1. Introduction to Emergency Medical Services
Unit 1
Introduction to Emergency Medical Services

2. Overview Introduction and mission of EMS History and evolution of EMS
Network of EMS professionals
Components of EMS system
Future challenges

3. Introduction Emergency Medical Services (EMS) Mission of EMS
A coordinated network of professionals
Provides a variety of emergency medical care services
Mission of EMS
Provide patient care prior to hospitalization
Involvement in public health
Identify and resolve public health concerns

4. History of Medical Services
Military contribution to EMS
Roman Wars (1500 B.C.)
Chariots used to transport wounded
Napoleonic Wars (1797)
Horse-drawn ambulance volante is constructed
U.S. Civil War (1860s)
The First Ambulance Service and American Red Cross are created

5. History of Medical Services (cont’d.)
A horse-drawn carriage called the ambulance volante in Napolean’s time.
The First Ambulance Service in the United States is developed by U.S. Army Surgeon Jonathan Letterman.

6. History of Medical Services (cont’d.)
Military contribution to EMS (cont’d.)
The World Wars ( )
Air medic transport, combat medic, field hospitals, first aid stations, and mechanized ambulances arrive
Korean and Vietnam Wars ( )
Mobile Army Surgical Hospitals (MASH) are developed

7. History of Medical Services (cont’d.)
Military contribution to EMS (cont’d.)
Iraq War (1970s–Present)
68W health care specialist (Army medic) introduced
Development of specialized medical techniques to treat combat-specific injuries: special blood-stopping dressings, one-handed tourniquets, surgical procedures for extremity injuries and burns

8. History of Medical Services (cont’d.)
Civilian contribution to EMS
U.S. ambulances ( )
First civilian ambulance service in Cincinnati
Horse-drawn carriage ambulance with interns in New York City
Hospital staff accompany the “Invalid’s Car” in Des Moines
First volunteer rescue squad formed in Roanoke
Figure 1.2 Modern civilian EMS

9. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
Out-of-hospital medical advances (1950s)
American Red Cross provides basic medical training to rescue squad members
Mouth-to-mouth ventilation
Civilian cardiopulmonary resuscitation (CPR) course
Prototypical EMT-Ambulance course

10. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
Development of an EMS system (1960s)
In 1966 a white paper was produced on “Accidental Death and Disability: The Neglected Disease of Modern Society
The National Highway Safety Act
First coronary care units
First paramedic telemetry units
Medic One paramedic program

11. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
The Star of Life & Voices of EMS (1970s)
National Registry of EMTs (NREMT)
“Emergency!” debuts on television
Emergency Medical Services System Act
National Association of EMTs (NAEMT) American Ambulance Association (AAA)

12. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
Star of Life adopted as national EMS symbol (1973)
Six points: integrated components of EMS
Central staff symbolic of medicine and healing
Star of Life, the national EMS symbol

13. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
Agenda for the future – funding (1980 – 2006)
Omnibus Budget Reconciliation Act
EMS for Children (EMS-C) program
The Trauma Care Systems and Development Act

14. History of Medical Services (cont’d.)
Civilian contribution to EMS (cont’d.)
Agenda for the future – education (1980 – 2006)
National Research Council
National Highway Traffic Safety Administration
Institute of Medicine
“The EMS Agenda for the Future”

15. Modern EMS Universal access
9-1-1 allows universal access to emergency services
Computer-aided dispatch (CAD) system
PASP (Public Safety Access Point)
Medical Priority Dispatching

16. Modern EMS (cont’d.) Universal access (cont’d.)
Emergency Medical Dispatch
Emergency dispatcher takes caller info, alerts emergency services and prioritizes calls
Provides medical care instructions
Figure 1.4 Emergency Medical
Dispatcher

17. Modern EMS (cont’d.) Universal access (cont’d.)
Emergency Medical Responders
First responder (FR)
Emergency Medical Responder (EMR)
Figure 1.5 Emergency Medical
Responder

18. Modern EMS (cont’d.) Universal access (cont’d.)
Emergency Medical Technician (EMT)
Basic entry level training
Found aboard ambulance or field
Knowledge covers basics of many illnesses and management of a patient during transport to hospital

19. Modern EMS (cont’d.) Universal access (cont’d.)
Advanced Emergency Medical Technician (AEMT)
Intermediate level EMS provider
Skills of an AEMT are of high benefit and low risk to the patient
Trained in specialized or advanced techniques

20. Modern EMS (cont’d.) Universal access (cont’d.) Paramedic
Highest level of EMS pre-hospitalization education
1,000 to 1,500 hours of training
Expanded training and education in the management of the ill or injured patient
Advanced skill set

21. Modern EMS (cont’d.) Origins and practice of emergency medicine
American College of Emergency Physicians (ACEP) formed in 1968
Emergency medicine recognized as a specialty in medicine in 1979
Figure 1.8 The Emergency
Physician is the leader of the EMS
team

22. Modern EMS (cont’d.) Specialty care centers Aeromedical transportation
Trauma centers
Provide expert surgical care within the first hour of traumatic injury
Aeromedical transportation
Provides mix of pre-hospital emergency response and interfacility transport
Composed of nurses and an Emergency Medical Technician-Paramedic (EMT-P)

23. Modern EMS (cont’d.) The future of EMS Aging Americans Homelessness
Baby boomer generation is aging
EMS calls to elderly patients are increasing
Homelessness
Results in greater use of EMS system and emergency departments
Infectious disease
Increasing resistance to antibiotics

24. Modern EMS (cont’d.) Operational challenges Human resources
Decreasing membership because many EMS workers are volunteers
Financial restrictions
Cost of equipment, training, and insurance
Many EMS organizations are under-funded

25. Conclusion
Rich past of EMS has many examples of heroism and leadership
Future of EMS depends on attention to trends in emergency medicine and the challenges they may present
Research-based practices should be used to refine daily practices to provide the best quality of care