ABEM EMS flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Compression rate and depth

Adult CPR compressions are delivered at 100-120 per minute to a depth of 5-6 cm (2-2.4 inches), allowing full chest recoil between compressions.

Epinephrine dose in anaphylaxis

Intramuscular epinephrine 0.3 mg of 1:1000 solution for adults, 0.15 mg for children, injected into the lateral thigh and repeated every 5-10 minutes if needed.

Field triage for STEMI

Obtain a 12-lead ECG within 10 minutes of first medical contact and transport suspected STEMI patients to a PCI-capable center when transport time is reasonable.

Tourniquet indications

A tourniquet is indicated for life-threatening extremity hemorrhage not controlled by direct pressure, applied proximal to the wound and tightened until bleeding stops.

Permissive hypotension in trauma

In penetrating trauma without traumatic brain injury, targeting a systolic blood pressure near 90 mmHg limits hemorrhage until surgical control is achieved.

Naloxone titration goal

Naloxone is titrated to restore adequate spontaneous ventilation rather than full consciousness, reducing the risk of abrupt withdrawal and agitation.

Pediatric weight estimation

When actual weight is unknown, a length-based tape or the formula weight in kg equals (age in years plus 4) multiplied by 2 estimates dosing weight.

Last known well time

In suspected stroke, the time the patient was last known to be at neurologic baseline anchors thrombolysis and thrombectomy eligibility decisions.

Response time benchmarks

Common urban benchmarks are BLS first response within 4-8 minutes and ALS within 8-12 minutes, with agencies tracking 90th percentile times.

System status management

A deployment strategy that dynamically repositions ambulances based on predicted call demand patterns rather than fixed static posting locations.

Automatic versus mutual aid

Automatic aid dispatches the nearest available unit regardless of jurisdiction under prearranged agreement; mutual aid is requested when local resources are exhausted.

Offline versus online medical direction

Offline medical direction consists of written protocols and standing orders; online medical direction is real-time consultation with a physician or designee.

NEMSIS purpose

The National EMS Information System is the national standard for EMS data elements, enabling electronic patient care reports to feed state and national registries.

Span of control

In incident management, a supervisor should directly manage roughly 3 to 7 subordinates, with 5 considered the optimal span.

Crew resource management

A teamwork training approach using clear communication, role clarity, and assertiveness to reduce human error during high-stress out-of-hospital operations.

Ambulance crash risk

Emergency response carries the highest crash risk for ambulances; seatbelt use, intersection caution, and driver training are key mitigations.

Medical director authority

The agency medical director holds legal responsibility for clinical care, approving protocols, credentialing providers, and overseeing quality improvement activities.

Just culture framework

A safety framework distinguishing human error, at-risk behavior, and reckless behavior, supporting nonpunitive reporting of errors while addressing reckless conduct.

QA/QI improvement cycle

A structured cycle of identifying an indicator, collecting data, analyzing variance, implementing an intervention, and re-measuring to confirm improvement.

NCCP recertification model

The National Continued Competency Program structures recertification into national, local, and individual components, replacing a single fixed-hour requirement.

Root cause analysis

A structured review method examining system and process failures contributing to an adverse event, producing recommendations rather than individual blame.

High-risk skill maintenance

Low-frequency, high-risk skills such as intubation and pediatric dosing require simulation and documented competency verification to maintain proficiency.

Credentialing and privileging

Initial and periodic verification of licensure, certification, and clinical competency before a provider is permitted independent practice within an agency.

Protocol review cycle

Clinical protocols are reviewed on a defined schedule, commonly annually or after a sentinel event, using current evidence and local outcome data.

START triage categories

Adults who walk are green; those with spontaneous breathing after repositioning, adequate perfusion, and normal mentation are red; apneic and pulseless are black.

JumpSTART pediatric differences

Pediatric triage provides rescue breaths for apneic children with a pulse, classifies them immediate if breathing resumes, and uses adjusted respiratory thresholds.

Incident Command System sections

The ICS general staff comprises Operations, Planning, Logistics, and Finance/Administration sections, all reporting to a single Incident Commander.

Hazmat hot zone entry

Only trained personnel wearing appropriate PPE enter the hot zone; the warm zone supports decontamination and the cold zone is the safe support area.

Rescue task force model

An active-threat response integrating law enforcement protection with EMS providers staged in the warm zone to rapidly extract and treat casualties.

Crisis standards of care

Declared frameworks that shift care expectations during overwhelming disasters, guiding ethical allocation of scarce resources across affected populations.

Decontamination sequence

Remove clothing and gross contamination before transport; ambulatory patients self-decontaminate first to conserve resources for nonambulatory casualties.

Expectant triage category

A category for casualties with survivable but resource-intensive injuries who are prioritized last when resources are overwhelmed and survival is unlikely.