Chapter 1: Introduction to Emergency Medical Care Assessment

Which of the following is LEAST likely to be an area of employment for an? EMT?
A.
Fire department
B.
Industrial warehouse
C.
Wilderness rescue
D.
Chain restaurant

D. EMTs are employed in public and private? settings, such as fire? departments, ambulance? services, and? rural/wilderness or? urban/industrial settings. A chain restaurant is least likely to be an area of employment for an EMT.

The expectation that an EMT will demonstrate good listening skills is considered a personal trait? involving:
A.
empathy.
B.
asserting authority.
C.
hunger for attention.
D.
need for validation.

A. You must be an effective listener when gathering information from patients and bystanders and when receiving orders from medical direction or others at the scene. This involves compassion and empathy

You are involved in a? single-car accident on a? rural, two-lane road. When you call? 911, who is most likely to? respond?
A.
Emergency physician
B.
Urban fire paramedic
C.
Home? health-care nurse
D.
Local volunteer EMT

D. EMTs are employed in public and private? settings, such as fire? departments, ambulance? services, and rural settings. A large portion of the United States is served by volunteer emergency medical services.

In transfer of? care, it is important to? provide:
A.
control of the scene of an emergency.
B.
patient assessment.
C.
safe transport.
D.
continuity of care.

D. It is important to provide continuity of care when transferring care of a patient to hospital staff. At the time of transfer of? care, you will have left the emergency? scene, provided safe? transport, and assessed the patient.

Which of the following best describes? off-line medical? direction?
A.
An EMT or other person who is authorized by a medical director to give medications and provide emergency care
B.
A physician who assumes ultimate responsibility for the? patient-care a

C. ?Off-line medical direction is standing orders issued by the medical director that allow EMTs to give certain medications or perform certain procedures.

Which of the following should the EMT do for every patient contact that will improve the quality of data collected for the QI? program?
A.
Read an EMS article.
B.
Practice infrequently used skills.
C.
Document carefully.
D.
Communicate with medical direct

C. The EMT should document every call carefully and thoroughly. This will provide feedback to the CQI program about the performance of the EMS system.

Your EMS employer provides injury prevention education to children. This is an example? of:
A.
communications.
B.
human resources and training.
C.
medical direction.
D.
public information and education.

D. This falls under public information and training as established by the NHTSA Technical Assistance Program.

Who can allow EMTs to perform a treatment that is NOT listed in their protocol but is in their scope of? practice?
A.
ER charge nurse
B.
Medical direction
C.
EMS chief
D.
EMS supervisor

B. The medical director is the only person who can issue orders to EMTs that are not clearly written in their protocols or standing orders.

The NHTSA Technical Assistance Program assessment standards for EMS systems address the resource management component by stating that each state must provide a centralized coordination of resources to ensure? that:
A.
a system of specialized care for trau

C. Resource management is the component regarding equal access of patients to EMS care. The other components are regulation and? policy, human resources and? training, transportation,? facilities, communications, public information and? education, medical

You have arrived at the ED with a patient when another call comes over the radio for your squad to respond to a cardiac arrest. Transfer of patient care to the staff has not been completed. What action would best demonstrate your ability to? lead?
A.
Stay

A. Stay with the patient until care is transferred to hospital staff.

Emergency Medical Responders? (EMRs) are generally trained to? provide:
A.
?advanced-level care such as advanced airway devices.
B.
the most advanced level of prehospital care.
C.
immediate care for? life-threatening injuries.
D.
transportation to a medic

C. The emphasis of EMR training is on activating the EMS system and providing immediate care for life threatening? injuries, controlling the? scene, and preparing for the arrival of the ambulance. It does not emphasize transportation or? advanced-level ca

In a public health? emergency, an example of work EMS providers may assist? with, if authorized by state? law, is:
A.
searching for missing children.
B.
vaccination programs.
C.
firefighting duties.
D.
traffic control.

B. In a public health? crisis, such as the massive vaccination clinics that were set up for H1N1 in recent? years, with appropriate state health authorization EMS providers may be asked to assist in vaccination of the public.

Which of the following statements is NOT a benefit of using the emergency 911 number during an? emergency?
A.
It allows faster access to emergency call centers.
B.
It eliminates the need for EMDs.
C.
It saves the caller time by not having to look up a? te

B. ?EMDs, or Emergency Medical? Dispatchers, are key members of the EMS prehospital team and are vital to the functioning of the 911 system.

Orders from the? on-duty physician given by radio or phone are referred to? as:
A.
?off-line medical direction.
B.
standing orders.
C.
treatment policy.
D.
?on-line medical direction.

D. In? on-line medical? direction, the EMT acquires permission from a physician via cell? phone, telephone, or radio communication before administering specific emergency care.

An? EMT's role in the quality improvement process? is:
A.
primarily a matter for medical direction to decide.
B.
to be determined by a QI committee.
C.
strictly limited to providing good documentation.
D.
a part of every call for the EMT.

D. Quality improvement has a place on every one of an? EMT's calls. It is not limited only to providing good? documentation, and it is not determined only by a committee or medical direction.

Which of the following is a common step in? evidence-based decision? making?
A.
Do whatever those with more training tell you to do.
B.
If evidence supports a change in? practice, change your protocols and implement the changes.
C.
Leave anything that app

B. Common steps in? evidence-based decision making include the? following: (A) formulate a question that needs to be? answered, (B) search medical literature for research data related to the? question, (C) appraise the evidence for validity and? reliabili

Something is evidence based if it is based? on:
A.
personal authority.
B.
tradition.
C.
scientific evidence.
D.
supposition.

C. A medical technique or practice is evidence based if it is supported by scientific evidence of its safety and efficacy.

What is the essence of QI? review?
A.
It is imposed by state law.
B.
It is? self-initiated.
C.
It is federally mandated.
D.
It happens on an annual basis.

B. Quality improvement is a process of continuous? self-review with the purpose of identifying and correcting aspects of the system that require improvement.

What is the BEST way to determine whether an intervention provided by EMTs is beneficial to patient? outcomes?
A.
Conduct research in the hospital ED setting on the same? topic, but use the hospital patients as subjects in the study.
B.
Perform? evidence-

C. Although all the methods listed will provide the researcher with some information about the research? question, the best information will be the data gained by doing the research in the prehospital environment so that variables that are specific to tha

Which of the following agencies has established an assessment program with a set of standards for EMS? systems?
A.
USMLE
B.
NREMT
C.
NAEMSE
D.
NHTSA

D. The? NHTSA, or National Highway Traffic Safety? Administration, has an established assessment program with a set of EMS systems standards.

What must someone do to gain registration with the National Registry of? EMTs?
A.
Pass just a? computer-based examination.
B.
Pass just a practical? hands-on examination.
C.
Pass both a? computer-based knowledge examination and a practical? hands-on exami

C. Certification at any level is attained by passing both a practical examination and a CBT examination.

Examining the reports of a crew that was on a call involving a patient with a communicable? disease, such as bacterial? meningitis, would be an example of a health? department's role? in:
A.
workplace safety.
B.
disease surveillance.
C.
injury prevention.

B. When a local health department gets involved in reviewing the reports of crew members who might have been exposed to a patient with a communicable? disease, this is an example of their disease surveillance role.

The 911 dispatchers who are specially trained to give prearrival instructions to? callers, such as how to control bleeding or how to perform? CPR, are? called:
A.
Emergency Medical Dispatchers.
B.
medical directors.
C.
base hospitals.
D.
physicians.

A. 911 call centers are generally staffed by trained communications personnel. Many of these individuals are specially trained as Emergency Medical Dispatchers? (EMDs), who not only take the call and facilitate the dispatch of emergency services but also

Quality improvement should? be:
A.
optional.
B.
active.
C.
subjective.
D.
involuntary.

B. Quality improvement should be active on the part of every EMT. A dedication to quality is one of the strongest assets of an EMT.

You respond to the residence of a senior citizen who has fallen. You make an observation about slippery throw rugs on the living room floor and bring this to the attention of the patient and her family. This is an example of? being:
A.
a? self-starter.
B.

A. Part of being an EMT is trying to make sure the current patient does not become a patient again if possible. Recommending improvements in safety in the home can be one way to do this. By taking the initiative to do this without being? prompted, you are

What is a lesson learned from the Korean and Vietnam? conflicts?
A.
There was a need for a common scope of practice for all prehospital personnel.
B.
Speed of evacuation is the most important element in an EMS system.
C.
Specialized centers should be devo

C. The field experience of medical teams in the Korean and Vietnam conflicts led to advances in the civilian? sector, including specialized emergency medical centers devoted to the treatment of trauma injuries.

Of the four nationally recognized levels of EMS? training, which one is the most? basic?
A.
Emergency Medical Technician
B.
Advanced EMT
C.
Paramedic
D.
Emergency Medical Responder

D. The Emergency Medical Responder provides immediate lifesaving care to patients who have accessed the EMS system while the patients are awaiting response from a? higher-level EMS practitioner. The EMR course is the shortest course in EMS training and ce

Safe transport? involves:
A.
securing the patient in the ambulance.
B.
avoiding? high-traffic areas.
C.
driving very slowly.
D.
avoiding lifting and moving the patient.

A. Safe transport? involves, in? part, securing the patient in the ambulance. The patient will need to be lifted and? moved, and it may not be possible to avoid? high-traffic areas and drive very? slowly, although the ambulance must be operated safely.

A personal trait that the EMT must possess that relates to overcoming the unpleasant aspects of an emergency? is:
A.
having emotional stability.
B.
needing to always be in control.
C.
being able to force others into action.
D.
having a good sense of humor

A. EMTs must possess a number of personal? traits, including emotional? stability, which relates in part to being able to overcome the unpleasant aspects of an emergency.

Which statement regarding states and the National Registry examinations is? true?
A.
The National Registry exams are suggested by many states but not required.
B.
Many states use these examinations as their certification exams.
C.
All states require passi

B. Many but not all states use the National Registry examinations as their certification exams.

The system by which the medical community oversees the basic health of a population is known? as:
A.
the public health system.
B.
the? hospital-based care system.
C.
emergency medical services.
D.
best clinical practices.

A. the public health system.

Which of the following is TRUE of? EMTs?
A.
All EMTs are paid.
B.
Many EMTs are volunteer EMS providers.
C.
Most EMTs work for the fire department.
D.
EMTs must be municipal employees

B. Many EMTs are volunteer EMS providers.

Refresher courses for EMTs are required at? 2- to? 4-year intervals. Being proactive and strongly committed to doing all the refresher work necessary BEST demonstrates which personality trait of a good? EMT:
A.
Good moral character
B.
Emotionally stable
C

D. ?Self-starter

You have just become an EMS? instructor, and now you are teaching a helmet safety awareness class for a local elementary school. This activity would be in support of which assessment standard for the Technical Assistance? Program?
A.
Human resources and t

B. Public information and education

In which quality improvement activity does the EMT participate MOST? often?
A.
Deposition
B.
Teaching EMS classes
C.
Documentation
D.
Writing new protocols

C. Documentation

An enhanced 911 system allows the emergency dispatcher? to:
A.
provide? step-by-step CPR instructions to the caller.
B.
contact? police, fire, and EMS personnel simultaneously.
C.
immediately access the phone number and address from which the call is bein

C. immediately access the phone number and address from which the call is being made.

Which of the following levels of EMS training was formerly called? EMT-Basic?
A.
Paramedic.
B.
Emergency Medical Technician.
C.
Emergency Medical Responder.
D.
Advanced Emergency Medical Technician.

B. Emergency Medical Technician.

What is the official name for the physician who assumes responsibility for all patient care aspects within a specific EMS? system?
A.
Chief of staff
B.
Medical administrator
C.
Physician on call
D.
Medical director

D. Medical director

What is LEAST likely to be an aspect of carefully and thoroughly documenting an emergency? call?
A.
Neatness
B.
Speculation
C.
Accuracy
D.
Completeness

B. Speculation

Oversight of the patient care aspects of an EMS system by the Medical Director is? called:
A.
?evidence-based practice.
B.
medical direction.
C.
standard of care.
D.
?off-line protocols.

B. medical direction.

How many nationally recognized levels of EMS practitioner are there and what is the highest? level?
A.
?Five; Paramedic
B.
?Three; EMT
C.
?Four; AEMT
D.
?Four; Paramedic

D. ?Four; Paramedic

One aspect of quality improvement in which every EMT can participate? is:
A.
arguing for changes to local statutes.
B.
developing standing orders.
C.
participating in continuing education.
D.
rewriting agency protocols.

C. participating in continuing education.

What aspect of equipment management will an EMT be involved in when working toward? high-quality care?
A.
Purchasing the equipment
B.
Recommending the equipment to other EMTs
C.
Checking and maintaining the equipmet
D.nt
Distributing equipment to other EM

C. Checking and maintaining the equipmet

EMS has a role in many public health? issues, including:
A.
promoting safer vehicle design.
B.
enforcing the speeding laws.
C.
vaccination programs.
D.
regulating the number of work hours.

C. vaccination programs.

The modern EMS system in the United States began in? the:
A.
1960s.
B.
1950s.
C.
2000s.
D.
1980s.

A. 1960s

You believe that your patient should be given nitroglycerin for his chest pain. You do not have? off-line protocols for? this, so you? should:
A.
administer the medication and document accordingly.
B.
do what you did for the last patient with chest pain.

C. contact medical direction.

The National Highway Traffic Safety Administration Technical Assistance Program provides a set of recommended standards for EMS systems for its assessment program. Which of the following is one of these ten? standards?
A.
System access
B.
Personnel schedu

C. Medical direction

Holding an NREMT certification may help you in which of the following? situations?
A.
Passing an EMT examination
B.
Providing prehospital care
C.
Establishing protocols
D.
Gaining reciprocity

D. Gaining reciprocity

The NREMT is involved? in:
A.
rules and regulations for EMTs.
B.
grading certification exams.
C.
establishing local EMS protocols.
D.
EMS curriculum development.

D. EMS curriculum development.

What do many fire departments require of an? employee?
A.
?Cross-training as a firefighter
B.
?Cross-training as an EMT
C.
?Cross-training as a volunteer
D.
?Cross-training as a policeman

B. Cross-training as an EMT

After World War? II, who was the person who usually provided ambulance? transport?
A.
The local police service
B.
The local? doctor's office
C.
The local undertaker
D.
The local National Guard

C. The local undertaker

From the? patient's perspective, care begins? with:
A.
an ambulance transporting the patient to the hospital.
B.
the EMS system sending available responders to the scene.
C.
the emergency department receiving the patient.
D.
the initial phone call to the

D. the initial phone call to the EMD.

You are taking care of a patient who has been assigned to you during a mass casualty incident. In communicating with this? patient, you? should:
A.
match the? patient's emotional response.
B.
advise the patient to avoid speaking except to answer questions

C. be measured and controlled.

To receive the highest quality of? care, some patients need to be transported to special? facilities, such as patients who have been critically burned or had a stroke. Determining what emergency care is appropriate for a patient relates to which area of E

B. Patient assessment.

Which of the following terms is the description of medical techniques or practices that are supported by scientific evidence confirming their safety and? efficacy?
A.
Injury prevention
B.
?Evidence-based
C.
Quality improvement
D.
Patient outcomes

B. ?Evidence-based

Which step in the? evidence-based medicine process deals with the concept of determining what we already know about a particular intervention or? situation?
A.
Searching medical literature
B.
Appraising evidence for validity and reliability
C.
Changing of

A. Searching medical literature

You respond to a domestic violence call with your partner and the local volunteer fire department. You should regard the fire department volunteers? as:
A.
a hindrance to providing necessary care.
B.
inappropriate responders unless there is a fire.
C.
par

C. partners in care who may need guidance from you.

A term for treatments backed by research that proves that the interventions have positive effects in patient care? is:
A.
traditional approach.
B.
early? goal-directed therapy.
C.
?authority-based treatment.
D.
?evidence-based medicine.

D. evidence-based medicine.

Which EMT action most likely could provide information important for community health initiatives that are designed to prevent? injuries?
A.
Observation of the emergency scene
B.
Assessment of the patient
C.
Lifting and moving the patient
D.
Transfer of c

A. Observation of the emergency scene

Notifying the receiving facility of the nature and extent of a? patient's injuries for every patient transport LEAST demonstrates which personal trait an EMT should? exhibit?
A.
Able to lead
B.
?Self-starter
C.
Resourceful
D.
Cooperative

C. Resourceful