Deck 19: Specialty Care Transport

Question 1

In order to minimize the chance of inappropriate blood unit administration, it is imperative that at least four persons confirm the patient's name and blood type, unit's blood type, unit number, and expiration date prior to administration.

Answer 1

False

Question 2

When hospitals attempted to transfer patients they felt were in need of care at another facility they often encountered difficulty in obtaining acceptance of these patients, a problem that appeared to have a financial motivation, sometimes referred to as ____.

A) reverse dumping
B) dumping
C) overtriaging
D) undertriaging

Answer 2

reverse dumping

Question 3

The scope of ____ is the extent to which a healthcare provider is permitted to perform medical procedures.

A) obligation
B) management
C) practice
D) need

Answer 3

practice

Question 4

The ____ must arrange for another hospital to accept the patient in transfer.

A) family
B) receiving hospital
C) sending hospital
D) first responder

Question 5

If a patient is brought by ambulance to a hospital-owned helipad, that hospital must provide the patient with a medical screening exam to be in compliance with EMTALA, regardless of intent.

Question 6

The certification of ____ may take many forms, but must include a statement of the medical benefits expected from transfer as well as the risks that can reasonably be expected due to the transfer.

A) medical necessity
B) informed consent
C) screening
D) risks and benefits

Question 7

Legal obligations for the transport agency and providers to effect a medically appropriate patient transport in the safest manner possible are detailed under EMTALA.

Question 8

If an initial screening exam reveals an emergency medical condition, the hospital is obligated to stabilize the patient.

Question 9

Consent must be informed and in writing and is often included as a part of the certification of ____.

A) screening
B) medical necessity
C) capacity
D) risks and benefits

Question 10

In general, the staffing required for an interfacility transport is determined based upon the ____.

A) patient's expected needs
B) incident location
C) receiving hospital's capabilities
D) transport provider's capabilities

Question 11

The practice of hospitals recommending a patient transfer for purely economic reasons is referred to as ____.

A) overtriaging
B) dumping
C) loading
D) undertriaging

Question 12

The sending facility is legally responsible for providing patient care (i.e., medical control) until care is assumed by the receiving facility physician.

Question 13

EMTALA defines "____" as the point when a patient is not likely to deteriorate during transfer.

A) regulated
B) stabilized
C) unstabilized
D) triaged

Question 14

If a hospital's assessment reveals that a patient has an emergency medical condition, the hospital must provide stabilization.

Question 15

Protocols that are written for the standard prehospital EMS response are not suited to the care provided during interfacility transport.

Question 16

The advent of the ____ on April 1, 2002, defined a separate category of reimbursement for interfacility transport patients requiring specialized interventions beyond the Paramedic's scope of practice.

A) Medical Treatment and Active Labor Fee Schedule
B) Affordable Transport Fee Schedule
C) Health Care and Education Reconciliation Fee Schedule
D) National Medicare Ambulance Fee Schedule

Question 17

In the early 1980s, it was not unusual for transfers to be motivated by both the need for a higher level of care and financial reasons.

Question 18

Continuous waveform capnography is becoming the standard of care for endotracheal tube confirmation.

Question 19

The ____ defines a hospital's responsibility to provide emergency care to anyone presenting with a request for help.

A) Health Care and Education Reconciliation Act
B) Patient Health Care Protection Reconciliation Act
C) Emergency Medical Treatment and Active Labor Act
D) Affordable Health Care Act

Question 20

Over the past several decades, the medical community has seen a decreased need to move sick patients from one hospital to another.

Question 21

Central venous catheters can take many forms, but are most commonly ____ bore and placed in the femoral, subclavian, or internal jugular veins.

A) small
B) short
C) long
D) large

Question 22

Many conditions might require a patient to be transferred from one facility to another. This is largely dependent upon the ____ resources.

A) dispatch center
B) incident scene
C) local hospital
D) transport provider

Question 23

Out-of-hospital care, both on-scene and during interfacility transport, is most often provided by ____.

A) non-physicians
B) primary care physicians
C) specialty physicians
D) surgeons

Question 24

When written guidelines do not provide the Paramedic with the guidance he is looking for, he should directly contact ____.

A) a physician
B) dispatch
C) any superior provider
D) patient transport

Question 25

Physician oversight that takes the form of written protocols and other guidelines is known as "____."

A) in-line medical control
B) off-line medical control
C) on-line medical control
D) straight-line medical control

Question 26

A patient with a pneumothorax or hemothorax might benefit from decompression of the pleural space prior to transport. This is done via ____.

A) tube thoracostomy
B) transducer line attachment
C) central venous catheter
D) pulmonary artery catheter

Question 27

"____" is required when the written guidelines do not provide the Paramedic with the guidance he is looking for.

A) Above-line medical control
B) Off-line medical control
C) On-line medical control
D) Straight-line medical control

Question 28

If a patient is intubated before or during a transport, the most consistent way to provide effective ventilations is by using (a) ____.

A) pulmonary catheter
B) ventilator
C) mouth-to-mouth
D) chest tube

Question 29

During hemodynamic monitoring using a central venous catheter and transducer, a pressure bag is typically applied to the flush solution and is set most commonly at ____.

A) 300 mmHg
B) 600 mmHg
C) 900 mmHg
D) 1200 mmHg

Question 30

Prior to beginning any blood transfusion, the Paramedic must assess and document the patient's temperature, heart rate, blood pressure, respiratory rate, oxygen saturation, and lung sounds. These parameters must be reassessed at least every ____ during a transfusion.

A) 5 minutes
B) 15 minutes
C) 25 minutes
D) 45 minutes

Question 31

Pulmonary artery catheters are placed in the ____ or internal jugular vein and advanced through the right atrium, the right ventricle, and into the pulmonary artery.

A) femoral
B) splenic
C) angular
D) subclavian

Question 32

Catheters can be placed into an artery, most commonly the radial or ____ artery, for the purpose of monitoring intra-arterial pressure.

A) femoral
B) popliteal
C) brachial
D) carotid

Question 33

____ teams are probably the most common specialty teams encountered by Paramedics during interfacility transport.

A) Pediatric and neonatal
B) Geriatric
C) Cardiac
D) Blood transfusion

Question 34

During a tube thoracostomy, the Paramedic places a tube in the patient's ____.

A) neck
B) mouth
C) spine
D) chest

Question 35

A patient who is ____, by definition, risks the possibility of deterioration during transport.

A) regulated
B) unstable
C) stabilized
D) overtriaged