AAOS EMT Basic (12th Edition) Chapter 1

EMS System

A coordinated network of resources that provides emergency medical care and transport, governed by state laws.

Primary Role of EMS

Provide emergency medical care to the sick and injured and transport patients to definitive care.

EMR (Emergency Medical Responder)

Provides immediate basic life support before an ambulance arrives and may assist EMTs.

EMT (Emergency Medical Technician)

Provides basic life support including airway management, AED use, and assisting with certain medications.

AEMT (Advanced EMT)

Provides limited advanced life support including IV therapy and administration of select medications.

Paramedic

Provides extensive advanced life support including intubation, cardiac monitoring, and advanced pharmacology.

National EMS Scope of Practice Model

Federal guideline defining EMS provider levels and allowable skills.

Medical Director

Physician responsible for medical oversight, protocols, training standards, and quality control.

Standing Orders

Off-line medical control that allows EMTs to perform life-saving care without contacting a physician first.

Online Medical Control

Direct physician orders given via radio or phone.

Offline Medical Control

Standing orders, protocols, training, and supervision.

Continuous Quality Improvement (CQI)

Ongoing process to review care, identify improvements, and reduce errors.

Just Culture

A system that balances accountability with a learning-focused approach to errors.

Public Access to EMS

Includes 9-1-1 systems, dispatchers, and emergency medical dispatch instructions.

Emergency Medical Dispatch (EMD)

System where dispatchers provide pre-arrival medical instructions.

Integration of Health Services

Coordination between prehospital care and hospital emergency departments.

Mobile Integrated Health Care (MIH)

Community-based healthcare delivery using EMS providers outside emergency transport.

Community Paramedicine

Expanded paramedic role providing preventive and follow-up care in the community.

Evidence-Based Medicine (EBM)

Clinical decision-making based on research and best available evidence.

EMS Agenda 2050

NHTSA vision focused on workforce well-being, patient-centered care, and system integration.

Roles of the EMT

Scene safety, patient assessment, emergency care, transport, documentation, and professionalism.

Highest Priority of the EMT

Personal safety.

Professional Attributes of EMT

Integrity, empathy, self-motivation, communication, teamwork, and professionalism.

HIPAA

Protects patient privacy and confidentiality.

ADA (Americans with Disabilities Act)

Prohibits discrimination and may require workplace accommodations.

Public BLS

Basic life support provided by trained laypersons, including CPR and AED use.

History of EMS

Developed from military medicine, volunteer ambulances, and national legislation.

1966 EMS White Paper

“Accidental Death and Disability” that led to the modern EMS system.

EMS Levels of Oversight

Federal guidelines, state laws, and local medical direction.

EMS Research

Improves patient outcomes through evidence-based guidelines.

System Finance

EMS funding through billing, insurance reimbursement, and government programs.

ET3 Program

CMS program reimbursing EMS for treatment and alternative transport options.

Incident Recognition

First phase of emergency care when an emergency is identified.

Prehospital Care

Care provided by EMS before arrival at the hospital.

Definitive Care

Advanced care provided at a hospital or specialty center.