1. Chapter 1: Introduction to Advanced Pre-hospital Care.
Part 1: Introduction to Advanced Pre-hospital Care
 The Paramedic is the highest level of pre-hospital care and the leader of the pre-
hospital care team.
 EMS has made significant advances over the last 30 yrs.
 Paramedic must always be an advocate for the patient and assure that the patient
receives the best possible care – without regard to the patient’s ability to ay or
insurance.
 Paramedic accepts and adheres to a code of professional ethics and etiquette.
 Paramedic must possess KNOWLEDGE, SKILLS & ATTITUDES consistent w/
expectations of the public and Profession.
Paramedic Characteristics:
 Confident LEADER
 Excellent JUDGMENT
 Prioritize DECISIONS
 Function INDEPENDENTLY
Paramedic Roles
 Public education
 Health promotion
 Participation in illness prevention.
Opportunities for the paramedic
o Critical care Transport
o Primary care
o Tactical EMS
o Industrial Medicine
o Sports Medicine
Part 2: EMS System
• EMS (Emergency Medical Services System) is a
comprehensive network of personnel, equipment, and
resources established to deliver aid and emergency medical
care to the community.
• BLS (Basic Life Support) refers to basic life-saving
procedures such as artificial ventilation and CPR.
• ALS (Advanced Life Support) refers to advanced life-
saving procedures such as IV therapy, drug therapy,
incubation, and defibrillation.
An EMS System should have a disaster Plan!!!

2. History of EMS
o 4,000-5,000 yrs. Ago Sumerians inscribed clay
tablets w/ some of the earliest medical records,
similar to today’s Protocols.
o 19th
Century Napoleon formed the ambulance
volante or “flying ambulance”, which focused
efforts on providing emergency surgery as close to
the battle as possible.
Triage- a method of sorting patients by the severity of their injuries.
Medical direction- medical policies, procedures, and practices that are available to
providers either on-line or off-line.
Medical director- a physician who is legally responsible for all of the clinical and
patient care aspects of an EMS system.
Trauma center- medical facility that has the capability of caring for the acutely injured
patient. . The 3 Levels of Hospitals
I. Provides the highest level of trauma care.
II. May not have specialty pediatrics or a neurosurgeon on site.
III. Generally does not have immediate surgical facility
Protocols- are the policies and procedure for all components of an EMS system.
4 T’s of Emergency Care
1. Triage
2. Treatment
3. Transport
4. Transfer
The National Standard Curriculum is divided into 3 domains:
1. Cognitive- consists of facts, or information knowledge
2. Affective- requires students to assign emotions, values, and attitudes to that
information
3. Psychomotor- consists of hands-on-skills
Certification is the process by which an agency or association grants recognition to an
individual who has met its qualifications. i.e. Paramedics, EMT’s, PA’s.
Licensure- is a process of occupational regulation. i.e. Dr., nurse practitioners.
Ethics- are the rules or standards that govern the conduct of members of a particular
group or profession.

3. Part 3: Roles & Responsibilities of the Paramedic
Primary Responsibilities
o Preparation
o Response
o Scene size-up
o Patient assessment
o Patient management
o Disposition and transfer
o Documentation
o Clean-up, maintenance, and review.
Patient Assessment
- Initial Assessment
- Physical Exam
- Patient History
- Ongoing Assessment
Part 4: The Well-Being of the Paramedic
BSI (Body Substance Isolation)- is a strict form of infection control that is based on
the assumption that all blood and other body fluids are infectious.
Hand washing- Probably the most important infection control practice.
Decontamination of Equipment
- Cleaning- refers to washing w/ soap and water and picking up trash
- Disinfecting- use of a commercial disinfectant or bleach diluted in
water.
- Sterilizing- is the use of a chemical, or a physical method such as
pressurized steam, to kill all microorganisms on an object
Stages of Loss
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Part 5: Illness & Injury Prevention
Epidemiology- the study of factors that influence the frequency, distribution, and causes
of injury, disease, and other health-related events in a population.
Part 5: Illness & Injury Prevention

4. Morals- social, religious, or personal standards of right and wrong.
Ethics- are the rules and standards that govern the conduct of members of a particular
group or profession.
Laws- similar to ethics but, laws are rules or standards that govern wrong behavior and
ethics define good and bad behavior.
Bioethics: Fundamental Principals
• Beneficence- the principle of doing good for the patient.
o Maleficence- means doing harm (opposite of beneficence)
• Nonmaleficence- the obligation not to harm the patient.
• Autonomy- a competent adult patient’s right to determine what happens to his
own body.
• Justice- the obligation to treat all patients fairly.
Legal, Ethical, & Medical issues overlap.
☺Always ask your self what is in the Patients best interest.
Medical
EthicalLegal