1)intro to ems
DESCRIPTION
TRANSCRIPT
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Emergency Medical Services
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Intro to EMS What Is EMS?
• “Planned configuration of community resources and personnel necessary to provide immediate care to patients with sudden/unexpected injury/illness.”
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Intro to EMSWhere did EMS come from?
• War• 1st Ambulances
• Napoleonic War• Baron Dominique Jean
Larrey - 1793
• “Flying Field Hospitals”• Troops taken off
battlefield for treatment
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Intro to EMSWhere did EMS come from?
• Civil War• Horse Drawn Ambulances
• WWI• Motorized Ambulance• Splinting fractures
• Korean War• Helicopter evacuation to
MASH units• Vietnam
• Reinforced helicopter evacuation
• Field medics
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Intro to EMSWhere did EMS come from?
• Civilians • Rural
• Undertakers
• Urban• Hospitals/FD/Police/
Private companies
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Intro to EMSWhere did EMS come from?
• Trauma • # 1 COD 1-45 y/o• MVA= ½ of all traumatic
deaths• Battle physicians saw
need • On scene care=
increased survivability
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Intro to EMSWhere did EMS come from?
• The “White Paper”- 1966• “Accidental Death and Disability: The Neglected
Disease of Modern Society”• National Academy of Science
• Prompted federal grants• “Safe Transport and Handling of ill/injured people”
• National Highway Safety Act - 1966• Established National Highway Safety Administration
(NHSTA) under U.S. D.O.T.• Improve EMS education/est. EMS system
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Intro to EMSWhere did EMS come from?
Wedworth-Townsend Paramedic Act -1970 – Senator James Q. Wedworth
Assemblyman Larry Townsend– Pilot Paramedic program
Los Angeles County Function without doctor/nurse
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Overview of the EMS System…
• 911• Access to ALL components of
EMS
• Enhanced 911• Exact location of caller
• Emergency Medical Dispatch • Dispatchers provide basic 1st aid
instructors • U.S. D.O.T. Curriculum
• Non 911 systems• Separate numbers separate
services
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Overview of the EMS system…
• Levels of training• First responder• EMT-Basic• EMT-Enhanced• EMT-Intermediate• EMT-Paramedic
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The Healthcare System
• Emergency Department/Medicine • Intersection of prehopsital/hospital care• Young specialty
• AMA recognition 1975
• Specialty Centers• Trauma Centers• Burn Centers• Pediatric Centers• Poison Centers
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Hospital Personnel
• Physicians• Overall management of
pt care
• Nurses• Coordinates pt care
• Others• Radiology, Respiratory,
Techs, etc.
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Other Public Safety Workers
• Firefighters • Fire• Extrication• AED
• Police• Crime scenes• Traffic control• Violent patients• Notifies family
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Roles and Responsibilities of the EMT
• Safety• Personal• Crew• Bystander• Pt.
• Pt assessment • Vital signs, History, Physical assessment
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Roles and Responsibilities of the EMT
• Pt care• Based on assessment
findings• Lifting/moving pt
• Movement based on pt needs
• Transport/transfer of care• Record keeping
• PPCR= ONLY source of info from the scene
• CYA…• Pt. Advocacy
• 1st provider at scene= the pt looks to YOU!
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Professional Attributes
• Appearance• Neat • Clean• Positive image
• Maintain up to date knowledge/skills• Continuing Ed (CE)
• Local/state/national conventions• EMS journals and classes• Handout on Va EMT CE requirements
• Refresher courses
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Category 1(Required Topic) Area # Hours Required
Patient Assessment 2 3
Airway Management w/Practical 3 3
Trauma Emergencies w/Scenarios 4 4
Medical Emergencies w/Scenarios 5 4 Infection Control 6 2
Medical Legal 7 1
Infants and Children 8 2
Practical Skills 9 3
AED 10 2
TOTAL: 24 Hours
Category 2 (Other) .
TOTAL: Up to 12 Hours
Category 3(Multimedia) .
TOTAL: Up to 10 Hours
Total Category 2 + Category 3 .
TOTAL: 12 Hours
TOTAL EMT RECERTIFICTION HOURS .
TOTAL: 36 Hours
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Neat….
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Not so neat…
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Quality Improvement
• “A system of internal/external reviews and audits of all aspects of an EMS system so as to identify those aspects needing improvement to assure the public receives the highest quality of prehospital care.”
• Anyone else think that’s a terribly long definition??
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The Role of the EMT in QI
• Documentation• Run reviews and audits• Pt and hospital
feedback• Preventative
maintenance• Counting Ed (CE)• Skill maintenance
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Maintain skills so you don’t do this…
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Medical Direction
• “A physician responsible for the clinical and pt care aspects of the EMS system”
• EVERY EMS system MUST have one• We are extensions of the OMD
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Types of Medical Direction
• On-Line• DIRECT communication
with physician• Telephone• Radio
• Off-Line• Medical direction without
direct communication• Protocol • Standing Orders
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Extra Credit to ANYONE who can tell me who these guys are and why they ROCK!!!
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That does it. Come back next time for more…