Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Introduction to EMS Systems

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Outline EMS System –Activities –Access –Levels of Providers –In-hospital Care First Responder –Roles –Responsibilities Medical Oversight

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. What is EMS? Emergency Medical Services –Resources in a community established for providing care and assistance in case of life threatening emergency Fire Departments Ambulance Services Police Departments Community Clinics Hospitals

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. 911 Access

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. EMS Access Systems Non-9-1-1: Does not have a universally recognized access number Basic 9-1-1: Has a universally recognized number for all emergencies Enhanced (E9-1-1): Displays information about the caller’s location on the dispatcher’s computer screen

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Components of an EMS System

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Who are First Responders? Provide very basic medical care on the scene –Fire/Rescue personnel (paid or volunteer) –Law enforcement personnel –Industrial response teams

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Roles of the First Responder Safety on scene Gaining access Patient assessment Initial care Transfer of patient Assisting EMS with ongoing care Record keeping Cooperation with other public safety agencies

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Responsibilities of the First Responder Caring, non- judgmental attitude Composure in stressful situations Professional appearance Up-to-date knowledge and skills Knowledge of local, state and national issues and trends in EMS

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Part of a Larger EMS Team Additional EMS resources may include: –EMT-Basics –EMT-Intermediates –Paramedics

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. EMT-Basic Performs basic life-support measures at the scene and during transport

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. EMT-Intermediate and Paramedic EMT-Intermediate –Performs advanced life-support measures EMT-Paramedic –The most highly trained provider –Has a wider understanding of disease processes

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Providing Emergency Care Emergency care at the scene Transportation to the hospital Care of the patient in the hospital

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Emergency Departments Emergency Departments (EDs) have varying levels of service available, depending on resources and staffing levels

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Hospital Personnel Physicians –Varying types of specialists Nurses –Many are certified in specialty areas Other Allied Health Professionals

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Specialty Services Trauma Centers Burn Centers Pediatric Hospitals Perinatal Centers Poison Control Centers

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Local EMS Capabilities Access and dispatching system Agencies providing EMS response and the level of care provided Area emergency departments and their capabilities Local or regional specialty facilities

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Oversight Also called medical control Provided in 2 ways –Indirect –Direct

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Medical Control Responsibilities System design Protocol development Education Quality management

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Indirect Medical Control Does not involve direct communication between the physician and the care provider during patient care Also called: –Offline –Retrospective –Prospective

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Direct Medical Control Communication between a physician and care provider during patient care Also called: –Online –Immediate

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Radio Communication Concise Accurate Organized Pertinent

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. New Mexico EMS

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Important Organizations EMS Academy (Division of UNM School of Medicine) –Curriculum Development –Instructor Development –Certification Injury Prevention & EMS Bureau –Licensing and Testing –Regulations (Scope of Practice) Regional offices –Help with CE’s and special skills

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. EMS Regional Offices EMS Region I Santa Fe EMS Region II Las Cruces EMS Region III Clovis

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. First Responder Licensure Registration for Training and/or Certification/Licensure application Copy of First Responder course completion certificate Copy of CPR card (front and back) Licensure fee

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. First Responder License Renewal Current Professional BLS Provider CPR Card 16 First Responder refresher or CE blueprint Eight (8) contact hours of additional Bureau approved continuing education activity –(2) contact hours must be of pediatric content. Completed renewal application and fee(s) Statement of verification, signed by the service medical director, that the applicant is competent in all EMT-B skills that require medical direction

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. License Renewal Period Good for 27 months but requirements MUST be met in 24 months Year 1Year 23 months All requirements done in this time

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. What’s the Difference between a Certificate and License ? Certificate –Notice of class completion –Looks cool but otherwise useless License –This allows you to practice medicine in the state on New Mexico as a First Responder

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Summary An EMS system is a network of resources to provide emergency medical care and transportation A variety of events take place in an EMS system, from injury prevention to EMS response to in-hospital care.

Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Questions?