Santa Clara county - exam Questions + Answers Graded A+

Emergent Patients encountered by EMT's - 1. Emergent=life or limp threatening condition requiring immediate definitive care 2. Respiratory Distress, Airway Compromise, Neurological changes from baseline, signs of actual or impending shock, or meet Major Trauma criteria 3. May be transported to nearest ED with red lights or sirens, if the time from arrival on scene to arrival at hospital is LESS THAN 10 minutes a. crew must inform county communications and request a County EMS event number 4. If on scene to hospital is greater than 10 minutes, 911 must be called for ALS assistance 5. If immediate transport is necessary and no paramedic ambulance is available, first arriving paramedic unit shall accompany the BLS crew using the ALS equipment from first response unit BLS Utilization Interfacility Transportation - Hospital to SNF, Hospital to residence, MD appointments, dialysis, etc BLS Utilization Use in the 911 system - 1. during times of high call volume, BLS ambulance query's may go out bringing BLS ambulances into 911 system 2. if patient requires ALS assistance, paramedic from ALS first responder shall provide any necessary ALS interventions en-route to hospital Clinical Practice Advisory Committee (CPAC) - Made of various system stakeholders (field personnel, physician, nurses, etc.) who provide recommendations related to the clinical aspects of EMS system. This includes protocols, orders, quality assurance and improvement, etc Diversion zones - 1. North:SUH, ECH, KSC 2. Central: RSJ, VMC, OCH 3. Southern: GSH, STH, SLHDo Not Resuscitate / Advanced Directives Handling decendent will depend on location (home) - Local police or fire agency hold jurisdiction and responsibility Do Not Resuscitate / Advanced Directives Handling decendent will depend on location (If patient dies en route to destination, withhold BLS/ALS interventions and choose one of the 3 options:) - 1. Transport to pre-arranged destination 2. Return to point of departure 3. Transport to closest ED of an acute care facility Do Not Resuscitate / Advanced Directives Handling decendent will depend on location (Public place) - Local public safety agency hold jurisdiction and responsibility for disposition of decedent Do Not Resuscitate / Advanced Directives Handling decendent will depend on location (Residential care facility (skilled nursing facility, etc.)) - Staff of facility hold jurisdiction and responsibility Do Not Resuscitate / Advanced Directives Procedure - If EMS personnel arrive, patient is pulseless and apneic: 1. Establish DNR/ Advanced Directives/ Code Status 2.May withhold resuscitative efforts if: a. Provides a valid DNR form, no code chart order, DNR medallion, POST, or DPAHC that clearly states Do Not Resuscitate 3. If no forms provided, continue resuscitative efforts until such form is provided If patient is conscious and states he/she wishes for resuscitative efforts, the POLST or DNR order is ignored, but document the request.If provided with a DNR form they are unfamiliar with, continue to resuscitate until proper documentation is provided. If no DNR is confirmed, or if crew believes POLST is not valid due to lack of signatures, patient receives full resuscitative efforts Do Not Resuscitate / Advanced Directives Proper DNR documents - 1. Physicians Orders for Life Sustaining Treatment (POLST) form stating No CPR 2. EMSA and CMA approved Emergency Medical Services, Prehospital DNR form 3. CA approved DNR medallions 4. Durable Power of Attorney for Health Care (DPAHC) Emergency Medical Services Committee (EMSCo.) - A diverse group of representatives of all provider levels (field paramedics, EMTs, city managers,etc.) that provide recommendations to the Agency and Health Advisory Commission EMS Communications Systems Guide Audible Tones - 1. Steady alert tone a. Used anytime when the dispatcher needs to announce a priority message (APB, BOLO, hospital on "internal disaster", etc.) b. NOT used to report changes in hospital timers, suspension of meal breaks, hospital status changes 2. Warbler tone a. All non-emergency traffic must stop until broadcast is completed b. Used when requested by EMS Command staff, County Communications, or when emergency traffic requires an immediate action such as evacuation, shelter in place order, eminent safety issue, etc.