Introduction to EMS Systems Chapter 1

Components of Emergency Medical Services (EMS) System  Care begins at the emergency scene  Formal transfer of care takes place at the hospital (in the ER or ED)  Medical facility ensures smooth transition and continuation of care

Resources in EMS System  Ambulances  Law enforcement  Fire department  Hospitals  Communication centers  Air medical transport  Rescue squads  Specially trained personnel

Chain of Events in EMS System  Call for EMS – usually a bystander makes call to 911  Public safety answering point- location where emergency calls are answered  Emergency medical dispatcher- person trained to answer and prioritize calls  Enhanced 911- communication center automatically receives caller information (phone #, address)  Personnel and other resources dispatched to the scene (Most emergency calls end up in ER, but not all)

Medical Oversight  Medical director- physician who assumes responsibility for direction of all patient care of EMS system  Protocols- written guidelines that direct care that EMS personnel provide to patients. Ex: protocols for chest pain, difficulty breathing, cardiac arrest, etc. Also referred to as standing orders (off-line or indirect medical direction)  Procedures not covered under standing orders require medical direction by phone, which is on-line or direct medical direction

 EMS personnel must provide care that is within their scope of practice (protocols and guidelines set by local, state, or regional regulations  Department of Transportation set national standard curriculum for EMS responders

Types of EMS Responders Paramedic Advanced Emergency Medical Technician Emergency Medical Technician Emergency Medical Responders

Emergency Medical Responder (EMR)  Previously referred to as First Responder  Training emphasizes scene safety, and how to provide immediate care for life- threatening injuries/illnesses  Assist ambulance personnel whey arrive  Police officers, firefighters

Emergency Medical Technician (EMT)  Minimum level of certification for ambulance personnel  Training emphasizes assessment, care, and transportation of ill or injured patients.  Assists with administrations of common medications.  Formerly called EMT-Basic

Advance Emergency Medical Technician (AEMT)  Basic-level EMT with additional training in certain skills, such as starting IV, inserting advanced airways, medication administration  Formerly EMT-Intermediate

Paramedic  Highest level of training for ambulance personnel  Trained to insert endotracheal tubes, start IVs, interpret EKGs, monitor cardiac rhythms, cardiac defibrillation  Formerly EMT-Paramedic

Roles and Responsibilities of EMR  Personal safety- #1 priority  Is the scene safe? Do not approach victim if area is not safe. Ex: violence, burning building  Avoid contact with infectious material by using personal protective equipment (PPE)  Disposable gloves  Barrier devices (face masks)  Protective eye wear (goggles, face shields)  Gowns or aprons

 Patient-related duties  Size up scene  Determine patient’s chief complaint or injury  Lift, move, reposition patient ONLY if necessary  Transfer patient and patient information  Protect patient’s privacy and maintain confidentiality  Be patient’s advocate

Traits of an EMR  Willingness to take on certain duties/responsibilities  Study to be up to date on licensure  Respectful of others  Ability to overlook rude behavior  Ability to respect others’ cultures, beliefs, socioeconomic background, age, gender, etc.