Introduction to EMS Systems Mosby items and derived

Outline • EMS System – Activities – Access – Levels of Providers – In-hospital Care Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc. • First Responder – Roles – Responsibilities • Medical Oversight

What is EMS? • Emergency Medical Services – Resources in a community established for providing care and assistance in case of life threatening emergency • • • Fire Departments Ambulance Services Police Departments Community Clinics Hospitals Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

911 Access 9 -1 -1 Mosby items and derived items © 2007, 2004 by

EMS Access Systems • Non-9 -1 -1: Does not have a universally recognized access number • Basic 9 -1 -1: Has a universally recognized number for all emergencies • Enhanced 9 -1 -1 (E 9 -1 -1): Displays information about the caller’s location on the dispatcher’s computer screen Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Components of an EMS System Mosby items and derived items © 2007, 2004 by

Who are First Responders? • Provide very basic medical care on the scene – Fire/Rescue personnel (paid or volunteer) – Law enforcement personnel – Industrial response teams Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Roles of the First Responder • Safety on scene • Gaining access • Patient assessment • Initial care • Transfer of patient Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc. • Assisting EMS with ongoing care • Record keeping • Cooperation with other public safety agencies

Responsibilities of the First Responder • Caring, non • Up-to-date judgmental attitude knowledge and skills • Composure in stressful situations • Knowledge of local, state and • Professional national issues and appearance trends in EMS Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Part of a Larger EMS Team • Additional EMS resources may include: – EMT-Basics – EMT-Intermediates – Paramedics Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

EMT-Basic • Performs basic lifesupport measures at the scene and during transport Mosby items

EMT-Intermediate and Paramedic • EMT-Intermediate – Performs advanced life-support measures • EMT-Paramedic – The most highly trained provider – Has a wider understanding of disease processes Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Providing Emergency Care • Emergency care at the scene • Transportation to the hospital • Care of the patient in the hospital Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Emergency Departments • Emergency Departments (EDs) have varying levels of service available, depending on resources and staffing levels Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Hospital Personnel • Physicians – Varying types of specialists • Nurses – Many are certified in specialty areas • Other Allied Health Professionals Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Specialty Services • • • Trauma Centers Burn Centers Pediatric Hospitals Perinatal Centers Poison Control Centers Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Local EMS Capabilities • Access and dispatching system • Agencies providing EMS response and the level of care provided • Area emergency departments and their capabilities • Local or regional specialty facilities Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Medical Oversight • Also called medical control • Provided in 2 ways – Indirect

Medical Control Responsibilities • System design • Protocol development • Education • Quality management

Indirect Medical Control • Does not involve direct communication between the physician and the care provider during patient care • Also called: – Offline – Retrospective – Prospective Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Direct Medical Control • Communication between a physician and care provider during patient care • Also called: – Online – Immediate Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Radio Communication • Concise • Accurate • Organized • Pertinent Mosby items and derived

New Mexico EMS Mosby items and derived items © 2007, 2004 by Mosby, Inc.

3 Important Organizations • EMS Academy (Division of UNM School of Medicine) – Curriculum Development – Instructor Development – Certification • Injury Prevention & EMS Bureau – Licensing and Testing – Regulations (Scope of Practice) • Regional offices – Help with CE’s and special skills Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

EMS Regional Offices • EMS Region I Santa Fe • EMS Region II Las

First Responder Licensure • Registration for Training and/or Certification/Licensure application • Copy of First Responder course completion certificate • Copy of CPR card (front and back) • Licensure fee Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

First Responder License Renewal • Current Professional BLS Provider CPR Card • 16 First Responder refresher or CE blueprint • Eight (8) contact hours of additional Bureau approved continuing education activity – (2) contact hours must be of pediatric content. • Completed renewal application and fee(s) • Statement of verification, signed by the service medical director, that the applicant is competent in all EMT-B skills that require medical direction Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

License Renewal Period • Good for 27 months but requirements MUST be met in 24 months Year 1 Year 2 All requirements done in this time Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc. 3 months

What’s the Difference between a Certificate and License ? • Certificate – Notice of class completion – Looks cool but otherwise useless • License – This allows you to practice medicine in the state on New Mexico as a First Responder Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.

Summary • An EMS system is a network of resources to provide emergency medical care and transportation • A variety of events take place in an EMS system, from injury prevention to EMS response to in-hospital care. Mosby items and derived items © 2007, 2004 by Mosby, Inc. , an affiliate of Elsevier Inc.