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Chapter 13 Emergency Medical Services Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

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Presentation on theme: "Chapter 13 Emergency Medical Services Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc."— Presentation transcript:

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2 Chapter 13 Emergency Medical Services Health Care Science Technology Copyright © The McGraw-Hill Companies, Inc.

3 Chapter 13 2 Objectives Compare the roles and responsibilities of the First Responder, Emergency Medical Technician-Basic, Intermediate, and Paramedic. Identify safety rules when using oxygen for therapy. Identify the use and flow requirement of a nasal cannula and nonrebreather mask.

4 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 3 Objectives (cont.) Define the role of the Automated External Defibrillator in cardiac arrest and identify the safety requirements for operating it. Identify situations requiring the use of the Automated External Defibrillator. Successfully complete 3 EMS procedures.

5 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 4 Careers in Emergency Medical Services (EMS) First Responder Emergency Medical Technicians

6 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 5 First Responder Arrives first at the scene of an accident or incident. – Usually, firefighters, law enforcement officers, industry workers, private citizens, or neighbors. – Individuals have taken an approved First Responder Program.

7 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 6 First Responder (cont.) First Responder Responsibilities – Take appropriate body substance isolation precautions. – Identify the cause of the injury or the nature of the illness. – Determine the total number of clients. – Request additional help, if necessary.

8 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 7 First Responder (cont.) First Responder Responsibilities (cont.) – Safely gain access to the client. – Determine what is wrong with the client and provide emergency medical care. – Lift or remove a client only when required. – Transfer the client and information to trained personnel.

9 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 8 Emergency Medical Technicians Work all hours in all weather at the scene of an accident.

10 Copyright © The McGraw-Hill Companies, Inc. Chapter 13 9 Emergency Medical Technicians (cont.) Responsibilities – Assess the situation to determine if its safe. – Take appropriate precautions. – Interview and examine the client. – Provide appropriate out-of-hospital care according to established local procedures and guidelines. – Transport the client to a medical facility.

11 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) EMT Equipment – Cervical collars – immobilize neck, back, and spinal injuries. – Automatic external defibrillator (AED) – device used to restore the normal heart rhythm of a cardiac arrest victim.

12 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) Responsibilities of the EMT–Basic – Ensure personal safety and safety of the crew, client, and bystanders. – Examine and interview the client to determine appropriate emergency care. – Provide client care based upon exam and interview.

13 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) Responsibilities of the EMT–Basic (cont.) – Lift, move, and transport the client to a medical facility. – Transfer care of the client to the medical staff at the receiving medical facility. – Speak on behalf of the client by reporting concerns and findings to the medical staff.

14 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) Responsibilities of EMT–Intermediate – Initiate intravenous (IV) lines. – Perform advanced airway techniques. – Interpret electrocardiogram (ECG). – Use manual defibrillators. – Administer certain medications beyond those permitted at the EMT – B level.

15 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) Responsibilities of EMT – Paramedic – Effectively understand the local EMS systems policies and procedures. – Utilize local communication systems. – Possess strong leadership skills, including self- confidence, inner strength, decision-making skills, and willingness to accept responsibility.

16 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Technicians (cont.) Responsibilities of EMT – Paramedic – Be able to size up the scene. – Examine and interview the client. – Assign of priorities of care, develop an action plan, and perform emergency care.

17 Copyright © The McGraw-Hill Companies, Inc. Chapter Section 13-1 Apply Your Knowledge #1 Which two levels of EMTs are allowed to defibrillate the client? Answer: 1.EMT – intermediate. 2.EMT – paramedic.

18 Copyright © The McGraw-Hill Companies, Inc. Chapter Section 13-1 Apply Your Knowledge #2 Why do you think all EMT personnel must use body substance isolation precautions at all times? Answer: To protect themselves and the client from transfer of infection.

19 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Medical Services Procedures Client Assessment Process Airway Management Additional Career Skills Emergency Childbirth

20 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process The client assessment process consists of the following: – Scene size-up. – Initial assessment. – Focused history and physical exam. – Detailed physical exam. – Ongoing assessment. – Communication. – Documentation.

21 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Evaluation includes evaluating: – Safety of the scene for the provider, other responders, the client, and bystanders. – Body substance isolation (BSI) precautions. – Mechanism of injury or nature of illness. – Number of clients. – Need for additional resources or assistance.

22 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Initial assessment includes 6 assessments: – Form a general impression. – Determine level of responsiveness. – Assess the airway. – Assess breathing. – Assess circulation, including presence of pulse and bleeding. – Make a decision regarding the priority or urgency of the client.

23 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Focused history and physical exam include the following: – In 90 seconds check head, eyes, neck, chest, abdomen, pelvis, arms, legs and back according to standard procedures. – Take complete set of vital signs. – Take SAMPLE history, if time permits.

24 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Detailed assessment requires: – A more detailed exam en route to the medical facility.

25 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Ongoing assessment requires: – Continuous reevaluation of initial assessments.

26 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Communication – Converse with client and family. – Communicate with dispatcher and medical facility. – Hand-off report at medical facility.

27 Copyright © The McGraw-Hill Companies, Inc. Chapter Client Assessment Process (cont.) Documentation – Written reports of pertinent information.

28 Copyright © The McGraw-Hill Companies, Inc. Chapter Airway Management First Responders and EMTs manage life- threatening problems of airway, breathing, and circulation. One of the greatest threats to the airway is the tongue. Use head tilt-chin lift to open the airway. Use jaw-thrust if neck or back injury is suspected.

29 Copyright © The McGraw-Hill Companies, Inc. Chapter Airway Management (cont.) Airway Adjuncts: – Maintain an open airway. – Two types: Oropharyngeal airway (OPA) – used in mouth and throat. Nasopharyngeal airway (NPA) – used in nasal passage.

30 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills Oxygen therapy is used at the scene for illnesses that create tremendous stress on the body such as: – Respiratory or cardiac arrest. – Heart attack. – Shock. – Severe blood loss. – Lung disease or disorders. – Stroke. – Drug overdose. – Severe bone injuries.

31 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Oxygen Therapy Equipment – Oxygen cylinders. – Oxygen regulator. – Oxygen flow meter. – Oxygen delivery devices. Nasal cannula Nonrebreather mask

32 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Automated External Defibrillator (AED) – Used to treat ventricular fibrillation, a chaotic heart rhythm (the most common cause of cardiac arrest). – American Heart Association recommends using in the first 5 minutes to improve chance of survival.

33 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Automated External Defibrillator (AED) (cont.) – Attaches to chest. – Analyzes the rhythm. – Determines the need for a shock. – Can deliver shock manually or automatically. – Use only when no response, breathing, or circulation.

34 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Automated External Defibrillator (AED) (cont.) – Modify procedures if: Client is wet or on a wet surface. Client is less than 8 years old or weighs 55 to 65 pounds. Client has pacemaker or internal defibrillator. Client is lying on a metal surface. Client has medication patches.

35 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) How to Attach the AED – Bare and dry the chest. – Position first pad over collarbone and not on the breast bone. – Position second pad below and to the left of the left nipple. – Connect the lead cables.

36 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Principles and Operation of the AED – Do not delay. – Turn on machine and attach pads. – Check machine for picture of the placement of pads. – Do not touch client during analysis or shock. – Say Clear before applying a shock. – Check machines battery periodically.

37 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Spinal Immobilization Skills – Spinal cord injuries occur from: Automobile collisions. Diving accidents. Motorcycle collisions. Falls. In the case of children: falls or being struck by a motor vehicle.

38 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Career Skills (cont.) Signs of Spinal Injury: – Paralysis to arms and/or legs. – Loss of feeling in arms or legs. – Pain or tenderness at back of neck or spine. – Pain with or without movement. – Loss of bowel or bladder control. – Labored breathing with little chest movement.

39 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth The mother should be taken to the hospital if possible. Know date when the baby is due. – Gestation is approximately 9 months. – Gestation is divided into three 3-month periods, or trimesters.

40 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth (cont.) Anatomy and Physiology – Placenta – allows oxygen and nutrients to go to fetus while carbon dioxide and wastes are eliminated by the mother. – Umbilical cord – cordlike structure attached between fetus and placenta. – Amniotic sac – thin, membranous sac. Allows fetus to float freely, cushioning it from shock. Contains from 1 to 2 liters of fluid.

41 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth (cont.) Labor – Uterus contractions in the ninth month signaling childbirth. – Has 3 stages.

42 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth (cont.) Labor – First Stage – Regular contractions of uterus and gradual dilation of cervix become shorter as delivery is imminent. – Could last from 4 hours to more than 24 hours. – Typically longer for first-time mothers. – Probable watery or bloody discharge and rupture of amniotic sac. – Ends with full dilation of cervix.

43 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth (cont.) Labor – Second Stage – Baby enters birth canal until born. – Contractions become intense and frequent. – Crowning occurs as babys head bulges from vaginal opening. – Ends when baby is born.

44 Copyright © The McGraw-Hill Companies, Inc. Chapter Emergency Childbirth (cont.) Labor – Third Stage – Starts after baby is born and lasts until delivery of placenta and umbilical cord is complete. – Contractions continue a little longer as uterus prepares to deliver the placenta. – Typically lasts from 10 to 20 minutes. – Ends with delivery of placenta.

45 Copyright © The McGraw-Hill Companies, Inc. Chapter Section 13-2 Apply Your Knowledge #1 Why is it essential to perform a thorough client assessment? Answer: The information obtained during the assessment provides the basis for the treatment given. It must be accurate to ensure proper treatment and survival. This information is also provided to the medical facility.

46 Copyright © The McGraw-Hill Companies, Inc. Chapter Section 13-2 Apply Your Knowledge #2 Why are a clear airway and breathing always given the top priority when providing care for your clients? Answer: The airway must be clear and breathing must be present to ensure the client survives the accident or injury. It is the most life- threatening concern.

47 Copyright © The McGraw-Hill Companies, Inc. Chapter Procedures in Student Text 13A1Inserting an Oropharyngeal Airway Adjunct 13A2Inserting a Nasopharyngeal Airway Adjunct 13BOperating of the Semiautomatic Defibrillator

48 Copyright © The McGraw-Hill Companies, Inc. Chapter Additional Procedures in Lab Activity Manual LM13-1APreparing an Oxygen Cylinder LM13-1BProviding Oxygen LM13-2AManual Stabilization of the Head and Neck LM13-2BApplying Cervical Collars LM13-3Emergency Childbirth During a Normal Delivery

49 Copyright © The McGraw-Hill Companies, Inc. Chapter Chapter 13 Credits Slide 5Kenneth Murry/Photo Researchers Slide 10 J.S. Reid/Custom Medical Stock Photo Slide 14Tim Courlas Slide 21Aaron Haupt Slide 28 Spencer Grant/PhotoEdit Slide 32 Wolfgang Spunbarg/PhotoEdit


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