NURSE-UN 001 STUDY GUIDE FOR EMT Final Exam Review_Melissa Perkowski,100% CORRECT
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NURSE-UN 001
NURSE-UN 001 STUDY GUIDE FOR EMT Final Exam Review_Melissa Perkowski
1. Review types of consent (implied, expressed, etc)
o Consent is generally required from every conscious adult before care can be started. The foundation of consent is
decision-making capacity.
o Implied consent legal...
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NURSE-UN 001 STUDY GUIDE FOR EMT Final Exam Review_Melissa Perkowski
1. Review types of consent (implied, expressed, etc)
o Consent ➔ is generally required from every conscious adult before care can be started. The
foundation of consent is
decision-making capacity.
o Implied consent ➔ legal assumption that treatment was desired.
▪ Applies to patients who are unconscious or are otherwise incapable of making a
rational, informed decision about care. It applies only when a serious medical condition
exists and should never be used unless there is a threat to life or limb.
▪ The principle of implied consent is known as the emergency doctrine.
▪ Sometimes what represents a “serious threat” is unclear, and it may become a lega
question.
o Expressed consent ➔ patient gives express authorization for provision of care or transport.
The patient acknowledges he or she wants you to provide care or transport.
▪ To be valid, the patient must provide informed consent, which means you have
explained the treatment being offered, along with the potential risks, benefits, and
alternatives, as well as the potential consequences of refusing treatment. Informed
consent is valid if given orally. Always document when a patient provides informed
consent, or have someone witness the patient’s consent.
o Involuntary consent ➔ Applies to patients who are mentally ill, in a behavioral
(psychological) crisis, are developmentally delayed.
▪ You should obtain consent from the guardian or conservator; however, it is not always
possible to obtain such consent, so understand your local provisions (sometimes need
a law enforcement authority to be present to take person to medical facility)
2. Review what your actions should be if you come across an MVC as an EMT on duty and off duty
o If you are off duty and come upon a crash, you are not legally obligated to stop and assist
patients.
3. Recall the functions of the National Registry, AHA, DOT, Trauma centers, Local EMS offices,
State EMS offices
o National Registry of Emergency Medical Technicians (NREMT) ➔ is a nongovernmental
agency that provides national standardized EMS testing and certification in much of the
United States. May states use the National Registry standards in certifying their EMTs and
grant licensing reciprocity to NREMT-certified EMTs
▪ EMS is regulated ENTIRELY by the state in which you are licensed
o American Heart Association (AHA) ➔Every 3 to 5 years, the AHA unveils a revised set of
guidelines based on large amounts of evidence and serves as a standard for basic life
support (BLS) and cardiopulmonary resuscitation (CPR).
o Department of Transportation (DOT) ➔ DOT published the first EMT training curriculum in
, the early 1970s. In the late 1970s, the DOT developed a recommended National Standard
Curriculum.
o Trauma Centers ➔ Trauma centers are categorized as either adult trauma centers or
pediatric trauma centers, but notnecessarily both. The goal of a trauma system is to get the
right patient to the right facility in the right amount of time.
▪ Trauma patients with shock, or a suspicious MOI, generally should go to a trauma center.
▪ Trauma centers are classified from levels I III, with level I being able to handle every
trauma.
o Local EMS offices ➔At the local level, each EMS service operates in a designated PSA in
which it’s responsible for the provision of prehospital emergency care and the
transportation of the sick and injured to the hospital. The medical director decides day-
to-day limits of EMS personnel. Examples include the medications that will be carried on
an ambulance or where patients are transported.
o State office of EMS➔ is the standards for prehospital emergency care and the individuals
who provide it are typically regulated by the state office of EMS
▪ EMT training in nearly every state meets or exceeds the guidelines recommended by the
National Highway Traffic Safety Administration (NHTSA)
4. Review types of medical direction, and know situations that would dictate the use of each type
o Medical direction ➔ a physician medical director authorizes EMTs to provide medical care
in the field. Appropriate care is described in standing orders and protocols.
▪ Medical control can be off-line or online.
➢ Off-line (indirect) - Standing orders, training, supervision
➢ Online (direct) - Physician directions given over the phone or radio
5. Review the components of an EMS system
,o There are 14 components of the EMS system
o The EMS Agenda for the Future outlines 14 components of an EMS system
▪ Public access ➔ easy access to help in an emergency is essential. The 9-1-1 system is
the public safety access point. At the communication center, trained dispatchers obtain
information and dispatch the ambulance crew and other equipment and responders.
An emergency medical dispatch (EMD) system has been developed to assist
dispatchers in providing callers with vital medical instructions until EMS arrival.
▪ Communication systems ➔ From caller information, the dispatcher selects the
appropriate parts of the emergency system to activate. EMS may be: part of the fire
department, part of the police department, Independent (either public or private). New
technology helps responders locate their patients for example cellular telephones
linked to global positioning system (GPS) units.
▪ Clinical care ➔ Describes the pieces of equipment, scope of practice for using that
equipment and familiarizes EMTs with their primary service area (PSA), or main area
in which an agency operates. Overall, it familiarizes EMTs with ambulance controls.
▪ Human resources ➔ Focuses on the people who deliver the care such as their
compensation, interaction with other members of medical community and well-being.
Efforts are underway to allow EMS providers to move from state to state more
seamlessly. The EMS Agenda for the Future encourages the creation of systems to help
protect the well-being of EMS providers, including building career ladders.
▪ Medical direction ➔ Physician medical director authorizes EMTs to provide medical
care in the field. Appropriate care is described in standing orders and protocols.
▪ Legislation and regulation ➔ Although each EMS system, medical direction, and training
program has latitude, its training, protocols, and practice must follow state legislation,
rules, regulations, and guidelines. A senior EMS official is usually in charge of necessary
administrative tasks such as scheduling, personnel, budgets, purchasing, and vehicle
maintenance, and the daily operations of ambulances and crews.
▪ Integration of health services ➔ Prehospital care by the EMT is coordinated with
care administered by the receiving hospital. Care simply continues in the hospital
emergency department. This ensures that the patient receives comprehensive
continuity of care.
▪ Evaluation ➔ The medical director maintains quality control. CQI reviews and performs
audits of the EMS system to identify areas of improvement and/or assign remedial
training. Information and skills in emergency medical care change constantly. Refresher
training and continuing education are important. Minimizing errors is the goal.
▪ Information systems ➔ Systems are used to document the care provided. Once stored
electronically, the information can be used to improve care. For example, stored
, information can help determine: Average on-scene time for trauma patients, Need for
educational sessions, National trends
▪ System finance ➔ Finance systems vary depending on which organization is involved.
Personnel may be paid, volunteer, or a mix. EMTs may be involved in gathering
insurance information, attending fund- raisers, or other activities that will help the
department secure its finances.
▪ Education systems ➔ EMS instructors are licensed in most states. ALS training is
usually provided in college, adult career center, or hospital settings. Continuing
education is needed to update knowledge and refresh skills.
▪ Prevention and public education ➔ Prevention and public education are aspects of
EMS where the focus is on public health. Public health examines the health needs of
entire populations with the goal of preventing health problems.
6. Recall the following terms and know the importance in the prehospital setting
Negligence, Abandonment, CQI, PCR, EMS administrator, Medical Director, DNR, living
will.
o Negligence ➔ Failure to provide standard of care
▪ It’s based on the following four factors: duty, breach of duty, damages, and causation.
All four elements must be present for the legal doctrine of negligence to apply and for
a plaintiff to prevail in a lawsuit against an EMS service or provider.
o Abandonment ➔ Unilateral termination of care. It’s termination of care without the
patient’s consent and without making provisions for the transfer of care to a medical
professional with skills at the same level or at a higher level than your own skills.
Abandonment is legally and ethically a very serious act.
o Continuous Quality Improvement (CQI) ➔ A system of internal reviews and audits of the
EMS system to identify areas of improvement and/or assign remedial training. Positive
feedback is also discussed. If a problem appears to be repeated by a single EMT or crew,
the medical director will discuss the details with the individual involved.
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