EMT (History, Public Health, and EMS Roles)

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-suicide lifeline

-connects callers to counselors

-reduces confrontation with law enforcement

EMD (emergency medical dispatcher)

gives medical instruction to 911 caller

enhanced 911

finds the location of the caller

medical director

physician responsible for providing medical oversight

QI (quality of improvement)

reviewing the EMS system areas to improve

-”CQI” continuous quality improvement

-medical director is responsible for QI oversight

EMS (emergency medical system)

resources to provide care and transportation
-public education

-prevention efforts

1960 history

white paper: beginning of modern EMS system

1970 history

Department of transportation (DOT) develops first EMT National standard of care (NSC)

1980 history

American heart association (AHA): increased heart disease prevention, science, andeducation

1990 history

National Registry of EMT (NREMT) advocates a unified national training curriculum

National highway and traffic safety administration (NHTSA): work with EMT

2000 history

National EMS education standard (NEMSES) developed

-EMR

-EMT (beta agonist medication, anticholinergic medication, OTC analgesics, BGL, CPAP, Pulse oximetry, Assisting AEMT and Paramedic)

-AEMT

-Paramedic

Clinical care

outlines scope of practice and equipment

Medical direction

physician oversight of patient care

Integrated health services

EMS help hospital for continuous care

Information system

information technology of EMS

Communication

systems used to activate EMS, dispatch responders, and communicate with medical direction

HR (human resources)

professionalize EMS occupations

Legislation and regulation

EMS conforms to local, state, and federal requirement

evaluation

quality of improvement component of EMS

finance

funding EMS

Public education

EMS system’s roles in larger public health system

EMS education

addresses quality of EMS training

911

-”enhanced” identifies phone number and location automatically

-EMD

Highest risk of harm

-airway obstruction

-respiratory distress/arrest

-cardiac arrest

-hypovolemic shock

-anaphylaxis

-stroke

-inhalation

Emergency medical responder (NREMR) lvl of training

-basic immediate care

-bleeding

-CPR/AED

-Epi autoinjector

-opioid antagonists

-uncomplicated child birth

Emergency Medical technician (NREMT) lvl of training 

-All EMR skills

-advanced oxygen and ventilation skills

-pulse oc

-NIBP monitoring

-BGL

-additional medications

Advanced EMT (NRAEMT) lvl of traing

-All EMT skills

-supraglottic advance airway

-IV/IO access

-additional medications

Paramedic (NRP)

-All AEMT skills

-advanced assessment and management

-invasive skills

-extensive medication

-highest level of prehospital care

EMT Roles and Responsibilities

-equipment preparedness

-emergency vehicle operations

-scene safety

-patient assessment and training

-lift and move

-communication and documentation

-patient advocacy

-professional development

-quality improvement

-illness and injury prevention

-certification and license

medical control

Medical director instruction for patient care

-”online” or DIRECT contact physician and EMS provider

-”offline” or INDIRECT written protocols

Transfer of patient care

EMT provides all information FOR continuity of care

Lifting and moving patients

EMT must avoid further injury

Transportation

Patients in ambulance are at high risk in a potential MVC (motor vehicle collision)

Spinal precautions

must be taken when indicated as patient can suffer (wrong position) when not indicated

medication administration

dangerous when not administered correctly

Professional attributes

-appearance

-skill competency

-physical capability

-leadership

-high ethical standards

-emotional stability

-critical and adaptive thinking skills

-listeners

-success of team over self interest