Emergency Medical Services Systems and History

Emergency Medical Services (EMS) Systems and History

The Symbol of Medicine

  • The Rod of Asclepius is a serpent-entwined staff serving as a symbol of medicine and healthcare.

  • It is named after the Greek god of healing, Asclepius.

Early History of EMS (Early 1800s - Early 1960s)

  • 1800: Dominque-Jean Larrey (Napoleon's Army Chief Physician) established principles of triage and transport for patients.

  • 1860-1870: Civilian ambulance services developed, primarily horse-drawn.

    • First recorded in Cincinnati, Ohio, in 1865.

    • New York City followed in 1869.

  • 1899: The first automobile-type ambulance was introduced at Michael Reese Hospital in Chicago, IL.

  • Early 1900s: Significant changes occurred between World War I and World War II.

    • Hospital-based ambulance services suffered due to a lack of workforce resulting from the wars.

  • 1926: The Phoenix Fire Department added EMS services to its operations.

  • 1928: Julian Stanley Wise founded the Roanoke Life Saving and First Aid Crew, which was the first volunteer rescue squad in the United States.

  • 1940s: Due to a shortage of medical personnel, EMS responsibilities were largely turned over to fire and police departments.

    • At this time, there were no minimum training standards for EMS personnel.

    • This role was not always welcomed by the fire and police departments.

The Rise of Modern Technology and Pre-hospital Care

  • 1950s (Korean War): Improvements in patient survivability were observed by bringing hospital-type services closer to the field of combat.

    • This era saw the introduction of helicopters for rapid transport of patients to Mobile Army Surgical Hospital (MASH) units.

  • 1956: Drs. James Elan and Peter Safar developed mouth-to-mouth resuscitation techniques.

  • 1959: Frank Patridge developed the first portable defibrillator.

Movement Towards Modern EMS

  • 1960: President John F. Kennedy highlighted a critical public health issue, stating, "Traffic accidents constitute one of the greatest, perhaps the greatest, of the nation's public health problems."

The "White Paper" - Foundation of Modern EMS

  • Title: Accidental Death and Disability: The Neglected Disease of Modern Society

  • Publication: Published in 1966 by the National Academy of Sciences and the National Research Council.

  • Purpose: To highlight and address critical deficiencies within the U.S. EMS system.

  • Significance: This document is considered the foundational cornerstone for the modern EMS system in the United States.

  • Recommendations: Called for the preparation of nationally-approved courses of instruction for ambulance personnel.

  • Ten Critical Points Identified:

    • Community Health/Safety

    • Financial Incentives

    • Community-Based Prevention

    • National EMS Research Agenda

    • State Legislation

    • Medical Direction

    • Information Systems

    • Cost/Benefit Analysis

    • 911 as the Emergency Number

    • Location Identification

Early Initiatives in Modern EMS

  • 1965: Ralph Nader published works accusing car manufacturers of resisting safety features, such as seat belts.

  • 1965: President Lyndon B. Johnson and the President's Commission on Highway Safety/National Academy of Sciences declared the carnage from traffic accidents as "the neglected disease of modern society."

  • 1966: Congress passed the National Highway Safety Act.

  • United States Department of Transportation (US DOT) was created to address transportation safety.

National Registry of Emergency Medical Technicians (NREMT)

  • Recommendation: Recommended by President Lyndon Johnson’s Committee on Highway Safety.

  • Establishment: Established in 1970.

  • Purpose: To set uniform certification standards and requirements for EMS training and testing.

  • 2020: Launched the national EMS-ID number system, providing a unique identification number that does not change as an individual progresses through different levels of licensure.

Modern EMS Milestones

  • 1968: The universal 9-1-1 emergency telephone number was implemented.

  • 1969: The first true paramedic program was established by Dr. Eugene Nagel, often referred to as the "father of paramedicine."

  • 1969: Standards for ambulance design and equipment were published, known as the KKK-1822 Standard.

  • 1970: The NREMT was established (reconfirming previous mention).

  • 1971: The first EMT textbook was published by the American Academy of Orthopedic Surgeons.

  • 1973: The EMS Act was signed into public law, detailing 15 required components of an EMS system.

  • 1977: The first National Standard Curriculum for paramedics was developed by the U.S. DOT, primarily based on the work of Dr. Nancy Caroline, and her textbook "Emergency Care in the Streets."

Heading into the 21st Century

  • The number of trained EMS personnel grew significantly, leading to the addition of paramedic engine companies.

  • The National Highway Traffic Safety Administration (NHTSA) developed 10 crucial elements for an effective EMS system.

  • Responsibility for EMS oversight gradually transferred from the federal government to the states.

  • Major legislative initiatives included:

    • The EMS for Children (EMSC) program, fully implemented in 1984.

    • Trauma systems began making significant headway in the 1990s.

Licensure, Certification, and Registration

  • Licensure:

    • Definition: The legal authority granted by a governmental agency to perform medical acts.

    • Requirements: Typically involves education/training, experience, and examination.

    • Note: The term "registration" is often used interchangeably with licensure in some contexts.

    • EMS Licensure Levels (Examples):

      • Emergency Medical Dispatcher

      • Emergency Medical Responder

      • Emergency Medical Technician (EMT)

      • Advanced EMT

      • Paramedic

      • Emergency Communications Registered Nurse (ECRN)

      • Trauma Nurse Specialist (TNS)

      • Pre-hospital Registered Nurse (PHRN)

      • Lead Instructor

  • Certification:

    • Definition: An examination used to ensure that all healthcare providers possess the same basic level of knowledge and skill.

    • Purpose: Verifies that an individual has met predetermined and standardized criteria.

  • Registration:

    • Definition: A recognized board of registration maintains an individual's education records, state/local licensure, and recertification information.

    • Accreditation for Paramedic Programs: Some states mandate that paramedics graduate from an accredited paramedic program.

      • Commission on Accreditation of Allied Health Education Programs (CAAHEP): The sole accrediting agency for paramedic programs.

      • Committee on Accreditation of Educational Programs for the Emergency Medical Services Profession (CoAEMSP): Conducts annual site surveys and provides recommendations to CAAHEP.

        • Mission: To continually enhance the quality of EMS education through comprehensive accreditation and recognition services.

Inter-State Recognition

  • Reciprocity:

    • Definition: The mutual exchange of privileges or the recognition by one institution of the validity of licenses or privileges granted by another.

    • The NREMT facilitates reciprocity in over 40 states.

  • REPLICA (Recognition of EMS Personnel Licensure Interstate CompAct):

    • Distinction: This is not a form of reciprocity, but rather extends the privilege to practice across state lines.

    • Purpose: Facilitates mutual response during events like mutual aid, Mass Casualty Incident Agreements (MABAS), and large-scale emergency events.

Illinois EMS Providers

  • First Responder – AED/EMR:

    • Requires 40+ hours of training.

    • Performs select lifesaving skills.

    • Acts as a pre-ambulance responder.

  • EMT-Basic/EMT:

    • Requires 110+ hours of training.

    • Is a Basic Life Support (BLS) provider.

    • Has limited medication administration/assistance capabilities, including Epi-Pen, Aspirin, Narcan, Albuterol, and AED.

    • Includes specialized designations like EMT-Coal Miner.

  • EMT-Intermediate/Advanced EMT:

    • Requires 350+ hours of training.

    • Performs Intermediate Life Support (ILS).

    • Possesses limited advanced knowledge and skills, often utilized in rural parts of the state.

  • EMT-Paramedic/Paramedic:

    • Requires 950+ hours of training.

    • Is an Advanced Life Support (ALS) provider.

    • Possesses advanced knowledge and skills, including advanced airway management, administration of an array of medications, defibrillation/pacing/cardioversion, and IV/IO access.

  • Pre-Hospital Registered Nurse (PHRN):

    • Must be a Registered Nurse (RN).

    • Requires a 24-hour training course, including extrication, telecommunications, and pre-hospital cardiac and trauma care.

    • Requires a minimum of 10 supervised ALS runs.

    • Operates within the same scope of practice as an EMT-P, but as a nurse.

  • Emergency Communications RN (ECRN):

    • Must be an RN with one year of emergency nursing experience.

    • Requires a 40-hour training course.

    • Involves supervised telemetry calls and ALS observation time.

    • Knowledgeable in Standard Operating Procedures (SOPs), pre-hospital policies/procedures, and communications.

    • Provides online medical control as per SOPs.

    • This role is unique to Illinois.

  • Trauma Nurse Specialist (TNS):

    • Must be an RN.

    • Requires an 80-hour, graduate-level training course.

    • Offers optional clinical observation in various settings such as EMS, Intensive Care Unit (ICU), and Emergency Department (ED).

    • This role is unique to Illinois.

  • EMS Lead Instructor:

    • Requires a 24-hour training course focusing on adult educational concepts.

    • Responsible for coordinating education, continuing education, and training courses.

    • Must be an EMT-B, EMT-I, EMT-P, RN, or physician.

  • Emergency Medical Dispatcher (EMD):

    • Requires a 24-hour training course.

    • Accepts calls from the public for EMS.

    • Dispatches EMS personnel.

    • Gives pre-arrival and post-dispatch instructions to callers.

EMS System Structure: Resource and Associate Hospitals

  • Resource Hospitals:

    • EMS System Medical Director: Bears primary responsibility and authority for the management of the EMS System, providing essential medical authority.

    • EMS System Coordinator: Works collaboratively with the Medical Director to oversee the operations of the EMS System.

    • Support Staff: Includes educators, assistant coordinators, and ECRNs.

  • Associate Hospitals:

    • Assist the Resource Hospital with education and complaint investigations.

    • Accept ambulance traffic and restock ambulance supplies.

    • Assist with notification of infectious disease exposures.

    • Are typically less aware of specific EMS SOPs, policies, and procedures.

    • Do not have ECRNs or independent Medical Control capabilities.

Hospital Specialty Classifications (Illinois Examples)

  • Trauma Center:

    • Designated as Level I or Level II.

    • Can also have Pediatric Level I or Level II designations.

  • Region Hospital Coordinating Centers (RHCC):

    • Centralized coordination centers designed to manage emergency events.

    • Pediatric Designations:

      • Pediatric Critical Care Center (PCCC): Includes an EDAP (Emergency Department Approved for Pediatrics), a district Pediatric Intensive Care Unit (PICU), and a helicopter landing zone.

      • Emergency Department Approved for Pediatrics (EDAP): Provides 24-hour pediatric coverage (excluding fast track and urgent care areas) with physicians, nurses, Nurse Practitioners (NPs), and/or Physician Assistants (PAs) who have specialized pediatric training (e.g., PALS, ACEP-AAP, APLS).

      • Standby Emergency Department Approved for Pediatrics (SEDP): Staffed by physicians with specialized pediatric training (e.g., PALS, ACEP-AAP, APLS).

  • Stroke Center Designations:

    • Comprehensive: Possesses significant resources in infrastructure, staff, and training; includes a dedicated neuro-intensive care unit, advanced imaging capabilities, and coordinated post-hospital care. Collects, analyzes, and utilizes performance measure data.

    • Primary: Features a designated stroke unit and a core stroke team with imaging capabilities.

    • Stroke-Ready: Provides 24/7 access to stroke expertise, has a core stroke team, can administer thrombolytics, and maintains transfer agreements.

  • STEMI Designations (ST-Elevation Myocardial Infarction):

    • EMS must perform a 12-lead electrocardiogram on scene for patients with symptoms consistent with STEMI.

    • Pre-hospital providers are required to complete yearly STEMI continuing education.

    • EMS transport directly to a PCI (Percutaneous Coronary Intervention)-capable hospital for primary PCI is the recommended triage strategy for STEMI patients.

    • Reperfusion therapy should be administered to eligible STEMI patients with symptom onset within the prior 12 hours.

    • If fibrinolytic therapy is indicated or chosen, it should be administered within 30 minutes of hospital arrival.

IDPH Division of EMS & Highway Safety

  • Responsibilities:

    • Approves EMS training programs.

    • Coordinates the state EMT testing program.

    • Inspects and licenses emergency vehicles.

    • Administers specialty programs.

    • Conducts investigations of complaints and violations.

    • Monitors compliance with the EMS Administrative Code and Regulations.

    • Coordinates annual statewide EMS Week and EMSC Day (Emergency Medical Services for Children Day) activities.

  • Data Management:

    • Oversees and maintains statewide data reporting requirements.

    • Manages the Trauma Registry.

    • Manages the Head/Spinal Cord/Violence Injury Registry.

    • Maintains the Pre-hospital Care Run Report database.

  • Fund Administration:

    • Administers AED Grants.

    • Manages the EMS Assistance Fund Grant.

    • Oversees the Trauma Fund.

Illinois EMS Regions (Region VIII Example)

  • Region VIII hospitals include: Loyola University Medical Center, Good Samaritan Hospital, Central DuPage Hospital, Edward Hospital, Gottlieb (primary), Hinsdale, LaGrange (primary), MacNeal, Rush Oak Park, Westlake, West Suburban, Glen Oaks, Elmhurst, Bolingbrook.

  • Region VIII Medical Directors & Coordinators (Examples):

    • Advocate Good Samaritan Hospital: Dr. Valerie Phillips, MD, FACEP (Medical Director); Frank Kolsky, EMT-P (Coordinator). Incoming Medical Director: Dr. Thomas Grudowski, DO.

    • Central DuPage Hospital: Dr. Stephen Graham, MD (Medical Director); Justin Williams, EMT-P (Coordinator).

    • Edward Hospital: Dr. Daryl Wilson, MD, FACEP (Medical Director); Ryan Klovahn, BA, EMT-P (Coordinator).

    • Loyola University Medical Center: Dr. Emily Fleming, MD (Medical Director); Robert Franciere, MSN, RN, CEN, TNS, PHRN (Coordinator).

Our Founding Father: Dr. Joseph R. Hartman

  • Motivation: In 7th grade, Dr. Hartman witnessed his father suffer a fatal cardiac arrest at age 35. The lack of paramedics and advanced pre-hospital care at that time motivated him to commit to training professional paramedics.

  • 1970: As a junior in medical school, Dr. Hartman founded the Loyola Paramedic Program.

  • 1980: He moved to Good Samaritan Hospital and established its EMS System and paramedic training program.

  • Successor: Succeeded by Dr. Valerie J. Phillips in 1994.

Roles of Medical Directors

  • Key Responsibilities:

    • Educate and train EMS personnel.

    • Recommend new personnel and equipment.

    • Develop protocols, guidelines, and quality improvement programs.

    • Provide essential input for patient care decisions.

    • Serve as an interface between EMS and other agencies.

    • Advocate for the EMS profession.

    • Act as the "medical conscience" of the system.

Medical Direction Modalities

  • On-Line Medical Direction:

    • Provides immediate and specific patient care resources (e.g., direct radio/phone contact).

    • Allows for continuous real-time quality improvement.

    • Can offer on-scene assistance when needed.

  • Off-Line Medical Direction:

    • Facilitates the development of:

      • Protocols or guidelines.

      • Standing orders.

      • Procedures.

      • Training programs.

Improving System Quality: Continuous Quality Improvement (CQI)

  • Definition: A systematic tool used to continually evaluate existing care practices.

  • Quality Control: The ongoing process of assessing current practices and identifying opportunities for enhancement.

  • Nature: CQI is a dynamic, iterative process focused on ongoing improvement.

CQI – Eliminating Error

  • Strategies for Error Reduction:

    • Ensure adequate lighting in work environments.

    • Limit interruptions during critical tasks.

    • Store medications properly to prevent errors.

    • Exercise caution during patient handoffs.

    • Adhere strictly to clear protocols.

    • Maintain strong situational awareness.

    • Regularly ask, "Why am I doing this?" to ensure clinical rationale.

    • Utilize "cheat sheets" or quick reference guides.

  • Three Main Sources of Errors:

    • Rules-based failure: Occurs when a rule or protocol is followed incorrectly or a wrong rule is chosen.

    • Knowledge-based failure: Stems from a lack of necessary knowledge or understanding.

    • Skills-based failure: Involves an inability to perform a procedure correctly despite knowing the steps.

EMS Research and Evidence-Based Practice

  • EMS has increasingly adopted evidence-based practice.

  • Protocols: Should be based on sound scientific findings and research.

  • Research Conduct: Typically performed by educated researchers holding PhD or MD degrees.

  • Evidence-based practice principles:

    • Patient care should prioritize procedures that have demonstrable utility in improving patient outcomes.

    • EMS providers must stay updated on the latest healthcare advances.

    • Researchers often rate the quality of a study to ensure the reliability of the evidence.

    • Research is critical for determining the effectiveness of treatments.

    • When implementing findings from new studies, measure the results using your CQI program to assess impact.

Evaluating Research

  • Peer review is essential for ensuring the quality and validity of research.

  • Reputable internet sites can serve as valid tools for obtaining information.

  • Studies must follow a structured, rigorous process.

  • All research will inherently have limitations, which must be considered.

  • Always review research critically and carefully.

The Paramedic Role and Responsibilities (NASEMSO, 2019)

  • Primary Focus:

    • Respond to, assess, and triage emergent, urgent, and non-urgent requests for medical care.

    • Apply basic and advanced knowledge and skills to determine patient physiologic, psychological, and psychosocial needs.

    • Administer medications.

    • Interpret and utilize diagnostic findings to implement treatment.

    • Provide complex patient care.

    • Facilitate referrals and/or access to a higher level of care when patient needs exceed the paramedic's capabilities.

  • Extended Roles:

    • Often serve as a patient care team member in a hospital or other healthcare setting, to the full extent of their education, certification, licensure, and credentialing.

    • May work in community settings, taking on additional responsibilities such as monitoring and evaluating the needs of at-risk patients and intervening to mitigate conditions that could lead to poor outcomes.

    • Help educate patients and the public on the prevention and/or management of medical, health, psychological, and safety issues.

Key Roles and Responsibilities (Operational Aspects)

  • Preparation:

    • Physical, mental, emotional readiness.

    • Possession of necessary knowledge and skill abilities.

    • Ensuring all equipment is appropriate and in working order.

  • Response: Executing timely and safe responses.

  • Scene Management:

    • Prioritizing the safety of yourself, your team, the patient, and bystanders.

    • Thoroughly assessing the situation.

    • Properly utilizing personal protective equipment.

  • Patient Assessment and Care:

    • Conducting an appropriate and organized assessment.

    • Recognizing and prioritizing the patient's immediate needs.

  • Management and Disposition:

    • Following established protocols or consulting with a medical director via radio.

    • Knowing the capabilities of receiving facilities to ensure appropriate transport.

  • Patient Transfer and Report:

    • Delivering a brief, concise handoff report to receiving medical staff.

    • Protecting the patient's privacy (HIPAA).

  • Documentation: Completing a detailed patient care report.

  • Return to Service: Restocking and preparing the unit for the next call.

Your Role Within the EMS System (Six-Step Process)

  1. Early detection of the emergency.

  2. Early reporting of the incident.

  3. Early response by EMS personnel.

  4. On-scene care and stabilization.

  5. Care in transit during transport.

  6. Transfer to definitive care at a medical facility.

  • The Rod of Asclepius is depicted as a symbol of healing throughout this process.

Specific Paramedic Responsibilities

  • Develop a comprehensive care plan for the patient.

  • Decide on the appropriate transport method (e.g., ground ambulance, air).

  • Determine the most appropriate receiving facility based on patient needs and hospital capabilities.

Levels of Education and Regulation in EMS

  • Federal Level:

    • NHTSA created the National EMS Scope of Practice Model, providing a national guideline.

  • State Level:

    • State laws regulate how EMS providers operate (e.g., Illinois Department of Public Health (IDPH) Administrative Code, Section 515, Subparts A - K).

  • Local Level:

    • The local medical director determines the day-to-day limits of EMS practice within their system.

    • This includes aspects like which medications are carried on an ambulance and where patients are transported.

    • These are often outlined in Standard Operating Procedures (SOPs) and System Medical Orders (SMOs).

Initial Paramedic Education

  • Most states base their paramedic education programs on the National EMS Education Standards.

  • As part of the 2009 revisions to the standards, the inclusion of a college-level anatomy and physiology course was recommended as part of the training program.

  • The standards outline the minimum knowledge a paramedic must possess to practice.

  • States require varying hours of education to meet these standards.

Paramedic Continuing Education (CE)

  • Importance: Continuing education is crucial for maintaining currency in skills and knowledge.

  • Acceptability: What types of CE are recognized and accepted?

  • Availability: Where are CE opportunities offered?

  • Responsibility: Who is ultimately responsible for ensuring the completion of CE requirements?

  • Tracking: Who is responsible for tracking CE completion?

  • Required Hours: What are the required CE hours for an EMT-B versus an EMT-P?

  • Quote: "EMS is about lifelong learning. The day you stop learning is the day you should hang up your stethoscope." - Dr. Valerie J. Phillips, Medical Director, Good Samaritan EMS System.

Specialty Care Center Transport

  • EMS systems facilitate transport to specialized facilities, including:

    • Level I Trauma Centers

    • Level II Trauma Centers

    • Burn Units

    • Pediatric Specialty Centers

    • Stroke Centers

    • STEMI Receiving Centers (for heart attacks)

    • Hyperbaric Chambers

EMS Career Opportunities

  • Diverse Pathways:

    • Fire service (commonly integrated)

    • Third-party EMS services (private)

    • Private agencies (e.g., industrial, event medicine)

    • Hospital-based EMS systems

    • Industrial EMS roles

    • Sport medicine EMS roles

Interfacility Transports

  • Involves transferring patients between various healthcare facilities, such as:

    • Hospitals

    • Skilled nursing facilities

    • Board and care homes

    • Patient residences

  • Responsibility: The patient’s health and well-being remain the paramedic's responsibility during ambulance transportation.

  • Team Collaboration: Other healthcare team members may accompany the patient during transport.

Working With Other Professionals

  • Hospital Staff: Familiarization with hospital staff and equipment is vital.

    • The best patient care outcomes are achieved through close rapport and cooperation among all emergency care providers.

  • Public Safety Agencies:

    • Optimal and most efficient patient care results from cooperation between various agencies.

    • This includes close collaboration with law enforcement, utility companies, and emergency management agencies.

Continuity of Care

  • Refers to the sustained quality of patient care over an extended period, through different settings and providers.

Staying Involved in Your Profession: National EMS Organizations

  • Key Organizations:

    • National Highway Traffic Safety Administration (NHTSA)

    • National Association of Emergency Medical Service Physicians (NAEMSP)

    • National Association of State EMS Officials (NASEMSO)

    • National Association of EMS Educators (NAEMSE)

    • National Registry of EMTs (NREMT)

    • National Association of EMTs (NAEMT)

    • Emergency Medical Services for Children (EMSC)

    • American College of Emergency Physicians (ACEP)

    • American Ambulance Association (AAA)

    • Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP)

    • International Association of Flight and Critical Care Paramedics (IAFCCP)

Essential Regulations and Resources (Illinois Specific)

  • 210 ILCS 50/1: The Emergency Medical Services Systems Act (Illinois state law).

  • IDPH Administrative Code:

    • Title 77: PUBLIC HEALTH

    • Chapter I: Department of Public Health

    • Subchapter f: Emergency Services and Highway Safety

    • Part 515 Emergency Medical Services, Trauma Center, Comprehensive Stroke Center, Primary Stroke Center and Acute Stroke Ready Hospital Code

  • KKK-A-1822: Federal Specification for the Star of Life Ambulance (ambulance design standards).

  • Good Samaritan EMS System Policy Manual.

  • Region VIII Procedure Manual.

  • Region VIII Standard Operating Procedures.

Professionalism in EMS

  • Measurement: Paramedics are measured by established standards, competencies, education requirements, performance parameters, and a code of ethics.

  • Visibility: Paramedics hold a highly visible role within their community.

  • Key Qualities: It is crucial to instill confidence, establish and maintain credibility, and consistently show genuine concern for patients.

  • First Impressions: "You Never Get a Second Chance to Make a First Impression." This emphasizes the importance of inspiring confidence and projecting a positive self-image.

Attributes of a Professional Paramedic

  • Integrity: Defined as "what you do when no one is looking."

  • Empathy: The ability to identify with and understand the patient's feelings. (Example: "Just remember, you're not alone. I'm scared to death too.")

  • Self-Motivation: An internal drive for excellence.

  • Confidence: Demonstrating belief in one's skills and abilities.

  • Communication: Effectively expressing and exchanging ideas, thoughts, and findings.

  • Teamwork & Respect: Working collaboratively with others and never undermining the team. (Example: "How can you say we're not behaving like a team? We're all wearing the same color shirts aren't we?")

  • Patient Advocacy: Always acting in the best interest of the patient.

  • Injury Prevention: Diplomatically discussing hazards and encouraging the use of safety equipment. (Example: In relation to a car, "What is it now, Mr. Hypochondriac?" followed by "I think it needs brakes.")

  • Careful Delivery of Service: Delivering the highest-quality patient care and adhering to all policies, protocols, and procedures.

  • Administration: Willingness to take on special projects or duties and play a role in forging partnerships with other public safety resources.

Good Samaritan Paramedic Program Attributes

  • Team Member:

    • Receptive to leadership and direction.

    • Maintains situational awareness.

    • Asks pertinent questions and provides constructive feedback.

    • Avoids freelance activity and remains focused on assigned tasks.

    • Maintains open lines of communication.

    • Performs tasks accurately and efficiently.

    • Displays professionalism at all times.

  • Team Leader:

    • Assesses, creates, coordinates, and revises the action plan for patient care.

    • Communicates accurately and concisely, and listens carefully.

    • Receives, processes, verifies, and prioritizes information.

    • Demonstrates confidence, compassion, maturity, and respect.

    • Accepts accountability while remaining open to suggestions and feedback.

    • Ensures the safety of patients and crew members at all times.

    • Reviews the event with the team for quality improvement purposes.

Sensitivity and Compassion

  • Quote: "How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant of the weak and the strong because someday in your life, you will have been all of these." - George Washington Carver.

Ethical Conduct and Professional Accountability

  • Who you are as a person directly reflects who you are as a professional.

  • Essential Virtues: Be respectful, honest, trustworthy, fair, and responsible.

  • Pre-emptive Question: Before taking any action, ask yourself if it's worth the risk to your character and your profession.

  • Behaviors to Avoid:

    • Inappropriate social media postings.

    • Reckless behavior.

    • Rude behavior.

    • Harassment.

    • Unlawful activity.

Recent Reasons for Loss of License

  • Man dies after refusal obtained; paramedic documented "no patient found."

  • Wallets and credit cards stolen from patients.

  • Failure to recognize esophageal intubation.

  • Taking "Selfies" with dying patients.

  • Performing a procedure outside of scope of practice (e.g., pericardiocentesis).

  • Sexual assault of an obtunded patient.

  • Diversion of narcotics for personal use.

  • Pilfering prescription IV solutions for self-administration.

  • "Flipping" a terminally ill patient from a stretcher to the floor when he refused to move to a hospital bed.