Ems Introduction
Ems Introduction
THIRTEENTH EDITION
CHAPTER 1
Introduction to
Emergency Medical Care
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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How It Began
• 1790s
Napoleonic Wars
• Civil War
• World War I
Volunteer ambulance corps
• Korea/Vietnam
MASH-type units and helicopter
transport from battlefield
continued on next slide
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How It Began
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EMS Today
• 1966
Department of Transportation charged
with developing EMS standards
• 1970
Founding of the National Registry of
EMTs (NREMT)
• 1973
National Emergency Medical Service
Systems Act (NEMSSA) passed by
Congress
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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The Long and Winding Road of
Ambulance Service Video
Click on the screenshot to view a video on the topic of the history of EMS.
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Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Daniel Limmer | Michael F. O'Keefe All Rights Reserved
NHTSA Standards for
EMS Systems
1. Regulation and policy
Each state establishes laws, policies, and
regulations.
2. Resource management
Centralized coordination of emergency
treatment and transport resources
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Components of the EMS System
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Components of the EMS
System
• Emergency Medical Dispatchers
• EMS responders
• Emergency Department/Hospital
Doctors, nurses, allied health personnel
• Specialty centers
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Components of the EMS System
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Accessing the EMS System
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Accessing the EMS System
• 911 telephone access
Available in most communities
• Enhanced 911- is a system used in North
America that links emergency callers with
the appropriate public resources
Provides caller number and location for
landline phones
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Accessing the EMS
System
• Emergency medical dispatchers
Can provide instructions to callers on
how to provide emergency care until
EMS personnel arrive
EMD certification required in some
jurisdictions
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Accessing the EMS System
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Examples of Critical
Decisions
• Is it better to take patient to closest hospital or to
one farther away but more appropriate for the
condition?
• Is patient stable enough for further evaluation on
scene, or should patient be transported
immediately?
• Will this treatment make patient better or worse?
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Levels of EMS Training
• Emergency Medical Responder (previously called
first responder)
• Emergency Medical Technician (previously called
EMT-Basic)
• Advanced Emergency Medical Technician
(previously called EMT-Intermediate)
• Paramedic (previously called EMT-Paramedic)
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Roles and
Responsibilities of EMTs
• Personal safety
• Safety of crew, patient, and bystanders
• Patient assessment
• Patient care
• Lifting and moving
• Transport
• Transfer of care
• Patient advocacy
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Think About It
• How would it impact an older adult patient if they
were transported to the hospital without glasses,
hearing aid, or dentures?
• On a routine call, would taking the time to gather
these items have a negative effect on the patient's
care?
• How about assuring the home is secure and locked
before leaving?
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Physical Traits of a Good
EMT
• Ability to lift and carry equipment and patients up
to 125 pounds
• Good eyesight (distance and reading)
• Awareness of any problems with color vision
• Good communication skills (oral and written)
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Personal Traits of a Good
EMT
• Pleasant
• Sincere
• Cooperative
• Resourceful
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Personal Traits of a
Good EMT
• Self-starter
• Emotionally stable
• Able to lead
• Neat and clean
• Of good moral character and respectful of others
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Education
• Maintain up-to-date knowledge and skills
• Refresher courses
• Continuing education courses
• Conferences, seminars, and lectures
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Education
Many EMS/rescue operations adopt new procedures and equipment on the basis of
research providing evidence that they are effective.
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Think About It
• How will you refresh your knowledge and stay
current once you are out of the classroom?
• What qualities would you like to see in an EMT
who is caring for you? How can you come closer to
being this kind of EMT?
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Where Will You Become
a Provider?
• Ambulance services
• Fire departments
• Rural/wilderness
teams
• Urban/industrial settings
• Volunteering
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Where Will You Become
a Provider?
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Quality Improvement
• Continuous self-review with the purpose of
identifying aspects of the system that require
improvement
• Develop plans to correct deficiencies and improve
performance
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Medical Direction
• All patient care performed under direction of Medical
Director
Ultimate responsibility for patient care
Oversees training
Develops treatment protocols
Issues off-line medical direction (standing
orders)
Provides on-line medical direction
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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EMS Role in Public
Health
• Injury prevention for geriatric patients
• Injury prevention for youth
• Public vaccination programs
• Disease surveillance
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Research
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Research
• Focus on improving patient outcomes and through
evidence-based techniques
• Evidence-based process
Forming a hypothesis
Reviewing literature
Evaluating the evidence
Adopting the practice if evidence
supports it
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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The Basics of EMS
Research
• Not all research is created equal.
• Rely on the scientific method.
• Exacting and comprehensive studies are both
difficult and time consuming.
• Obtain an objective opinion.
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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The Basics of EMS
Research
• Questions to ask when evaluating a study
Assists in identifying bias of flaws in
methodology
• Questions to ask before participating in a study
Assists in understanding the study and
providing needed information
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Daniel Limmer | Michael F. O'Keefe All Rights Reserved
Questions to Ask Before
Participating in EMS Research
• What is the title of the study?
• Who are the principal investigator and primary
contact?
• What is the research question or hypothesis?
• What are the study's inclusion criteria?
• What are the study's exclusion criteria?
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Special Issues
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Special
Issues
• Throughout the course we will discuss:
Local issues
Administrative matters
• Course description
• Class meeting times
• Requirements for certification as an EMT
Emergency Care, 13e Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Chapter Review
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Chapter Review
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Remember
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Questions to Consider
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Critical Thinking
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