2Positive Learning Environment A safe or positive learning environment is one in which students and faculty are free from harm, discrimination and teasing; where tolerance and acceptance are present; where new ideas and creative problem solving are encouraged; and where students can ask questions and learn without fear of mental or physical discomfort.
3Emergency Medical Response “The purpose of this course is to train emergency medical responders, people like you, who will often be the first trained individuals with/without a duty to provide care at the scene of an emergency. The course content and activities will prepare you to better recognize emergencies, make decisions, and provide care. This course teaches the skills you will need to manage emergency situations until more advanced medical personnel, such as EMTs and Paramedics arrive.”
4You Are the Emergency Medical Responder A terrified mother pulls her child from the bottom of a pool while a neighbor calls for help. You are the first to arrive at the scene and see the neighbor trying to breathe air into the boy’s limp body. The mother looks to you helplessly.
5Types of EMS Systems Fire-based services Third-party services Firefighters first EMRs trained in CPR and first aidThird-party servicesPrivate companiesHospital-based servicesLocal hospitalsOther systems, such as police and private systems
6Evolution of the EMS System 1966 white paper: Accidental Death and Disability: The Neglected Disease of Modern Society
7The EMS White Paper stated: in 1965 there were 52,000,000 accidental injuriesof these accidental injuries there were 107,000 killed, 10,000,000+ disabled and 400,000 permanently impairedthe estimated costs were $18 billion (this is $117 billion in 2008 dollars)
8The EMS White Paper identified that in 1965 there was a need to inform the public of these statistics. The Paper also identified that most people did not have basic first aid training.There were 49,000 motor vehicle crashes resulting in death or about 24.9 per 100,000 people in 1965.Those who do have some basic training had little to no training for cardio pulmonary resuscitation, childbirth and other life saving techniques. This included police departments, fire departments and many ambulance services.
9EMS System NHTSA Technical Assistance Program Assessment Standards First developed in 1973National Highway Traffic Safety Administration (NHTSA) oversees the national EMS systemCommunicationsPublic information and educationMedical directionTrauma systemsEvaluationRegulation and policyResource managementHuman resources and trainingTransportationFacilities
10Professional Levels of EMS Certification or Licensure Emergency Medical Responder (EMR)Basic knowledge and skills – 60 hoursEmergency Medical Technician (EMT)Assume care from EMR and stabilize/transport – 170 hoursAdvanced Emergency Medical Technician (AEMT)IV’s, drugs, advanced airways – 225 hoursParamedicMore invasive procedures – 1350 hours
11Emergency Medical Responders FirefightersLaw enforcement personnelAthletic trainersEmergency management personnelIndustrial response teamsLifeguardsSki patrol members
12An EMR’s Major Responsibilities Ensuring safety of self (first!) then bystandersGaining access to the patientElectrical, chemical, structuresDetermining any threats to the patient’s lifeLife-threatening conditionsSummoning more advanced medical personnel as neededProviding needed care for the patientAssisting more advanced medical personnel
13Secondary Responsibilities Summon additional helpControlling or directing bystanders or asking them for helpTaking additional steps, if necessary, to protect bystanders from dangersRecording what you saw, heard and did at the sceneReassuring the patient’s family or friends
14Personal Characteristics of an EMR Maintains a caring and professional attitudeControls his or her fearsPresents a professional appearanceKeeps his or her knowledge and skills up to dateMaintains a safe and healthy lifestyleRecognizes and keeps patient’s needs as priority
15Medical Direction Medical Director – physician Assumes responsibility for care providedIndirect medical directionOfflineDone through standing orders/protocolsDirect medical directionOnline - done by speaking with a physician or nurse practitioner via a mobile phone, radio or telephone about procedures not covered by standing orders
16Right to Practice Legislation and Scope of Practice EMRs must follow state regulationsCredentialing – three aspectsCertificationNational EMS certificationLicensureState of UtahLocal credentialingRed Cross
17ActivityYou approach a scene of a traffic collision in which a vehicle struck an older woman crossing the street. The driver of the vehicle is sitting on the sidewalk. The older woman is sitting in the middle of the road, crying and trembling. Her leg is bleeding and a section of bone can be seen protruding out of the skin. She has multiple bleeding wounds on the other leg and upper arms. Several lay bystanders have been providing care to the woman. One of the bystanders begins to scream at the driver about driving too fast and not paying attention.