EMT Block 1 Exam

Block 1 Study Guide 1. What does the state office of EMS regulate? a. The State EMS office is responsible for authorizing, auditing, and regulating all EMS services, training institutions, courses, instructors, and providers within the state. Designed to identify areas of improvement and assign training/education if necessary. 2. What level of provider has extensive training in ALS? a. Paramedic i. EMR: CPR, splinting, pt assessments ii. EMT: EMR+some medications, airway adjuncts, and suctioning. iii. AEMT: EMT+ some ALS such as starting an IV and administer a few more medications. Cannot admin cardiac meds. 1. Not applicable to CA, but services more rural areas. 3. EMT training guidelines are regulated by whom? a. The State EMS Office 4. What is the purpose of continuing education in EMS? a. remain current with the latest treatment guidelines 5. What kinds of skills are civilians most likely to be trained in? a. AED and CPR, bleeding control, etc. pg 13 6. What kind of call would require ALS? a. 3rd-degree burns, heavy blood loss, respiratory distress, any burns to face/ groin 7. What does the medical director do in an EMS system? a. authorizes EMTs to provide medical care in the field. the care and protocols are decided by the medical director pg 32 b. from MD comes online orders they come up with standing orders 8. What criteria are required to be licensed as an EMT? a. high school diploma, proof of immunization of certain communicable diseases, successful completion of a background check and drug screening, drivers license, completion of BLS and CPR, completion of ems course, completion of written exam, completion of practical, demonstrate mental and physical ability, compliance with state, local and employer 9. What does the National EMS Scope of Practice Model outline? a. the minimum guidelines an ems provider should follow. Works to create a standard of care 10. What is the purpose of continuous quality improvement (CQI)? a. Identify areas of improvement and appropriate education to help fix them (always positive) b. Its purpose is to audit EMS services (internal/external) in order to improve the systems. This is done by reviewing reports and assessing what is good and what needs to be improved, allowing the medical director to ID where addition training or instruction is needed. Pg. 20 11. How would you treat a patient you suspect of having TB? What kind of mask would you wear? Block 1 Study Guide a. Surgical masks are designed to prevent the respiratory secretions of the person wearing the mask from entering the air. b. A KN95 or N95 surgical mask placed on the patient helps prevent the formation of TB aerosols. Ask the patient to wear a surgical mask whenever he/she is outside an isolation room. c. Particulate respirator pg. 46 i. Note other respirators and their uses: ii. Surgical mask: blocks large particles/spray, which is best applied to pts iii. K/N95: a type of particulate mask iv. Nonrebreather mask (O2 delivery to pt): high-yield O2 delivery d. Rebreather mask (O2 delivery to pt): higher [M] of O2 mixed with atmospheric air. e. Wear a particulate respirator if you treat a patient with TB 12. What does a positive TB test indicate? a. A positive TB test result means only that TB bacteria has been detected. It does not indicate whether the person has active TB or latent (dormant/ inactive) infection. b. Signs and symptoms- flu-like symptoms need a positive TB test 13. What does OSHA require of employers? a. EMTs need to be trained in handling bloodborne pathogens and in approaching a person who may have an infectious or communicable disease 14. Why is a risk of exposure important in an infection control plan? a. defines who is at risk for contact with blood and body fluids and which tasks pose a risk of exposure. helps people take precautions 15. What is the role of compliance monitoring in an infection control plan? a. ensure that employees understand what they should do and why it is important b. employees document non-compliance to account for future disciplinary action pg 48 16. Who can you get a Hep B vaccine from? a. employers are required to offer the hepatitis B vaccination at no cost to employees with risk of occupational exposure from OSHA pg 51 b. 17. How often should you get a Tdap booster? a. every 10 years pg 53 18. What infectious diseases offer no protection from re-infection after initial exposure? a. syphilis, gonnarea, HIV 19. What is a cumulative stress reaction? a. Cumulative stress results from an accumulation of various stress factors such as a heavy workload, poor communications, the frustration of not being able to meet the beneficiaries' needs, having to cope with situations in which you feel powerless, lack of basic comforts, and inability to rest or relax. b. You can tell when someone says is everything okay c. Ex: a paramedic that starts performing badly and not caring about the patients Block 1 Study Guide 20. What are the different forms of stress a. Acute stress- during a stressful event usually stress lasting a month if fore then its PTSD b. Delayed stress- manifests after a stressful event c. cumulative stress- occurs after youve been exposed to prolonged stress d. PTSD- reexperiencing something traumatic and overresponding to stimulus that recall an event 21. What is the purpose of CISM? a. CISM is designed to help people deal with their trauma one incident at a time, by allowing them to talk about the incident when it happens without judgment or criticism. this is for EMS 22. Why is it important for EMS personnel to develop non-adversarial relationships with their co-workers? a. Maintaining good working relationships with EMS personnel allows for better community care in a stressful profession. This can be noticing excessive stress to offer help, substance abuse, or changed behavior. b. Because they depend on one another for their safety 23. How can we reduce risk of litigation in EMS? a. provide competent care that meets current standards b. Understand and work under our scope of practice c. Understand local laws regulating EMS 24. Know the different types of consent including minor, implied and involuntary a. Minor consent- A parent or guardian is required to consent for a child unless they are emancipated (legally are treated like adults), i. in loco parentis- if they dont have a parent present a company or provider can make a decision for the child, or if they are married b. Expressed consent- verbal or acknowledged consent c. Informed consent- you explained the risks and the nature of the treatment to get the patients consent d. Implied Consent- allows EMS to make medical decisions if the patient is unable to such as intoxicated, mentally impaired or suffering e. Involuntary Consent- Consent given/granted by the court. for mentally challenged people who are not mentally competent i. also allows police to make decisions for their prisoners 25. How do we check for decision making capacity? a. PPPT i. P- person what is your name ii. P- place where are you? iii. P- purpose what are you here for? iv. T- time What time, day, month is it? v. If they answer all 4 questions then they are competent and A&Ox4 b. Over age of 18 or emancipated 26. When can patients withdraw their consent from treatment? Block 1 Study Guide a. Anytime as long as they are competent. Every competent adult b. Have to sign AMA i. if they refuse to sign you need to get a a witness that is not an EMT 27. Who will your skills and duties be compared to as an EMT? a. The standard of care of an EMT will be compared to how a person with similar training, equipment, and location would act in the same situation b. 28. Define negligence. What would be an example of it? a. Negligence is failure to provide the same care that a person with similar training would provide in a similar situation. Duty, breach duty, damages, causation (cause and effect between beach of duty and damages) i. if you find someone unconscious and as you take them to the hospital you drop them giving them a facial laceration pg. b. A breach of the following four factors pg 98 c. Duty: if you’re on the clock, even if you’re one minute at the end of your shift, you must go and provide care. d. Breach of Duty: when an EMT goes against that duty e. Damages: there are measurable damages caused by the action of the EMT, even something as small as the EMT causing acute stress that results in PTSD, which requires professional treatment, causing monetary loss. f. Causation: an EMT drop the pt and they break a bone in their hand. 29. What is abandonment? Give an example (*hint check your book for examples!) a. termination of care without the patient’s consent and without transfer of care to a provider as skilled or more skilled than you b. Ex: you are caring for a patient who was in a crash and you hear of a worse crash with more patients and hand care over to 2 injured patients as you go help the others 30. When does transfer of care occur? a. When an EMT gives an oral report to the emergency room doctor or nurse b. When the EMS service arrives at the hospital to transfer the pt to another caregiver, when the pt must be transferred to another transport. c. NOTE: it is a good idea to get a signature on the PCR noting a transfer of care. 31. How can a patient refuse transport? What is an informed refusal? a. b. c. d. e. 32. If your portable radio is not working what should you use? (*hint, it’s not your cellphone) a. use the mobile radio in the ambulance to contact dispatch 33. What has the weakest transmission signal? Block 1 Study Guide a. Hand-held portable radio 34. What is a scanner? a. a radio receiver that can automatically tune, or scan, two or more discrete frequencies, stopping when it finds a signal on one of them and then continuing to scan other frequencies when the initial transmission ceases. 35. What are the functions of the Federal Communications Commission (FCC)? a. has jurisdiction over interstate and international telephone and telegraph services and satellite communications b. Allocate specific radio frequencies for ems to use, license base stations &assign appropriate radio call signs for those stations, Establish licensing standards and operating specifications for radio equipment used by ems providers, establish limitations for transmitter power output PG 1522 36. What occurs during the alert and dispatch phase of EMS communications? a. properly screen and assign priority to each call, select and alert appropriate ems, dispatch & direct ems response unit to the correct location, coordinate ems unit with other public safety services until the incident is over, provide emergency medical instructions to the telephone callerso that essential care may begin before emts arrive 37. What is the first thing you should do after being dispatched for a response? a. You should confirm that you en-route to the dispatched location and let them know if you have any problems b. make sure to get nature and severity of the call, exact location, number of patients, responses by other public safety agencies, special directions or advisories, time at which the units are dispatched 38. What are the general guidelines of effective radio communication? a. turn radio on and adjust volume, ensure a clear frequency when speaking pg 143 b. Keeping it short and clear. Do not waste time with pleasant remarks and friend making. Only provide clear information. Do not yell and speak in a monotone voice. 39. What is included in a radio report to the hospital? a. your unit identification, the receiving hospital, the ETA, the patients age and gender, chief complaint or your perception of it/ its severity, history of the current problem, brief report of physical findings/ vital signs, brief report of care given and any patient response, brief description of patients response, determine if recieving facility have any additional questions 40. After receiving online orders from med-control what should you do? a. repeat the order word for word then get confirmation, this eliminates confusion. when an order doesnt sound right then ask again and question the order 41. If you can’t contact medication control for online-orders, what type of orders can you follow? a. medical control? b. Use the offline (indirect) instructions c. Offline control is when the EMS practitioner follows protocols d. Standing orders are written by MD pg 145 Block 1 Study Guide 42. When would you use a blanket/clothes drag to extricate a patient? a. blanket drag is used to move a patient from a bed to a stretcher b. clothes drag is used to move patients who are blocking another patient or in a spot where they cannot be assessed pg 269, 281 43. When would you use the rapid extrication technique? How do you do this? (*hint long backboard) a. Urgent moves are performed with precaution for spinal injury b. the vehicle or scene is unsafe, explosives or other hazardous materials are on scene, fire or a danger of fire, the patient cant be properly assessed before being taken out of the vehicle, the patient needs to be in supine position to be treated (emergency), the patient has a life-threatening condition that requires them to be rapidly transported to the hospital, the patient blocks you from a seriously injured patient c. Performed by 3 providers who are knowledgeable and experienced with the procedures, one is stabilizing neck and head, the second is moving the pt onto a long backboard, the third gives commands and performs primary assessment d. https://www.youtube.com/watch?v=5RSL1w7QPbg 44. What type of situation would a direct ground lift be effective? a. with patients with no suspected spinal injury, lying supine on the ground, use this lift when you have to carry a patient to be placed on a stretcher 45. When should you NOT use an extremity lift to move a patient? a. when a patient has an extremity/ spinal injury and is not in a supine or sitting position pg 290 46. What is the direct carry technique used for? a. It is used to transfer a patient supine on a bed to the stretcher pg 291 i. if no sheet present 47. When is the draw sheet method used? a. similar to a blanket drag. The rescuers drag sideways the bedsheet beneath the patient so that both the bedsheet and the patient is moved. used to transfer a patient from bed onto a stretcher 48. How would you immobilize a patient who has a severely kyphotic spine? a. a patient with a curved spine must be placed on their side and immobilized in place with towel and blanket rolls 49. How do you push a wheeled ambulance stretcher? a. Step 1: Face each other and use both hands. Step 2: Lift the backboard to carrying height. Step 3: Turn in the direction you will walk, and switch to using one hand. When rolling the wheeled ambulance stretcher, make sure that it is in the fully elevated position. 50. When would you use a vest-style device? a. A vest style device would be used to move a patient in a similar situation as the use of a RET, but there is not a time-critical need to move them. It takes about 6-8minutes, but provides greater spinal support in moving the patient onto a backboard. 51. When and how do you use a scoop stretcher? Block 1 Study Guide a. it is split to 2 to 4 pieces and can go around a patient b. You must have access to the patients from all sides. At least 2 rescuers are required, one to prepare and position the stretcher and one to move the patient c. is a device used specifically for moving injured people. It is Ideal for carrying casualties with possible spinal injuries. 52. When is humidified oxygen recommended for use in transport? a. When the oxygen will be administered over a long period of time b. Humidified oxygen is used when a patient needs to be on oxygen for long periods of time. Humidifying the oxygen prevents it from drying out and irritating the upper airway tissues. 53. What is in a jump kit? What is the purpose of it? a. ensure that you have immediate access to the AED. have available all of the equipment that you will use in the entire call. have easy access to manage patients with severe uncontrolled bleeding. b. disposable gloves, face shield, triangular bandages, trauma shears, adhesive tape, trauma dressings, self adhering rolled bandages, oropharyngeal, bvm with mask for adults kids and infants, blood pressure cuff, Stethoscope, pen light, sterile gauze, sterile dressing, adhesive strips, oral glucose, activated charcoal 54. What is the main objective of traffic control? a. the purpose of traffic control is to ensure some orderly traffic flow and to prevent another crash 55. What occurs during the delivery phase in the 10 phases of an ambulance call? a. during the delivery scene you will report your arrival to the triage nurse or other arrival personnel, physically transfer the patient from the stretcher to the bed directed for your patient, present a complete verbal report at the bedside to the one who is taking over the patient's care, complete a detailed report of patient and get required signatures and leave a copy with appropriate staff member ereports are commonly used and need to be printed 56. How do you use your ambulance lights when it’s nighttime? a. You should always use your PA system, but you could use them in conjunction with the high beams pg 1375 b. In accordance with local guidelines 57. Why is aggressive ambulance driving an issue? a. it may not allow for other vehicles to have a proper reaction time to your vehicle. b. We should drive defensively in order to ensure safety for ourselves and our pt. Aggressive driving could be assumed that we are 1.) not building a 4 second cushion in front of the vehicle or a safety cushion around the vehicle and 2.) it could be assumed that you are no longer scanning the road for potential dangers. Pg. 1372. 58. When can ambulances drive in opposing traffic lanes? a. when you urgently have to but you have to use your lights also when the other side is blocked 59. What should you do if you are being tailgated while responding lights/sirens? Block 1 Study Guide a. never speed up to create more distance, never slam on your brakes to intimidate the driver it will end in a crash, b. slow down because tailgaters are impatient and will pass you pg 1317 60. Why is excessive speed unsafe? a. because it makes it difficult for the emt to treat the patient, it is a higher risk for a crash because the driver has less time to react pg 1372 61. What should you do if you begin hydroplaning? a. you start hydroplaning more than 30 miles an hour b. gradually slow down without jamming on the brakes 62. When should you use your warning lights and sirens? a. it depends on the local rules but regardless the ems should do a risk-benefit analysis b. the time saved is minimal so only use it for absolute emergencies c. also take into account how a patient reacts due to their condition. do they get seizures triggered by flashing lights? consider if it’ll make the patients condition worse 63. What is your primary concern on the scene of a motor vehicle crash? a. your safety so make sure to assess the scene for hazards 64. What is a scene size up? a. the ongoing process of information gathering and scene evaluation to determine appropriate strategies to manage the emergency while still being aware of possible hazards 65. What is situational awareness? a. the ability to understand and react to the threats around you pg 1392 b. remember that scenes are always changing and pay attention to weathe traffic, patients and bystanders 66. What is a 360 degree walk around? Why do we do this? a. walk around and assess the mechanism of injury, downed power lines, leaking fuels or fluids, smoke or fire, broken glass, trapped or ejected patients the # of patients and vehicles involved 67. How/when is the rapid extrication technique used in car crashes? a. Rapid extrication is indicated when the scene is unsafe, a patient is unstable, or a critical patient is blocked by another less critical patient. b. technique to move a patient from a sitting position inside a vehicle to supine on a backboard in less than 1 minute when conditions do not allow for a standard immobilization 68. What are some of the types of specialized rescue teams? a. CAVE RESCUE, CONFINED SPACE RESCUE, CROSSFIELD AND TRAIL RESCUE (PARK RANGERS), dive rescue, missing person search and rescue, mine rescue, mountain rock and ice climbing rescue, ski slope or cross country snow rescue, structural collapse rescue, special weapons, and tactics SWAT, technical rope rescue, trench rescue, water, and small craft rescue, white water rescue 69. What is your role as an EMT during a search and rescue? Block 1 Study Guide a. stand by the command post until the missing people have been found pg 1400 70. What are some of the hazards associated with trench rescues? a. in a trench there is soil that weighs 100 pounds per cubic foot making it difficult for people to expand their lungs if caught under thousands of pounds of weight b. there is also the risk of a secondary collapse c. when EMS personnel arrive park at least 500 feet from the trench pg 1401 71. If the incident command is already established who should you report to? a. first, check in with the incident commander at the base staging area or other location designated by the ic b. b) take into consideration the level of the incident he could have section chiefs to support if a level is at a higher scale 72. What does the U stand for in FAILURE? a. F- failure to understand the environment b. A- additional medical problems not considered c. I- inadequate rescue skills d. L- lack of teamwork or experience e. U- underestimating the logistics of a situation f. R- rescue versus recovery mode is not considered g. E- equipment not mastered 73. Know the triage categories and what injuries are associated with them (Green, Yellow, Red, Black) a. Green- third priority, minor fractures, minor soft tissue injuries b. Yellow- second priority, burns without airway compromise, major burn injuries, back injuries w/o spinal cord damage c. red-first priority, airway compromised, uncontrolled bleeding, severe medical problems, signs of shock, severe burns, open chest or ab injuries d. black- fourth priority, obvious death, obviously unsurvivable, respiratory arrest, cardiac arrest 74. Know START triage and JumpSTART triage a. use flashcards for this b. START is for 9 or older/ at least 101 lbs it sorts patients based on priority 75. START stands for Simple Triage And Rapid Treatment 76. Is there a correlation between the color of the container and the contents? a. In most cases, there is no correlation between the color of the drum and the possible contents 77. What kind of chemical requires a placard regardless of size/weight? a. explosives, poisonous gas, water-reactive solids and high-level radioactive substances 78. What agent possesses an odor similar to almonds? What does it do? a. Cyanide is a metabolic agent, it affects the body’s ability to use oxygen, starts in the cellular level then rapidly affects the organ level pg 1462 79. Define a disease vector a. When an animal spreads a disease its infected with, with another animal Block 1 Study Guide 80. Describe the skin lesions in smallpox (what is their size, shape, how/when do they develop?) a. in smallpox all the lesions are identical in their development, they begin on the face and extremities then move to the chest/ abdomen b. It is very contagious but most contagious when the blisters have formed pg 1465 81. Know the clinical presentation of smallpox a. severe fever, malaise, body aches, headaches, small blisters on the skin, bleeding on the skin, mucous membranes, incubation period 10 -12 days, duration 4 weeks pg 1465 82. How do viral hemorrhagic fevers present (aka what are their initial signs and symptoms)? What do they do to the body? a. initially the patient will have flu-like symptoms then progressively getting worse such as internal and external hemorrhaging b. it causes the blood vessels and tissues to seep blood pg 1465 83. What form of anthrax is the deadliest? Why? a. Pulmonary anthrax or inhalation anthrax is the most deadly b. deadly when anthrax bacteria are inhaled; the protein causes rapid swelling and fluid buildup in the lungs 84. What is Botulinum toxin? a. a neurotoxin that is produced by bacteria and is the most potent neurotoxin b. this toxin affects the nervous system ability to function, voluntary muscle control diminishes and eventually causes muscle paralysis which includes respiratory tract 85. What are the S/S of both inhaled and ingested ricin? a. ingested are fever, chills, headache, muscle aches, nausea, vomiting, diarrhea, , severe ab cramping, dehydration, gastrointestinal bleeding, necrosis of liver spleen kidneys& gastrointestinal tract b. inhaled- fever, chills, nausea, local irritation of nose eyes throat, profuse sweating, headache, muscle aches, noproductive cough, chest pain, dyspnea, pulmonary edema, severe lung inflammation, cyanosis, seizures, respitory failure 86. What are the biological agents that can be transmitted from person to person? a. Pneumonic plague (high), Smallpox (high), viral hemorrhagic fevers (moderate) 87. What are Vesicants? a. Blister agents that if left long enough on skin can produce vapors that burn the respiratory tract 88. What are the different agents pg 1462 a. Chemical Agents- liquids or gases that are dispersed to kill or injure, they can have a vapor or contact hazard also called vesicants (blister agents)i. sulfur mustard is a gas that is instantly absorbed and does irreversible damage to the cells it is a mutagen that mutates, damages the cells Block 1 Study Guide ii. Lewisite and phosgene are similar to sulfur mustard and are forms of vesicants b. Pulmonary Agents- gases that cause immediate harm to people exposed to them i. Chlorine and phosgene (not phosgene oxime) are pulmonary agents ii. these agents damage the lung tissue and fluid leaks into the lungs c. Nerve Agents- classified as WMDs (weapons of mass destruction) they can cause cardiac arrests within seconds to minutes of exposure i. Organophosphates block an essential enzyme in the nervous system causing the bodys organs to become overstimulated and burn out ii. G agents- created by germans the following are listed from high to low votality 1. Sarin(GB), Soman(GD), Tabun(GA), V Agent (VX) d. Metabolic Agents (cyanide)- affects the bodys ability to use o2 i. Cyanide- a colorless gas that has a smell similar to almonds effects start at the cellular level then rapidly progress and affect the organs e. Biologic Agents- they are undetectable and sometimes have the same symptoms as many minor illnesses i. spread through dissemination (terrorist spreads it), disease vector(animal to animal) 89. What are neurotoxins? a. They are the most deadly substance known to humans but are not WMDs because they haven’t been successful in turning them into WMDs i. Botulinum Toxins, Ricin 90. What are the WMDs? a. B-NICE is a good acronym Biologic weapons, Nuclear, Incendiary, chemical, explosive 91. Phases of EMS Communications a. Initial receipt of call: acknowledge the call, respond to the call b. En route to call: request assistance with directions, when needed. Request additional resources when needed c. On the scene: report arrival at the scene, check-in; often a system will require EMS units to transmit every 20 minutes as a safety measure, requisition additional resources when needed, report leaving the scene d. Arrival at the hospital (or point of transfer): notify dispatch of arrival at the point of transfer e. Return to service: Notify dispatch when the unit is available for another call f. Misc: some systems require EMS units to notify dispatch anytime they are not in station.