 - Clinical decision making |
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Definition
| Hx + PE + data gathering narrow your differential diagnosis - first r/o life threats then focus on the likely diagnosis |
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Term
| step 8 - treatment/interventions |
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Definition
may be extensive vs minimal - focused toward stabilization and evidence based
continually re-evaluation - pts condition is often dynamic |
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Term
| how many times do we do the primary survey? |
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Definition
| as often as we need to. not just once |
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Term
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Definition
where will this patient go?
begins when you first meet your patient
sick = admit or transfer (who to admit, where to transfer)
not sick = dismissed (but still follow-up with someone) |
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Term
| If you get talked out of admitting/transferring and there is a bad outcome..... |
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Definition
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Term
| remember, even if you discharge your patient - everyone gets referred |
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Definition
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