Introduction to Emergency Medical Care Part 1

Emergency Care Chapter 1 Introduction to Emergency Medical Care 1) Which of the following refers to a program or process for evaluating and improving the effectiveness of an EMS system? A) Quality improvement B) System effectiveness management C) Process Improvement Plan (PIP) D) Total quality system Answer: A Explanation: A) CORRECT. Quality improvement (QI) consists of continuous self-review with the purpose of identifying aspects of the EMS system that require improvement, with subsequent action plans to make subsequent changes. B) INCORRECT. System effectiveness management does not refer to a program of evaluating and improving an EMS system. C) INCORRECT. A program or process for evaluating and improving the effectiveness of an EMS system is not referred to as a Process Improvement Program. D) INCORRECT. The term "total quality system" does not refer to a program for improving the effectiveness of EMS systems. 2) Which of the following groups is credited with developing the earliest documented emergency medical service? A) The Spanish B) The Egyptians C) The Mayans D) The French Answer: D Explanation: A) INCORRECT. The Spanish did not develop the first documented emergency medical service; the French did in the 1700s. B) INCORRECT. Although known for progress in technical areas, the Egyptians were not responsible for the first documented emergency medical service. In 1790, the French first began transporting wounded soldiers away from battlefields and to waiting medical care. C) INCORRECT. The earliest documented emergency medical service was in France in 1790, nearly a thousand years after the Mayan civilization disappeared. D) CORRECT. The earliest documented emergency medical service was in 1790 when the French began transporting wounded soldiers from the scenes of battle to waiting physicians. 3) In 1966 the National Highway Safety Act charged which of the following agencies with the development of emergency medical service standards? A) U.S. Department of Transportation B) U.S. Department of the Interior C) U.S. Department of Health Services D) U.S. Department of Homeland Security Answer: A Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with developing EMS standards and assisting the states to upgrade the quality of their prehospital emergency care. B) INCORRECT. The U.S. Department of the Interior is charged with the management and conservation of federal land and the country's natural resources. The Department of Transportation was charged with developing EMS standards. C) INCORRECT. Although the U.S. Department of Health and Human Services is charged with protecting the health of all Americans, the United States Department of Transportation was assigned the task of developing emergency medical service standards. D) INCORRECT. Although the U.S. Department of Homeland Security is tasked with protecting the nation from threats, it was established in 2002 and did not exist in 1966. It was the U.S. Department of Transportation that was charged with developing EMS standards. 4) Centralized coordination of emergency medical access, transportation, and care most refers to which of the following? A) Emergency preparedness plan B) Trauma system C) Resource management D) Central deployment Answer: C Explanation: A) INCORRECT. Emergency preparedness plans are usually developed to guide the actions of a specific group of people at the outset of an emergency, with the goal of protecting people and/or property. They generally will not address the specifics of medical care or transport. B) INCORRECT. A trauma system is an organized, coordinated effort between facilities and responders within a defined geographic area to deliver a full range of care to injured patients. It does not address the coordination of basic (non-trauma) emergency care or transportation. C) CORRECT. Resource management refers to the centralized coordination of an emergency response so that all victims have equal access to basic emergency care and are transported by certified personnel, in a licensed and equipped ambulance, to an appropriate facility. D) INCORRECT. The centralized coordination of emergency medical access, transportation, and care within an EMS system is not referred to as central deployment. 5) Which of the following agencies is responsible for establishing EMS system assessment programs? A) Department of Health and Human Services (HHS) B) National Transportation Safety Board (NTSB) C) National Highway Traffic Safety Administration (NHTSA) D) United States Health Services Agency (HSA) Answer: C Explanation: A) INCORRECT. The Department of Health and Human Services (HHS) is not responsible for EMS system assessment programs. B) INCORRECT. The National Transportation Safety Board (NTSB) does not establish EMS system assessment programs. C) CORRECT. The National Highway Traffic Safety Administration (NHTSA) Technical Assistance Program has established assessment programs with set standards for EMS systems. D) INCORRECT. The United States Department of Health and Human Services has no oversight of EMS systems. 6) Which of the following BEST describes the purpose of the modern emergency medical services (EMS) system? A) To have trained personnel respond quickly and provide emergency care on the scene, during transport, and at the hospital B) To have trained personnel capable of assessing and caring for injured and ill patients on the scene C) To have trained personnel understand the limitations of their training and "do no harm," while providing prompt transport to the hospital D) To have trained personnel knowledgeable in all aspects of prehospital care Answer: A Explanation: A) CORRECT. The modern Emergency Medical Services (EMS) system has been developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff. B) INCORRECT. In addition to having trained personnel able to help patients on scene, the modern Emergency Medical Services (EMS) system also aims to provide that same assistance while en route to the hospital and at the hospital until hospital staff can take over care. C) INCORRECT. Although understanding limitations and doing "no harm" are important aspects of an emergency care provider's job, the modern Emergency Medical Services (EMS) system was developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff. D) INCORRECT. Although knowledge is an important aspect of an emergency care provider's job, the modern Emergency Medical Services (EMS) system was specifically developed to get trained personnel to patients as quickly as possible and to provide emergency care on the scene, en route to the hospital, and at the hospital until care is assumed by the hospital staff. 7) What has the modern emergency medical services (EMS) system been developed to provide? A) Prehospital care B) Prompt emergency response C) Safe emergency transportation D) Trained medical personnel Answer: A Explanation: A) CORRECT. In 1966 the National Highway Safety Act charged the United States Department of Transportation (DOT) with assisting the states in upgrading the quality of their prehospital emergency care. B) INCORRECT. Prompt responses are an important part of any EMS system, but not what they were specifically developed to provide. C) INCORRECT. Safe emergency transportation is only part of what modern EMS systems were developed for. D) INCORRECT. Modern EMS systems were designed to provide more than just trained medical personnel. 8) Which of the following is the most common gateway for hospital services for patients who need emergency medical assistance? A) Emergency department B) Emergency medical services system C) Surgical services department D) Emergency medical dispatch center Answer: A Explanation: A) CORRECT. The emergency department serves as the gateway for the rest of the services offered by a hospital. B) INCORRECT. The EMS system is not generally involved with hospital services other than the emergency department. C) INCORRECT. Although an important component of a hospital's services, not all emergency medical patients will require surgery. D) INCORRECT. An emergency medical dispatch center coordinates transports to the hospitals, but is not involved in determining or promoting specific hospital services. 9) Which of the following BEST describes a communication system capable of identifying the number and location of the phone from which a caller is calling? A) Data display 911 B) Priority dispatch 911 C) Enhanced 911 D) Advanced 911 Answer: C Explanation: A) INCORRECT. Data display 911 does not refer to a system capable of identifying a caller's location. B) INCORRECT. Priority dispatch 911 would refer more to an internal communication center protocol than a system for displaying locations and phone numbers. C) CORRECT. An enhanced 911 system has the capability of automatically identifying the caller's phone number and location. D) INCORRECT. Advanced 911 is an emergency texting system rather than a system for locating callers. 10) What is the minimum level of certification required of ambulance personnel responsible for direct patient care? A) Emergency Medical Technician B) Emergency Medical Responder C) Advanced EMT D) Emergency Ambulance Driver Answer: A Explanation: A) CORRECT. In most areas, the Emergency Medical Technician (EMT) is considered the minimum level of certification for ambulance personnel. B) INCORRECT. An Emergency Medical Responder (EMR) is below the EMT certification level, and below the minimum usually expected for ambulance personnel. C) INCORRECT. Advanced EMTs have a higher level of certification than what is commonly required as the minimum for ambulance personnel. D) INCORRECT. Most ambulance personnel are expected to be at the EMT level or higher. 11) What BEST describes the level of EMS training that emphasizes activation of the EMS system and provides immediate care for life-threatening problems? A) Emergency Medical Dispatcher B) Cardiac care responder C) EMT D) Emergency Medical Responder Answer: D Explanation: A) INCORRECT. The Emergency Medical Dispatcher is responsible for coordinating the appropriate EMS response and potentially providing important instructions to the person calling for assistance. B) INCORRECT. A cardiac care responder is not a recognized level of EMS training. C) INCORRECT. EMTs provide basic-level medical and trauma care and transportation to a medical facility. D) CORRECT. The emphasis of an Emergency Medical Responder is on activating the EMS system and providing immediate care for life-threatening injuries, controlling the scene, and preparing for the arrival of the ambulance. 12) What BEST describes the level of EMS training that emphasizes use of advanced airway devices and some prehospital medication administration? A) Advanced EMT B) Paramedic C) Emergency Medical Responder D) EMT Answer: A Explanation: A) CORRECT. The Advanced EMT (AEMT) provides basic-level care and transportation as well as some advanced-level care, such as use of advanced airway devices, monitoring of blood glucose levels, and administration of some medications, which may include intravenous and intraosseous administration. B) INCORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care. C) INCORRECT. The first level of EMS training (Emergency Medical Responder) is primarily focused on activating the EMS system and immediate care for life-threatening injuries. D) INCORRECT. EMTs provide basic-level medical and trauma care but cannot manage advanced airways or administer medications. 13) What level of emergency medical training provides the most advanced pre-hospital care? A) Advanced EMT B) Emergency Medical Responder C) Emergency Medical Technician D) Paramedic Answer: D Explanation: A) INCORRECT. The AEMT provides basic-level care and transportation as well as some advanced-level care in the pre-hospital setting. B) INCORRECT. Emergency Medical Responders are trained to activate the EMS system, provide immediate care for life-threatening injuries, control the scene, and prepare for the arrival of the ambulance. C) INCORRECT. EMTs provide basic-level medical and trauma care and transportation to a medical facility. D) CORRECT. The Paramedic performs all of the skills of the EMT and AEMT plus advancedlevel skills. The Paramedic provides the most advanced level of prehospital care. 14) Which of the following is the primary responsibility of the EMT? A) Protect and stabilize the patient B) Communicate with other responders on the scene C) Maintain personal health and safety D) Provide emergency care Answer: C Explanation: A) INCORRECT. Although protecting and stabilizing the patient is an important aspect of the EMT's job, maintaining personal health and safety first is the priority. B) INCORRECT. Communicating with other emergency responders is necessary for effective scene safety and coordination, but the first priority for any EMT is to ensure their own health and safety. C) CORRECT. It is not possible to help a patient if you are not physically capable or are injured while performing your job, so your first responsibility is to keep yourself healthy and safe. D) INCORRECT. Providing emergency care is the EMT's purpose, but maintaining her own personal health and safety is the EMT's primary responsibility. 15) What BEST defines the evaluation of the patient's condition in order to provide emergency care? A) Patient access B) Patient assessment C) Medical intervention D) Patient advocacy Answer: B Explanation: A) INCORRECT. Patient access means getting to the patient's location. B) CORRECT. Patient assessment is used to find out enough about what is wrong with your patient to be able to provide the appropriate emergency care. C) INCORRECT. A medical intervention is the care provided once what is wrong with the patient has been determined. D) INCORRECT. Patient advocacy is speaking up for the patient. 16) Upon arrival at the hospital, the EMT advises hospital personnel of the patient's condition, observations from the scene, treatment rendered, and other pertinent data to assure continuity of care. This process is known as which of the following? A) Transfer of care B) Breach of duty C) Definitive care D) End of tour Answer: A Explanation: A) CORRECT. Providing the receiving hospital staff with information on the patient's condition, observations of the scene, and other pertinent data so that there will be continuity of care is part of the transfer of care process. B) INCORRECT. A breach of duty occurs when an EMT has a responsibility to care for a patient and does not follow through. C) INCORRECT. Definitive care refers to the type of care ultimately needed by a patient, not to the process of transferring the patient to hospital staff. D) INCORRECT. The end of tour generally refers to the end of a scheduled EMS shift and is not related to patient care. 17) Which of the following is a component of patient advocacy? A) Immobilizing the neck of a patient with a possible spinal injury B) Granting patient wishes and not reporting spousal abuse to the authorities C) Building rapport with the patient during transport to the hospital D) Providing oxygen to a patient that is short of breath Answer: C Explanation: A) INCORRECT. This is simply an example of patient care. Advocacy is working to understand the patient so that the EMT can speak up for them and promote their needs. B) INCORRECT. Patient advocacy is not supporting a patient whose wishes will ultimately be harmful or against the law. C) CORRECT. Building rapport with the patient is a critical component of advocacy. Without it, the EMT won't be able to know the patient's needs or challenges enough to effectively speak on their behalf. D) INCORRECT. Advocacy is about truly understanding the patient and speaking up for them to promote the best care possible, not simply providing an intervention. 18) Who is responsible for on-scene safety of EMS providers? A) Traffic director B) Law enforcement C) All crew members D) Triage officer Answer: C Explanation: A) INCORRECT. The on-scene safety of EMS providers is not the responsibility of a traffic director. B) INCORRECT. Law enforcement personnel can be an important part of scene safety, but they are not necessarily responsible for the safety of EMS crews. C) CORRECT. It is the responsibility of all EMS crew members to keep themselves, the patient(s), and bystanders safe. D) INCORRECT. The triage officer is not solely responsible for the on-scene safety of EMS providers. 19) Which of the following BEST describes a person who speaks up on behalf of the patient and supports his cause? A) Guardian B) Assistant C) Advocate D) Representative Answer: C Explanation: A) INCORRECT. A guardian is generally someone who is legally responsible for a patient, whether or not they support or advocate for them. B) INCORRECT. A person who assists a patient with tasks may not necessarily speak up for the patient or support them in seeking better care. C) CORRECT. EMTs should be advocates for their patients, speaking up for them and supporting them in getting appropriate care. D) INCORRECT. The term "representative" does not indicate the same level of personal involvement in a patient's care and outcome as an "advocate" has. EMTs should always see themselves as advocates for their patients. 20) To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are all examples of which of the personal traits of a quality EMT? A) Able to listen to others B) Pleasant C) Judgmental but fair D) Emotionally stable Answer: A Explanation: A) CORRECT. To be compassionate and empathetic, to be accurate with interviews, and to inspire confidence are examples of the ability to listen to others. B) INCORRECT. Inspiring confidence and helping to calm the sick and injured are examples of being pleasant. C) INCORRECT. Being nonjudgmental and fair means treating all patients equally regardless of race, religion, or culture. D) INCORRECT. Emotional stability is the ability to overcome the unpleasant aspects of an emergency so that needed care may be rendered and any uneasy feelings that exist afterward may be resolved.