Research Profession and Practice EMS SYSTEMS Components of

Research, Profession and Practice EMS SYSTEMS Components of an EMS System

Research, Profession and Practice Today’s EMS System • Every EMS system must develop an EMS system that best meets its needs. • Provincial and regional-level EMS systems are often responsible for planning, developing protocols, and establishing standards.

Research, Profession and Practice What Constitutes an EMS System • By accepted definition, an EMS System is: – A comprehensive network of personnel, equipment, and resources established to deliver aid and emergency medical care to the community.

Research, Profession and Practice OUT-OF-HOSPITAL COMPONENTS OF AN EMS SYSTEM MEMBERS OF THE COMMUNITY PUBLIC UTILITIES COMMUNICATIONS SYSTEM EMS PROVIDERS POISON CONTROL CENTERS FIRE RESCUE HAZMAT

Research, Profession and Practice IN-HOSPITAL COMPONENTS OF AN EMS SYSTEM EMERGENCY NURSES EMERGENCY AND SPECIALTY PHYSICIANS ANCILLARY SERVICES REHABILITATION SERVICES

Research, Profession and Practice Some Systems are tiered in which BLS arrives first and then, if required, ALS arrives later.

Research, Profession and Practice Medical Direction • A medical director is a physician who is legally responsible for all clinical aspects of the system. • Ontario Base Hospital Group.

Research, Profession and Practice Medical Direction • The medical director’s role in a is to: – – – – – system educate and train personnel participate in equipment and personnel selection develop clinical protocols participate in problem resolution and QA/QI provide direct input into patient care interface with the EMS system advocate within the medical community serve as the “medical conscience” of the EMS system Certify and License personnel to practice

Research, Profession and Practice The Medical Director can provide on-line guidance to EMS personnel in the field. This is known as on-line medical direction.

Research, Profession and Practice Off-line medical direction refers to medical policies, procedures, and practices that medical direction has set up in advance of a call, such as standard protocols or standing orders.

Research, Profession and Practice Protocols are the policies and procedures for all elements of an EMS system.

Research, Profession and Practice Protocols are designed around the four “T’s” of emergency care. • • Triage Treatment Transport Transfer

Research, Profession and Practice Patient Transportation • Patients should be taken to the nearest facility whenever possible. • Medical direction should designate the facility. • Patients may be transported by ground or air.

Research, Profession and Practice The helicopter has become an integral part of prehospital care.

Research, Profession and Practice Military helicopters frequently assist civilian EMS systems.

Research, Profession and Practice A Type-I Ambulance

Research, Profession and Practice A Type II Ambulance

Research, Profession and Practice A Type III Ambulance

Research, Profession and Practice An Emergency Response Unit

Research, Profession and Practice Air Ambulance

Research, Profession and Practice Not all receiving facilities are equal in emergency and support service capabilities. Local systems and regions categorize hospitals based on capabilities.

Research, Profession and Practice American Trauma Center Levels • Level I – provides the highest level of trauma care • Level II – may not have specialty paediatrics or a neurosurgeon on site • Level III – generally does not have immediate surgical facilities available

Research, Profession and Practice Canadian Trauma Centre Levels • Tertiary Trauma Centre (TTC) • District Trauma Centre (DTC) • Primary Trauma Centre (PTC)

Research, Profession and Practice Mutual Aid and Mass. Casualty Preparation • A formalized mutual aid agreement ensures that help is available when needed. • Agreements should be between neighbouring departments, municipalities, systems, or provinces. • Each system should also put a disaster plan in place for catastrophes that can overwhelm available resources.

Research, Profession and Practice KEY POINT An EMS system should have a disaster plan in place that is practiced frequently.

Research, Profession and Practice Quality Assurance and Improvement • Quality Assurance is designed to maintain continuous monitoring and measurement of the quality of clinical care. • Continuous Quality Improvement (CQI) is designed to refine and improve an EMS system, emphasizing customer satisfaction.

Research, Profession and Practice An EMS system must be designed to meet the needs of the patient. Therefore, the only acceptable quality of an EMS system is EXCELLENCE!

Research, Profession and Practice Service Quality Customer satisfaction can be created or destroyed with a simple word or deed.

Research, Profession and Practice Public Education • An essential and often overlooked component of EMS is the public. • EMS systems should develop plans to educate the public on recognizing an emergency. ¤… accessing the system. ¤… initiating BLS procedures.

Research, Profession and Practice Communications A coordinated, flexible communications plan should include: • Citizen Access • Single Control Centre • Operation Communication Capabilities • Medical Communication Capabilities • Communications Hardware • Communications Software

Research, Profession and Practice Education and Certification • Two kinds of EMS education are initial and continuing education. ¤Initial education is the original training course for pre-hospital providers. ¤Continuing education programs include refresher courses for recertification and periodic in-service training sessions.

Research, Profession and Practice Initial Education • Ideally based on the PAC NOCP’s ¤establishes the minimum competencies for the course ¤CMA accredits education courses ¤http: //www. paramedic. ca/nocp. html ¤Not all programs follow NOCP

Research, Profession and Practice Once the initial education is completed, the paramedic will become either certified or licensed.

Research, Profession and Practice Certification vs. Licensure • Certification is the process by which an agency grants recognition to an individual who has met its qualifications. • Licensure is the process of occupational regulation.

Research, Profession and Practice 4 Certification Levels • • Emergency Medical Responder Primary Care Paramedic Advanced Care Paramedic Critical Care Paramedic

Research, Profession and Practice The First Responder is usually the first EMS-trained provider to arrive on the scene.

Research, Profession and Practice The PCP is trained to do all that a first responder can do, plus other complex skills.

Research, Profession and Practice The ACP Should Possess All the Skills of a PCP and Be Competent in Advanced Airway, IV Therapy, and Other Skills.

Research, Profession and Practice The CCP is the most advanced EMS provider.

Research, Profession and Practice Paramedic Association of Canada • Canada’s only national organization • ‘May’ Regulate Practice • ‘May’ Approve Training Programs

Research, Profession and Practice For next Week National Groups and Associations