10/19/23,n12:05nAM Final nParamedic nFisdapnStudynGuid
e
2
FinalnParamedicnFisdap nStudynGuidenlatest
EmsnOperationsn-
nPagen1n OB/Gynecolog
yn-
nPagen11n Pediatricsn-
nPagen20n Airwayn-
nPagen30
MedicalnEmergenciesn-
nPagen39n Trauman-nPage
Cardiologyn-nPagen-nPagen54
EMS nOPERATIONS
1 . Airbags nSafety nDuringnExtricationn(2228)
• Un-
deployednairbags nmay ndeploynduringnextricationnandncausenharm ntonthenpatients nandn rescu
ers.
• Look nfornairbagnbadgingnornlabelingnsystem
• Anvehiclesnairbags nsystem ncomes nequippednwithnannenergy ncapacitornthat ncannstorenpower
nforn upnton30nmins ninnsomenmodels
• Removenkey nfrom nignition
4.Criteria nfor nTransferring nCare nofnPatientn(154)
• Innyourndocumentationnof ncare, nit nis nimportant nthat nyounwerenablentonshowninnwhosencareny
oun left nthenpatientnwith, notherwisenyouncouldnfacenallegationsnof nabandonment.nsomenage
ncies n havenbegunntonrequirenphysiciannornnursensignatures ntonverifynthat nthenpatient nwas nl
eftnwithnan medicalnprofessionalnof nanhighernlevelnofntraining. nAnothernsituationnthatnmaynreq
uirenyounton documentnantransfernof ncarenisnwhennyounhandnovernyournpatientntonanotherna
gency nsuchnas nan paramedic ntransport ncrew nornannairnmedicalnteam.
5.Decontamination nofnAirway nEquipment
• Sanitizenandndisinfect neverythingnafternancall
• Any npiecenof nequipmentnthatnisnintendednfornsinglenusenshouldnbendiscardedninnannappropri
aten hazardous nmaterials nbag. nFornany nreusablenpiecenof nequipment nthatn hasnhadndirect nco
ntactn withnthenpatient nornpatientsnbodily nfluids, nusenancommercialndisinfectingnagent nforn de
contamination. nBleachndilutedninnwatern(1:10)ncannalsonbenusednas ndisinfectingnagent.
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6.Documenting nMedicationnAdministrationn(471)
• Documentationnis neverything, nif nyoundidnnot ndocument nit, nyoundidn’tndonit. nAlwaysndocument
n yournactions nandnthenpatients nresponsenonnthenonnthenpatient ncarenreport nafternadministe
ringnan medication. nThis nincludes...
- Name
- Dose
- Time
- Route
- Persons nnamenwhonadministerednit
- Patients nresponsentonthenmedication, nwhethernpositivenornnegative
7.Indications n for n N95n Mask
• 95n(Heppa)nMask nonnyou, nsurgicalnornnormalnmask nonnpatient
8.Indications n for n Rapidn Extricationn (1677-1699)n (2226)
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• Patient n cann ben movedn from n sittingn inn an carn ton layingn supinen onn an backboardn inn 2n mins.
Indications nlistednbelow
- Thenvehiclenornscenenis nunsafe
- Thenpatient ncannot nbenproperly nassessednbeforenbeingnremovednfrom nthencar
- Thenpatient nneeds nimmediateninterventionnthat nrequires nansupinenposition
- Thenpatients nconditionnrequires nimmediatentransport ntonthenhospital
- Thenpatient nblocks nyournaccess ntonanothernseriously ninjurednpatient
• Anteamnmembernshouldnremainnwithnthenpatient ntondirect nthenrescuers nwhonarenpreformingn
then disentanglement. nFornexample, nunless ntherenis nannimmediatenthreat ntonfire, nexplosion, n
ornothern danger, nyounshouldnpreformnanprimarynassessmentnandnperform nandncriticalninterv
entionsn beforendisentanglement nbegins. nThis nmay nincludenprovidingnc-
spinenimmobilization,nopeningn airway, nprovidingnO2,nventilations, norncontrollingnsignificant nb
leeding. nOncenlifenthreats nhaven beenntreated, ndisentanglement ncannbegin. nSometimesnanpa
tient nmust nbenremovednquicklyn (Rapidnextrication)nbecausenhis nornherngeneralnconditionnis n
deterioratingnandntimendoes nnotn permit nmeticulous nsplintingnandndressingnprocedures.nQuic
k nremovalnmaynalsonoccurnif nhazardsn arenpresent,nsuchnasnas nspilledngas nornothernmaterial
s nthatn couldnendangernthenpatient norn rescuenpersonnel. nThenonly n timenthen patient nshould
n benmovedn priornton completionnofn initialn care,nassessment, nstabilization,nandntreatment nis
nwhennthenpatient’s nornemergency nresponders n lifenis ninnimmediatendanger.
10. MakingnDecisions nRegarding na nPatients nRequestntonRefuse nCar
e n(96-99)
• Patients nwithndecision-
makingncapacity nhaventhenright ntonrefusenallnornpartnof nthenemergencyn medicalncarenoffere
dntonthem
• Refusingncaren-nNeeds ntonbeninformednconsent.
• Needntonusenyourn“Peoplenskills”nandnjust ntalk ntonthenpatient
· Ensure n yourn ptn is n fullyn informed n aboutn theirn currentn situa琀椀
on,n his n orn hern rightn ton receive norn refuse n medicaln care,n and n then consequences
n of n an refusaln of n care
· Unresponsive n pa琀椀ents n mayn be n treated n undern implied n consent
· Involve n online n medicaln controln ifn ptn have n severe n injuries n butn refusingn care
· Documentn carefullyn and n have n ptn sign n AMA
Minorsn-
nBecausenminors nhavennonlegalnstatus, nthey ncannneithernrefusennonconsentntonmedicaln care.
nInnthencasenofnchildrennandnadultsnwhonhavenlegalnguardians, nconsent nmustnbenobtained, nif
n possible,nfromnanparent nornlegalnguardiannof nthenpatient.nIf nthenparent nornguardiannis nnotnav
ailable, n emergencyntreatment ntonsustainnlifenmay nbenundertakennwithoutndirectnconsentnunde
rn then doctrinenof nimpliednconsent. nYounshouldnalsonbenawarenofnthenlegalnprinciplenknownna
s n“Innlocon parentis”. nThis nterm nliterally nmeans n“Innplacenof nthenparent”. nThisnprinciplenmaynap
ply ninnschool,n day ncare, nornsummerncampnsituationsnif nanparentnisnunavailable.nThenschoolna
dministratornornday n carendirectornmay nmakentreatmentnandntransportationndecisions nonnbehal
f nof nthenminor.
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Anparticularly ndifficult ncircumstancencannarisenif nanparent nornlegalnguardiannrefuses ntongrant n c
onsent ntontreat n anminornwhonclearlynrequiresnlifesavingnornlimb-
savingn treatment. n Althoughn adultsnclearly nhaventhenright ntonrefusentreatment nfornthemselves,
nstatenlawsngenerally ndonnotn permit nanparent norn guardiannton denyn treatment nton an minornch
ild. nInnfact, nthenfailuren of n anparent n ton allow nsuchntreatmentnmay nconstitutenneglect.nWhennc
onfrontednwithnsuchnancircumstance, nthen paramedic nshouldnnotify nlaw nenforcement nandnmedi
calncontrol. nStatenlaw nmay npermit nthenstatento
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FinalnParamedicnFisdap nStudynGuidenlatest
EmsnOperationsn-
nPagen1n OB/Gynecolog
yn-
nPagen11n Pediatricsn-
nPagen20n Airwayn-
nPagen30
MedicalnEmergenciesn-
nPagen39n Trauman-nPage
Cardiologyn-nPagen-nPagen54
EMS nOPERATIONS
1 . Airbags nSafety nDuringnExtricationn(2228)
• Un-
deployednairbags nmay ndeploynduringnextricationnandncausenharm ntonthenpatients nandn rescu
ers.
• Look nfornairbagnbadgingnornlabelingnsystem
• Anvehiclesnairbags nsystem ncomes nequippednwithnannenergy ncapacitornthat ncannstorenpower
nforn upnton30nmins ninnsomenmodels
• Removenkey nfrom nignition
4.Criteria nfor nTransferring nCare nofnPatientn(154)
• Innyourndocumentationnof ncare, nit nis nimportant nthat nyounwerenablentonshowninnwhosencareny
oun left nthenpatientnwith, notherwisenyouncouldnfacenallegationsnof nabandonment.nsomenage
ncies n havenbegunntonrequirenphysiciannornnursensignatures ntonverifynthat nthenpatient nwas nl
eftnwithnan medicalnprofessionalnof nanhighernlevelnofntraining. nAnothernsituationnthatnmaynreq
uirenyounton documentnantransfernof ncarenisnwhennyounhandnovernyournpatientntonanotherna
gency nsuchnas nan paramedic ntransport ncrew nornannairnmedicalnteam.
5.Decontamination nofnAirway nEquipment
• Sanitizenandndisinfect neverythingnafternancall
• Any npiecenof nequipmentnthatnisnintendednfornsinglenusenshouldnbendiscardedninnannappropri
aten hazardous nmaterials nbag. nFornany nreusablenpiecenof nequipment nthatn hasnhadndirect nco
ntactn withnthenpatient nornpatientsnbodily nfluids, nusenancommercialndisinfectingnagent nforn de
contamination. nBleachndilutedninnwatern(1:10)ncannalsonbenusednas ndisinfectingnagent.
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6.Documenting nMedicationnAdministrationn(471)
• Documentationnis neverything, nif nyoundidnnot ndocument nit, nyoundidn’tndonit. nAlwaysndocument
n yournactions nandnthenpatients nresponsenonnthenonnthenpatient ncarenreport nafternadministe
ringnan medication. nThis nincludes...
- Name
- Dose
- Time
- Route
- Persons nnamenwhonadministerednit
- Patients nresponsentonthenmedication, nwhethernpositivenornnegative
7.Indications n for n N95n Mask
• 95n(Heppa)nMask nonnyou, nsurgicalnornnormalnmask nonnpatient
8.Indications n for n Rapidn Extricationn (1677-1699)n (2226)
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• Patient n cann ben movedn from n sittingn inn an carn ton layingn supinen onn an backboardn inn 2n mins.
Indications nlistednbelow
- Thenvehiclenornscenenis nunsafe
- Thenpatient ncannot nbenproperly nassessednbeforenbeingnremovednfrom nthencar
- Thenpatient nneeds nimmediateninterventionnthat nrequires nansupinenposition
- Thenpatients nconditionnrequires nimmediatentransport ntonthenhospital
- Thenpatient nblocks nyournaccess ntonanothernseriously ninjurednpatient
• Anteamnmembernshouldnremainnwithnthenpatient ntondirect nthenrescuers nwhonarenpreformingn
then disentanglement. nFornexample, nunless ntherenis nannimmediatenthreat ntonfire, nexplosion, n
ornothern danger, nyounshouldnpreformnanprimarynassessmentnandnperform nandncriticalninterv
entionsn beforendisentanglement nbegins. nThis nmay nincludenprovidingnc-
spinenimmobilization,nopeningn airway, nprovidingnO2,nventilations, norncontrollingnsignificant nb
leeding. nOncenlifenthreats nhaven beenntreated, ndisentanglement ncannbegin. nSometimesnanpa
tient nmust nbenremovednquicklyn (Rapidnextrication)nbecausenhis nornherngeneralnconditionnis n
deterioratingnandntimendoes nnotn permit nmeticulous nsplintingnandndressingnprocedures.nQuic
k nremovalnmaynalsonoccurnif nhazardsn arenpresent,nsuchnasnas nspilledngas nornothernmaterial
s nthatn couldnendangernthenpatient norn rescuenpersonnel. nThenonly n timenthen patient nshould
n benmovedn priornton completionnofn initialn care,nassessment, nstabilization,nandntreatment nis
nwhennthenpatient’s nornemergency nresponders n lifenis ninnimmediatendanger.
10. MakingnDecisions nRegarding na nPatients nRequestntonRefuse nCar
e n(96-99)
• Patients nwithndecision-
makingncapacity nhaventhenright ntonrefusenallnornpartnof nthenemergencyn medicalncarenoffere
dntonthem
• Refusingncaren-nNeeds ntonbeninformednconsent.
• Needntonusenyourn“Peoplenskills”nandnjust ntalk ntonthenpatient
· Ensure n yourn ptn is n fullyn informed n aboutn theirn currentn situa琀椀
on,n his n orn hern rightn ton receive norn refuse n medicaln care,n and n then consequences
n of n an refusaln of n care
· Unresponsive n pa琀椀ents n mayn be n treated n undern implied n consent
· Involve n online n medicaln controln ifn ptn have n severe n injuries n butn refusingn care
· Documentn carefullyn and n have n ptn sign n AMA
Minorsn-
nBecausenminors nhavennonlegalnstatus, nthey ncannneithernrefusennonconsentntonmedicaln care.
nInnthencasenofnchildrennandnadultsnwhonhavenlegalnguardians, nconsent nmustnbenobtained, nif
n possible,nfromnanparent nornlegalnguardiannof nthenpatient.nIf nthenparent nornguardiannis nnotnav
ailable, n emergencyntreatment ntonsustainnlifenmay nbenundertakennwithoutndirectnconsentnunde
rn then doctrinenof nimpliednconsent. nYounshouldnalsonbenawarenofnthenlegalnprinciplenknownna
s n“Innlocon parentis”. nThis nterm nliterally nmeans n“Innplacenof nthenparent”. nThisnprinciplenmaynap
ply ninnschool,n day ncare, nornsummerncampnsituationsnif nanparentnisnunavailable.nThenschoolna
dministratornornday n carendirectornmay nmakentreatmentnandntransportationndecisions nonnbehal
f nof nthenminor.
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Anparticularly ndifficult ncircumstancencannarisenif nanparent nornlegalnguardiannrefuses ntongrant n c
onsent ntontreat n anminornwhonclearlynrequiresnlifesavingnornlimb-
savingn treatment. n Althoughn adultsnclearly nhaventhenright ntonrefusentreatment nfornthemselves,
nstatenlawsngenerally ndonnotn permit nanparent norn guardiannton denyn treatment nton an minornch
ild. nInnfact, nthenfailuren of n anparent n ton allow nsuchntreatmentnmay nconstitutenneglect.nWhennc
onfrontednwithnsuchnancircumstance, nthen paramedic nshouldnnotify nlaw nenforcement nandnmedi
calncontrol. nStatenlaw nmay npermit nthenstatento
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