Chapter 1 EMS SYSTEMS 1 EMS l Emergency

Chapter 1 EMS SYSTEMS 1

EMS l Emergency Medical Services (EMS) encompasses prehospital emergency care and transportation of the sick and injured l Extends from notification of an incident until delivery to a medical facility l Encompasses treatment and transportation 2

History of EMS (1 of 3) l Emergency care developed during warfare at the beginning of the 20 th century. l By the 1960 s, domestic emergency care lagged behind. l Staffed emergency departments were often limited to large urban areas. 3

History of EMS (2 of 3) l EMS, as we know it today really began with the publication of Accidental Death and Disability: The Neglected Disease of Modern Society (1966) -Recommended: -Development of training -Development of federal guidelines and policies -Provide emergency care and transport -Establish staffed emergency departments 4

History of EMS (2 of 3) l The US DOT developed the first EMS training curriculum in the early 70’s l The TV show Emergency, in the 1970’s, propelled EMS into the mainstream of the US – Johnny Gauge and Roy De. Soto 5

Levels of Training (1 of 2) l Lay Rescuer- “good Samaritan” l First Responder-trained to save a life using a minimum of equipment – In Texas, this level is known as Emergency Care Attendant (ECA) l EMT-B: Uses Basic Life Support, some drugs, and even some invasive procedures 6

Levels of Training (2 of 2) l EMT-Intermediate: Uses some ALS including IVs and advanced airways. Limited Drugs l EMT-Paramedic: Extensive training in EKG interpretation and drug therapies 7

Components of the EMS System (1 of 5) l Access – Easy access in an emergency is essential. – 911 system is now used nation wide l Administration and Policy – Policies and procedures are essential. 8

Components of the EMS System (2 of 5) l Medical Direction and Control -Each EMS system must have a medical director. -Medical control may take place online or offline. Online is via voice. Offline is via protocols (standing orders) -Medical Director serves as a liaison between the medical community, hospitals and an EMT l Quality Control and Improvement -Process used to assure patient care meets standards. 9

Components of the EMS System l Other (3 of 5) physician input – Local, state and national specialists provide guidance. l State-specific statutes and regulations – All EMS systems are subject to state regulations. – In Texas, EMS is regulated by the Texas Department of State Health Services (TDSHS) l Equipment – Properly maintained equipment is essential. 10

Components of the EMS System (4 of 5) l Ambulance – EMT-Bs must be familiar with the ambulance and its functions. l Specialty Centers – Focusing on care for certain types of patients l Interfacility Transports – Transportation of patients from one care facility to another 11

Components of the EMS System l Hospital (5 of 5) Staff – EMS is part of the whole continuum of care. l Working with Public Safety Agencies – EMT-Bs should understand the role of each agency. l Training – Quality of care depends on training. 12

Source: www. ems. gov

Providing a Coordinated Continuum of Care l 1 st Phase—access to EMS system l 2 nd Phase—out of hospital care l 3 rd Phase—emergency department care l 4 th Phase—definitive care

Roles and Responsibilities of the EMT (1 of 5) l Keep vehicles and equipment ready for an emergency. l Ensure safety of yourself, partner, patient, and bystanders. l Operate an emergency vehicle. l Be an on-scene leader.

Roles and Responsibilities of the EMT (2 of 5) l Perform an evaluation of the scene. l Call for additional resources as needed. l Gain patient access. l Perform a patient assessment.

Roles and Responsibilities of the EMT (3 of 5) l Give emergency medical care to patient while awaiting arrival of additional medical resources. l Only move patients when absolutely necessary to preserve life. l Give emotional support to patient, family, other responders.

Roles and Responsibilities of the EMT (4 of 5) l Maintain continuity of care by working with other medical professionals. l Resolve emergency incidents. l Uphold medical and legal standards. l Ensure and protect patient privacy.

Roles and Responsibilities of the EMT (5 of 5) l Give administrative support. l Constantly continue professional development. l Cultivate and sustain community relations. l Give back to the profession.

Professional Attributes (1 of 4) l Integrity l Empathy l Self-motivation l Appearance hygiene and

Professional Attributes (2 of 4) l Self-confidence l Time management l Communication skills l Teamwork and diplomacy l Respect

Professional Attributes (3 of 4) l Patient advocacy l Careful delivery of care l Every patient is entitled to compassion, respect, and the best care.

Professional Attributes (4 of 4) l As health care professionals, EMTs are bound by patient confidentiality. l Be familiar with requirements of the Health Insurance Portability and Accountability Act (HIPAA).

Continuing Education l Continuing (1 of 2) education is required to renew certification l Keep up-to-date on new procedures and issues on local, state, and national levels l Maintain knowledge and skills 24

Continuing Education (2 of 2) l Obtaining the required CE is the responsibility of each EMT l CE requirements set forth by the Texas Department of State Health Services (TDSHS) – Requires 72 hours every 4 years for EMT – Sets minimum hours in certain content areas 25