Questions and Answers 1 What is hypotension? Decreased blood pressure relative to a person’s baseline blood pressure. Hypotension is a systolic blood pressure less than 90 mm Hg or a mean arterial pressure of less than 60 mm Hg for a duration of at least 30 minutes. Another definition is a decrease in a person’s baseline blood pressure of 30%. The absolute point of hypotension varies between individuals.…
Questions and Answers 1 You arrive on the scene at a local restaurant to find a 65-year-old gentleman who reportedly had a witnessed cardiac arrest. Cardiopulmonary resuscitation (CPR) was started by bystanders. How common is out-of-hospital cardiac arrest? 350,000 patients suffer an out-of-hospital cardiac arrest annually in the United States, and the overall fatality rate is over 90%. 2 After you stabilize your patient, what is…
Questions and Answers Case: You arrive on scene at a high school football game to find an adult male lying under the bleachers with first responders on scene. He has an abrasion to his forehead and there is emesis on his shirt. The EMT on the scene turns to you as you approach and your partner yells, “What are his vitals?” 1 How do you rapidly…
Questions and Answers Critical Incident Stress 1 What is a critical incident? A critical or incident is defined as a powerful or emotionally provoking event experienced by the EMS provider. This stressor typically overwhelms the person’s normal coping mechanisms and significantly differs from the ordinary events experienced on the job. Incidents such as line-of-duty death or critical injury, death of child, severe child abuse case, mass…
Questions and Answers 1 What is scene safety and how does it affect emergency medical service (EMS) providers? Scene safety is the general principle of keeping safe from all hazards while working as an EMS provider. Scene safety is critical to all emergency responders and starts the moment they receive a call. Providers face risks, including traffic accidents, infectious disease exposures, and violence. While some events…
Questions and Answers 1 What is the difference between quality assurance and quality improvement ? Sometimes used synonymously, the terms quality assurance (QA) and quality improvement (QI) refer to distinct processes with different goals. The goal of QA is to monitor and measure compliance against a standard. In this way, QA is a reactive process that detects errors after they have occurred. On the other hand,…
Questions and Answers 1 What is public health? Public health can be a very wide-ranging field that can include injury prevention, disease surveillance, and management of underserved populations. The American Public Health Association is a group based in Washington, DC, that advocates for and promotes the topic of public health. The group currently has 34 topics listed on their website, of which they are currently focused.…
Questions and Answers 1 What is direct medical oversight? While state specific, emergency medical services (EMS) agencies have providers (typically physicians or advanced practice providers) on standby to provide direct medical oversight. Direct medical oversight, also referred to as online medical control, medical command, or online medical direction, refers to orders given by a physician or designee to the prehospital provider either in person or via…
Questions and Answers 1 What is the role of a public information officer (PIO)? PIOs are the relay between the organization/department and the public They serve as the spokespersons providing information as necessary to the media. Having a designated spokesperson for your department who works with the marketing/public relations team before and when addressing the media will ensure that there is only one message being communicated.…
Questions And Answers 1 What types of vehicles are used by emergency medical services (EMS) systems? There are multiple types of vehicles employed in emergency services response, with the most common being an ambulance. Other vehicle types like helicopters, airplanes, four-wheel all-terrain vehicles, snowmobiles, and boats or nontransport vehicles like bicycles and fire engines may also be utilized. Vehicle choice is dependent on multiple factors including,…
Questions and Answers 1 Are there other important determinants of patient outcome besides assessment and treatment of a patient? While prehospital assessment and interventions are important to patient care, the determination of where to transport is also critical. If there is only one available hospital, the choice is easy. However, if there are multiple potential facilities, the decision must be based on the patient’s medical needs.…
Questions and Answers 1 When did emergency medical services originate? There are reports from biblical times where care was performed outside of places for healing. The Edwin Smith Papyrus and Babylonian Code of Hammurabi detailed early treatment and transport protocols. The Good Samaritan parable tells the story of a man who remedied travelers’ wounds with oil and wine on the roadways. The man also helped care…
You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here
You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here
Case presentation A 10-year-old female presents with 2–3 weeks of progressively worsening throat pain and dysphagia. She was diagnosed 2 weeks ago with Streptococcal pharyngitis by her primary care provider. She was treated with a 10-day course of amoxicillin and had mild improvement, but her symptoms returned. She was evaluated by her physician again and told she had a viral infection, since her rapid strep test…
Case presentation A 4-year-old child is referred from her primary care provider’s office over concerns for meningitis. The patient has had fever and decreased oral intake and has not wanted to move her neck or head for the past 3 days. She has had rhinorrhea and mild cough for the past 3 days. She was seen by her primary care physician initially, who diagnosed an upper…
Case presentation A 14-month-old, previously healthy child presents to the Emergency Department in the middle of the night with respiratory distress, hoarseness, and a barky cough. He has had mild congestion and a low-grade fever for a day. On physical examination, the child is in moderate respiratory distress and is anxious appearing while struggling to inhale each breath. His respiratory rate is 58 breaths per minute,…
Case presentation A 5-year-old male presents with left arm pain after a fall. He was playing soccer when he fell and landed on his left shoulder. He immediately complained of upper arm pain. His examination is significant for focal tenderness to the proximal left humerus with decreased range of motion when he attempts to raise the arm. There is mild edema. He is grossly neurovascularly intact.…
Case presentation A 9-year-old male presents with a 4-month history of right upper arm pain. Over the past 2 months, he and his parents have noted the development of swelling to the arm as well. The patient is active in sports, particularly baseball, and the pain started after he pitched a game. He was given ibuprofen with some relief of the pain, but over the past…
Case presentation A 6-year-old female presents with persistent, worsening right knee swelling for the past 2 months. The area has become painful over the past few weeks, especially at night. There has been no fever, erythema, or swelling of the other extremities or joints. There is no report of trauma, but prior to the development of symptoms, the child was quite physically active and it is…