Chapter 1

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What is a primary purpose of the modern-day EMS system?

Decrease the incidence of death and disability related to injury and illness

Most authorities agree that the modern-day EMS system evolved after the release of which document?

The white paper "Accidental Death and Disability: The Neglected Disease of Modern Society," in 1966

An Emergency Medical Responder comes to you and states that they would like to work for your emergency ambulance service on a full-time basis. Knowing the National EMS Scope of Practice Model, you inform them of which element they need to attain first?

They will first have to become an Emergency Medical Technician (EMT).

As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners include:As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners include:

Paramedics.

An Emergency Medical Responder (EMR) approaches you and states that they are interested in becoming an EMT. Specifically, they ask what they will be able to do as an EMT that they cannot presently do as an EMR. You respond by saying they will be able to:

Administer some medications

You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical Responders (EMRs) are on the scene. In your community, all EMS practitioners are trained according to the National EMS Scope of Practice Model. Given this, which type of care do you expect the EMRs to be providing?

Automated external defibrillation

An EMT with your service states that they desire to become a Paramedic because they want to provide advanced care. Under the National EMS Scope of Practice Model, which one of these types of care will they be able to provide as a Paramedic that they cannot provide as an EMT?

Initiating intravenous (IV) therapy

Which statement made by an EMT requires immediate intervention by a superior or the service supervisor?

I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or injured according to dispatch information."

Which statement shows that the EMT has a good understanding of their role and responsibilities related to being an EMT?

My safety comes first, and then the patient's safety."

An ambulance with two EMTs arrives in front of a house for an unknown medical emergency. On scene, bystanders report that a female patient was beaten by her husband in the driveway and then dragged back into the house. They state that the patient appeared unconscious and was bleeding from the head. Which action would the EMTs perform next?

Do not enter the scene until it has been controlled by law enforcement.

Why is EMS in a unique position to contribute significantly to mobile integrated health care?

EMS providers are familiar with and capable of functioning in the out-of-hospital environment.

You have arrived on the scene of a motor vehicle collision. A car has gone off the road and into a utility pole. The pole is broken and wires are hanging just above the car. You do not see any sparking or arcing of the wires. The driver of the car is slumped over the steering wheel and not moving. Several bystanders around the car are yelling for you to help. Which steps represent the correct order of your response?

Clear the bystanders, allow the fire department to secure the wires, access the patient, extricate the patient, transport

Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the:

Patient.

You have been asked to sit on your service's quality improvement (QI) committee. As a knowledgeable EMT, you recognize that in this role you will be involved in projects that are primarily designed to:

Develop ways in which the delivery of emergency care can be improved.

What would be a logical project to be undertaken and developed by a quality improvement QI committee

Monthly continuing education programs in which seldom-used skills are practiced

You are interviewing for the position of EMT with a busy urban service. This morning you are to meet with the service's medical director. You have been told that she likes it when applicants ask questions about her role as the medical director. Related to her responsibilities as medical director, which question is most appropriate?

How often are the emergency care protocols updated?

To be a medical director of an ambulance service, which requirement must the interested individual satisfy?

Licensed physician

As an EMT, which requirement must be met so that you can provide routine and emergency medical care to the sick and injured, as an extension of the medical director's authority?

A service medical director

It has been some time since you were involved in the care of a pediatric patient. You decide to review the assessment and treatment basics that your medical director requires. To review this information, which resource should you consult first?

Service protocols

Before the EMT contacts medical direction for authorization to assist a patient with shortness of breath in using their metered-dose inhaler, protocols state that the EMT must first attempt to provide relief by administering oxygen if the pulse oximeter reading is less than 94%. You recognize that the administration of oxygen is best described as a(n):

Standing order.

If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to contact an emergency department physician first before administering additional aspirin. The act of contacting the emergency department physician by phone or radio for permission to administer additional aspirin is an example of:

On-line medical direction.

At the scene of a minor motor vehicle collision, you are attending to a female patient who complains of head and neck pain. A crowd has gathered to watch the action. What will the observing public most likely remember about the role EMS portrayed?

EMTs who were yelling and cursing loudly at the fire department to hurry up and get the patient out of the car

You work in a community that has an "enhanced" 911 system. Given this, which is true about such a system?

The physical location of the landline used to make the 911 call is displayed to the call taker.

Which patient would most benefit from calling an enhanced 911 system from the home phone?

Patient with sudden onset of confusion

A 14-year-old boy has fallen through a plate glass window and is bleeding heavily from a laceration to his arm. His panicked mother has called 911 for help. Since the 911 operators are also emergency medical dispatchers, what sort of assistance will they be able to provide?

Instructions on how to control bleeding before EMS arrives

Which of these would be an EMS public health initiative?

Educating the public on the benefit of wearing seat belts

Your service's medical director would like to explore the idea of EMTs using special transport ventilators when caring for patients who require assistance with their breathing. When using an evidence-based medicine approach, what task should you do first?

Search the medical literature for research related to this topic.

You are by the side of a confused patient who has diabetes and a low blood sugar level. You know that the patient needs orally administered sugar, so following your service's guidelines, you call the physician on duty at the hospital emergency department and request permission to administer it. This request is an example of:

On-line medical direction.

Which statement about emergency medical services (EMS) in the United States is true?

Each state has governmental control of its own EMS system, independent of the federal government.

The county dispatch center where you work employs emergency medical dispatchers (EMDs) as call takers. Using EMDs as opposed to a person who is just a "call taker" enables the dispatch center to:

Provide medical instructions to the caller prior to the arrival of EMS personnel.

A 40-year-old man has been seriously injured in a car crash. He is unresponsive and has what you believe to be a collapsed lung. Additionally, his left leg is severely deformed with heavy bleeding and his vital signs are unstable. A passenger in the car informs you that the patient has diabetes and significant heart problems. Given this information, what is the best destination for this patient, assuming all of the facilities are the same distance away?

Trauma center

You have arrived at the scene of a medical emergency and find a woman lying on the floor of a grocery store. As you approach her, you know that your first priority as an EMT is:

Personal safety.

A female jogger has collapsed on a trail at a public park. A crowd of curious onlookers have collected and are watching as the EMT examines the patient for any life-threatening conditions. After determining that there are none and the patient is stable, the EMT acts as a patient advocate by:

Asking curious onlookers to leave the scene.

At a public 911 center meeting, a concerned woman asks whether voice over Internet Protocol (VoIP) can be used to access the community emergency operations center. You would inform her that:

Internet providers must provide a callback number and physical location of the phone from which the 911 call was placed

What would the EMT recognize as an advantage of the 911 universal number?

It is a common number through which to request EMS, law enforcement, and fire services.

Which statement accurately describes the hospital emergency department?

It is a health care destination staffed by physicians, nurses, and others designed to evaluate and stabilize patients, preparing them for further care.

As a supervisor with an emergency ambulance service, which situation regarding a potential employee would you recognize as falling under the Americans with Disabilities Act (ADA), and as a case in which you would make reasonable accommodations?

A dispatcher with a prosthetic leg who requires parking next to the building entrance

How would the Americans with Disabilities Act (ADA) be satisfied for a pregnant emergency medical dispatcher (EMD) who suffers from paralysis of both legs and requires the use of a wheelchair?

Wheelchair accessibility to and from dispatch

A young man wishes to become an emergency medical technician and asks you what he will need to do to become certified. You would reply that he must first:

Complete a course that meets the requirements of the U.S.

The functions of a state Emergency Medical Services (EMS) agency include:

Planning and coordination of the statewide EMS system.

What actions place the patient at greatest risk for a medical mistake?

Transferring care from one EMT to another

Which statement best summarizes the underlying benefit of using evidence-based medicine?

Allows the use of research and evidence in determining which care is effective

Which item of protective gear is appropriate to wear at an automobile collision?

Reflective clothing

At a bare minimum, which type of personal protective equipment should be worn by emergency medical services providers at any emergency scene involving a shooting?

Gloves

Which of these tasks has not been identified as one that could be provided by a mobile integrated health care system?

Conduct health screening and provide minor outpatient surgical services

In the public health continuum, what is the first responsibility that public health officials must satisfy to improve the health of a community?

Identify problems that affect the health of the population in question

Which attribute of a person would not likely work out well in the emergency medical services profession?

Inability or no desire to "take charge"

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