Chapter 1
EMS Systems
and Research
Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1-1
Course Overview
1-2
Objectives
1-3
The Emergency Medical Technician
• Emergency Medical Technician (EMT)
– A member of the Emergency Medical
Services (EMS) team who
• Responds to emergency calls
• Provides efficient emergency care to ill or
injured patients
• Transports the patient to a medical facility
1-4
The Emergency Medical Technician
• Emergency Medical Technicians
– May be paid or volunteer personnel
1-5
Goals of EMT Training
• Recognize the nature and seriousness of a patient’s
condition or extent of injuries to determine the
emergency medical care the patient requires
• Safely and efficiently provide appropriate emergency
medical care based on your assessment findings of
the patient's condition
• Lift, move, position, and otherwise handle the patient
to minimize discomfort and prevent further injury
• Safely and effectively perform the expectations of
the job description
1-6
Origins of
Emergency Medical Services (EMS)
1-7
Origins of EMS
• Emergency
– An unexpected illness or injury that
requires immediate action to avoid
risking the life or health of the person
being treated
1-8
Origins of EMS
1-9
Origins of EMS: 1900–1960
• Civilian ambulance services began
in Cincinnati and New York City
• Mid-1940s
– Rural communities recognized
need for local fire protection and
first aid
• 1950s
– Mobile Army Surgical Hospital
(MASH) units used helicopters
for evacuation in Korean War
• 1960
– Cardiopulmonary resuscitation
shown to be useful
1-10
(Bettmann/CORBIS.)
How It Began
• Non-military ambulance services began
operating in early 1900s in U.S.
• Often operated by hospitals, fire
departments, or funeral homes
• No requirements or standards for equipment,
crew training, or ambulance design
• “You call, we haul, that’s all!”
Origins of EMS: 1960–1970
•
Before 1966
– Volunteers untrained in emergency care
– Minimal stabilization at emergency scene
– Transport to nearest hospital often
provided by
•
•
•
Funeral homes
Taxis
Automobile-towing companies
1-13
Origins of EMS
• 1966
– Accidental Death and Disability: The
Neglected Disease of Modern Society
• “The White Paper”
– Exposed inadequacies of prehospital
services
– Beginning of modern EMS
1-14
Origins of EMS
Highway Safety Act of 1966
• Charged National Highway
Traffic Safety Administration
(NHTSA) with responsibility for
improving EMS
• Provided funding for programs
to reduce highway-accidentrelated deaths
• Established national standards
1-15
Origins of EMS
1988 – 10 EMS System Components
1. Regulation and
policy
2. Resource
management
3. Human resources
and training
4. Communications
5. Transportation
6.
7.
8.
9.
Medical oversight
Trauma systems
Facilities
Public information
and education
10. Evaluation
1-16
Origins of EMS – 1996
• EMS Agenda for the Future
– Proposed continued integration of EMS
into the healthcare system
1-17
Origins of EMS-2006
• National EMS Scope of Practice Model which
confirmed the new label for the second level
of Emergency Medical Technician—Basic
(EMT-B) to EMT.
• Increases uniformity in EMS practice nationwide
and facilitates reciprocity between states.
1-18
Origins of EMS-2009
• 2009-NHTSA National EMS Education
Standards
– Outlines the minimum objectives to be
covered by each level of EMS provider
1-19
The Emergency Medical Services System
1-20
Course Description (1 of 8)
• EMS system
– Team of health care professionals
– Provides emergency care and transport
– Governed by state laws
Source:© Corbis
The Emergency Medical Services System
• EMS system
– Coordinated network of resources
– Provides emergency care and
transportation to victims of sudden
illness or injury
• Healthcare system
– A network of people, facilities, and
equipment designed to provide for
the general medical needs of the
population
• EMS is a part of the healthcare system
1-22
EMS System Components
Legislation & Regulation
• Each state must have
laws in place that
govern its EMS system
1-23
EMS System Components
Communications
• An EMS system must
– Provide a means by which a citizen can
reliably access the EMS system (usually
by dialing 9-1-1)
– Allow contact between different agencies,
vehicles, and personnel
1-24
EMS System Components
Communications
• 9-1-1
– Official national emergency number
in the United States and Canada
• Enhanced 9-1-1 (E9-1-1)
– Routes call to 9-1-1 center closest
to caller
– Automatically displays caller’s
phone number and address
– Most 9-1-1 systems today are
Enhanced 9-1-1 systems
1-25
Emergency
Medical Dispatchers
• Can provide instructions to callers on how to
provide emergency care until EMS personnel
arrive
• EMD certification required in some
jurisdictions
Chain of Human
Resources in EMS System
Critical Decision Making
• Critical decision making is very important in
EMS
• Information must be gathered, patients
assessed, and determination made on
treatment and transport options
• Decisions often time-critical
Examples of Critical Decisions
• Is it better to take patient to closest hospital
or to one farther away but more appropriate
for the condition?
• Is patient stable enough for further
evaluation on scene, or should patient be
transported immediately?
• Will this treatment make patient better or
worse?
EMS System Components
Human Resources & Education
• Persons working in an EMS system are
expected to be trained to a minimum
standard
• National EMS Scope of Practice Model
– Defines four levels of EMS professionals
1. Emergency Medical Responder (EMR)
2. Emergency Medical Technician (EMT)
3. Advanced Emergency Medical Technician
(AEMT)
4. Paramedic
1-31
EMS System Components
Human Resources & Education
• Emergency Medical
Responder (EMR)
– A person who has the basic
knowledge and skills necessary
to provide lifesaving emergency
care while waiting for the arrival
of additional EMS help
– Trained to assist other EMS
professionals
1-32
EMS System Components
Human Resources & Education
• Emergency Medical
Technician (EMT)
– More skilled than an EMR
– Responds to emergency calls
– Provides efficient emergency
care to ill or injured patients
– Transports the patient to a
medical facility
1-33
EMS System Components
Human Resources & Education
• Advanced EMT (AEMT)
– More skilled than an EMT
– Has additional training in skills including
the following:
• Patient assessment
• Giving intravenous (IV) fluids and medications
• Performing advanced airway procedures
1-34
EMS System Components
Human Resources & Education
• Paramedic
– Can perform the skills of
an Advanced EMT
– Has had additional
instruction in
pathophysiology, physical
examination techniques,
assessing abnormal heart
rhythms using a heart
monitor, and invasive
procedures
1-35
Right to Practice
• Statutes
• Certification
• Licensure
• Scope of practice
• Credentialing
1-36
EMT Certification
• To be certified as an EMT, state agencies
require successful completion of an
approved EMT course
– National Registry of EMTs (NREMT)
requirements
– Maintenance of current status is a
personal responsibility
– Participation in CE courses or an EMT
Refresher Course is required for
recertification
1-37
Maintaining Knowledge and Skills
• An EMT’s education does not end with
completing the EMT course
• Must keep knowledge and skills current
– Continuing education (CE) courses
– Refresher courses
1-38
EMS System Components
Transportation
• Safe transport
• Appropriately staffed and equipped vehicle
– Ground ambulance
– Air medical service
1-39
EMS System Components
Medical Oversight
• Medical Oversight
– Process by which a physician
directs emergency patient care
provided by EMS personnel
– Every EMS system must have
medical oversight
– Physician who provides
medical oversight is called the
medical director
– Also referred to as medical
control or medical direction
1-40
EMS System Components
Medical Oversight
• On-line medical direction
– Also called direct or concurrent medical
direction
– Direct communication with a physician
• Radio
• Telephone
• Face-to-face communication at the scene
1-41
Medical Direction (2 of 2)
• 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
EMS System Components
Medical Oversight
• Off-line medical direction
– Also called indirect, prospective, or
retrospective medical direction
– Medical supervision through the use of:
•
•
•
•
•
Policies
Treatment protocols
Standing orders
Education
Quality management reviews
1-43
EMS System Components
Medical Oversight
• Prospective medical direction
– Activities performed by a physician
medical director before an emergency
call
• Treatment protocols
• Standing orders
• Retrospective medical direction
– Actions performed by a physician after
an emergency call
1-44
EMS System Components
Medical Oversight
• Treatment protocols
– List of steps to be followed during
provision of emergency care to an ill or
injured patient
• Standing orders
– Written orders authorizing EMS
personnel to perform certain medical
procedures before establishing direct
communication with a physician
1-45
EMS System Components
Facilities
• An ill or injured patient receives definitive
care in the hospital
• Examples of specialty centers
–
–
–
–
–
–
–
–
–
Trauma centers
Burn centers
Heart/cardiovascular centers
Hyperbaric centers
Pediatric centers
Perinatal centers
Poison centers
Spinal cord injury centers
Stroke centers
1-46
EMS System Components
Public Health & Injury Prevention
• Public health
– The science and practice of protecting and
improving the health of a community as a
whole.
• Healthcare professionals have a
responsibility to educate the public.
– Public education and injury prevention
programs often lead to more appropriate
use of EMS resources.
1-47
EMS System Components
Evaluation
• Quality management
– A system of internal and external
reviews and audits of all aspects of an
EMS system
– Used to identify areas of the EMS
system needing improvement and
ensure that patients receive the
highest quality medical care
1-48
Your Role in the Quality Management Process
• Quality management includes:
– Obtaining information from the patient,
other EMS professionals, and facility
personnel about the quality and
appropriateness of the medical care you
provided
– Reviewing and evaluating your
documentation of an emergency call
1-49
Your Role in the Quality Management Process
• Quality management includes evaluating:
– Your ability to perform skills properly
– Your professionalism during interactions
with the patient, EMS professionals, and
other healthcare personnel
– Your ability to follow policies and
protocols
– Your participation in continuing education
opportunities
1-50
Quality Improvement
• Continuous self-review to identify areas for
improvement
• Develop plans to address areas
continued
Quality Improvement
• Everyone in organization has a role
– Prepare careful documentation
– Involved in quality process
– Get feedback from patients, hospital staff
– Maintain equipment
– Continuing education
Phases of a
Typical EMS Response
1-53
Phases of a Typical EMS Response
1. Detection of the emergency
2. Reporting
– Call made for assistance
1-54
Phases of a Typical EMS Response
3. Dispatch/Response
– Medical resources sent to the scene
1-55
Phases of a Typical EMS Response
• On arrival at the scene, perform scene
size-up
– Look for hazards or potential hazards
1-56
Phases of a Typical EMS Response
4. On-scene care
1-57
Phases of a Typical EMS Response
5. Care during transport
1-58
Phases of a Typical EMS Response
6. Transfer to definitive care
1-59
Characteristics of
Professional Behavior
1-60
Professional Behavior: Integrity
• Integrity
– Honesty, sincerity,
truthfulness
– Assumed by public
– Single, most important
behavior
– Integrity in all actions
1-61
Professional Behavior: Empathy
• Empathy
– Identifying with and
understanding the
feelings, situations,
and motives of others
– Demonstrate empathy
to patients, families,
and other healthcare
professionals
1-62
Professional Behavior: Self-Motivation
• Self-Motivation
– Internal drive for excellence
– Must also be self-directed
1-63
Professional Behavior: Appearance
• “You never get a second chance to make a
good first impression.”
• Presenting a neat, clean, professional
appearance:
– Invites trust
– Instills confidence
– Enhances cooperation
– Brings a sense of order to an emergency
1-64
Personal Traits
of a Good EMT
•
•
•
•
Pleasant
Sincere
Cooperative
Resourceful
continued
Professional Behavior: Hygiene
• Good personal hygiene
– Bathing daily
– Using a deodorant or an antiperspirant
– Making sure hair, nails, and teeth are clean
• Good grooming
– Uniform that is clean, mended, and fits well
– Shoes that are clean, comfortable, provide
support, fit properly
– Wear a watch that displays seconds
– Fragrances should not be worn
– Tattoos and piercings should not be visible
1-66
Professional Attributes (1 of 4)
•
•
•
•
Integrity
Empathy
Self-motivation
Appearance and
hygiene
Professional Attributes (2 of 4)
•
•
•
•
•
Self-confidence
Time management
Communication skills
Teamwork and diplomacy
Respect
Professional Attributes (3 of 4)
• Patient advocacy
• Careful delivery of care
• Every patient is entitled to compassion,
respect, and the best care.
Professional Attributes (4 of 4)
• As health care professionals, EMTs are
bound by patient confidentiality.
• Be familiar with requirements of the Health
Insurance Portability and Accountability Act
(HIPAA).
Professional Behavior: Self-Confidence
• You will encounter situations involving:
– Minor injuries
– Life-threatening injuries
– Patients and family members who are upset
• Others will look to you as the person in
control
• You must be able to:
– Adapt to these situations
– Remain calm
– Display confidence
1-71
Professional Behavior: Communication
• Communication
– The exchange of thoughts, messages, and
information
– You must be able to convey information to
others verbally and in writing.
– You must also be able to understand and
interpret verbal and written messages.
1-72
Professional Behavior: Respect
• Feeling and showing polite regard,
consideration, and appreciation for others
• Introduce yourself to your patient
– “Hello. My name is ______, and I am an
Emergency Medical Technician. I am here
to help you. What is your name?”
1-73
Professional Behavior:
Time Management
• You must be able to prioritize tasks,
while simultaneously providing
patient care, and work quickly to
accomplish those tasks.
1-74
Professional Behavior:
Teamwork / Diplomacy
• Teamwork
– Ability to work with
others to achieve a
common goal
• Diplomacy
– Tact and skill in dealing
with people
1-75
Professional Behavior: Patient Advocacy
• An advocate is a person who supports
another.
– You must protect the patient from further
injury.
– If the patient is unable to speak, you must
be his voice and act in his best interests.
– You must protect the patient’s rights,
privacy, and dignity.
1-76
Professional Behavior:
Careful Delivery of Service
• Deliver the highest quality of patient care
with careful attention to detail
• Critically evaluate performance and attitude
1-77
Personal Traits
of a Good EMT
•
•
•
•
Pleasant
Sincere
Cooperative
Resourceful
continued
Personal Traits
of a Good EMT
•
•
•
•
Self starter
Emotionally stable
Able to lead
Neat and clean
continued
Personal Traits
of a Good EMT
•
•
•
•
•
Good moral character
Respectful of others
Control of personal habits
Control of conversation
Able to communicate
properly
• Able to listen to others
• Nonjudgmental and fair
Education
• Maintain up-to-date knowledge and skills
• Read EMS magazines; join EMS
organizations
• Refresher courses for recertification
• Continuing education to supplement original
training
continued
Education
• Conferences, seminars, lectures, classes,
videos, and demonstrations
Job Opportunities
• Ambulance
services
• Fire departments
• Medical facilities
• Rural/wilderness
teams
• Industrial settings
Duties as an
Emergency Medical Technician
1-84
Standard of Care
• No matter where they work, EMTs are
expected to provide the same standard of
care in an emergency
• Standard of care
– Minimum level of care expected of
similarly trained healthcare professionals
1-85
Your Obligations as an EMS Professional
• Respect each patient as an individual
• Provide emergency medical care to every
patient to the best of your ability
• Listen attentively to your patients
• Provide clear explanations
• Provide patients with emotional support
• Preserve each patient’s dignity during
examinations
1-86
Your Obligations as an EMS Professional
• The emergency medical care you provide
must be based on need and without regard to
the patient’s:
–
–
–
–
–
–
–
–
–
Race
Ethnicity
National origin
Religion
Gender
Age
Mental or physical disability
Sexual orientation
Ability to pay for the care provided
1-87
Primary Duties: Preparation and Safety
• Physical demands
– Stamina and endurance
– Walking, standing, and assisting in lifting
and carrying ill or injured patients
– Climbing and balancing may be required
– Patients may be accessible only if you
stoop, kneel, crouch, or crawl
1-88
Primary Duties: Preparation and Safety
• Maintain your health by exercising regularly
– Improves muscle tone and circulation
– Provides physical release for stress
• Get adequate sleep and rest
• Practice good nutrition and keep
immunizations up to date
1-89
Primary Duties: Preparation and Safety
• Appropriate equipment and supplies
• Adequate knowledge and skill maintenance
1-90
Primary Duties: Preparation and Safety
• Safety
1. Personal
2. Crew
3. Patient
4. Bystanders
1-91
Primary Duties: Response
• Safety
• Timeliness
1-92
Primary Duties: Scene Assessment
• Size up the scene before initiating patient
care
– Determine if the scene is safe
– Identify the mechanism of injury or the
nature of the illness
– Identify the total number of patients
– Request additional help if necessary
• Put on appropriate personal protective
equipment before approaching the patient
1-93
Primary Duties: Gaining Access
• Additional resources may be needed
– Law enforcement personnel
– Fire department
– Utility company
– Special rescue team
• Notify dispatch if resources are needed
1-94
Primary Duties: Patient Assessment
• Perform a systematic patient assessment
• Obtain vital signs
• Gather information about the emergency
1-95
Primary Duties: Emergency Care
• Give emergency medical care based on your
assessment findings
1-96
Primary Duties: Emergency Care
• Lifting and moving patients safely
– You must know the following:
• Body mechanics
• Lifting and carrying techniques
• Principles of moving patients
– You must be also familiar with equipment
used for lifting and moving
1-97
Primary Duties: Emergency Care
• Once you begin emergency care, you must continue
that care until:
– An individual with medical training equal to or
greater than your own assumes responsibility for
the patient, or
– You are physically unable to continue providing
care because of exhaustion, or
– There is a change in the scene that weakens or
endangers your physical well-being or
– When an adult patient, of adequate mental
capabilities and fully informed of the risks and
benefits of treatment, elects to terminate care
1-98
Primary Duties: Transport/Transfer of Care
• Identify yourself as an EMT
• Report the patient’s age, gender, primary problem,
and current condition
• Describe what happened and the position in which
the patient was found
• Describe pertinent assessment findings, including
vital signs
• Report any medical history obtained
• Describe the emergency medical care that you gave
• Describe the patient’s response to the treatment
given
1-99
Verbal Report
•
Remember “The Four Cs” when giving a
verbal report:
1. Courteous
2. Clear
3. Complete
4. Concise
1100
Primary Duties: Documentation
• Documentation is an important part of
prehospital care
• Documentation must be:
– Accurate
– Complete
– Concise
• Documentation should reflect:
– What you saw and heard at the scene
– The emergency care you gave
– The patient’s response to that care
1101
Primary Duties: Returning to Service
• Rapidly prepare for the next call
– Clean equipment as needed
– Restock any disposable equipment used
– Return equipment to its storage area
• Know policies regarding restocking of
supplies
1102
Primary Duties: Community Involvement
• Become actively involved in public education
– How to access the EMS system
– Injury prevention programs
•
•
•
•
•
Bicycle safety
Use of child safety seats
Poisoning prevention
Drowning prevention
CPR and first aid programs
1103
Primary Duties:
Personal Professional Development
• Healthcare professionals are responsible for
their personal professional development.
• Examples:
–
–
–
–
Participating in continuing education activities
Mentoring
Getting involved in professional organizations
Supporting and participating in research activities
1104
EMS Research
• Research is the foundation for medical
practice decisions and changes in patient
management.
• If you are asked to participate:
– Approach this responsibility seriously
– Complete the task assigned to the best of
your ability
1105
Questions?
1106
Source: www.ems.gov
Chapter Review
• EMS system includes 911 or other
emergency access system, dispatchers,
EMTs, hospital emergency department,
physicians, nurses, physician’s assistants,
and other health professionals.
• EMT’s responsibilities include safety; patient
assessment and care; lifting, moving, and
transporting patients; transfer of care; and
patient advocacy.
continued
Chapter Review
• EMT must have certain personal traits to
ensure the ability to do the job.
• Education, quality improvement procedures,
and medical direction are all essential to
maintaining high standards of EMS care.
Remember
• EMS dates back to Napoleonic times.
• Modern EMS standards come from 1960s–
1970s and National Emergency Medical
Service Systems Act (NEMSSA).
• There is a chain of human resources
involved in EMS. Critical decisions are made
by each member of the chain.
continued
Review
1. Which of the following is an example of care
that is provided using standing orders?
A.Medical control is contacted by the EMT after a
patient with chest pain refuses EMS care.
B.The EMT defibrillates a cardiac arrest patient,
begins CPR, and then contacts medical control.
C.A physician gives the EMT an order via radio to
administer oral glucose to a diabetic patient.
D.Following an overdose, the EMT contacts the
medical director for permission to give activated
charcoal.
Review
Answer: B
Rationale: Standing orders—a form of
off-line (indirect) medical control—involves
performing certain life-saving interventions
(ie, CPR, defibrillation, bleeding control)
before contacting a physician for further
instructions.
Review (1 of 2)
1. Which of the following is an example of care
that is provided using standing orders?
A.Medical control is contacted by the EMT after a
patient with chest pain refuses EMS care
Rationale: This is an example of online medical
control given via the phone or radio.
B. The EMT defibrillates a cardiac arrest patient, begins
CPR, and then contacts medical control
Rationale: Correct answer
Review (2 of 2)
1. Which of the following is an example of care
that is provided using standard orders?
C.A physician gives the EMT an order via radio to
administer oral glucose to a diabetic patient
Rationale: This is an example of online medical
control given via the phone or radio.
D.Following an overdose, the EMT contacts the
medical director for permission to give activated
charcoal
Rationale: This is an example of online medical
control given via the phone or radio.
Review
2. Quality control in an EMS system is the ultimate
responsibility of the:
A.paramedic.
B.lead EMT.
C.medical director.
D.EMS administrator.
Review
Answer: C
Rationale: The medical director is
responsible for maintaining quality control,
which ensures that all staff members who
are involved in caring for patients meet the
standard of care on every call.
Review (1 of 2)
2. Quality control in an EMS system is the ultimate
responsibility of the:
A.paramedic.
Rationale: A paramedic has the knowledge and
mastery of BLS and ALS skills.
B.lead EMT.
Rationale: This is the senior EMT with a service
or company.
Review (2 of 2)
2. Quality control in an EMS system is the ultimate
responsibility of the:
C.medical director.
Rationale: Correct answer
D.EMS administrator.
Rationale: The EMS administrator sees to the
daily operations and overall direction of the
service or company.
Review
3. Upon arriving at the scene of a domestic
dispute, you hear yelling and the sound of
breaking glass from inside the residence. You
should:
A.immediately gain access to the patient.
B.carefully enter the house and then call the
police.
C.retreat to a safe place until the police arrive.
D.tell the patient to exit the residence so you can
provide care.
Review
Answer: C
Rationale: Never enter a scene in which
signs of violence are present, including
yelling, screaming, or the sound of
breaking glass. Law enforcement must
secure the scene prior to the EMT’s entry.
Review (1 of 2)
3. Upon arriving at the scene of a domestic dispute,
you hear yelling and the sound of breaking glass
from inside the residence. You should:
A.immediately gain access to the patient.
Rationale: Never enter a scene in which signs of
violence are present. Law enforcement must
secure the scene.
B.carefully enter the house and then call the police.
Rationale: Never enter a scene in which signs of
violence are present. Law enforcement must
secure the scene.
Review (2 of 2)
3. Upon arriving at the scene of a domestic
dispute, you hear yelling and the sound
of breaking glass from inside the
residence. You should:
C.retreat to a safe place until the police
arrive.
Rationale: Correct answer
D.tell the patient to exit the residence so
you can provide care.
Rationale: Never enter a scene in which
signs of violence are present. Law
enforcement must secure the scene.
Review
4. Which of the following is NOT a component of
continuous quality improvement (CQI)?
A.Periodic review of run reports
B.Discussion of needs for improvement
C.Negative feedback to those who make mistakes
while on a call
D.Remedial training as deemed necessary by the
medical director
Review
Answer: C
Rationale: The purpose of CQI is to ensure
that the standard of care is provided on all
calls. This involves periodic run report
reviews, discussing needs for
improvement, and providing remedial
training as deemed necessary by the
medical director. Positive feedback should
be provided during this process.
Review
4. Which of the following is NOT a component of
continuous quality improvement (CQI)?
A.Periodic review of run reports
Rationale: This is a part of CQI.
C.Discussion of needs for improvement
Rationale: This is a part of CQI.
C.Negative feedback to those who make mistakes
while on a call
Rationale: Correct answer
D.Remedial training as deemed necessary by the
medical director
Rationale: This is a part of CQI.
Review
5. All of the following are responsibilities of the
EMS medical director, EXCEPT:
A.evaluating patient insurance information.
B.serving as liaison with the medical community.
C.ensuring that the appropriate standards are met by
EMTs.
D.ensuring appropriate EMT education and
continuing training.
Review
Answer: A
Rationale: Responsibilities of the medical
director include serving as liaison with the
medical community, ensuring that appropriate
standards are met by EMS personnel, and
ensuring appropriate EMT education and
continuing training. Insurance matters are
handled by the EMS billing department.
Review (1 of 2)
5. All of the following are responsibilities of the
EMS medical director, EXCEPT:
A.evaluating patient insurance information.
Rationale: Correct answer
B.serving as liaison with the medical community.
Rationale: This is the responsibility of the
medical director.
Review (2 of 2)
5. All of the following are responsibilities of the
EMS medical director, EXCEPT:
C.ensuring that the appropriate standards are met
by EMTs.
Rationale: This is the responsibility of the
medical director.
D.ensuring appropriate EMT education and
continuing training.
Rationale: This is the responsibility of the
medical director.
Review
6. Which of the following situations would MOST
likely disqualify a person for EMS certification?
A.A misdemeanor at the age of 17
B.Driving under the influence of alcohol
C.Possessing a valid driver’s license from another
state
D.A mild hearing impairment that is corrected with
hearing aids
Review
Answer: B
Rationale: In most states, a person may be
denied EMS certification for being convicted
of a felony, such as driving under the
influence of alcohol or other drugs.
Review (1 of 2)
6. Which of the following situations would MOST
likely disqualify a person for EMS certification?
A.A misdemeanor at the age of 17
Rationale: Most states seal misdemeanor juvenile
records, so it would not likely disqualify a person.
B.Driving under the influence of alcohol
Rationale: Correct answer
Review (2 of 2)
6. Which of the following situations would MOST
likely disqualify a person for EMS certification?
C.Possessing a valid driver's license from another
state
Rationale: Most states require providers to have a
valid in-state driver’s license.
D.A mild hearing impairment that is corrected with
hearing aids
Rationale: If the performance of tasks are not
impaired, it would not disqualify a person.
Review
7. Which of the following should be the EMT’s
highest priority?
A.Controlling severe bleeding
B.Maintaining a patient’s airway
C.Ensuring the safety of his or her partner
D.Sizing up every scene prior to entering
Review
Answer: D
Rationale: Personal safety is of utmost
concern for the EMT. This involves sizing up
a scene to determine whether or not the
scene is safe to enter. This will ensure the
safety of all personnel.
Review (2 of 2)
7. Which of the following should be the EMT’s
highest priority?
A.Controlling severe bleeding
Rationale: This is the priority once the patient’s
airway and breathing have been addressed.
B.Maintaining a patient’s airway
Rationale: This is most the important priority
once patient contact is made.
Review (2 of 2)
7. Which of the following should be the EMT’s
highest priority?
C.Ensuring the safety of his or her partner
Rationale: Safety is first determined during scene
size-up. You do not enter an unsafe scene.
D.Sizing up every scene prior to entering
Rationale: Correct answer
Review
8. A patient who requires cardiac monitoring in
the field would require, at a minimum, which
level of EMS provider?
A.EMR
B.EMT
C.Paramedic
D.AEMT
Review
Answer: C
Rationale: Of all levels of EMS provider, the
paramedic is trained in advanced medical
care, including cardiac monitoring, IV
therapy, and the administration of a variety
of emergency drugs.
Review (1 of 2)
8. A patient who requires cardiac monitoring in the
field would require, at a minimum, which level of
EMS provider?
A.EMR
Rationale: This level is trained to initiate BLS
before an ambulance arrives.
B.EMT
Rationale: This level has the knowledge and skills
to provide basic emergency care.
Review (2 of 2)
8. A patient who requires cardiac monitoring in the
field would require, at a minimum, which level of
EMS provider?
C.Paramedic
Rationale: Correct answer
D.AEMT
Rationale: This level can interpret cardiac
rhythms but cannot perform cardiac monitoring.
Review
9. Which of the following is a professional
responsibility of the EMT?
A.Telling the family of a dying patient that
everything will be OK
B.Maintaining only the skills that he or she feels
uncomfortable with
C.Maintaining a professional demeanor even under
the most stressful situations
D.Advising an emergency department nurse that
patient reports are only given to a physician
Review
Answer: C
Rationale: Because the public relies upon
the EMT to remain calm when others cannot,
he or she must project a professional and
calm demeanor even when under extreme
stress.
Review (1 of 2)
9. Which of the following is a professional
responsibility of the EMT?
A.Telling the family of a dying patient that
everything will be OK
Rationale: Discussions about dying patients are
handled by providers of a higher level.
B.Maintaining only the skills that he or she feels
uncomfortable with
Rationale: The quality of care depends upon your
ability, so you must maintain all of your skills.
Review (2 of 2)
9. Which of the following is a professional
responsibility of the EMT?
C.Maintaining a professional demeanor even under
the most stressful situations
Rationale: Correct answer
D.Advising an emergency department nurse that
patient reports are only given to a physician
Rationale: You must give your report to the
receiving hospital emergency department staff,
including a nurse.
Review
10. Emergency patient care occurs in progressive
phases. What occurs first?
A. Activation of EMS
B. Initial prehospital care
C. The patient receives definitive care
D. Incident recognition
Review
Answer: D
Rationale: Someone must recognize an
emergency before EMS can be activated.
Review (1 of 2)
10. Emergency patient care occurs in progressive
phases. What occurs first?
A.Activation of EMS
Rationale: This occurs once an incident is
recognized.
B.Initial prehospital care
Rationale: This occurs when the EMT arrives on
scene.
Review (2 of 2)
10. Emergency patient care occurs in progressive
phases. What occurs first?
C.The patient receives definitive care
Rationale: This occurs when the EMT and patient
reach the hospital.
D.Incident recognition
Rationale: Correct answer
Remember
• There are certain personal and physical traits
that help you to be a successful EMS
provider.
• An EMS provider should actively pursue
opportunities to improve personal knowledge
and abilities as well as the unit’s overall
quality.