EMT Operations Practice Test 2
This is a timed quiz. You will be given 60 seconds per question. Are you ready?
Which of the following statements regarding continuing education is most valued by the public?
Since medicine is a constantly evolving profession, the paramedic must stay abreast of current information, techniques, and medications. And while it is true within the profession that state EMS boards and the National Registry of EMTs will define specific requirements for continuing education in order to stay certified, these reasons would be least important to the community. What the community would want most is a paramedic who is abreast of the most current assessment and treatment modalities, so that they would receive the best care possible.
As an EMT, you release information on a patient to the newspaper. The patient felt he has been slandered. Which specific area of the law may the patient sue under?
Slander is not considered criminal law. While constitutional and federal law may apply, the best answer is the broad area in all states called "tort law." These types of laws deal with differences between individuals - such as this example where one person was providing information about another person without previous and appropriate consent.
You are called to a local industrial complex for a potential hazardous materials incident. The dispatcher reports to you that approximately 30 workers have been affected and that several workers have been overcome by fumes. The specialized hazardous materials response team has been dispatched but will arrive approximately 20 minutes after your ambulance. Upon arrival, you are met at the gate by a worker who points to a large white tank next to the building which is the apparent source of the contamination. On the side of the tank you see a multi-colored NFPA 704 symbol with a number four (4) located within the blue diamond, a number one (1) located within the red diamond, a number one (1) located within the yellow diamond, and no indicator located within the white diamond. You are immediately approached by a crowd of approximately fifteen workers who state that they were exposed to fluid which was leaking from the tank. What is your next immediate action?
Based upon the fact that the substance involved has already been identified as posing a significant health hazard, time cannot be wasted prior to initiation of field expedient gross decontamination. The universal decontaminating solution is water, and no time should be wasted in beginning to rinse any potential contamination away with it. Removal of the outer layer of clothing will immediately reduce the level of contamination on the victims. It is unreasonable to expect that the victims will wait for the hazardous materials team to arrive and begin decontamination. At no time should EMS personnel jeopardize their own safety by performing physical assessment or obtaining vital signs from potentially contaminated victims. Although weakened bleach solutions are sometimes used for decontamination, water is the best choice when the exact contaminating agent is unknown.
Of the following, which item is NOT a desired outcome of continued quality improvement (CQI) programs in an EMS system?
The benefits of a well-run Continuous Quality Improvement program for an Emergency Medical Service system go well beyond the ability to assess system performance. It allows for the collection of data for statistical analysis, provides a means by which areas of system weakness can be determined and addressed in a checks and balance manner, and also allows the ability to determine what type of continuing education courses may be offered since many times case studies are done on interesting calls. One thing that Continuous Quality Improvement programs should not do is develop and implement punitive recourses, should an area of improvement be identified. This would lead to providers who get better at hiding system weaknesses through inaccurate patient care reports and who are apprehensive to bring up concerns with management.
What are the rules or standards that govern the conduct of EMS professionals?
Ethics are rules or standards that govern professional conduct, whereas morals are the individual's perceptions of what is right and wrong. Neither standards nor codes are terms applicable to the concept of the question.
You've arrived at the scene of what appears to be a domestic dispute over child molestation. You are asking a 5-year-old child about elimination habits. What word would be best to use when questioning this child?
A 5-year-old will not understand urination, micturation or deltrusion. The best term to use in this instance is "pee-pee." (This is a good example where the paramedic needs to correlate life span development and effective communication knowledge.)
Why is it critical that the paramedic complete an equipment checklist at the beginning of each shift?
Completion of an equipment/supply checklist enables the paramedic to determine the overall preparedness of the ambulance for patient care. Checklists allow the paramedic to ascertain whether all necessary supplies and equipment are present and working as well as the expiration dates on medications carried on the ambulance. This decreases liability associated with providing prehospital emergency medical services by ensuring that everything needed to properly care for a patient is present and in good working order. Missing supplies, malfunctioning equipment, and expired drugs represent sources of liability, especially if they result in improper patient care. The Occupational Safety and Health Administration and US Department of Health and Human Services do not require EMS services to complete an equipment/supply checklist. Finally, insurance agencies do not require the submission of the equipment/supply checklists in order to provide ongoing liability coverage for the service.
You are called to the scene of a car versus tree accident. Upon arrival, you find the car to be engulfed in flames, with fire showing from underneath the hood and inside the passenger compartment. You can see that the operator of this vehicle is unconscious and slumped over the steering wheel. Which of the following is your first priority?
While all of the answers listed are considered priorities in this scenario, the safety of yourself and your crew must always come first. Your primary responsibility is always to ensure the safety of yourself and your crew. Once this is completed, then the focus can turn to the extrication and management of the patient. Always stay attentive to the scene, however, as things may suddenly change for the worse.
After releasing care of a possible child abuse victim over to the emergency department staff, you are having a discussion with another ambulance crew who was not present at the incident. As you are describing your suspicion that the child's mother is the perpetrator of child abuse, you are overheard by one of the child's family members. What legal violation have you possibly committed?
Slander is the act of injuring a person’s character, name, or reputation by making a false or malicious statement with malicious intent or reckless disregard for the falsity of the statement. If you had put the statement into writing, that would constitute possible Libel. Negligence is a deviation from accepted standards of care. Malfeasance is a form of negligence involving the performance of a wrongful or unlawful act.
As the head of the Quality Assurance Committee for your service, you review all patient care reports prior to passing them on to the medical director. On one trip sheet, you note the following narrative: Patient states that he cannot move his bowls and has had abdomenal pane for three weaks. Patient also states that he has had a fever and took too Tylenol tablets this morming, but then became naseated. What advice would you give the paramedic regarding this report?
Proper spelling is critical to prehospital documentation. Documentation containing spelling mistakes looks unprofessional and can cast doubt on the quality of care provided. Therefore, it is best to advise the paramedic to use a dictionary and look up any and all words that he is unsure of how to spell. Having the EMT-Basic document the advanced level care is inappropriate. However, it would not be inappropriate to have the EMT read over the documentation to point out spelling errors. Making up abbreviations for words the paramedic is unsure of how to spell can create additional confusion and is not considered good practice. Just documenting the aspects of patient care for which the paramedic is comfortable with spelling creates incomplete documentation and is likewise inappropriate.
You are in charge of devising an ambulance deployment plan for the EMS system within your community. Your goal is to minimize response times while simultaneously using all of the EMS resources in an efficient and cost effective manner. As such, which of the following information would be most valuable in formulating a plan?
Determining the time and location of calls over the past five years is critical, since analysis may reveal patterns to which the appropriate number of EMS resources can be matched. If an increase in the number of motor vehicle collisions is seen during morning rush hour, additional units can be deployed to strategic locations so that they can readily access future incidents. Socioeconomic status may be linked to call volume and time, but by itself is not the best criterion for location of resources. Location of previous ambulance collisions is important data, and should be used to minimize collisions, not locate ambulances. While the average age of the population provides a larger picture of the medical needs of the community, as a whole it is not the best factor in dictating the deployment of resources.
Which of the following patients encountered would the paramedic most likely benefit from critical incident stress management?
Death of a child is often a reason for a paramedic to need CISM. In addition a death of a coworker, an extreme threat to the paramedic, or any other significant incident may also be reasons for CISM. What is most important, however, is that the recognition of stress and poor coping on the part of the provider is more important than assuming the use of CISM's should be guided by the nature of the call.
Upon arrival at a local residence, you hear three possible gunshots in your vicinity. What should be your immediate next action?
If you enter a dangerous scene, you should leave the scene in the ambulance and immediately notify law enforcement so that the scene can be secured. Although it is true that dispatch and law enforcement should be notified, you must first ensure that your safety has been secured.
During completion of your patient care report, you write the following statement: The patient was obviously intoxicated and intentionally uncooperative. Subjective statements such as this can open the paramedic up to which of the following legal charges?
Libel is the act of injuring a patient’s character through written statements. Documenting personal opinion and derogatory statements expose the paramedic to Libel. Slander is similar to Libel, but refers to false or malicious statements made verbally. Malfeasance is defined as breach of duty by performing a wrongful or unlawful act. Res ipsa loquitur is a legal doctrine sometimes used in support of negligence claims.