NREMT RECERTIFICATION QUESTIONS WITH CORRECT ANSWERS

EMT (basic) level of training - Provide basic, immediate care including bleeding control, CPR, AED, and emergency childbirth. Advanced oxygen and ventilation skills, pulse oximetry, noninvasive blood pressure monitoring, and administration of certain medications. EMT roles and responsibilities - Equipment preparedness Emergency vehicle operations Establish and maintain scene safety Patient assessment and treatment Lifting and moving Strong verbal and written communication skills Patient advocacy Professional development Quality improvement Illness and injury prevention Maintain certification/licensure Transfer of patient care - The movement of the patient from one stretcher to another and providing all necessary information to allow continuity of care. What is always the top priority? - The EMT's first priority is always his or her own safety. Once the EMT is safe then they can worry about other people's safety. Acute stress - Immediate physical and psychological reaction to a specific event triggering the body's fight or flight response. Delayed stress - A stress reaction that develops after the stressful event. It does not interfere with the EMT's ability to perform during the stressful event. PTSD is an example. Cumulative stress - Exposure to stressful situations over a prolonged period of time leading to burnout. Five stages of grief - 1. Denial: the "not me" stage 2. Anger: the "why me" stage 3. Bargaining: the "but I still need to.." stage 4. Depression: the state of despair stage 5. Acceptance: accepting death Minimum PPE - minimum personal protective equipment: gloves and eye protection should be used during any patient contact situation. Expanded PPE - Use disposable gown and mask for significant contact with any body fluid- for example during childbirth. Use a high-efficiency particulate air (HEPA) mask or N-95 respirator for suspected airborne disease exposure, such as TB. Biohazard bags - Contaminated medical waste (bloody gause) and exposed of according to medical guidelines. Sharps container - Sharps (needles, lancets) are placed i designated puncture proof containers. Sharps should not be recapped before placing in an approved sharps container. Recommended Vaccines and immunizations - Regular TB testing, Hep B, Tetanus shot, flu vaccine, MMR vaccine (measles, mumps, rubella), Varicella Hazardous material incident - 1. Maintain a safe distance 2. Call for specially trained HAZMAT responders. 3. Look for placards without entering the scene and utilize the emergency response guidebook to determine evacuation distance. 4. Do not enter a HAZMAT scene until cleared by HAZMAT specialists. 5. Do not begin emergency care until patients have been decontaminated or otherwise cleared by HAZMAT crew. Crime scenes - 1. Do not enter crime scene until PD has determined it is safe. 2. If responding to a crime scene wait a safe distance away for staging of PD. Accident scene - Extrication situation. Federal law requires EMS workers to wear an approved highly reflective traffic safety vest when working on roadways, around traffic or at an accident scene. Hazardous situations requiring special training - 1. Downed power lines 2. Fires 3. Terrorism 4. High angle rescue (swift water, confined space) Supine position - Prone position - Medical restraint - 1. Last resort to restrain a patient. 2. Anticipate and plan: use PD 3. Use the minimum amount of restraint 4. Secure in supine, use soft padded restraints. Informed consent - Patient must be informed of your care plan and associated risks of accepting or refusing care and transport. Patient must be informed of and understand all information that influence the decision of accepting or refusing care and transport. Expressed consent - Patient is alert and competent. Used to acquire consent for basic procedures. Implied consent - Assumption of consent from an unresponsive or incompetent patient. Also used for someone who refused care but loses consciousness later Minor consent - Minors are not competent to accept or refuse care. Consent is required from a parent or legal guardian. Not needed for emancipated minors. Implied consent is also used for minors. Involuntary consent - Used for mentally incompetent adults or those in custody of law enforcement. Consent must be obtained from the entity with the appropriate legal authority. DNR - Advanced directive Do not resuscitate: they are specific to resuscitation efforts and do not affect treatment prior to the patient entering cardiac arrest. Living will - They are broader than dnrs. They address healthcare wishes prior to entering cardiac arrest. This may include use of advanced airways, ventilators, feeding tubes, etc. Good Samaritan law - Designed to protect someone who renders care as long as he or she is not being compensated and gross negligence is not committed. What four factors must someone prove in order to sue for negligence - 1. Duty to act: EMT had an obligation to respond and provide care. 2. Breech of duty: EMT fails to assess, treat, or transport patient according to the standard of care. 3. Damage: The plaintiff sustained injury worthy of compensation. 4. Causation: the injury was due to EMT's breach of duty. Gross negligence - Involves an indifference to and a violation of a legal responsibility. Reckless patient care that is clearly dangerous to the patient is grossly negligent. This results in civil/criminal charges. Abandonment - Once care is initiated EMS providers cannot terminate care without the patient's consent. Sometimes requires direct contact with medical direction prior to terminating care. Abandonment is also the termination of care without transferring the patient to an equal or higher medical authority. False imprisonment - Guilty of false imprisonment if you transport a competent patient without consent. Four factors of competency - 1. Person: they know their name 2. Place: know where they are 3. Time: aware of date and time 4. Event: aware of present circumstances Patient refusals - 1. Patient must be fully informed of the recommended treatment and possible consequences of refusing treatment. 2. Insure patient is competent 3. Try convincing the patient 4. Contact medical direction 5. Document extremely well. 6. Get a witness to sign (not another EMS provider). HIPAA - Health Insurance Portability and Accountability Act: federal law that gives patients greater control over how health care records are used and transferred.