chapter 1 introduction to emergency medical services

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Chapter 1 Introduction to Emergency Medical Services

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Page 1: Chapter 1 Introduction to Emergency Medical Services

Chapter 1Introduction to Emergency Medical Services

Page 2: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Overview

The History of Emergency Medical Services Components of an EMS System Voices for EMS Providers Modern EMS Acute Medical Care The Future of EMS

Page 3: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The History of Emergency Medical Services

The military truly gave emergency medical services the field to be tested.

Page 4: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The History of Emergency Medical Services

The Napoleonic Wars– Brought about the first use of ambulances– Use of ambulances could greatly reduce casualty

rates by allowing one to get to the patient and treat en route

Page 5: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Civil War– Makeshift field hospitals were effective in the

treatment of the wounded– Covered wagon ambulances still in use – “Treat them where they lie”

The History of Emergency Medical Services

Page 6: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The World Wars– Soldiers trained in front line medical care– The first field medics to arrive in specialized

ambulance designated with the red cross

The History of Emergency Medical Services

Page 7: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Korean War– Ambulances took to

the air– Specialized helicopters

took patients to M.A.S.H. units in the field.

Courtesy of Bell Helicopter Textron Inc., Fort Worth, TX.

The History of Emergency Medical Services

Page 8: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Vietnam War– The helicopter changed into a

mobile treatment center– Care was rendered en route by medics– Lowest en route casualty rate in a war

The History of Emergency Medical Services

Page 9: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Civilian World– It was quickly realized that an

EMS system needed to be in place

The History of Emergency Medical Services

Page 10: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The American Red Cross– The first agency to take aid to the public– Taught CPR and first aid to lay persons in

the late 1950s and 60s

The History of Emergency Medical Services

Page 11: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Father of EMS– Dr. Joseph D. (“Deke”) Farrington – Realized training was needed in the streets – Began training the Chicago Fire Department

in street medicine

The History of Emergency Medical Services

Page 12: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The White Paper– An article written by experts for

President Kennedy– Laid groundwork for inclusion

of EMS legislation

The History of Emergency Medical Services

Page 13: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

National Highway Safety Act (1966)– Encouraged states to begin

organized EMS programs– Organization of the National Highway

Safety Administration

The History of Emergency Medical Services

Page 14: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Emergency Medical Services Act (1973)– Identified the components of an EMS system

The History of Emergency Medical Services

Page 15: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Components of an EMS System

Personnel Training Communications Transportation Emergency facilities Critical care units Public safety agencies Consumer participation

Access to care Patient transfer Standardization of record

keeping Public information and

education System review and

evaluation Disaster management Mutual aid agreements

Page 16: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Voices for EMS Providers

National Association of Emergency Medical Technicians (NAEMT)– Supports EMS activities in both the private

and public sectors

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Voices for EMS Providers

American Ambulance Association (AAA)– Represents ambulance services

in the EMS industry

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Voices for EMS Providers

The International Association of Fire Fighters (IAFF)– 80% of EMS is provided

in the fire service

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Voices for EMS Providers

The National Registry of EMTs– An advocate for standardization

in EMS education

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Stop and Review

Name historical events that shaped the field of EMS.

Name a key position paper and its impact on the field of EMS.

Name the professional groups that represent the interests of EMS.

Page 21: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

Universal Access Integrated 911

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

Emergency Medical Dispatch– EMD course– Provide instruction on care

until EMS arrives

Page 23: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

First Responders– Basic assessment– Simple airway management– Oxygen administration– Bleeding control – Rescuer CPR– Defibrillation

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

Emergency Medical Technician–Basic– Airway maintenance– Oxygen administration– Bleeding control– CPR– Defibrillation– Patient assessment– Limited medication administration

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

Emergency Medical Technician–Intermediate– Advanced airway management, intubation– Cardiac arrest management, ECG interpretation– Intravenous therapy– Higher level patient assessment– Drug administration– Advanced trauma care

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Modern EMS

Emergency Medical Technician–Paramedic– Comprehensive patient assessment – Advanced airway management– Intravenous access– Expanded medication administration– Cardiac arrest management

Page 27: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Acute Medical Care

Emergency Medicine– American College of Emergency

Physicians organized in 1968

Page 28: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Acute Medical Care

Trauma Centers– Specialized care with the

Golden Hour of EMS response

Page 29: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Acute Medical Care

Aeromedical Transport– Rapid transportation to hospitals

with specialized services

Page 30: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Stop and Review

What is the relationship of EMS to the modern health care system?

How is the EMT of today different from the EMT of the 1960s? How are they the same?

What are the EMT’s role and responsibilities within the health care system?

Page 31: Chapter 1 Introduction to Emergency Medical Services

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

The Future of EMS

Where do we go from here?

You can make the difference!

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Future of EMS

Aging Americans– Increasing health problems– Increasing use of EMS

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Future of EMS

Homelessness– Deinstitutionalization – Poor economic means

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Future of EMS

Human Resources– Declining volunteers – Financial restrictions

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Future of EMS

Accountability– Continuous quality improvement

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Future of EMS

EMS Research– Proof that something works

scientifically to gain validity

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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved

Stop and Review

What are the challenges that EMTs will face in the future?

How do changes in emergency health care affect the field of EMS?