The provider ends the provider-patent relationship without making sure the patient’s healthcare needs are met.

An injury that only affects the surface of the skin and results in mild oozing of blood. It is commonly known as “road rash.”

A way for a person to spell out ahead of time the care they would like to receive should they become unable to state their wishes. Examples of advance directives include Comfort One and POLST.

A procedure that is likely to produce a fine mist of suspended airborne particles (aerosol). Airway suction and  bag-valve-mask ventilation are examples of AGPs. Vomiting and coughing can also generate aerosols. A respirator mask, such as an N-95, protects against the greater risk of infection associated with an aerosol.

The location of air exchange in the body. Lung passages end in tiny sacs known as alveoli, which are surrounded by small blood vessels (capillaries). Oxygen diffuses across the thin membrane of each alveolus and the thin membrane of the capillary, while carbon dioxide makes the journey in reverse. "Alveoli" is plural; "alveolus" is singular.

An extremity or part of it of has been cut or torn completely free from the body.

A life-threatening allergic reaction usually associated with low blood pressure, shortness of breath and wheezing, and nausea and vomiting.

When describing an injury or other exam finding, the finding is described as if the patient were standing up with both arms slightly outstretched and palms facing forward. For example, even if the patient is lying supine, “superior” will always reference the top of the head and not the part that may be farthest from the ground in the patient's current position.

A break in a bone that leaves the limb at an angle.

A blood vessel that carries blood away from the heart. The blood usually carries oxygen (except for the pulmonary artery which carries de-oxygenated blood from the heart to the lungs).

Threatened or actual physical harm. If an ETT attempts to move a patient or to provide treatment against the patient’s wishes, the ETT may be guilty of assault.

This is the term used for listening (usually with a stethoscope). It is commonly used when listening to obtain a blood pressure or to a patient’s lung sounds.

This is used to describe a patient’s level of consciousness. The letters stand for:

A-Alert OR Awake (these words do not mean the same thing, be sure you understand which one is meant when you hear that AVPU = A)

V- Responds to verbal stimuli

P- Responds to pressure on the space between thumb and first finger

U- Unresponsive to any stimuli.

You may see P as painful stimulus in the text; EMS is transitioning away from pain to pressure.

A tearing away of soft tissue. May be minor like a torn-off nail or severe like a torn-off ear or partial amputation.

A device that allows the rescuer to breathe for the patient by squeezing a self-refilling bag. It can be attached to an oxygen source and provide nearly 100% oxygen to the patient.

Relates to the treatment of obesity.

Accepted medical standards of care. This may be based on evidence (evidence-based practice), but when there is no hard data to guide care, best practices are the combined expert guidance and direction from leading agencies in healthcare on a specific aspect of care.

Both right and left sides. If a patient has bilateral wrist injuries, both wrists are injured.

The smallest of the blood vessels. Oxygen and nutrients are transferred to body cells from capillaries, while wastes are removed from cells to capillaries.

A complete stoppage of the heart’s pumping of blood, resulting in death if not treated immediately.

A failure of the heart to provide sufficient blood flow to supply the brain and vital organs with oxygen and nutrients.

The area of the spine in the neck. The cervical spine includes seven vertebrae, the spinal cord, and supporting muscles, ligaments, and blood vessels.

The lowest part of the uterus. It is a thick, muscular ring that is normally closed but opens (dilates) during labor. The opening usually reaches 10 centimeters (2.5 inches) before the fetus descends through the vaginal canal.

The Alaskan “Do Not Resuscitate” program in which patients with terminal illnesses may request that they receive comfort measures and are allowed a natural death.

The system that will replace the Comfort One in Alaska, called Physician Orders for Life Sustaining Treatment (POLST), will allow patients to select several care options from a list.  POLST forms will be in use in the near future.

A patient is competent to refuse care (treatment and/or transport) if they are able to make decisions for themselves. In EMS, we verify that the patient is alert and oriented. We also make sure that they can tell us in their own words why we're recommending care and the risks of refusing.

A mask and pressure system providing airway pressure to people with sleep apnea, heart failure, and obstructive breathing difficulty. This helps to keep the small airways open throughout the respiratory cycle.

Every individual and system involved in the care of a particular patient, from the point of injury or illness onset to  ongoing care and return to wellness.

Blood vessels under the skin are injured, resulting in leakage of blood into the tissue. Commonly known as a bruise.

As labor progresses, the baby is pushed down through the vaginal canal. Crowning describes the moment when the top of the baby’s head is visible from the outside.

A blue color given to the skin by blood that lacks oxygen. It is a sign of inadequate oxygenation.

Used to find hidden injuries and signs of illness by examining a patient from head to toe.

Moist skin caused by sweating.

The lower of the two numbers in the blood pressure. It represents the pressure of blood between heartbeats.

Typically the first step in controlling external bleeding. Pressure is applied directly to the source of bleeding.

An injury in which a bone end is pulled out of a socket. Common joints to have dislocations include the shoulder, fingers, and the hip.

The point of reference for the comparisons “distal” and “proximal” is the patient’s heart. Distal means farther from the heart.

A life-threatening condition in which a pregnancy begins outside of a woman’s uterus, causing bleeding and shock.

1. emergency medical service.
2. Digital Technology.enhanced message service: a system for sending long or formatted text messages, images, music, etc., from one cell phone to another.

Any component of patient care that has a significant amount of data to show that it is safe and effective in improving patient outcomes.

The authorization given by a patient to allow a medical provider to provide treatment. If this consent is informed, it also includes a description of the risks and benefits associated with the treatment being offered.

A red coloration of the skin. Commonly seen in allergic reactions, sunburns and as a reaction to some medications.

In a conscious patient, this exam may center on the complaint of the patient. For example, if the patient has ankle pain, the exam should target the injured ankle.

A break of a bone.

Sugar, an essential nutrient for the body’s cells.

Young children and infants in respiratory distress may grunt at the end of each respiration in an attempt to keep their alveoli open. Grunting may be a quiet sound, very easy to miss unless you are specifically listening for it. It is a sign of increased work of breathing.

A maneuver to open the airway by simultaneously lifting the chin and tilting the head back.

This law codifies healthcare providers’ responsibility to actively safeguard patient confidentiality. HIPAA spells out conditions for releasing patient information for patient care, payment, training, quality improvement, research, law enforcement, and other operational needs. You may see this mis-abbreviated as HIPPA.

Blockage in an artery that feeds a portion of heart muscle, resulting in injury and death of the affected area; also described as a myocardial infarction.

Low blood pressure from any cause. Usually defined as less than 90/60 in the adult patient.

Low body temperature due to prolonged exposure to the elements or inability to generate body heat.

Loss of blood or fluid leading to inadequate tissue perfusion.

A condition in which cells are not provided with sufficient oxygen.

Any object that has penetrated the skin and remains in place.

The process used in the event that a patient is not mentally or legally able to provide expressed consent. It is based on the assumption that a reasonable person would want necessary treatment .

Shock. Commonly seen by the ETT as pale and diaphoretic skin, an altered level of consciousness, fast pulse, and (later) low blood pressure.

Loss of control of the bowel or bladder

“Inferior” is a comparison word. With the patient in the anatomical position, inferior means below; lower than; farther from the top of the head.

The authorization given by a patient to allow a medical provider to provide treatment. This includes a description of the risks and benefits associated with the treatment being offered.

A maneuver to open the airway while limiting the amount of head and neck movement when spinal trauma is suspected. The jaw is moved forward to move the tongue out of the airway.

A cut or tear in the skin and/or the underlying tissue.

"Lateral" is a comparison word that means farther from the midline, or middle of the body.

ETTs are among the many mandatory reporters in Alaska, along with school teachers, counselors, and others. Mandatory reporters must report suspected child abuse or neglect. ETTs are also required to report abuse or neglect of a vulnerable adult.

"Medial" is a comparison word that means closer to the midline, or middle of the body.

A doctor who provides direction to an EMS provider. This can be online (calling a physician about the patient in front of you) or offline (written guidance that the EMS crew uses for patient care generally).

The area under the finger and toenails. An area that can be examined for the presence of cyanosis and capillary refill.

A flexible tube, inserted through a nostril, used to help maintain an airway. Can usually be used in patients with a gag reflex.

Failure of a provider to deliver appropriate medical care. This is determined by comparing to the care that would be delivered by a provider of similar training and by comparing to the provider’s scope of practice.

Sometimes called spinal shock, this is a failure of the body to move sufficient blood to the tissues due to a spinal injury. Typically seen as flushed and dry skin, normal pulse, and low blood pressure.

A dressing used to seal an area, such as over a sucking chest wound or over an area of exposed abdominal organs.

The process for repeating the Primary Assessment, vital signs, and checking the effectiveness of treatment. This is performed every five minutes for a seriously ill or injured patient. It is performed every fifteen minutes for someone with more minor problems.

A broken bone in which the skin overlying the area has been cut (either by the bone or by other trauma).

A rigid, curved tube that assists in maintaining an airway by holding the tongue forward.

To feel an area as part of the physical exam. Also used when assessing the blood pressure by feeling the radial artery.

A parent’s authorization for their child’s medical care.

The ethical and legal concept that binds healthcare workers to protect details of a person’s experience as a patient, including the fact that they were a patient. Only what is required to provide care can be shared.

Patient Refusal The patient declines to accept the treatment or transport that the ETT recommends. Patient refusals require thoughtful communication with the patient, ensuring that the patient is competent and knowledgeable of the risks involved, and that they know how to seek care later.

The back of the throat. The nose and the mouth empty into the pharynx, while the trachea and esophagus begin here.

Lying with the front of the body resting on the supporting surface.

The point of reference for the comparisons “distal” and “proximal” is the patient’s heart. Proximal means closer to the heart.

Typically a state, local, or federal governmental function, Public Health “promotes and protects the health of people and the communities where they live, learn, work and play”

Quote from American Public Health Association. www.apha.org.

See Patient Refusal.

A position used to help an unconscious patient maintain an airway. The patient is rolled onto their left side preventing secretions in their mouth from blocking their airway.

Simple Triage And Rapid Transport; a common triage system used to facilitate triage, treatment, and transport in mass casualty events.

A rapid process in which the responder looks at the scene to find out if there are any dangers, how many patients there are, what the mechanism of injury is, and if more responders are needed.

The range of skills that a state authorizes a medical provider to use. This is defined by the State of Alaska in regulations and laws

Inadequate tissue perfusion. Most commonly, caused by blood loss, heart failure, severe allergic reaction, and massive infection of the blood.

The condition of maintaining continual alertness to changing conditions and evolving dangers. It is not possible to focus fully on one task (ventilating a patient or troubleshooting an equipment problem, for example) while maintaining a high level of situational awareness.  This is why it’s good to have one person step back to maintain situational awareness.

See Neurogenic shock.

Using protective equipment and practices for all patients as if they have a communicable disease.

The breastbone, located at the center and front of the chest. This is the bone compressed during CPR.

A high pitched sound heard in the upper airway during inspiration, it indicates partial airway obstruction

An opening through the chest wall into the space around the lungs in which air enters and/or exits.

Cardiac arrest due to a change in the rhythm of the heart. Patients may have no symptoms before sudden cardiac death. High performance CPR and rapid defibrillation are the ETT’s treatments for sudden cardiac death

"Superior" is a comparison word. With the patient in the anatomical position, superior means above; higher than; closer to the top of the head.

Lying with the back of the body resting on the supporting surface.

The top number of the blood pressure. Reflects the pressure surge through arteries with each heartbeat.

 A tight, wide band that controls bleeding by stopping all blood flow to an injured arm or leg.

The windpipe; the connection from the pharynx to the lungs. The trachea is protected by rigid C-shaped rings of cartilage in the front and sides, keeping the passage open during inhalation. These rings are softer in younger children.

A sick patient; the medical state when a patient is at risk for death in the near future.

A blood vessel that carries blood back to the heart. Veins carry de- oxygenated blood (except for the pulmonary veins

 A whistling sound made by narrowing of the small airways heard most commonly in patients with asthma and emphysema.