EMS Systems Lecture Notes

These flashcards cover the foundational concepts of Emergency Medical Services (EMS) systems, including history, levels of training, medical direction, quality improvement, and public health principles as outlined in the Chapter 1 lecture notes.

emergency medical services (EMS)

A multidisciplinary system that represents the combined efforts of several professionals and agencies to provide prehospital emergency care to the sick and injured.

Americans With Disabilities Act (ADA)

Comprehensive legislation passed in $1990$ that is designed to protect people with disabilities against discrimination and requires employers to provide full and equal employment to the disabled.

emergency medical responder (EMR)

A first trained professional, such as a law enforcement officer, firefighter, or lifeguard, who has basic emergency care and operations training focused on initiating immediate life-saving care before an ambulance arrives.

emergency medical technician (EMT)

An individual who has training in basic life support (BLS), including automated external defibrillation, use of definitive airway adjuncts, and assisting patients with certain medications.

advanced EMT (AEMT)

An individual who has training in specific aspects of advanced life support (ALS), such as intravenous (IV) therapy, advanced airway management, and the administration of certain emergency medications.

paramedic

An individual with the greatest breadth and depth of education in emergency care, focusing on ALS assessment, diagnostic tools, heart rhythm interpretation, and emergency pharmacology.

advanced life support (ALS)

Advanced life-saving procedures, such as advanced airway management and intravenous therapy, which were formerly reserved for paramedics but can now be partially performed by AEMTs.

certification

A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.

licensure

The legal authority granted by a competent authority, usually the state, allowing an individual to practice in a particular profession.

credentialing

An established verification process, typically overseen by a physician medical director, to determine the qualifications necessary for a healthcare provider to function within a specific area or system.

National Registry of EMTs (NREMT)

A nongovernmental, not-for-profit organization that provides a valid, uniform process to assess the knowledge, skills, and abilities (KSAs) for competent EMS practice.

Accidental Death and Disability: The Neglected Disease of Modern Society

A landmark report published in $1966$ by the National Academy of Sciences that revealed the serious inadequacy of prehospital emergency care and transportation in the United States.

National Highway Traffic Safety Administration (NHTSA)

The federal agency under the US Department of Transportation (DOT) responsible for enacting the Highway Safety Act of $1966$ and creating the National EMS Scope of Practice Model.

Emergency Care and Transportation of the Sick and Injured

The first EMT textbook, published by the American Academy of Orthopaedic Surgeons in $1971$, commonly referred to as the Orange Book.

National EMS Scope of Practice Model

A document created by NHTSA that provides overarching guidelines for the minimum skills each level of EMS provider (EMR, EMT, AEMT, and paramedic) should be able to accomplish.

National EMS-ID

A $12-digit$ identification number issued by the National Registry to all EMS professionals and students that remains constant regardless of changes in certification level.

Star of Life

A symbol created by NHTSA representing EMS, where each of the six bars represents a function: detection, reporting, response, on-scene care, care in transit, and transfer to definitive care; it also features the staff of Asclepius.

public safety access point

A centralized emergency communication center where trained dispatchers manage requests for fire, police, and ambulance services, typically reached by dialing $9-1-1$.

emergency medical dispatch (EMD)

A system that assists dispatchers in selecting appropriate units to respond to a call and provides callers with vital instructions to manage the emergency until EMS arrival.

medical director

A physician who authorizes EMTs in a service to provide medical care in the field and serves as the liaison between the medical community and the EMS service.

medical control

Physician instructions provided either online (direct via radio or phone) or off-line (indirect via standing orders, training, and protocols) as authorized by the medical director.

standing orders

Part of a protocol that designates what an EMT is required to do for a specific complaint or condition; the EMT is not required to consult medical direction before implementing these actions.

primary service area (PSA)

The designated geographic area in which an EMS agency is responsible for the provision of prehospital emergency care and transportation to the hospital.

mobile integrated health care (MIH)

A method of delivering health care within the community rather than a physician's office or hospital, utilizing an integrated team of healthcare professionals.

community paramedicine

An evolving field where experienced paramedics receive advanced training to provide services such as health evaluations, monitoring chronic illnesses, and patient advocacy within the community.

continuous quality improvement (CQI)

A quality management process consisting of internal and external reviews and audits of all aspects of an EMS system aimed at improving patient outcomes.

Just Culture

A strategy that promotes a learning environment by holding employees accountable for behavioral choices while balancing fairness and encouraging the reporting of errors without shame or blame.

Plan-do-study-act cycle

A learning and improvement cycle used in CQI: Plan involves analyzing data; Do entails enacting ideas; Study evaluates changes; and Act incorporates positive changes system-wide.

rules-based failure

A type of medical error where an EMT performs an action they do not have the legal right or permission to perform, such as administering a medication not approved by the medical director.

Health Insurance Portability and Accountability Act (HIPAA)

Federal legislation passed in $1996$ aimed at protecting patient privacy and limiting the availability of a patient's health care information.

Emergency Triage, Treat, and Transport (ET3)

A pilot program implemented by CMS in $2020$ designed to reimburse EMS systems for transport to alternative destinations or on-scene treatment rather than only ED transport.

public health

The branch of medicine focused on examining the health needs of entire populations with the goal of preventing health problems.

primary prevention

Public health strategies that focus on preventing an illness or injury from ever happening, such as vaccination programs or pool safety education.

secondary prevention

Efforts to limit the effects of an injury or illness that has already occurred, such as the use of helmets, seat belts, or improved guardrail construction.

evidence-based medicine (EBM)

Medical practice and decision-making focused on procedures and treatments that have been proven useful in improving patient outcomes through scientific research.

patient advocacy

A fundamental role of the EMT that involves constantly keeping the needs of the patient at the center of care and speaking on their behalf.