Introduction to Emergency Medical Care

1
Introduction to Emergency Medical Care

• The Emergency Medical Services System

2
Brief History

• Funeral Homes ambulance provider
• World War 1 2 care in the field
• 1960s
• D.O.T. charged with developing curriculum for EMS
• A.H.A began to teach CPR which is now a
  prerequisite to EMT-Basic
• Role the television show Emergency played

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Current StandardsFederal Recommendations

• Each state controls its own EMS system, however,
  the federal government continues to provide
  guidance and support through the National Highway
  Traffic Safety Administration Technical
  Assistance Program Assessment Standards which
  include

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Regulation and Policy

• Each state must have laws of existence,
  regulations, policies and procedures that govern
  its EMS system
• State level agency to provide leadership to local
  areas. (OSDH EMS DIVISION)

5
Resource Management

• Central coordination of resources
• Victims have equal access to basic care
• Victims are transported by certified personnel in
  a licensed equipped ambulance to an appropriate
  facility

6
Human Resources and Training

• All ambulance personnel must be trained at the
  EMT- Basic level using standardized curriculum
  taught by qualified instructors

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Transportation

• Patients must be provided with safe, reliable
  transportation by ground or air ambulance

8
Facilities

• Each seriously ill or injured patient must be
  delivered in a timely manner to an appropriate
  medical facility

9
Communications

• Public access must be provided
• Communication link established between dispatcher
  to ambulance crew
• Ambulance crew to hospital
• Hospital to hospital

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Public Information Officer

• Education of public in prevention of injuries
• Proper way to access the EMS system

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Medical Direction

• Each EMS system to have a physician as medical
  director involved in all aspects of emergency
  care
• Responsibilities
• Oversee patient care
• Delegate appropriate medical practices to EMS
  personnel
• We are the eyes and ears of the physician in the
  field..

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Trauma Systems

• Develop guidelines for specialized trauma care
• Development of trauma centers
• Rehabilitation programs
• System for assigning and transporting patients to
  those facilities (triage and transfer)

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Evaluation

• Quality improvement system for continuing
  evaluation and upgrading of the system

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Access to the System

• 9-1-1 (universal number)
• Public service answering port (PSAP) EMD
• Minimizes risk of delay
• Non 9-1-1
• Seven digit number
• Risks delays in reaching appropriate agency

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Levels of Training

• First Responder
• EMT-Basic
• EMT-Intermediate
• EMT-Paramedic

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Health Care System

• Prehospital Care
• Emergency medical treatment given to patients
  before transport to the hospital.

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Special Facilities

• Trauma centers
• Burn centers
• Pediatric centers
• Poison (control) centers
• Other specialty centers

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Hospital Personnel

• Doctors
• Nurses
• Other allied professionals (x-ray, physical
  therapy)

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Liaison With Public Safety Workers

• Local law enforcement
• State and federal law enforcement

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The Big Picture
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All Parts Work Together as a Whole. Bottom Line
is Patient Care!!!!!
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4 Rules When Overwhelmed

• Always Stay Calm
• Dont Sweat the Small Stuff
• Everything is Small Stuff
• The Patient is Having the Crises.. NOT YOU!

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Roles and Responsibilities of the EMT-Basic
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Personnel Safety and Others

• You are the first priority
• Drive safely
• Hazardous environments
• Crime
• Hostile crowds
• Animals
• Hazardous chemicals
• On scene follow directions from agency in charge
• Wear reflective clothing when necessary

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Patient Assessment and Care

• Once scene is secure find out what is wrong and
  undertake emergency care
• Perform initial assessment and provide CPR,
  airway management, bleeding control, emotional
  support, etc.

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Safe Lifting and Moving

• Use proper body mechanics
• Lift or move patient safely so you dont get hurt
  or drop the patient

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Transport and Transfer of Care

• Treat the patient
• Safely secure the patient
• Drive safely
• Transport and transfer patients valuables to with
  patient. Transfer to E.R. staff
• Transfer all vital information to E.R staff both
  verbally and written

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Record Keeping/Data Collecting

• PCR or run sheet is a legal document
• Neat documentation
• Becomes permanent record for hospital EMS agency

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Patient Advocacy

• Patients rights
• Safeguard valuables
• Patient privacy
• Honor patients request
• Loved ones or friends at the scene
• Provide information about patient to hospital
  personnel

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Professional Attributes
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Appearance

• Neat
• Clean
• Positive image

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Knowledge and Skills

• Maintain up-to-date knowledge and skills
• Refresher and continuing education
• Know how to use emergency equipment
• Assistance with medications
• Clean, disinfect, and sterilize equipment
• Safety and security measures
• Territory and terrain
• State and local laws

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Physical Demands

• Good physical shape
• Good eyesight (corrective lenses)
• Good color vision

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Temperament and Abilities

• Pleasant personality
• Leadership ability
• Good judgement
• Good moral character
• Stability and adaptability

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Medical Direction

• A physician who is legally responsible for the
  clinical and patient care aspects of an EMS
  system
• Types of Med. Control
• On-line (telephone or radio)
• Off-line (protocols or standing orders)

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Relationship Medical Direction/EMT-Basic

• Designated agent of the physician (eyes and ears)
• Care is an extension of medical directors
  authority (varies by state law)

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Quality Improvements

• Definition - a system of internal/external
  reviews and audits of all aspects of an EMS
  system to assure that the public receives the
  highest quality of prehospital care

38
Quality Improvement/EMT-Bs Role

• Thorough documentation
• Run reviews and audits
• Gathering feedback from patients, hospital staff
• Conducting preventative maintenance
• Refresher courses and continuing education
• Skill maintenance