This document discusses the role of EMS providers in public health and injury prevention. It describes how public health aims to protect community health through preventative measures, epidemiology, and responding to health emergencies. The document advocates that EMS providers are well-positioned to support public health goals such as educating the public, collecting data, and reducing risks of injuries. EMS employers and providers should prioritize their own safety as well as injury prevention strategies tailored to their communities.

1. Copyright © 2017, 2013, 2009 Pearson
Education, Inc. All Rights Reserved.
Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Paramedic Care: Principles & Practice
Volume 1, 5e
Chapter 6
Public Health

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Standard
• Public Health

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Competency
• Applies fundamental knowledge of principles of
public health and epidemiology, including public
health emergencies, health promotion, and illness
and injury prevention.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Introduction
• EMS providers drawn to EMS to make
contribution to society and those in need.
• Respond to scenes of crisis and tragedy; excited
when critically ill or injured patient improves after
receiving emergency medical care.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Basic Principles of Public Health
• Public health: science and practice of protecting
and improving health of a community.
– Use of preventive medicine
– Health education
– Control of communicable diseases
– Application of sanitary measures
– Monitoring of environmental hazards

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Basic Principles of Public Health
• Strong medical oversight of both public health and
EMS.
• Educate emergency care and public health
providers about roles.
• Recognition of role of and commitment to develop
and maintain relationships between leaders of
component groups.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Basic Principles of Public Health
• Bring community stakeholders into planning
process.
• Create disaster plans developed locally; public
health and emergency care; drill repeatedly.
• Pursue and secure funding.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Figure 6-1 An overview of public health.
(Source: Centers for Disease Control and Prevention)

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Richard A. Cherry
Robert S. Porter
Accomplishments in Public Health
• Vaccination
• Motor vehicle safety
• Safer workplaces
• Control of infectious diseases
• Decline in deaths from coronary artery disease
and stroke

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Accomplishments in Public Health
• Safer and healthier foods
• Healthier mothers and babies
• Family planning
• Fluoridation of drinking water
• Recognition of tobacco as health hazard

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Richard A. Cherry
Robert S. Porter
Public Health Laws
• Illness and prevention
• Police powers for public health agencies
• Epidemiological tools
– 2009: Public Health Law Research Program (PHLRP).
 Aids public health entities in promoting effective regulatory and
legal solutions to public health problems.

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Richard A. Cherry
Robert S. Porter
Epidemiology
• Epidemiology
– Incidence and prevalence of disease in large
populations
– Source and causes of epidemics of infectious disease
– Frequency and pattern of health events that occur in a
population

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Richard A. Cherry
Robert S. Porter
Epidemiology
• Concepts
– Years of productive life
– Injury (unintentional or intentional)
– Injury risk
– Injury surveillance program
– Primary prevention
– Secondary prevention
– Tertiary prevention

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Richard A. Cherry
Robert S. Porter
Epidemiology
• Major Roles in Public Health Practice
– Public health surveillance
– Field investigation
– Analytic studies
– Evaluation
– Linkage
– Policy development

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Richard A. Cherry
Robert S. Porter
Epidemiology
• EMS Public Health Strategies
– Roles for EMS in Public Health
 Health promotion
 Disease surveillance
 Disaster management
 Injury prevention

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Public Health and EMS
• EMS personnel prime candidates to be advocates
of injury prevention.
• EMS providers perform CPR and other life-saving
procedures.
• EMS providers widely distributed in population;
reflect composition of their communities.

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Richard A. Cherry
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Public Health and EMS
• Organizational Commitment
– Protection of EMS providers
– Education of EMS providers
– Data collection
– Financial support
– Empowerment of EMS providers

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Figure 6-4 EMS in the United States needs to be proactive in public education programs.
(Dr. Bryan E. Bledsoe)

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Richard A. Cherry
Robert S. Porter
Public Health and EMS
• EMS Provider Commitment
– Standard Precautions
– Physical fitness
– Stress management
– Seeking professional care
– Driving safety

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Richard A. Cherry
Robert S. Porter
Figure 6-5 Disease prevention starts with health care workers.
(Photo: Dr. Bryan E. Bledsoe)

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Public Health and EMS
• EMS Provider Commitment
– Scene safety:
 Safety is always first priority.
 Attention on response and equipment that will be needed
 Do not approach dangerous scenes until law enforcement has
arrived and deemed the scene safe.

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Richard A. Cherry
Robert S. Porter
Figure 6-6 Every paramedic should have the appropriate safety equipment readily available and
in good repair.
(© Ken Kerr)

23. Copyright © 2017, 2013, 2009 Pearson
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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Public Health and EMS
• EMS Provider Commitment
– Scene safety:
 Traffic, road conditions, hazards
 Wear reflective clothing.
 Precautions in place, approach patients with your own safety in
mind.
 All crew members should be restrained while ambulance in
motion.

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Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Areas Where EMS Can Be Active in Prevention
– Infants and children:
 One of every three deaths among children in U.S. results from
injury.
 Motor vehicle collisions, pedestrian or bicycle injuries, burns,
falls, firearms

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Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Areas Where EMS Can Be Active in Prevention
– Motor vehicle collisions:
 Responsible for more than half of all deaths from unintentional
injuries
 Alcohol use factor in about half of all motor vehicle fatalities.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Areas Where EMS Can Be Active in Prevention
– Geriatric patients:
 Falls responsible for largest number of preventable injuries for
persons over 75.
 Some may suffer from some degree of dementia.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Areas Where EMS Can Be Active in Prevention
– Work and recreation hazards:
 22%: back injuries; disabling injuries.
 22%: injuries to eyes, hands, fingers.
 Sports injuries common.

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Areas Where EMS Can Be Active in Prevention
– Medications:
 Taken improperly; taken by others
 Following physician's, pharmacist's, label directions imperative.
– Early discharge

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Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Implementation of Prevention Strategies
– Preserve safety of response team
– Recognize scene hazards
– Document findings
– Engage in on-scene education
– Know your community resources

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Implementation of Prevention Strategies
– Conduct community needs assessment:
 Childhood and flu immunizations
 Prenatal and well-baby clinics
 Elder-care clinics
 Defensive driving classes

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Prevention in the Community
• Implementation of Prevention Strategies
– Conduct community needs assessment:
 Workplace safety courses
 Health clinics
 Prevention information on your agency's website

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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Summary
• Each member of EMS shares responsibility of
promoting wellness and preventing illness and
injury among coworkers and community.
• EMS services have gone beyond traditional
treatment-and-transport-only.

33. Copyright © 2017, 2013, 2009 Pearson
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Bryan E. Bledsoe
Richard A. Cherry
Robert S. Porter
Summary
• Commonplace for EMS services to offer programs
to public.
• Partner with members of community to make
everyone more aware of how to prevent avoidable
illness and injury.