EMT COMPLETE

A Comprehensive Worktext
SECOND EDITION

CHAPTER 1
You and the EMS
System

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 Learning Readiness

• EMS Education Standards, text p. 2

• Objectives, text p. 2
• Key terms, text p. 3

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 Setting the Stage

• Overview of Lesson Topics

 A brief history of modern EMS
 A systematic approach to saving lives
 Key components of an EMS system
 National levels of EMS training
 EMS and health care system
 The role of the public health system
 The role of research in EMS

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 EMERGENCY DISPATCH

• Chapter 1 Emergency Dispatch, text p. 3

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 EMERGENCY DISPATCH

• Discussion Questions
 What do you think of when you see
emergency vehicles responding?
 What are the roles of various
emergency responders at the scene of a
sick or injured person?
 What knowledge and skills do you think
emergency responders call on to
manage emergency situations?
continued on next slide
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 EMERGENCY DISPATCH

• Discussion Questions
 What do you imagine are the thoughts
and feelings of the patient? Family
members? Bystanders? Emergency
responders?

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 Introduction

• People in EMS have a variety of

personal and career goals
• Being an EMT
 Is rewarding
 Requires dedication to serving others

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A Brief History of Modern EMS

• Influences on development of modern

EMS
 Lessons learned from war
 Civilian first aid and rescue squad
movement

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A Brief History of Modern EMS

• Influences on development of modern

EMS
 19th and early 20th Centuries
• Emphasis on transport, not treatment
• 1909 – American Red Cross First Aid
classes
• 1928 – Julian Stanley Wise and the
Roanoke Rescue Squad

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A Brief History of Modern EMS

An ambulance parked at the entrance of City Hospital, which would later become Wishard Memorial
Hospital, circa 1901–1903. The first City Hospital ambulance began carrying sick and injured
Indianapolis-area patients in 1887. (Courtesy of Wishard Health Services.)

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A Brief History of Modern EMS

• Emphasis on prehospital care began in

the 1950s and 1960s
 Oxygen carried on ambulances
 CPR
 The 1966 White Paper detailed
weaknesses in preventing and
responding to motor vehicle collisions

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A Brief History of Modern EMS

• Emphasis on prehospital care began in

the 1950s and 1960s
 1966 Highway Safety Act led to
formation of National Highway Traffic
Safety Administration

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A Brief History of Modern EMS

• The 1970s
 Emergency! brought the idea of EMS
systems to the public's attention
 Emergency Medical Systems Act
provided federal funding and
established standards for developing
EMS systems

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A Brief History of Modern EMS

• EMS made strides as a profession in the

1980s and 1990s
 Professional organizations established
 Revision of National Standard Curricula
 EMS Agenda for the Future
• EMS Core Content
• EMS Scope of Practice Model
• EMS Education Standards

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A Brief History of Modern EMS

• The EMS Agenda for the Future

established the vision for EMS
• NHTSA EMS Website: www.ems.gov

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A Systematic Approach to Saving
Lives
• Injury is the leading cause of death
among people aged 1 to 44 years
• Injury and trauma deaths were the
events that led to creation of modern
EMS

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A Systematic Approach to Saving
Lives
• Emergency medical services (EMS)
system
 A highly specialized chain of resources
designed to minimize the impact of
sudden injury and illness on our society

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A Systematic Approach to Saving
Lives
• NHTSA Statewide 1. Regulation and
Technical policy
Assistance 2. Resource
Program management
established 10 3. Human resources
components of an and training
EMS system
4. Transportation
5. Facilities

continued on next slide

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A Systematic Approach to Saving
Lives
• NHTSA Statewide 6. Communications
Technical 7. Public information
Assistance and education
Program 8. Medical direction
established 10
components of an 9. Trauma systems
EMS system 10.Evaluation

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A Systematic Approach to Saving
Lives

The EMS system is designed to help those in need of immediate medical care.

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A Systematic Approach to Saving
Lives

The EMS system is activated by a call to 911.

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A Systematic Approach to Saving
Lives

A trained dispatcher receives the call and deploys the appropriate resources.

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A Systematic Approach to Saving
Lives

Emergency medical responders often are the first to arrive and begin care.

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A Systematic Approach to Saving
Lives

EMTs continue the care and provide transport to the most appropriate facility.

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A Systematic Approach to Saving
Lives

The patient is transferred to more definitive care at an appropriate receiving hospital.

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National Levels of EMS Training

• Emergency Medical Responder

• Emergency Medical Technician
• Advanced Emergency Medical
Technician
• Paramedic

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National Levels of EMS Training

• Emergency Medical • Very basic

Responder lifesaving skills to
provide care to
critically ill and
injured patients
• 48 to 60 hours of
training

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National Levels of EMS Training

• Emergency Medical • Provides basic

Technician (EMT) emergency care
and transportation
for ill and injured
patients using
basic equipment
found on an
ambulance

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National Levels of EMS Training

• Emergency Medical • 150 to 190 hours

Technician (EMT) of training,
including
classroom, lab, and
clinical rotations

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National Levels of EMS Training

• Advanced • Greater breadth

Emergency Medical and depth of
Technician understanding of
(Advanced EMT) topics introduced
at lower levels of
training.

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National Levels of EMS Training

• Advanced • 150 to 250 hours

Emergency Medical beyond EMT-level
Technician training
(Advanced EMT)

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National Levels of EMS Training

• Advanced • Limited advanced

Emergency Medical life support skills,
Technician such as starting
(Advanced EMT) IVs and
administering
medications

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National Levels of EMS Training

• Paramedic • Allied health care

professionals
• Complex
assessments and
interventions for
critical and
emergent patients

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National Levels of EMS Training

• Paramedic • 1,000 to 1,500

hours of training
beyond EMT-level
training
• Associate's and
bachelor's degrees
available

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National Levels of EMS Training

• Emergency Medical • The various levels

Responder of providers allow
• Emergency Medical the operation of a
Technician tiered EMS system.
• Advanced
Emergency Medical
Technician
• Paramedic

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Stop, Review, Remember

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EMS and the Health Care System

• EMS is just one component of a larger

health care system
• EMS often provides the patient's point
of entry into the health care system

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EMS and the Health Care System

Oversight of all aspects of patient care belongs to a designated physician called the
medical director.

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EMS and the Health Care System

• Medical Direction
 EMTs act as an agent of the medical
director
• Off-line medical direction
• Protocols
• Standing orders
• Online medical direction

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EMS and the Health Care System

• Medical Direction
 Medical director
• Establishes minimum standards,
• Approves protocols and standing orders
• Responsible for continuing quality
assurance of the EMS system

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EMS and the Health Care System

• Access to the EMS System

 Commonly accessed through 911
 Calls answered at a public safety
answering point by trained
dispatchers.

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EMS and the Health Care System

• Access to the EMS System

 Emergency medical calls are routed
emergency medical dispatchers.
• Decide what resources are needed
• Provide pre-arrival instructions

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EMS and the Health Care System

A typical 911 emergency communications center staffed with trained dispatchers and
call takers.

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EMS and the Health Care System

• Access to the EMS System

 911 technology has continued to
develop
• Standard 911
• Enhanced 911 (E-911)
• Difficulties with taking 911 calls from
cellular phones, but technology is
improving

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EMS and the Health Care System

• Roles and • Safety officer

Responsibilities of • Care provider
the EMT • Recordkeeper
• Patient advocate
• EMS professional
• Quality
improvement
officer

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EMS and the Health Care System

• Roles and • You must always

Responsibilities of have safety in
the EMT mind
 Safety officer • No obligation to
put yourself at
unreasonable risk

continued on next slide

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EMS and the Health Care System

• Roles and • Some situations

Responsibilities of that pose risk:
the EMT  Emergency driving
 Safety officer  Lifting and moving
patients
 Communicable
diseases

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EMS and the Health Care System

• Roles and • Core job

Responsibilities of responsibility
the EMT • Based on patient
 Care provider assessment
• Includes moving
patient to
ambulance and
transporting to
appropriate facility

continued on next slide

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EMS and the Health Care System

• Roles and • Continuity of care

Responsibilities of requires
the EMT communication
 Care provider with hospital
personnel

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EMS and the Health Care System

• Roles and • Documentation

Responsibilities of  Record of medical
the EMT care
 Recordkeeper  Data collection for
statistical analysis
to guide system
improvement
 Legal document

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EMS and the Health Care System

• Roles and Responsibilities of the EMT

 Patient advocate: putting the patient's
needs above your own

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EMS and the Health Care System

Being an advocate for the patient means always showing compassion.

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EMS and the Health Care System

• Roles and Responsibilities of the EMT

 EMS professional
• Representative of the wider health care
and public safety systems
• Knowledge of laws, issues, EMS practice;
skills

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EMS and the Health Care System

As an EMT you will interact with other public service agencies, such as the fire service
and law enforcement.

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EMS and the Health Care System

• Roles and • Quality

Responsibilities of improvement
the EMT  System of reviews
 Quality of all aspects of an
improvement officer EMS system
 Ensures the public
receives quality
care

continued on next slide

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EMS and the Health Care System

• Roles and • EMTs'

Responsibilities of responsibilities
the EMT  Complete, accurate
 Quality documentation
improvement officer  Attending formal
reviews
 Gathering feedback

continued on next slide

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EMS and the Health Care System

• Roles and • EMTs'

Responsibilities of responsibilities
the EMT  Maintain equipment
 Quality  Continuing
improvement officer education
 Skill maintenance

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EMS and the Health Care System

• Know your EMS system

 Necessary to providing good care and
making good decisions
 Must learn laws, protocols, guidelines,
available resources

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Stop, Review, Remember

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 The Role of the Public Health
System
• Some areas of a public health system
include:
 Health education
 Injury prevention
 Disease surveillance
 Vaccinations
 Health screening

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The Role of the Public Health
System

One of the roles of an EMS provider is to assist in educating the public.

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 The Role of the Public Health
System
• Disaster assistance
 Disaster medical assistance teams
(DMAT)
 Can include EMS personnel
 Deployed on short notice to assist in
disaster situations such as hurricanes
and earthquakes

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 The Role of Research in EMS

• Research
 A systematic investigation to establish
facts
 Many practices in EMS are being
challenged
 Goal is to establish evidence-based
practice
 The military has been source of
research to inform EMS practice

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 Lesson Summary

• The shape of the modern EMS system

has been influenced by many events
throughout history
• EMS systems must address 10 specific
areas as defined by the NHTSA
• 911 is the access number for EMS in
the United States

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 Lesson Summary

• There are four standardized levels of

care identified by the National Scope of
Practice Model
• Safety is the highest priority when
performing the duties of an EMS
professional
• Other responsibilities: patient care,
patient advocacy, transportation,
recordkeeping, professionalism
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 Lesson Summary

• EMS systems have a medical director

and must have quality improvement
systems
• EMS systems work with local and state
public health systems and initiatives
• Research shapes the care that EMS
personnel provide

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