Questions and Answers 1 Who is considered a “geriatric patient” and why does that matter? Geriatric patients are classified as persons over the age of 65 years. This is the fastest-growing segment of the population in the United States. The US Census Bureau estimates that by the year 2040, there will be 80 million older adults, making up 21% of the population. The chronological age is the…
Questions and Answers 1 How is obesity defined? Body mass index (BMI) is a measure of body fat based on height and weight. BMI = body weight (in kg) ÷ height (in meters) squared Using BMI, obesity is then classified as follows: Overweight = BMI ≥25.0 to 29.9 kg/m 2 . Class I obesity = BMI of 30.0 to 34.9 kg/m 2 . Class II obesity (formerly known as morbid obesity) = BMI of 35.0 to…
Questions and Answers 1 What is an interfacility transport? Interfacility transport is the movement of a patient from one healthcare facility to another by licensed EMS personnel. 2 What are the reasons patients may need to be transferred between healthcare facilities? Interfacility transports in the healthcare industry take place for many reasons. They may be as simple as a wheelchair van transport of a patient from…
Questions and Answers 1 What is drowning? Drowning is “the process of experiencing respiratory impairment due to submersion or immersion in liquid.” Depending on outcomes, drowning can further be divided into drowning with morbidity, drowning with mortality, or drowning with neither morbidity nor mortality. Terms such as near drowning , dry drowning , and delayed drowning should be avoided as they are outdated and are not…
Questions and Answers Case: Four utility workers are assessing damage to a high-voltage power line transformer. One worker drops a wrench, creating an arc flash, with resultant flash of light and explosion. They are thrown. EMS arrives 7 minutes after the explosion to find three of the men in various stages of distress and a fourth man in cardiopulmonary arrest. 1 Which of the men should…
Questions and Answers Heat-Related Illness 1 What is the definition of a heat-related illness? An illness resulting from inadequate acclimatization, impaired heat dissipation, increased heat production, and/or an elevated wet bulb globe temperature. 2 How does the human body respond to heat and humidity? Sensors from the periphery alert the hypothalamus to an elevation in temperature. Signals are then sent to the sweat glands to begin…
Questions and Answers Dysbarisms 1 What are dysbarisms? A collection of illnesses resulting from changes in ambient air pressure, to which an individual cannot readily adapt. Dysbarisms include barotrauma, decompression sickness (DCS), arterial gas embolism (AGE), nitrogen narcosis, and oxygen toxicity. 2 Who is at risk of developing dysbarisms? Astronauts, aviators, compressed air workers (e.g., caisson workers, tunnel workers, hyperbaric chamber observers), and scuba divers. 3…
Questions and Answers 1 A 60-year-old man was sweeping the floor of his garden shed when he was bitten by a large spider. He has managed to trap the spider under a glass jar. On arrival to his Houston, Texas, residence, you find him sitting on a chair anxiously holding his wounded left hand. You are unsure if the trapped spider is a black widow or…
Questions and Answers 1 What is wilderness medicine? Wilderness medicine is, in general, as defined by Hawkins in Wilderness EMS , “medical care and problem-solving in circumstances where the surrounding environment, has more power over our well-being than does the infrastructure of our civilization.” Many texts have defined wilderness medicine with various verbiage over the years, but as the field has matured, the definition has evolved.…
Questions and Answers 1 How has emergency medical services been involved in disasters in the past? Emergency medical services (EMS) has been involved with disaster response as part of their routine responses. During a disaster, EMS will typically be called on through 911. EMS is likely to be the first to respond on a scene for an unexpected incident. EMS providers have acted as Incident Command…
Questions and Answers 1 What is search and rescue (SAR)? SAR is comprised of search functions and rescue functions. This is an important point not only because of differences in the skills and resources involved between these two types of operations, but sometimes due to differences in responsibilities, jurisdictions, and legal aspects. Search is an operation that uses available personnel and facilities to locate persons in…
Questions and Answers 1 Describe the origin of Tactical Emergency Medical Services (TEMS). The concept of TEMS was born at a series of national conferences in 1989 and 1990 with representatives from EMS, law enforcement, and emergency medicine. The National Tactical Officers Association endorsed that TEMS should be on every tactical team in 1994 and again in 2007. 2 What is the injury rate among SWAT…
Questions and Answers Initial Response Considerations 1 What is the best way to plan for potential hazardous material (HAZMAT) incidents in a particular region or community? Management of HAZMAT incidents begin well before the alarm goes off. Every organization involved in HAZMAT response should perform a comprehensive vulnerability analysis to identify any and all potential threats for their particular community. This includes working with governmental organizations,…
Questions and Answers 1 Why is this chapter important and what is the chance that an EMS provider will see injuries from a blast or explosion? The frequency of blast injuries due to military conflict and terrorist activities has increased dramatically in the last 15 years. Injury patterns that used to be seen only in military conflicts are now being seen outside of these areas of conflict…
Questions and Answers 1 Is it safe to treat patients who have been exposed or contaminated during a radioactive disaster? This is the first question because it is the most important. Like any other situation in the field, safe is a relative term. There are three primary sources of danger: the origin of the radiation, the hazards of the disaster environment, and the patient. By maintaining…
Questions and Answers 1 What is the importance of preplanning regarding chemical and biological terrorism? Without preplanning, the risk of injury or death to first responders is greatly increased. Each responding organization should develop standard operating procedures (SOPs) to implement personal protective equipment (PPE) use, decontamination of casualties, and technical decontamination of first responders. Individual SOPs should be part of the overall incident response plan. Frequent…
Questions and Answers 1 What are casualty collection points that are used during a mass casualty incident? These are areas that have been designated to move patients from the scene of the incident. They need to be in a safe area, usually a distance from the scene, and should not be accessible to the public. The collection points usually coincide with the levels of triage to…
Questions and Answers 1 What is a mass casualty incident (MCI)? The World Health Organization describes an MCI as a disaster and major incident characterized by a quantity, severity, and diversity of injuries in patients that can rapidly overwhelm the ability of local medical resources to deliver comprehensive and definitive medical care. Multiple resources, such as EMS, police, hospitals, and equipment, will likely be depleted/exhausted during…
Questions and Answers 1 What is a disaster? A disaster is defined by the World Health Organization as a sudden ecologic phenomenon of sufficient magnitude to require external assistance. Essentially, it is any event that overwhelms the capabilities of a particular service. For example, a multicar accident on a highway can easily overwhelm the nearest trauma center if there are multiple serious injuries or a power…
Questions and Answers 1 What is the prevalence of burn injuries in children in the United States? Over 250,000 children require medical attention for burns; of these, 200,000 are scald injuries. Males outnumber females 2:1. Approximately 15,000 kids per year require hospitalization for burn injuries. Burns and fires kill 1100 children aged 14 years and under in the United States each year. Children aged 5 years and under…