Chapter 1 - Introduction to Emergency Medical Services

prehospital or out-of-hospital care

The modern Emergency Medical Services (EMS) system has been developed to provide what kind of care?

U.S. Department of Transportation (DOT)

Who was charged with developing EMS standards and assisting the states to upgrade the quality of their prehospital emergency care?

National Highway Safety Act

What act, passed in 1966, charged the U.S. Department of Transportation with the development of EMS standards?

the National Registry of Emergency Medical Technicians (NREMT)

What was founded in 1970 to establish professional EMS standards?

the National Emergency Medical Services Systems Act

In 1973, what act was passed as the cornerstone of a federal effort to implement and improve EMS systems across the United States?

Regulation & policy

What standard consists of the following: Each state EMS system must have in place enabling legislation, a lead EMS agency, a funding mechanism, regulations, policies, and procedures?

Resource management

What standard consists of the following: There must be centralized coordination of resources so that all victims of trauma or medical emergencies have equal access to basic emergency care and transport to an appropriate facility?

Human resources & training

What standard consists of the following: All those transporting prehospital personnel should be trained to the EMT level using National EMS Education standards that are taught by qualified instructors?

Transportation

What standard consists of the following: Safe, reliable ambulance transportation is a critical component?

Facilities

What standard consists of the following: The seriously ill or injured patient must be delivered in a timely manner to the closest appropriate facility?

Communications

What standard consists of the following: There must be an effective communications system that encompasses the universal system access number (911) and dispatch-to-ambulance, ambulance-to-ambulance, ambulance-to-hospital, and hospital-to-hospital communications?

Public information & education

What standard consists of the following: EMS personnel may participate in efforts to educate the public about their role in the system, their ability to access the system, and prevention of injuries?

Medical direction

What standard consists of the following: Each EMS system must have a physician as a Medical Director who is accountable for the activities of eMS personnel within that system?

Trauma systems

What standard consists of the following: In each state, enabling legislation must exist to develop a trauma system including one or more trauma centers?

Evaluation

What standard consists of the following: Each state must have a program for evaluating and improving the effectiveness of the EMS system, known as a quality improvement (QI) program, a quality assurance (QA) program, or total quality management (TQM)?

the initial phone call to the Emergency Medical Dispatcher (EMD)

Where does patient care begin in the EMS system?

emergency department

Where are patients received from the ambulance?

trauma centers

Where are surgery teams capable of the comprehensive treatment of trauma patients available 24 hours a day?

911 system

What is a system for telephone access to report emergencies?

Enhanced 911

What type of 911 system also identifies the caller's phone number and location automatically?

four

How many general levels of EMS training and certification are there?

Emergency Medical Responder (EMR)

What level of training is designed for the person who is often first at the scene (police officers, firefighters, etc.)? The emphasis is on activating the EMS system, providing immediate care for life-threatening injuries, controlling the scene, and preparing for the ambulance.

Emergency Medical Technician (EMT)

What is the minimum level of training for ambulance personnel? These individuals provide basic-level medical/trauma care and transportation to a medical facility.

Advanced Emergency Medical Technician (AEMT)

What level of training involves all features of the EMT training as well as some advanced-level care? They may include use of advanced airway devices and administration of some fluids or medications via intravenous (IV) and intraosseous (IO) routes.

paramedic

Who provides the most advanced level of prehospital care, with advanced-level assessment, decision making, and skills?

keeping yourself safe

What is the first responsibility of an EMT?

patient assessment

What always precedes emergency care?

patient care

What is an action or series of actions that your training will prepare you to take to help the patient deal with and survive illness or injury?

transfer of care

What involves turning the patient over to hospital personnel, providing information on the patient's condition, and ensures continuity of patient care?

you, the advocate

Who is the person that speaks up for your patients and pleads their cause?

the rapport built during your time with the patient

What gives you an understanding of the patient's condition and needs?

at two-to-four-year intervals

How often are refresher courses required?

continuing education

What type of training supplements the EMT's original course?

successful completion of NREMT practical and computer-based knowledge examinations

How is EMT registration obtained?

quality improvement (QI)

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

Medical Director

What is a physician who assumes ultimate responsibility for the patient-care aspects of the EMS system?

medical direction

What is the oversight of the patient-care aspects of an EMS system by the Medical Director?

protocols

What is a list of steps, such as assessments and interventions, to be taken in different situations?

standing orders

What is a policy or protocol issued by a medical Director that authorizes EMTs and others to perform particular skills in certain situations?

off-line medical direction

What consists of standing orders issued by the MD that allow EMTs to give certain medications or perform certain procedures without speaking to the MD or another physician?

on-line medical direction

What consists of orders from the on-duty physician given directly to an EMT in the field by radio or telephone?

public health

What is generally considered to be the system by which the medical community oversees the basic health of a population?

research

What is medicine based on?

patient outcomes

What is the long-term survival of patients?

evidence-based techniques

What are techniques or practices that are supported by scientific evidence of their safety and efficacy, rather than merely on supposition and tradition?

long-term results

Research into what type of results allows us to make the best decisions for the patient's overall care?

evidence-based decision making

What means that the procedures and knowledge we use in determining what care works are based on scientific evidence?

scientific method

What is a process of experimentation for answering questions and acquiring new knowledge?

peer reviewed

What type of research is published in medical journals?

Americans with Disabilities Act (ADA)

What has set strict guidelines to preserve the rights of Americans with disabilities?