CH01_Intro to EMS

Instructor Emails

  • Cam Addis: caddis@cataldoambulance.com

  • Nicole Famiglietti: nfamiglietti@cataldoambulance.com

  • Nick Metcalf: nmetcalf@cataldoambulance.com

  • P Pearson

Emergency Care Overview

Chapter 1: Introduction to Emergency Medical Services

  • Publication: Emergency Care Fourteenth Edition

  • Copyright: © 2021, 2016, 2012 Pearson Education, Inc. All Rights Reserved

  • Accessibility Note: Slides contain hyperlinks; JAWS users can access link lists using INSERT+F7.

Topics Covered

  • The Emergency Medical Services System

  • Components of the EMS System

  • Roles and Responsibilities of the EMT

  • EMS Role in Public Health

  • Research

  • Special Issues

History of Emergency Medical Services

How It Began (1 of 3)

  • 1790s: French transported wounded soldiers for physician care - earliest documented EMS.

  • Civil War: Clara Barton established emergency service for the wounded, later helped found the American Red Cross.

How It Began (2 of 3)

  • Development of volunteer ambulance corps.

  • Korea/Vietnam Wars: Medical teams produced advances in field care; led to civilian specialized emergency medical centers.

How It Began (3 of 3)

  • Early 1900s: Nonmilitary ambulance services began operating in the U.S.

  • Initially focused on transport with minimal emergency care.

  • Emerged in smaller communities during the late 1940s, operated by local undertakers or fire services.

  • Recognized the need for organized emergency prehospital care and training.

EMS Today

Critical Developments

  • 1966: Publication of the "White Paper" leading to EMS standards under the Highway Safety Act.

  • 1967: Freedom House Ambulance introduced first EMS in the U.S. staffed by paramedics.

  • 1970: Founding of the National Registry of EMTs (NREMT).

  • 1973: National Emergency Medical Service Systems Act passed.

NHTSA Standards for EMS Systems

Regulation and Policy

  • State laws and lead EMS agency established to create policies, procedures, and regulations.

Resource Management

  • Centralized coordination for emergency treatment and transport resources.

Human Resources and Training

  • Ensuring EMS personnel are trained and certified to minimum standards.

Transportation

  • Providing safe and reliable patient transport.

Facilities and Transportation

  • Transporting patients to the closest appropriate medical facility.

Communications

  • Universal access number (911) and effective communication between all components of the EMS system.

Public Information and Education

  • Educating the public on their roles in the EMS system and prevention of injuries.

Medical Direction

  • Medical directors oversee EMS personnel and ensure adherence to protocols.

Trauma Systems

  • Development of trauma triage, transport, and treatment protocols.

Evaluation

  • Establishing programs to evaluate and improve EMS effectiveness (QI, QA, TQM).

Components of the EMS System

Key Components

  • Emergency Medical Dispatchers: Activate EMS response.

  • EMS Responders: Emergency medical responders and EMTs.

  • Emergency Departments: Hospitals with doctors, nurses, and allied health personnel.

  • Specialized Care Facilities: Trauma, burn, pediatric, cardiac, and stroke centers.

Accessing the EMS System

911 Access

  • Universal access available in most communities.

  • Enhanced 911: Provides caller information and location from landline phones.

Emergency Medical Dispatchers

  • Can instruct callers on emergency care until EMS arrives.

  • Research indicates early access and initiation of care, including CPR, are critical.

Critical Decision Making in EMS

Importance

  • Essential to gather and interpret information from the scene and patient assessment for treatment decisions.

Inadequate Information

  • If information is insufficient, ask more questions or conduct further examinations.

Examples of Critical Decisions

  • Deciding between the closest facility or a specialized hospital.

  • Evaluating potential effects of medications on patients.

Levels of EMS Training

Training Levels

  1. Emergency Medical Responder

  2. Emergency Medical Technician

  3. Advanced Emergency Medical Technician

  4. Paramedic

Roles and Responsibilities of EMTs

Key Responsibilities

  • Prioritize personal safety and the safety of patients and crew.

  • Conduct patient assessment and care.

  • Lift, move, and transport patients.

  • Transfer patient care and advocate for their needs.

Considerations for Older Adults

  • Impact of forgetting personal items on patient care and security of homes post-transport.

Traits of a Good EMT

Physical Traits

  • Ability to lift and carry patients/equipment up to 125 pounds.

  • Good communication skills and awareness of any vision problems.

Personal Traits (1 of 4)

  • Pleasant, sincere, cooperative, and resourceful.

Personal Traits (2 of 4)

  • Professional appearance to inspire confidence.

Personal Traits (3 of 4)

  • Self-starter, emotionally stable, able to lead, and clean.

Personal Traits (4 of 4)

  • Control of habits, effective communication, and non-judgmental demeanor.

Education for EMTs

Ongoing Education

  • Importance of refresher courses, continuing education, and participation in seminars.

  • Adoption of new EMS procedures based on research findings.

Career Opportunities for EMTs

Potential Employment Areas

  • Ambulance services, fire departments, rural/wilderness teams, urban/industrial settings, and volunteering.

National Registry of Emergency Medical Technicians

Registration Benefits

  • Registration assists with licensing transfers and enhances job applications.

Quality Improvement in EMS

Objectives

  • Continuous self-review and development plans to address system deficiencies.

Roles in Quality Improvement

  • Importance of documentation, engagement in quality processes, patient feedback, and equipment maintenance.

Medical Direction

Responsibilities

  • Medical Director is accountable for the EMS personnel and patient care protocols.

EMS Role in Public Health

Focus Areas

  • Injury prevention for adults and youth, public vaccination programs, and disease surveillance.

Research in EMS

Impact of Research

  • Aimed at improving patient outcomes using evidence-based techniques.

Evidence-Based Process

  • Formulating hypotheses, reviewing literature, and evaluating evidence to adopt practices.

Basics of EMS Research

Research Challenges

  • Treatment dynamics make EMS research complex.

  • Importance of relying on the scientific method.

Types of Medical Research

  1. Peer-reviewed journal articles

  2. Non-peer-reviewed articles in EMS magazines

Special Issues in EMT Training

Course Discussions

  • Local issues and administrative matters related to EMT certification and class meetings.

  • Overview of ADA rights for individuals with disabilities.

Chapter Review

Summary Points

  • Development of EMS for prehospital and hospital emergency care.

  • EMT responsibilities include patient care, safety, and advocacy.

  • Importance of ongoing education and quality improvement processes.

Key Reminders

  • EMS origins trace back to the Napoleonic era with modern standards established in the 1960s-70s.

  • EMS involves a chain of human resources where critical decisions are made at each level.

  • Successful EMS providers should focus on continual self-improvement and maintaining high standards.

Questions to Consider

  • Innovations from military conflicts that shaped modern EMS practices.

  • Identify the four levels of EMS providers.

  • Understanding of medical control through physician communication during emergencies.

Critical Thinking Scenarios

  • Explore how an EMT could assist a patient hesitant to go to a hospital due to concerns for their pet.