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
  • 1. ems & disaster response

    1. 1. Paleerat Jariyakanjana, MDFaculty of MedicineNaresuan UniversityEmergency Medical Services &Disaster Response
    3. 3. EMS is the extension of emergency medicalcare into the prehospital setting.
    4. 4. History1 &23
    5. 5. Key elements
    6. 6. Manpower
    7. 7. Traininginitial provider trainingcontinuing education
    8. 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. 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. 10. BLS ambulances
    11. 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. 12. ALS ambulances
    13. 13. Transportationhttp://www.manafeth.com/index.php/en/products/view/Ambulance-Type-I#
    14. 14. Air transport
    15. 15. Facilities and Critical-Care Unitsclosest appropriate hospital or to the hospitalof the patients choicedivert patients to other hospitals ED overcrowding
    16. 16. Public Safety Agenciesstrong ties with police and fire departments1. providing scene security2. provide first responder services
    17. 17. Consumer Participationencourage representation of the generalpublic on the membership of regional EMScouncilspublic can participate by volunteering forlocal EMS agencies
    18. 18. Access to Careno barriers or disincentives preventing timelyaccess to the system
    19. 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. 20. Coordinated Patient Record KeepingStandardization of EMS medical records
    21. 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. 22. Review and Evaluationradio communications, response times,scene times, and patient care recordsOutcome: cardiac arrest, stroke, and traumaEMS research
    23. 23. Disaster Planwritten policies and proceduresstockpiling suppliesparticipating in regional disaster drills withother emergency response agencies andhospitals
    24. 24. Mutual Aidmutual aid agreements with neighboringjurisdictions so that uninterrupted emergencycare is available when local agencies areoverwhelmed or unable to provide services
    25. 25. Phases of EMS response
    27. 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. 28. Disaster Management Cycle
    29. 29. Major Incident Medical Managementand Support (MIMMS)major incidenttraining coursesystematic, allhazards approachto the principles ofpre-hospital,multiple-casualtyincident medicalmanagement
    30. 30. Management and Support PrinciplesCommandSafetyCommunicationAssessmentTriageTreatmentTransport
    31. 31. CommandCSCATTT
    32. 32. SafetyThe 1-2-3 of Safety1. Staff2. Situation3. SurvivorsCSCATTT
    33. 33. CommunicationCSCATTT
    34. 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. 35. TriageCSCATTT
    36. 36. Triage sieveCSCATTT
    37. 37. Triage sortCSCATTT
    38. 38. Triage sortCSCATTT
    39. 39. TreatmentAim: “do the most for the most”CSCATTT
    40. 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. 41. Take home messageEMS is the extension of emergency medicalcare into the prehospital setting.Disaster response: CSCATTT
    42. 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. 43. ANY QUESTIONS?