EMT

• Ambulance types:

  -1: truck chassis with modular ambulance body

  -2: standard van

  -3: specialty van design with square patient compartment mounted on chassis
• Sterilization: removes and kills all life forms/biological agents
• Disinfection: removes pathogenic microorganisms but not microbial forms (ex. Spores)
• Decontamination: reduces microbial contamination
• HEPA:

  -aerosol generating procedures such as suctioning, CPR, endotracheal intubation

  -tuberculosis

  -NOT required for bloodborne (HIV), use face shield and eye protection for bodily fluid contact splatter risk (uncontrolled bleeding, vomiting, suctioning)
• Handwashing: 20 seconds
• DNR: still need to give oxygen/other treatment if patient is in respiratory distress
• ICS (incident command system)

  -used in mass casualty (3+ patients)

  -ensures responder and public safety, achieves incident management goals, and promotes the efficient use of resources.

  -does not train or evaluate EMS system
• Medical Incident Command:

  -Triage- treatment does not begin until triage ends

  -Treatment

  -Transportation

  -Staging (for large incidents when numerous vehicles on scene)

  -Rehabilitation (for responders to recover)

  -Extrication and special rescue
• Red (Immediate): airway breathing issue, severe bleeding, shock, hypoperfusion severe burn, open chest/abdominal wound
• Yellow (Delayed): burns without airway compromise, major bone injuries, back injuries, with or without spinal cord damage
• Green (minimal): minor fractures, soft tissue injuries
• Black (Expectant): non survivable injury, pulseless, major open brain trauma, cardiac arrest, resp arrest if limited resources
• Liason officer: relays info to responding agencies
• Logistics: procure and stockpile equipment
• IC: responsible for incident operations and operations at incident site
• Extrication: determines equipment and resources needed for extrication or special rescue
• Standing order: part of EMS protocol (ex. Giving oxygen to chest pain), if it requires medical direction contact, it is not a standing order
• Medical director authorizes or delegates EMS to provide medical care in the field

  medical control is the instructions given
• Good Samaritan Law: not liable for errors made in good faith emergency care
• Duty to Act: responsibility to provide patient care
• Battery: unlawful touching, including providing emergency care without consent
• Assault: unlawful placement of a person in fear of immediate bodily harm
• Negligence: failure to provide same care that person of similar training would
• Helicopters

  -approach helicopter in crouched position from front, after pilot gives OK
• Primary assessment: immediate life threatening conditions

  -general impression, consciousness (AVPU), ABCs
• Secondary assessment: can be complete or focus on chief complaint

  -adults: head to toe

  -children: feet to head
• Abuse:

  -injuries at various staged of healing

  -injuries to genitals/buttocks

  -unusual patterns of injury

  -femoral fractures without trauma

  -delay in seeking care

  -inconsistent history
• At scene of mvc, park ambulance 100 ft away if possible, with wheels turned away from scene, angle in fend off position (10 degrees) 🡪 keeps ambulance from being pushed into scene if struck
• PCR (patient care report): 

  -patient info

  -chief complaint

  -LOC

  -vitals

  -objective and subjective findings

  -treatment provided

  -times of incident reporting, EMS arrival on scene, departure, EMS arrival at receiving facility, transfer of patient care
• Patient report to receiving hospital:

  -Unit, service level

  -Receiving hospital and ETA-patient age and gender

  -chief complaint

  -brief history of chief complaint

  -physical findings

  -treatment provided

  -description of patient’s response to treatment
• Hepatitis: general term referring to inflammation of the liver, and it may result from either infectious or noninfectious
• Hep A, Hep B, and Hep C can all result in disease, nausea, abdominal pain, malaise, jaundice and right upper quadrant pain can develop several weeks after exposure
• Vaccines are available for Hep A and Hep B
• Hep B, Hep C and Hep D can transmitted through blood or sexual contact
• Hep A can be transmitted through fecal-oral
• Hep B and Hep C can lead to chronic infection, cirrhosis, cancer
• Primary blast injury is blast on body

  Signs and symptoms are barotrauma (blast lung), middle ear damage, abdominal hemorrhage, intestinal perforation, eyeball rupture, mild concussion
• Secondary blast injury is blast debris on body

  signs and symptoms are penetrating or blunt injuries
• Tertiary blast injury is body hurled onto debris

  signs and symptoms are fractures, amputations, closed/open brain injury