Iroduction to Emergency Medical Care

INTRODUCTION TO EMERGENCY MEDICAL CARE EMERGENCY MEDICAL TECHNICIAN - BASIC Origins of EMS • Accidental Death & Disability: The Neglected Disease of Modern Society • Department of Transportation (DOT) – Highway Safety Act of 1966 • Department of Health and Human Services (DHHS) – Emergency Medical Act of 1973 National Standard Curriculum • Developed by DOT – First developed in early 1970’s – Current - 1994 • Purpose – Standardization of Training Programs – Standardization of Levels of Certification – Standardization of Patient Care Components of an EMS System • Advisory Council • Medical Direction – The process used by the Medical community to assure quality and accountability in the delivery of pre-hospital care – On-line – Off-line • Protocols • Quality Improvement Components of an EMS System • EMT Training – Initial – Continuing Education • Instructor Training Components of an EMS System • Communications Systems – System Communication • Radio • Cellular – System Access • 911 • Other easily remembered numbers Components of an EMS System • Dispatch Center – – – – Well Designed Well Equipped Well Staffed & Trained Policies & Procedures Components of an EMS System • Ambulance Service – – – – Well Designed Well Equipped Well Maintained Well Trained Staff • Initial • Continuing Education Components of an EMS System • Rapport with Other Healthcare Professionals • Reports & Records • System Evaluation – Quality Improvement • Protocol Review/Update • Run Review • Remedial or Continuing Education Components of an EMS System • System Evaluation (Cont.) – Risk Management/Loss Control – Outcome Studies – System Status Management • Disaster Plans – Major Incident Response • Designed by EMS • Designed to Integrate with Other Agencies Components of an EMS System • Public Information & Education • Categorized Hospital Emergency Capabilities • Funding Components of an EMS System • Management – Well Educated • Initial • Continuing Education – Well Supported •$ • by Upper Level Management Continuum of Care • 1st Phase - Out of Hospital Care • 2nd Phase - Emergency Department Care • 3rd Phase - Definitive Care EMS RELATED AGENCIES • First Responders • Law Enforcement – – – – Police Sheriff's Department Department of Public Safety Federal EMS RELATED AGENCIES • Fire Department • Regional Organizations • Texas Department of Health Roles & Responsibilities • Safety – Priorities • • • • Yourself Partner By-standers Patient Roles & Responsibilities • Safety (cont.) – Safe Behaviors • Health – – – – No Destructive Activities Rest Conditioning Do not push body past limitations (Mentally and Physically) – Wear Personal Protective Equipment • Survey Scene – Look for Hazards – Listen to Others Roles & Responsibilities • Patient Care – – – – – – Patient Assessment Basic Life Support Mechanical Aids to Breathing Pulse-Oximetry Semi-Automatic External Defibrillator Pneumatic Anti-Shock Garment (PASG or MAST) Roles & Responsibilities • Patient Care (cont.) – – – – – Hand-held Metered Dose Nebulizers Epinephrine Auto-injectors (Epi pens) Nitroglycerin Aspirin Charcoal Roles & Responsibilities • Patient Care (cont.) – – – – – Oral Glucose Bandaging & Splinting / Traction Splinting Emergency Childbirth Spinal Immobilization Advanced Airway (Optional) EMT-Intermediate Roles & Responsibilities • Patient Care - Intermediate – Intermediate Patient Assessment – Advanced Airway • • • • Esophageal Airways Endotracheal Intubation (Oral & Nasal) Cricothyrotomy (Needle & Surgical) End-tidal CO2 Monitoring EMT-Intermediate Roles & Responsibilities • Patient Care - Intermediate (Cont.) – Vascular Access • Intravenous • Intraosseus – Gastric Tube Placement (Oral & Nasal) – Pleural Decompression EMT-Intermediate Roles & Responsibilities • Patient Care - Intermediate – Drug Therapy • D50W • Narcan – Intermediate Recordkeeping – Intermediate Radio Communication EMT-Paramedic Roles & Responsibilities • Patient Care - Paramedic – – – – Advanced Patient Assessment Drug Administration Techniques EKG Interpretation Defibrillation/Cardioversion EMT-Paramedic Roles & Responsibilities • Patient Care - Paramedic (Cont.) – – – – External Pacemakers IV Infusion Pumps Mechanical Ventilators Urinary catherization Roles & Responsibilities • • • • • Extrication & Rescue Transport Transfer of Care Communications Records & Reports Roles & Responsibilities • Patient Advocacy • Maintenance – Vehicle Maintenance – Equipment Maintenance – Self Personal Attitude & Conduct • Professionalism – – – – – – Appearance Attitude Manner Speech Writing Knowledge & Skills • Participation in CE • Participation in QI Personal Attitude & Conduct • • • • Confidence Compassion Empathy Leadership Personal Attitude & Conduct • • • • Sound Judgement Good Moral Character Stability Adaptability Texas EMT Certification • Requirements – Successfully complete a TDH approved EMTBasic course – Submit to TDH: • Course Completion Certificate • Completed TDH EMS Personnel Application • TDH application fees (if not exempt) – Schedule state exam appointment with TDH regional office