1. ems & disaster response
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  • Emergency medical technician: EMT
  • prearrival instructions On-line vs off-line protocol
  • Type of ambulance
  • Facilities:สิ่งอำนวยความสะดวก
  • mutual aid:ฃ่วยเหลือซึ่งกันและกันJurisdictions: เขตอำนาจศาล

Transcript

  • 1. Paleerat Jariyakanjana, MDFaculty of MedicineNaresuan UniversityEmergency Medical Services &Disaster Response
  • 2. EMERGENCY MEDICALSERVICES
  • 3. EMS is the extension of emergency medicalcare into the prehospital setting.
  • 4. History1 &23
  • 5. Key elements
  • 6. Manpower
  • 7. Traininginitial provider trainingcontinuing education
  • 8. Communications1. collect the necessary information from thecaller, dispatch appropriate medicalresources, and offer first aid information orprearrival instructions2. Ambulance personnel should also be ableto communicate with the destination hospital3. online medical control
  • 9. TransportationBLS ambulancescarry equipment appropriate for personneltrained at the EMT-B level oxygen, bag-mask ventilation devices,immobilization and splinting devices, anddressings for wound care and hemorrhage controldo not carry medication and cannot transportpatients requiring IVs or cardiac monitoring,although some may carry AEDs
  • 10. BLS ambulances
  • 11. TransportationALS ambulancesequipped for EMT-Ps or other advancedhealth care personnel IV supplies, IV medication, intubation devices,cardiac monitoring and defibrillation, andequipment for other specialized techniquesunique to specific areas, such as hypothermiaapplication after cardiac resuscitation
  • 12. ALS ambulances
  • 13. Transportationhttp://www.manafeth.com/index.php/en/products/view/Ambulance-Type-I#
  • 14. Air transport
  • 15. Facilities and Critical-Care Unitsclosest appropriate hospital or to the hospitalof the patients choicedivert patients to other hospitals ED overcrowding
  • 16. Public Safety Agenciesstrong ties with police and fire departments1. providing scene security2. provide first responder services
  • 17. Consumer Participationencourage representation of the generalpublic on the membership of regional EMScouncilspublic can participate by volunteering forlocal EMS agencies
  • 18. Access to Careno barriers or disincentives preventing timelyaccess to the system
  • 19. Patient Transferall patients must receive a medical screeningexam and be stabilized before transfer toanother facilityexplicit acceptance of the transfer by thereceiving hospital
  • 20. Coordinated Patient Record KeepingStandardization of EMS medical records
  • 21. Public Information and Educationtrain the public how to access them whenneeded and how to use them appropriatelyconvey to the public is the importance oflearning CPR, first aid, and basic disasterpreparedness principles
  • 22. Review and Evaluationradio communications, response times,scene times, and patient care recordsOutcome: cardiac arrest, stroke, and traumaEMS research
  • 23. Disaster Planwritten policies and proceduresstockpiling suppliesparticipating in regional disaster drills withother emergency response agencies andhospitals
  • 24. Mutual Aidmutual aid agreements with neighboringjurisdictions so that uninterrupted emergencycare is available when local agencies areoverwhelmed or unable to provide services
  • 25. Phases of EMS response
  • 26. DISASTER RESPONSE
  • 27. DefinitionMajor Incidents: any incident where thenumber, severity, type or location of livecasualties requires extraordinary resourcesDisaster: need > resourceMass casualty incident: Healthcare need >resource
  • 28. Disaster Management Cycle
  • 29. Major Incident Medical Managementand Support (MIMMS)major incidenttraining coursesystematic, allhazards approachto the principles ofpre-hospital,multiple-casualtyincident medicalmanagement
  • 30. Management and Support PrinciplesCommandSafetyCommunicationAssessmentTriageTreatmentTransport
  • 31. CommandCSCATTT
  • 32. SafetyThe 1-2-3 of Safety1. Staff2. Situation3. SurvivorsCSCATTT
  • 33. CommunicationCSCATTT
  • 34. AssessmentMy call sign/Major incident declaredExact location: Grid ref.Type of incidentHazards: Present/PotentialAccess: Roads, Landing areaNumber of casualties: Type, SeverityEmergency services: Present and RequiredCSCATTT
  • 35. TriageCSCATTT
  • 36. Triage sieveCSCATTT
  • 37. Triage sortCSCATTT
  • 38. Triage sortCSCATTT
  • 39. TreatmentAim: “do the most for the most”CSCATTT
  • 40. TransportAim: get the right casualty to the right placein the right timeCasualties should be dispersed to differenthospitals, most appropriate to their need.Mechanism of injuryInjury found or suspectedSigns (vital signs)Treatment givenCSCATTT
  • 41. Take home messageEMS is the extension of emergency medicalcare into the prehospital setting.Disaster response: CSCATTT
  • 42. ReferenceTintinallis Emergency Medicine, 7th editionhttp://www.emsworld.com/article/10319356/the-star-of-lifehttps://sites.google.com/site/dimersarred/disaster-management-cyclehttps://sites.google.com/site/sarbook1/excerpt-incident-command
  • 43. ANY QUESTIONS?