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EMS (Emergency Medical Services)
Dispatch
EMR
EMT-B (Basic)
EMT-A (Advanced)
EMT-P (Paramedic)
EMR
basic life support
AED
tourniquet application
ABCs
abdominal thrusts
EMT-B (Basic)
interfacility transport (IFT) 3-6 months
all responsibilities of EMR
EMT-A (Advanced)
all responsibilities of the EMT-B
IV/IO
medication administration
EMT-P (Paramedic)
1:1 ratio of paramedic to EMT
IO/IV
needle cricoid
interpreting EKGs
cardiac monitoring
EMS Components
comprehensive, quality, convenient care
evidence-based clinical care → e.g. 30 compression : 2 respirations
efficient, well-rounded care
preventative care
comprehensive and easily accessible patient records
NREMT
EMT School → NREMT Psychomotor Exam → NREMT Cognitive Exam → NREMT Certification
Cognitive Exam → 3 attempts, pass with 70%
NREMT Certification → Renewed every 2 years (refresher courses)
Medical Director
physician that oversees EMS system in each locality
can expand and restrict scope of practice
creates protocols
sets the standard for training and patient care
responsible for maintaining quality control
Medical Control
contacted to challenge scope of practice & affirm administration of medication
EMT-B = 8 medications
dosage and reason for administration must be stated to be approved
Offline → standing orders, protocols, policies from protocol book
Online → involves calling medical control (obtaining permission over phone)
Continuous Quality Improvement (CQI)
Goal = minimizing errors → plan-do-study-act cycle
reviews and performs audits of the EMS system to identify areas of improvement and/or assign remedial training
PCRs regarding major issues (cardiac/respiratory arrest) are periodically reviewed
Patient Care Report (PCR)
legal documents
everything must be documented appropriately using facts not opinions
BSI vs PPE
important aspects of scene safety
standard precautions → encompass BSI and PPE
BSI is a type of PPE
BSI → body, substance, isolation (gloves, gowns, masks)
PPE → personal protective equipment (reflective gear)