Operations Study Guide for the EMT Test

General Information

It is the overall operation of the emergency medical services (EMS) system to provide emergency care and transport to the sick and injured. Within that system are a multitude of procedural guidelines that contribute to lifesaving efforts, and each one has its role in delivering exceptional results. Be sure you know all of the guidelines and understand how they function in a well-run EMS system. You need to consult your textbook for complete details on all of the following concepts. The EMT exam uses between 10% and 14% of its questions to assess your knowledge of Operations.

Emergency medical services are a system of response for the care of the sick and injured. An EMS system includes many components, including personnel, training, and equipment to report and respond to emergencies. The system includes ambulances, other first responders, emergency dispatching, and medical oversight. The Americans with Disabilities Act (ADA) provides provisions for EMTs with disabilities to pursue a career in EMS when possible.

Here are some concepts to know:

• Emergency Medical Services (EMS)—This is a coordinated system of trained personnel, equipment, and resources that provides medical care before a patient reaches the hospital. It includes dispatchers, first responders, EMTs, paramedics, ambulances, and emergency departments all working together to respond quickly, assess and stabilize patients, provide life saving treatment, and transport them safely to an appropriate medical facility.

• certification—process by which an individual is formally recognized as having met the required knowledge and skill standards for a specific level of medical training

• licensure—legal authorization granted by a state or government agency that allows an individual to practice as an EMS provider at a specific level

• Americans with Disabilities Act of 1990—This is the federal law that prohibits discrimination against individuals with disabilities in areas such as employment, public service, transportation, and public accommodations. This helps ensure that patients with disabilities receive equal access to emergency care and that EMS providers with disabilities are given fair opportunity to work.

• National EMS Scope of Practice—This framework was created to define what EMS providers at each certification level are trained and authorized to do. It outlines the skills, interventions, and responsibilities allowed for EMRs, EMTs, AEMTs, and Paramedics.

Equipment

An ambulance is stocked with hundreds of pieces of equipment and supplies. These tools, devices, and medical supplies are used by providers to assess, treat, and care for patients in the field. These items include airway tools, oxygen equipment, bandages, splints, stretchers, monitors, and other resources needed to provide safe and effective prehospital care. The vehicle should be inspected daily to ensure it is mechanically ready to be operated and that all supplies are present and equipment is in functioning order prior to a call.

Defensive Driving

Ambulances must be operated following standard defensive driving techniques. Exemptions from normal traffic laws are allowed in emergency mode, but the liability still exists. Ambulances are large vehicles with their own handling characteristics. Transport with lights and sirens is usually unnecessary.

Here are some concepts to know:

• blind spots—areas around an emergency vehicle that cannot be seen by the driver through standard mirrors or windows

• driver characteristics—personal qualities, skills, and behaviors that affect how safely and effectively an EMS provider operates an emergency vehicle

• cushion of safety—safe space or buffer zone an emergency vehicle maintains around itself while driving, this space allows the driver enough time and distance to see hazards, react appropriately, and avoid collision

• excessive speed—driving faster than what is safe for the current road, traffic, weather, or visibility conditions; increases stopping distance, reduces reaction time, makes maneuvers harder to control, and increases risk of collision

• siren syndrome—occurs when the use of lights and sirens causes other drivers to react unpredictably, often by pulling into unsafe positions, stopping suddenly, or panicking

• hydroplaning—occurs when a vehicle’s tires lose contact with the road surface because of a layer of water, causing the vehicle to slide or skid uncontrollably

Postrun Duties

The postrun phase includes completion of anything necessary to return the ambulance to its pre-run status. Any equipment or ambulance maintenance issues should be resolved or reported, as necessary.

Here are some concepts to know:

• decontaminated—process of removing or neutralizing hazardous substances such as blood, bodily fluids, chemicals, or infectious materials from people, equipment, or surfaces

• CPR board—ridgid backboard placed under a patient during CPR to provide a firm, stable surface, this allows for more effective chest compressions and prevents the patient’s body from sinking into a soft surface such as a bed or the stretcher

• jump kit—portable bag containing essential medical supplies that an EMT may need immediately at the scene of an emergency

• cleaning—process of removing dirt, debris, and visible contaminants from surfaces, equipment, or skin

• disinfection—process of using chemicals or solutions to kill most or all harmful microorganisms on surfaces, equipment, or medical tools

• high-level disinfection—process that destroys nearly all microorganisms, including most bacteria, viruses, and fungi, on medical equipment or devices that come into contact with sterile body tissues or fluids

• sterilization—process of completely destroying all forms of microbial life, including bacteria, viruses, fungi, on medical equipment or surfaces

Medication and Supplies

Medications and medical supplies are essential tools that allow EMS providers to deliver timely and effective patient care. Proper management includes not only knowing how and when to use these items but also ensuring that inventory is sufficient, organized, and up to date. Regularly checking expiration dates, restocking used items, and verifying that all necessary equipment is available helps maintain readiness, supports patient safety, and allows providers to respond efficiently to emergencies.

Documentation

At the conclusion of a run, paperwork should be completed and filed. It’s important that EMTs and paramedics have a good understanding of medical terminology so they can communicate effectively to other medical professionals.

Parts of a Medical Term

Medical words have different parts, including the root, suffix, and prefix, and changing one part of the word can change the entire meaning. The root word is the foundation of the word, or the main part. Most medical terms have a root word. The prefix comes before the root word and the suffix after the root word. The prefix of the root medical term often describes location. For example, in the word tonsillitis, tonsil is the root word, and itis is the suffix. Here are some commonly used word parts to know:

Written Communication

Patient contacts require written documentation, and different forms often exist based on the outcome of the contact. This can include transports, refusals of care, and special situations, such as a multi-casualty event. Errors should also be honestly recorded along with corrective actions.

Here are some concepts to know:

• patient care report (PCR)—written or electronic record created by EMS providers to document all aspects of patient care during an emergency call; includes patient information, vital signs, assessment findings, treatments provided, and patient’s response; ensures continuity of care, legal documentation, quality assurance, and communication with receiving healthcare facilities

• refusal of care—This occurs when a mentally competent patient chooses not to receive medical evaluation or treatment from EMS providers. EMTs must assess the patients decision-making capacity, explain the risks of refusal, and document the refusal thoroughly on the PCR.

Notation Shortcuts

Abbreviations, symbols, and acronyms are sometimes used in place of full terms. These can make communication easier and quicker, provided the shortcuts used are legible and accurate. For example, certain symbols may stand for post, right, or left. Using a symbol is quicker than writing the entire word. Acceptable abbreviations and symbols may vary by agency. Be sure to use only approved abbreviations and symbols when documenting. Here are some to be familiar with:

Movement and Directional Terms

Many terms are used to describe movement and direction. A few of the most crucial terms include superior, inferior, medial, and lateral. Superior refers to nearest to the head, while inferior refers to closest to the feet. Medial refers to a body part closer to the middle of the body, while lateral is a part away from the middle of the body.

Here are some terms to know:

• proximal—position closer to the point of attachment on the body
• distal—position further from the point of attachment on the body
• superficial—located near or on the surface of the body
• anterior—front of the body
• posterior—back of the body
• apex—top or highest point of a structure
• flexion—bending of a joint
• extension—straightening of a joint