Notesale: Turn your study into money

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JA
Professor Idleman
EMS121EM3
Chapter 1 Notes
Quality Improvement - A process of continuous self-review with the purpose of identifying and correcting
aspects of the system that require improvement
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Designated Agent - An EMT or other person authorized by a Medical director to give medications and
provide emergency care
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Standing Orders - A policy or protocol issued by a medical director that authorizes EMTs and others to
perform particular skills in certain situations,
EMS Role in Public Health:
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Injury prevention for geriatric patients
injury prevention for youth
public vaccination programs
disease surveillance

Patient Outcomes - long-term survival of patients
Evidence based - description of medical techniques and practices

Evidence Based Decision Making Process

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Forming a Hypothesis
Evaluating the evidence
Adapting practices that the evidence supports

Retrospective Reviews – look at events that have occurred in the past
Prospective studies – designed to look forward
Randomization – compares one therapy against another while there is controlled randomization of the
application variables
Control groups – help evaluate standard outcomes
Study group similarity – uniformity between studies
Types of Medical Research:
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Case studies: review treatment of a single patient or series of patients
Cohort/Concurrent Control/Case-control: two groups are compared but not randomized
Randomized controlled trials (RCTs) – random assignment of eligible subjects into test groups
Systematic Review – studies pertaining to single questions
Meta-analysis – a study of the compilation of many studies relating to a single topic

Levels of Evidence:
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Highest, most valuable – Results from Randomized Controlled Trials
Concurrent controls without randomization – retrospective
Retrospective controls, little amounts of control; have already occurred
Studies without a control group
Studies that are not directly related to the specific patient population

Questions to ask when Evaluating a Research Study:
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What is the title?
Who is the principal investigator? Primary contract/
What is the research question?
What are the study’s inclusion criterion?
What EMS data is needed?
How will informed consent be handled?
How will randomization take place?
Samples?
Risks?
Benefits?
What institutional board has approved the study?

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Has the EMS agency’s administration approved the study/
Key Terms:
Designated Agent – An EMT or other person authorized by a medical director to give medications and
provide emergency care
Evidence-Based – description of medical techniques or practices that are supported by scientific evidence
Medical direction – oversight of the patient-care aspects of an EMS system by the Medical Director
Medical Director – A physician who assumes ultimate responsibility of the patient care aspects of the
EMS system
911 System – A system for telephone access to report emergencies; enhanced 911 has location tracking
Off-Line Medical direction – standing orders issued by the medical director that allows EMTs to give
certain medication or perform certain procedures without speaking to the medical director or another
physician
On-Line Medical direction – orders from the on-duty physician given directly to an EMT in the field via
radio or telephone
Patient Outcomes – long-term survival of patients
Protocols – lists of steps; such as assessments and interventions, to be taken in different situations; are
developed by the medical director of an EMS system
Quality Improvement – A process of continuous self-review
Standing orders policies issued by medical directors
Levels of EMS Training:
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EMR – Emergency Medical Responder
EMT Basic – Emergency Medical Technician
EMT Intermediate
AEMT – Advanced EMT (Paramedic)



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