Chapter 1 - EMS systems

who are EMRs, and what can they do?

Law enforcement officers or firefighters that are trained in basic emergency care and operations training. They focus on managing the emergency scene and doing BLS before the ambulance arrives with limited equipment

50-80 hours

EMT roles and responsibilities

Immense depth and training in BLS. They transport patients to and from medical offices and hospitals. Mainly focus on initial stabilization and fundamental emergency care

150-200 hours

AEMT roles and responsibilities

An EMT that has more training than a regular EMT but less than a paramedic. They can place IVs, intubate, and administer more meds than a EMT. 

200-400 hours

Mainly used in places where paramedics aren’t available 

Paramedic roles and responsibilities 

The most medically trained out of all the EMS. They focus on ALS assessment, diagnostic and treatment tools and techniques. They can interpret heart rhythms, intubate, and deal with pharmacology

1,000-2,000 hours

Medical directors

A physician that oversees EMS personnel. Deal with various day-to-day operations such as medications on an ambulance and where patients are transported etc.

They dictate what an EMT can and cannot do (limit scope and expand (within state law) SOP

Medical control

Online (direct) when the medical director or medical director adjacent gives direction over the phone or radio directly from the hospital

Offline (indirect) is standing orders training, and supervision authorized by the medical director. These are things that each EMT must know

Integration of Health Services

Alerting the hospital of what type of medical care the patient requires 

• Getting a call for a cardiac arrest, alerting the ED of that, the ED tells the Cath lab team

Mobile integrated health care (MIH)

healthcare is provided within the community instead of a physician’s office or hospital

Composed of various EMS professionals 

Primary prevention

Strategies that prevent events from ever happening

• Vaccines prevent people from getting ill

Secondary prevention

The event has already happen, but these prevent the effect of the event

• public education

Emergency medical dispatch

A system that assists dispatchers in selecting appropriate units to respond to a particular call for assistance and provides callers with vital instructions until the arrival of EMS crews.

Licensure

The process whereby a competent authority, usually the state, allows people to perform a regulated act.

quality control

Oversight by the medical director to ensure the appropriate medical care standards are met by EMTs on each call.

public health

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

EMS

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

Credentialing

An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.

Primary service area

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

Continuous quality improvement

A system of internal and external reviews and audits of all aspects of an EMS system aimed at improving outcomes