Ch. 1 study guide, introduction to Emergency Medical Care

What does EMS stand for?

Emergency

Medical

Services

what war was the earliest documented EMS service in?

Napoleonic wars

The civil war what EMS service?

American Red Cross

What war had volunteers to help the injured?

WWI

What is a MASH unit

Mobile army surgical hospital

What war started the use of air transport?

Vietnam war

non-military ambulance services began operating in:

early 1900s in U.S.

Who were EMS run by at first?

often operated by hospitals, fire departments, or funeral homes

what was the original EMS lacking?

- no requirements or standards for equipment, crew training, or ambulance design
- "you, call, we haul, that's all"

Freedom house was run from ______ to _________

1968-1975

Freedom house was:

the only ambulance service that would respond to impoverished sections of the city

What was freedom house the first to treat?

cardiac arrest with: chest compressions, rescue breathing. and prehospital intubation

who was the first medical director of freedom house?

Dr. Nancy Caroline

who is Dr. Peter Safer?

- "father of CPR"
- trained lay people to become medics

who became the Medical Director of the City of Pittsburgh Department of Public Safety Bureau of EMS in 1978?

Dr. Ron Stewart

What is Dr. Ron Stewart known for?

founder of the center for Emergency Medicine

EMS today 1966:

Department of transportation charged with developing EMS standards

EMS today 1970:

founding of National Registry of EMTs (NREMT)

EMS today 1973:

National Emergency Medical Service Systems Act (NEMSSA)

NHTSA standards for EMS systems

1. regulation and policy
2. resource management
3. human resources and training
4. transportation
5. facilities
6. communications
7. trauma systems
8. public information and education
10. medical direction

Chain of human Resources in EMS system

Patient→ A citizen calls 911→ 911 dispatcher→first responders→EMTs→Emergency department staff→allied health staff

Accessing EMS system

- 911 telephone access
- enhanced 911
- cell phones

enhanced 911

provides caller number and location for landline phones

cell phones

newer models may provide location in some areas

BLS

basic life support

EMR

emergency medical responder

QRS

quick response service

EMT

emergency medical technician

ALS

advanced life support

AEMT

Advanced Emergency Medical Technician

highest level of EMS

paramedic

Emergency department staff

patient care transferred to someone with higher or equal level of care

examples of Allied health staff

- imaging
- respiratory therapists
- physical therapy
- Etc.

specialized care facilities

- trauma care facilities
- burn centers
- stroke centers
- cardiac centers
- labor and delivery
- pediatrics

critical decision making happens from:

- gathering information from scene, patient assessment, and other sources
- synthesize information to make decisions regarding treatment and transport options

critical decision making when given and found information if not enough

- ask more questions
- perform additional examinations

roles and responsibilities of EMTs

- personal safety

- safety of crew, patient, and bystanders

- patient assessment

- patient care

- lifting and moving

- transport

- transfer of care

- patient advocacy

physical traits of a good EMT

- ability to lift and carry equipment and patients
- good eyesight (distance and reading) and color vision
- good communication skills (oral and written)

personality traits of a good EMT

- pleasant
- sincere
- cooperative
- resourceful
- self starter
- emotionally stable
- able to lead
- neat and clean
- good moral character
- respectful of others
- control of personal habits
- control of conversation
- able to communicate properly
- able to listen to others
- nonjudgmental and fair

job opportunities

- ambulance services
- fire departments
- medical facilities
- rural/wilderness teams
- industrial settings
- volunteer

medical director:

a physician that has ultimate responsibility for patient care aspects of EMS system

medical direction

- all patients care performed under their direction
- oversees training
- develops treatment protocols

off-line medical control

- standing orders
- protocols

on-line medical control

orders by phone or radio

Quality Improvement (QI)

a process of continuous self-review with the purpose of identifying and correcting aspects of the system that require improvement

ways you can be a part of QI

- carefully written documentation
- obtain feedback
- maintain equipment
- continue your education

research

- vitally important: more needed in EMS field
- goal is improving patient outcomes

research impacts EMS through:

- evidence based techniques
- patient outcomes

EMS roles in public health

- community paramedicine
- injury prevention for geriatric patients and youth
- blood pressure clinics
- file for life
- public vaccination programs
- disease surveillance

education

"Half of what we are going to teach you is wrong, and half of it is right. Our problem is that we don't know which half is which." -Dr. Charles Sidney Burwell, Dean, Harvard Medical School 1935-1949