Chapter 1 Introduction to Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 2 Overview  The History of Emergency Medical Services  Components of an EMS System  Voices for EMS Providers  Modern EMS  Acute Medical Care  The Future of EMS

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 3 The History of Emergency Medical Services  The military truly gave emergency medical services the field to be tested.

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 4 The History of Emergency Medical Services  The Napoleonic Wars –Brought about the first use of ambulances –Use of ambulances could greatly reduce casualty rates by allowing one to get to the patient and treat en route

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 5  The Civil War –Makeshift field hospitals were effective in the treatment of the wounded –Covered wagon ambulances still in use –“Treat them where they lie” The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 6  The World Wars –Soldiers trained in front line medical care –The first field medics to arrive in specialized ambulance designated with the red cross The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 7  The Korean War –Ambulances took to the air –Specialized helicopters took patients to M.A.S.H. units in the field. Courtesy of Bell Helicopter Textron Inc., Fort Worth, TX. The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 8  The Vietnam War –The helicopter changed into a mobile treatment center –Care was rendered en route by medics –Lowest en route casualty rate in a war The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 9  The Civilian World –It was quickly realized that an EMS system needed to be in place The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 10  The American Red Cross –The first agency to take aid to the public –Taught CPR and first aid to lay persons in the late 1950s and 60s The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 11  The Father of EMS –Dr. Joseph D. (“Deke”) Farrington –Realized training was needed in the streets –Began training the Chicago Fire Department in street medicine The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 12  The White Paper –An article written by experts for President Kennedy –Laid groundwork for inclusion of EMS legislation The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 13  National Highway Safety Act (1966) –Encouraged states to begin organized EMS programs –Organization of the National Highway Safety Administration The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 14  Emergency Medical Services Act (1973) –Identified the components of an EMS system The History of Emergency Medical Services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 15 Components of an EMS System  Personnel  Training  Communications  Transportation  Emergency facilities  Critical care units  Public safety agencies  Consumer participation  Access to care  Patient transfer  Standardization of record keeping  Public information and education  System review and evaluation  Disaster management  Mutual aid agreements

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 16 Voices for EMS Providers  National Association of Emergency Medical Technicians (NAEMT) –Supports EMS activities in both the private and public sectors

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 17 Voices for EMS Providers  American Ambulance Association (AAA) –Represents ambulance services in the EMS industry

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 18 Voices for EMS Providers  The International Association of Fire Fighters (IAFF) –80% of EMS is provided in the fire service

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 19 Voices for EMS Providers  The National Registry of EMTs –An advocate for standardization in EMS education

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 20 Stop and Review  Name historical events that shaped the field of EMS.  Name a key position paper and its impact on the field of EMS.  Name the professional groups that represent the interests of EMS.

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 21 Modern EMS  Universal Access  Integrated 911

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 22 Modern EMS  Emergency Medical Dispatch –EMD course –Provide instruction on care until EMS arrives

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 23 Modern EMS  First Responders –Basic assessment –Simple airway management –Oxygen administration –Bleeding control –Rescuer CPR –Defibrillation

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 24 Modern EMS  Emergency Medical Technician–Basic –Airway maintenance –Oxygen administration –Bleeding control –CPR –Defibrillation –Patient assessment –Limited medication administration

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 25 Modern EMS  Emergency Medical Technician–Intermediate –Advanced airway management, intubation –Cardiac arrest management, ECG interpretation –Intravenous therapy –Higher level patient assessment –Drug administration –Advanced trauma care

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 26 Modern EMS  Emergency Medical Technician–Paramedic –Comprehensive patient assessment –Advanced airway management –Intravenous access –Expanded medication administration –Cardiac arrest management

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 27 Acute Medical Care  Emergency Medicine –American College of Emergency Physicians organized in 1968

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 28 Acute Medical Care  Trauma Centers –Specialized care with the Golden Hour of EMS response

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 29 Acute Medical Care  Aeromedical Transport –Rapid transportation to hospitals with specialized services

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 30 Stop and Review  What is the relationship of EMS to the modern health care system?  How is the EMT of today different from the EMT of the 1960s? How are they the same?  What are the EMT’s role and responsibilities within the health care system?

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 31 The Future of EMS Where do we go from here? You can make the difference!

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 32 Future of EMS  Aging Americans –Increasing health problems –Increasing use of EMS

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 33 Future of EMS  Homelessness –Deinstitutionalization –Poor economic means

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 34 Future of EMS  Human Resources –Declining volunteers –Financial restrictions

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 35 Future of EMS  Accountability –Continuous quality improvement

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 36 Future of EMS  EMS Research –Proof that something works scientifically to gain validity

© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved 37 Stop and Review  What are the challenges that EMTs will face in the future?  How do changes in emergency health care affect the field of EMS?