Resuscitate!: How Your Community Can Improve Survival from Sudden Cardiac Arrest

Guide to Terminology

xix Guide to Terminology ACS — acute coronary syndrome. An unstable condition ranging from increas­ ing or unstable angina to acute myocardial infarction. ACS usually occurs in individ­ uals with underlying coronary artery disease. AED — automated external defibrillator. AEDs are used primarily by EMTs and first responders (see below) such as police. They are increasingly being found in pub­ lic locations such as airports, malls, exercise facilities, etc. ALS — advanced life support. Refers to the level of care provided by para­ medics (see below). Asystole — without contraction and synonymous with flat line. There is no elec­ trical signal or heart muscle contraction. BLS — basic life support. Refers to the level of care provided by basic EMTs (see below ). CAD — coronary artery disease. Other terms with the same meaning are athero­sclerotic heart disease or ischemic heart disease (which implies that the patient has symptoms of angina). Dispatchers are specifically designated by their role within a communications center. The call receiver speaks with the person calling 911 and offers telephone CPR instruc­ xx Guide to Terminology' tions. The dispatcher receives the location information from the call receiver and dis­ patches the proper units. In small centers both roles are wrapped up in one individual . I use the term dispatchers for both roles since this is how the general public thinks of these individuals. The term telecommunicators is also used for dispatchers and call receivers. In King County dispatchers receive 40 hours of training, specifically in med­ ical emergencies (this is above the training required for general dispatching) and must complete 8 hours of emergency medical continuing education every year. Many com­munity colleges and private companies offer preparatory training for employment in public safety emergency communications centers. Because of differing computeraided dispatch systems, most communication centers offer their own extensive inhouse training program. DOA — dead on arrival. EMTs and paramedics (see below) are allowed not to begin resuscitation in patients for whom there is no chance of success. These patients are termed DOA. They are cool to the touch and have pooling of blood in dependent por­ tions of the body. This pooling and discoloration of the skin is termed lividity. DNR — do not resuscitate. Patients who express end-of-life wishes and choose not to be resuscitated in the event of a cardiac arrest are DNR patients. Whenever possible EMTs and paramedics attempt to determine whether the patient has expressed endof -life wishes and to respect these desires. See chapter 8 for further dis­cussion of DNR. EMS — emergency medical service(s). EMS involves the spectrum of commu­nity-based emergency services ranging from emergency dispatch centers and prehospital emergency response agencies to emergency departments, as well as to the communica­ tion links that bind all these components into a system. Though EMS comprises the totality of care from 911 to hospital emergency department, in common use it refers to the prehospital components of the larger spectrum. This book uses the more common definition for EMS to denote the prehospital component of emergency care. EMT refers to a basic emergency medical technician, sometimes called EMT-B. The training for an EMT-B consists of a 110-hour national curriculum published by the Department of Transportation. EMTs can provide CPR, manage an airway with oral airways and bag valve masks, and defibrillate using automated external defibrillators. There are also intermediate EMTs (EMT-I) who are trained in IV skills, medication administration (such as nitroglycerine), and airway control beyond what basic EMTs can provide. In Seattle and King County, intermediate EMTs are not part of the EMS system. First responders is an ambiguous term because it can refer to uniformed individuals Guide to Terminology' xxi with a duty to respond to emergencies when they encounter them. Thus, police and security guards are often referred to as first responders, especially when they arrive at the scene prior to EMTs or paramedics. The term also refers to uniformed individuals who have completed a formal 40-hour training program using a curriculum published by DOT. These individuals are certified as First Responders (capital F, capital R). Though police may be called first responders, they usually have not completed the First Responder training or certification. MI and AMI are used interchangeably and denote myocardial infarction and acute myocardial infarction, respectively. Technically, an MI can be old or acute and the con­ text usually clarifies the matter. “He is having an MI” refers to an AMI. “He has a...