1)Intro To Ems


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1)Intro To Ems

  1. 1. Emergency Medical Services
  2. 2. Intro to EMS What Is EMS? <ul><li>“ Planned configuration of community resources and personnel necessary to provide immediate care to patients with sudden/unexpected injury/illness.” </li></ul>
  3. 3. Intro to EMS Where did EMS come from? <ul><li>War </li></ul><ul><ul><li>1 st Ambulances </li></ul></ul><ul><ul><ul><li>Napoleonic War </li></ul></ul></ul><ul><ul><ul><li>Baron Dominique Jean Larrey - 1793 </li></ul></ul></ul><ul><ul><li>“ Flying Field Hospitals” </li></ul></ul><ul><ul><ul><li>Troops taken off battlefield for treatment </li></ul></ul></ul>
  4. 4. Intro to EMS Where did EMS come from? <ul><li>Civil War </li></ul><ul><ul><li>Horse Drawn Ambulances </li></ul></ul><ul><li>WWI </li></ul><ul><ul><li>Motorized Ambulance </li></ul></ul><ul><ul><li>Splinting fractures </li></ul></ul><ul><li>Korean War </li></ul><ul><ul><li>Helicopter evacuation to MASH units </li></ul></ul><ul><li>Vietnam </li></ul><ul><ul><li>Reinforced helicopter evacuation </li></ul></ul><ul><ul><li>Field medics </li></ul></ul>
  5. 5. Intro to EMS Where did EMS come from? <ul><li>Civilians </li></ul><ul><ul><li>Rural </li></ul></ul><ul><ul><ul><li>Undertakers </li></ul></ul></ul><ul><ul><li>Urban </li></ul></ul><ul><ul><ul><li>Hospitals/FD/Police/Private companies </li></ul></ul></ul>
  6. 7. Intro to EMS Where did EMS come from? <ul><li>Trauma </li></ul><ul><ul><li># 1 COD 1-45 y/o </li></ul></ul><ul><ul><li>MVA= ½ of all traumatic deaths </li></ul></ul><ul><ul><li>Battle physicians saw need </li></ul></ul><ul><ul><li>On scene care= increased survivability </li></ul></ul>
  7. 8. Intro to EMS Where did EMS come from? <ul><li>The “White Paper”- 1966 </li></ul><ul><ul><li>“ Accidental Death and Disability: The Neglected Disease of Modern Society” </li></ul></ul><ul><ul><ul><li>National Academy of Science </li></ul></ul></ul><ul><ul><li>Prompted federal grants </li></ul></ul><ul><ul><ul><li>“ Safe Transport and Handling of ill/injured people” </li></ul></ul></ul><ul><li>National Highway Safety Act - 1966 </li></ul><ul><ul><li>Established National Highway Safety Administration (NHSTA) under U.S. D.O.T. </li></ul></ul><ul><ul><ul><li>Improve EMS education/est. EMS system </li></ul></ul></ul>
  8. 9. Intro to EMS Where did EMS come from? <ul><li>Wedworth-Townsend Paramedic Act -1970 </li></ul><ul><ul><li>Senator James Q. Wedworth </li></ul></ul><ul><ul><li>Assemblyman Larry Townsend </li></ul></ul><ul><ul><li>Pilot Paramedic program </li></ul></ul><ul><ul><ul><li>Los Angeles County </li></ul></ul></ul><ul><ul><ul><li>Function without doctor/nurse </li></ul></ul></ul>
  9. 10. Overview of the EMS System… <ul><li>911 </li></ul><ul><ul><li>Access to ALL components of EMS </li></ul></ul><ul><li>Enhanced 911 </li></ul><ul><ul><li>Exact location of caller </li></ul></ul><ul><li>Emergency Medical Dispatch </li></ul><ul><ul><li>Dispatchers provide basic 1 st aid instructors </li></ul></ul><ul><ul><li>U.S. D.O.T. Curriculum </li></ul></ul><ul><li>Non 911 systems </li></ul><ul><ul><li>Separate numbers separate services </li></ul></ul>
  10. 11. Overview of the EMS system… <ul><li>Levels of training </li></ul><ul><ul><li>First responder </li></ul></ul><ul><ul><li>EMT-Basic </li></ul></ul><ul><ul><li>EMT-Enhanced </li></ul></ul><ul><ul><li>EMT-Intermediate </li></ul></ul><ul><ul><li>EMT-Paramedic </li></ul></ul>
  11. 12. The Healthcare System <ul><li>Emergency Department/Medicine </li></ul><ul><ul><li>Intersection of prehopsital/hospital care </li></ul></ul><ul><ul><li>Young specialty </li></ul></ul><ul><ul><ul><li>AMA recognition 1975 </li></ul></ul></ul><ul><li>Specialty Centers </li></ul><ul><ul><li>Trauma Centers </li></ul></ul><ul><ul><li>Burn Centers </li></ul></ul><ul><ul><li>Pediatric Centers </li></ul></ul><ul><ul><li>Poison Centers </li></ul></ul>
  12. 13. Hospital Personnel <ul><li>Physicians </li></ul><ul><ul><li>Overall management of pt care </li></ul></ul><ul><li>Nurses </li></ul><ul><ul><li>Coordinates pt care </li></ul></ul><ul><li>Others </li></ul><ul><ul><li>Radiology, Respiratory, Techs, etc. </li></ul></ul>
  13. 14. Other Public Safety Workers <ul><li>Firefighters </li></ul><ul><ul><li>Fire </li></ul></ul><ul><ul><li>Extrication </li></ul></ul><ul><ul><li>AED </li></ul></ul><ul><li>Police </li></ul><ul><ul><li>Crime scenes </li></ul></ul><ul><ul><li>Traffic control </li></ul></ul><ul><ul><li>Violent patients </li></ul></ul><ul><ul><li>Notifies family </li></ul></ul>
  14. 15. Roles and Responsibilities of the EMT <ul><li>Safety </li></ul><ul><ul><li>Personal </li></ul></ul><ul><ul><li>Crew </li></ul></ul><ul><ul><li>Bystander </li></ul></ul><ul><ul><li>Pt. </li></ul></ul><ul><li>Pt assessment </li></ul><ul><ul><li>Vital signs, History, Physical assessment </li></ul></ul>
  15. 16. Roles and Responsibilities of the EMT <ul><li>Pt care </li></ul><ul><ul><li>Based on assessment findings </li></ul></ul><ul><li>Lifting/moving pt </li></ul><ul><ul><li>Movement based on pt needs </li></ul></ul><ul><li>Transport/transfer of care </li></ul><ul><li>Record keeping </li></ul><ul><ul><li>PPCR= ONLY source of info from the scene </li></ul></ul><ul><ul><li>CYA… </li></ul></ul><ul><li>Pt. Advocacy </li></ul><ul><ul><li>1 st provider at scene= the pt looks to YOU! </li></ul></ul>
  16. 17. Professional Attributes <ul><li>Appearance </li></ul><ul><ul><li>Neat </li></ul></ul><ul><ul><li>Clean </li></ul></ul><ul><ul><li>Positive image </li></ul></ul><ul><li>Maintain up to date knowledge/skills </li></ul><ul><ul><li>Continuing Ed (CE) </li></ul></ul><ul><ul><ul><li>Local/state/national conventions </li></ul></ul></ul><ul><ul><ul><li>EMS journals and classes </li></ul></ul></ul><ul><ul><ul><li>Handout on Va EMT CE requirements </li></ul></ul></ul><ul><ul><li>Refresher courses </li></ul></ul>
  17. 18. Category 1(Required Topic) Area # Hours Required Patient Assessment 2 3 Airway Management w/Practical 3 3 Trauma Emergencies w/Scenarios 4 4 Medical Emergencies w/Scenarios 5 4 Infection Control 6 2 Medical Legal 7 1 Infants and Children 8 2 Practical Skills 9 3 AED 10 2 TOTAL: 24 Hours Category 2 (Other) . TOTAL: Up to 12 Hours Category 3(Multimedia) . TOTAL: Up to 10 Hours Total Category 2 + Category 3 . TOTAL: 12 Hours TOTAL EMT RECERTIFICTION HOURS . TOTAL: 36 Hours
  18. 19. Neat….
  19. 20. Not so neat…
  20. 21. Quality Improvement <ul><li>“A system of internal/external reviews and audits of all aspects of an EMS system so as to identify those aspects needing improvement to assure the public receives the highest quality of prehospital care.” </li></ul><ul><ul><ul><li>Anyone else think that’s a terribly long definition?? </li></ul></ul></ul>
  21. 22. The Role of the EMT in QI <ul><li>Documentation </li></ul><ul><li>Run reviews and audits </li></ul><ul><li>Pt and hospital feedback </li></ul><ul><li>Preventative maintenance </li></ul><ul><li>Counting Ed (CE) </li></ul><ul><li>Skill maintenance </li></ul>
  22. 23. Maintain skills so you don’t do this…
  23. 24. Medical Direction <ul><li>“A physician responsible for the clinical and pt care aspects of the EMS system” </li></ul><ul><li>EVERY EMS system MUST have one </li></ul><ul><li>We are extensions of the OMD </li></ul>
  24. 25. Types of Medical Direction <ul><li>On-Line </li></ul><ul><ul><li>DIRECT communication with physician </li></ul></ul><ul><ul><ul><li>Telephone </li></ul></ul></ul><ul><ul><ul><li>Radio </li></ul></ul></ul><ul><li>Off-Line </li></ul><ul><ul><li>Medical direction without direct communication </li></ul></ul><ul><ul><ul><li>Protocol </li></ul></ul></ul><ul><ul><ul><li>Standing Orders </li></ul></ul></ul>
  25. 26. Extra Credit to ANYONE who can tell me who these guys are and why they ROCK!!!
  26. 27. That does it. Come back next time for more…