1. Immunizations to prevent communicable disease (such as, but not limited to,
meningitis)
MMR (Measles, Mumps, Rubella)
DPT (Diphtheria, Pertussis (Whooping Cough), Tetanus)
Meningitis, Hepatitis A + B
...
1. Immunizations to prevent communicable disease (such as, but not limited to,
meningitis)
MMR (Measles, Mumps, Rubella)
DPT (Diphtheria, Pertussis (Whooping Cough), Tetanus)
Meningitis, Hepatitis A + B ONLY, Polio, Varicella (Chickenpox)
VACCINE: Bacterial Meningitis = “Haemophilus” H.influenza type B
Majority viral vaccines
Bacterial vaccines: tetanus toxoid (causes trismus/lockjaw), meningitis, typhoid
Influenza virus (flu; provided annually)
2. Evaluation criteria for rapid extrication
1) Unsafe scene: fuel leaking, fire, etc
2) Unstable patient condition
3) One patient blocking a more critical (airway compromised, AMS,
hypoperfusion) patient
Maintain c-spine stabilization, prepare for move to longboard/spinal board
Remember; environmental hazards relate to time of day, weather, temp, and
ambient lighting
Technical Rescue: high angle, vehicle extrication, trench, ice/swiftwater,
hazardous materials
If appear critical (bleeding to airway, AMS, hypoperfusion), apply cervical
collar, rotate patient as a unit, place backboard on seat, and remove from car
by sliding on backboard = RAPID EXTRICATION. Following removal, then
do rapid head-to-toe. IV and other skills should be performed en route to
hospital. Vest device takes too long to apply!
3. Commonly prescribed diabetic medications
TYPE I (Insulin): Levemir, Lantus, Byetta, Humalog
TYPE II (Enhances insulin production): Glucophage, metformin, glipizide,
glyburide, glimepiride
EMS: 25g of Dextrose (D50) – hypertonic, can cause tissue necrosis, IV Push
1mg Glucagon – Causes glycogen to be released from liver/muscles, IM
Hypoglycemic patient given D50, now alert but confused; asks same question
over and over. RESPOND = Repeat the truth/tell them what happened each time.
Keeps patient aware of surroundings.
REMEMBER, patient who is hypoglycemic (ie 40 mg/dL) and denies IV/dextrose
MUST BE INFORMED of risks! Thus, explain they can go into a coma and die;
make sure they are aware of this
4. Types of extrication devices and tools
Scoop stretcher = Great for hip/pelvic fractures; excellent support; metal frame;
NO log roll needed; SPINAL SUPPORT
1 / 2
Stokes basket/litters = Great for moving over rough terrain; use SIX people
Folding stretcher = LESS support than scoop; better for 2nd patient to be strapped
to bench seat
Stair chair = move patient in tight spaces, down stairs safely, good for stroke,
nausea, cardiac; NO spine support!
Rescue = “figure eight on a bight/bite” = secure loop at the working end of a rope,
can attach to a person, fixed object, or piece of equipment. More secure than a
standard figure 8. Half hitch NOT secure. Hitch knot only to ROUND object.
5. Methods to developing EMS research
Mean = average of the numbers
Median = midpoint number
Mode = Most frequent number
Overall, research validates existing treatments/protocols, provides better patient
care, and improves EMS system
Case Control – TWO groups; one w/ injury and other w/o or patients with same
injury & diff outcomes. Considered observational, neg = lots of variables.
Looking for causative factors of condition
Prospective – Controlled, randomized, participants followed FORWARD in time,
high consistency
Cohort = groups of people with common characteristics (age, living
conditions, personal habits). Ex: determining assoc. of smoking + lung
cancer. Over time, group will divide into those who smoke and those who
don’t. Determine similiarities between those groups.
Retrospective – Occur AFTER event taken place (review of all chest pain PCRs);
however, no control over patient pop, not randomized, gathered data not designed
for specific study
Randomized – Divided into control/study groups randomly = no bias. Impractical
due to nature of EMS. Computer program better to randomize.
Single blind study = Patient OR provider do not know if standard therapy or
research therapy is being given
***Double blind study = Both patient/provider do not know if standard/research
therapy is being given. NO BIAS + PROVIDE BEST EVIDENCE
REGARDING EFFECTIVENESS OF TREATMENT***
We collect data regarding illness and injury prevention programs is to obtain
funding for the programs, target the appropriate groups with education and other
interventions, and then measure the success of our programs.
6. Agencies responsible for certification
White paper/1966 – created DOT (Department of Transportation)
NHTSA (Natl highway traffic safety admin) part of DOT; made EMS
NREMT – national org. that offers uniform testing process; allows reciprocity
(3) types of ambulances regulated by Fed Govt = KKK = Dept of Transportation
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