23 Fire and Emergency Medical Care

2 Objectives (1 of 3) Describe how the delivery of Emergency Medical Services (EMS) fits into the mission of the fire department. Describe how EMS delivery can be a customer service issue. Distinguish between basic life support and advanced life support. 23

3 Objectives (2 of 3) Identify the skills performed by advanced life support EMS that are not performed by basic life support EMS. Define the two levels of EMS training within basic life support. Define the two levels of EMS training within advanced life support. 23

4 Objectives (3 of 3) Explain why EMS can work well within a fire department. Differentiate a combination EMS system from a fire department EMS system. List three groups that interact with an EMS provider. 23

5 Introduction Role of the fire department in providing EMS varies. To become an EMS provider, you must take an approved course. –This chapter will introduce you to the EMS system and help you understand the fire department’s role. 23

6 Importance of EMS to the Fire Service and Community (1 of 3) Fire department’s mission is to save lives and property. High percentage of emergency calls are EMS-related. Most fire departments provide some level of EMS. Fire department involvement in EMS varies. 23

7 Importance of EMS to the Fire Service and Community (2 of 3) Same fire stations, emergency vehicles, and fire fighters that can respond to fires can also be used to deliver EMS. The citizens of the community are your customers. –Their support is vital to fire suppression and EMS activities. 23

8 Importance of EMS to the Fire Service and Community (3 of 3) From the caller’s perspective, this is an emergency. EMS providers must be supportive of the patient in all types of EMS calls. 23

9 Two Major Levels of Service Basic Life Support –Initial assessment –Non-invasive treatment –Intervention support Advanced Life Support –Initial assessment –Medications –Intravenous fluids 23

10 Basic Life Support: Limited Emergency Skills (1 of 2) Skills include: –Scene control –Scene safety surveillance –Patient assessment –Basic airway management –CPR –Oxygen administration –Splinting 23

11 Basic Life Support: Limited Emergency Skills (2 of 2) Skills (continued): –Bleeding control –Bandaging –Treating for shock –Lifting/moving patients –Transport to hospital –AED –Selected approved interventions 23

12 Advanced Life Support: More Complex Skills (1 of 2) Skills include: –Advanced airway management –Endotracheal intubation –Intravenous fluids –Medication administration 23

13 Advanced Life Support: More Complex Skills (2 of 2) Skills (continued): –Cardiac rhythm monitoring and interpretation –Cardiac pacing –Defibrillation –Thoracic decompression 23

14 Training Most fire fighters need some EMS training. Many FD’s require all personnel to be trained. Level of training depends on the system. Based on DOT National Standard Curriculum 23

15 EMS Training: Levels Basic Life Support –First responder –EMT-Basic Advanced Life Support –EMT-Intermediate –EMT-Paramedic Continuing Education 23

16 Training: First Responder (1 of 2) Provides assessment and provides basic care Typically requires more than 40 hours lecture, skills practice Includes airway management, CPR/AED, bleeding control 23

17 Training: First Responder (2 of 2) Covers same topics as EMT but in less detail Does not prepare for working on an ambulance Designed for those under the direction of an EMT Can be certified in some states and/or nationally registered 23

18 Training: Emergency Medical Technician-Basic Involves more than 110 hours of lecture, skills practice, and clinical observation Basic patient assessment, treatment, and transport skills Minimum level required for ambulance duty After training, student can be state or nationally certified. 23

19 Training: Emergency Medical Technician-Paramedic (1 of 2) Teaches advanced life support skills and techniques Most require at least one year to complete and build on the EMT- Basic course Covers causes and treatments of diseases 23

20 Training: Emergency Medical Technician-Paramedic (2 of 2) Includes clinical time in the hospital and working on an advanced life support unit Can be state-certified or nationally registered Work under direction of physician medical directors 23

21 Training: Emergency Medical Technician-Intermediate Limited advanced life support skills training Skills vary by state. Can be state-certified or nationally registered Work under direction of physician medical directors 23

22 EMS Training Agencies Training may be offered through: –Community colleges –Vocational training centers –Hospitals –Fire departments 23

Continuing Medical Education (CME) Also known as CEU’s Ensures proficiency levels and awareness of changes in protocols Allows for discussion of previous calls May count toward recertification 23

24 EMS Delivery Systems May be provided by various agencies –Law enforcement agencies –Volunteer ambulance services –Commercial ambulance services –Hospitals –Fire departments May have a cooperative system Determined by local and state officials 23

25 Advantages of a Fire Department Delivery System Entry requirements assure quality personnel. Already has health and fitness mechanisms Already has base infrastructure in place Already familiar with the community 23

26 Combination System Fire department provides medical first response only. Separate agency provides transport. May be offered at the basic or advanced life support levels First response by engines, trucks, or specialized units Requires good relationship between fire department and transport agency 23

27 Fire Department EMS System Provides on-scene care and patient transport May provide basic or advanced life support First response by engines, trucks, or specialized units Easier coordination of personnel Some use cross-trained personnel 23

28 Interaction with the Community You must strive to provide equal service. You must provide prompt, efficient, competent care. Your attitude will affect the patients. 23

29 Medical Director (1 of 2) Authorizes providers to deliver medical care Determines appropriate care procedures 23

30 Medical Director (2 of 2) May be online (direct communication with physician) May be offline (through protocols and standing orders) Determines appropriate training requirements 23

31 Interaction with Hospital Personnel Patient information must be transferred to the hospital staff. Good working relationship improves patient care. Understanding the hospital’s policies is important. 23

32 Summary Fire fighters have an important role in EMS. EMS may involve basic or advanced life support. Most fire fighters need some medical training. There are many methods of delivering EMS. It is important to provide prompt, efficient, and competent care without bias. 23