pre hospital care introduction teaching

8/2/2019 Pre Hospital Care Introduction Teaching

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It provides the first professional medical aids to the

victims..

Ambulance service is very challenging and

rewarding service provided by hospital through outthe country.

INTRODUCTIONINTRODUCTION

Through quick assessment, treatment, management,

communications and transportation countless life can

be saved.


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Occasionally, they get called to exciting and

dangerous emergencies that would make a good

TV shows, but that doesnt happen every day.

In real life, paramedics try to comfort little

old ladies with broken hips, and they sometimeshelp derelicts who are dirty and smell bad.

Other times they take abuse from people who

are under influence of alcohol and drugs.

INTRODUCTIONINTRODUCTION


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The purpose:

- is to get trained personnel to the patient

quickly as possible, and

- to provide emergency care on the scene,

- en route to the hospital, and

- at the hospital.

Modern EMS system developed to provide what

is known as prehospital or out of hospital care.


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No actual records are available.

HISTORYHISTORY

Ambulance was said to be introduced in the fifties.

Ambulance services were more of scoop and run.

Ambulance team consist of a driver and anattendant.

Later a medical assistant role was inevitable


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In 1790s, French transported wounded soldiers so

that they can be cared by physicians away fromthe scene.

HOW DID PARAMEDICS COME TO BE?HOW DID PARAMEDICS COME TO BE?

During WWI &WWII, many volunteers joined

battlefield non military ambulance corps

- transport service only. During conflict in Korea (1950s) andVietnams

War (1960s & 1970s), medical teams

produces advances in field care for trauma

MAST suit.


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Importance of extending hospital-quality

care to sick and injured at emergencyscene were recognized

- of beginning care at the scene and continuing

it, uninterrupted, during transport to hospital.


Need to organize systems for such

Emergency Pre Hospital Care and to train

personnel to provide it.


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30 years ago, no such things as EMT,

paramedic.

Today more than 50,000 EMT-paramedic in

USA, Australia, Germany, Canada & U.K.


Story begins in Belfast, Northern Ireland,Germany, Eastern Europe, where mobile ICU

introduced in 1950s and 1960s to enable early

care of critically ill and injured.


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Idea was simple Bring the emergency room

to the patient before bringing the patient to theemergency room & therefore saves precious

minutes that could mean life and death.


The idea worked and MICUs proliferate in

various European countries.


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In USA, not feasible to staff ambulances

around the clock with physicians speciallytrained in Emergency Care. In 1960s, no

physicians specially trained in Emergency Care.

Early MICUs in USA staffed with cardiologist.


Very few interested in riding the ambulances.Become necessary to look for alternatives to

physician staffing in MICUs.


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The question were asked:

Can a non physician be taught thesophisticated skills of Advance Life

Support!


1st Doctor to provide affirmative answer to the

question was Dr. EugeneN

agel and he wasconsidered the Father of Paramedics, trained

Miami fireman in Advance Emergency skills to

supplement the basic first Aid the learned as

part of their fire training.


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In addition, Dr. Nagel developed the telemetry

system that enables firemen to transmit apatients ECG to doctors and receive instructions

from the doctor regarding measures to take.


With the introduction of radio / telemetry

communication, the rescuer working in thestreet became an extension of the doctor

working in the emergency room.


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This idea of operating under radio command

by physicians spread quickly. By 1976, US Department of Transportation

issued 1st set ofNational Standards and

Guidelines for paramedic training.


By end of 1980, there were >50,000

paramedics certified in USA.


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In 196

0s, development of modern EMSsystem begin.

In 1966, USDOT set up and upgrade quality

Prehospital Emergency Care

EMS TODAYEMS TODAY


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The categories and standards set summarized

below:

EMS TODAYEMS TODAY

Regulation and policy

- must have legislation, regulations,

policies and procedures.

Resource management- centralised coordination of resources

so that all victims of trauma or medical

emergencies have equal access to


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Resource management

- basic emergency care and transport bycertified personnel, in a licensed and

equipped ambulance, to an appropriate

facility.

EMS TODAYEMS TODAY

Human Resources and Training- at the minimum, all transporting

prehospital personnel should be trained

using standardized curriculum taught

by qualified professional


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Transportation

- Safe, reliable ambulance transportation isa critical component.

- Ground ambulances / Helicopter or

airplane rapid transportation

EMS TODAYEMS TODAY

Facilities -

Seriously ill or injured patient must be

delivered in a timely manner to the

closest appropriate facility


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Communications

- must have effective communicationsystem:

* beginning with Universal Number,

* dispatched -to-ambulance,

* ambulance-to-ambulance,* ambulance-to-hospital, and

* hospital-to-hospital communications

EMS TODAYEMS TODAY


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Public Information and Education Center

- EMS personnel may participate in efforts

to educate the public about:

* their role in the system,

* their ability to access the system,

* and prevention of injuries.

EMS TODAYEMS TODAY

Medical Direction

- EMS physician delegate medical practice

to non-physician providers (Medical

Delegate Act) and must be involved in all

aspects of the patient care system


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Trauma systems

- Enabling legislation must exist to developa trauma system including :

* one or more trauma center, triage, and

transfer guidelines for trauma patients,

* rehabilitation programs, data collection,

mandatory autopsies, and

* means of managing and assuring the

quality of the system

EMS TODAYEMS TODAY


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Evaluation

- Must have a program for evaluating andimproving the effectiveness of the EMS

system, known as Quality Improvement

Program (QIP), a Quality Assurance

Program (QAP), or a Total QualityManagement (TQM).

EMS TODAYEMS TODAY


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Dial 999 via Telecoms

AMBULANCE SERVICE FLOWCHARTAMBULANCE SERVICE FLOWCHART

AED Medical Asistants

Alarm / Ambulance

Staff Equipment Communications

Ambulance Team Departs


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VICTIMS

AMBULANCE SERVICE FLOWCHARTAMBULANCE SERVICE FLOWCHART

Scoop & Run

Enroute to Hospital

AED

CPR

/ BLS1ST

AID

Discharge Admission to Ward

Specialist Clinic Mortuary


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Privatisation- Foundation Level (3 months)

- Paramedic Level I (6 months)

- Paramedic Level II (2 years)

- Paramedic Level III - Post Diploma(Advance Diploma Paramedical Science (Pre

Hospital Care - Australia[ LevelV - 6 months])

Whatarethe future directions oftheWhatarethe future directions ofthe

Ambulance ServiceAmbulance Service

pre hospital care introduction teaching

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