Chapter 1

EMS Systems
 National EMS Education
Standard Competencies (1 of 4)
Preparatory
Applies fundamental knowledge of the
emergency medical services (EMS) system,
safety/well-being of the advanced emergency
medical technician (AEMT), medical/legal,
and ethical issues to the provision of
emergency care.
 National EMS Education
Standard Competencies (2 of 4)
EMS Systems
• EMS systems
• History of EMS
• Roles/responsibilities/professionalism
of EMS personnel
• Quality improvement
• Patient safety
 National EMS Education
Standard Competencies (3 of 4)
Research
• Impact of research on emergency medical
responder (EMR) care
• Data collection
• Evidence-based decision making
 National EMS Education
Standard Competencies (4 of 4)
Public Health
Uses simple knowledge of the principles of
the role of EMS during public health
emergencies.
 Introduction

• This textbook is the primary resource for

the AEMT course.
• EMS is a system.
• This chapter discusses:
– That system’s key components
– How they influence and affect AEMTs
– Administration, medical direction, quality
control, and regulation of EMS services
– Roles and responsibilities of AEMTs
 Course Description (1 of 7)

• Emergency medical services (EMS)

– Team of health care professionals
– Provides prehospital emergency care and
transport for the sick and injured
– Part of a local or regional EMS system
– Governed by state laws and typically regulated
by a state EMS office

• People who provide emergency care,

except licensed physicians, must be state-
licensed or certified.
Course Description (2 of 7)

• Four training and

licensure levels:
– EMR, formerly first
responder
– EMT, formerly
EMT-Basic
– AEMT, formerly
EMT-I
Source: © Corbis
– Paramedic,
formerly EMT-
Paramedic
 Course Description (3 of 7)

• EMRs have very • EMTs have training

basic training. in basic life support
– Provides care (BLS), including:
before ambulance – Automated external
arrives defibrillation
– May assist within – Airway adjuncts
ambulance – Assistance with
certain medications
 Course Description (4 of 7)

• AEMTs have training in specific aspects of

advanced life support (ALS), including:
– Intravenous (IV) therapy
– Administration of certain emergency
medications
 Course Description (5 of 7)

• Paramedics have extensive ALS training,

including:
– IV therapy
– Pharmacology
– Cardiac monitoring
– Other advanced assessment and treatment
skills
 Course Description (6 of 7)

• AEMT role and former EMT-I roles:

– Formerly, there were two EMT-I curricula.
• 1985 and 1999
– AEMT role resembles EMT-I 1985 curriculum.
• AEMTs do not perform skills that were part of
EMT-I 1999 level training, such as intubation.
• AEMTs can assist with administering certain
medications, but not others.
 Course Description (7 of 7)

• Upon completion of this course, you should

be able to take the state certification exam.
• After passing the exam, you are eligible to
apply for licensure.
• Almost every state’s requirements follow or
exceed the guidelines in the current NHSTA
EMS Education Standards.
 AEMT Training: Focus and
Requirements (1 of 2)
• AEMTS provide emergency care to the sick
and injured.
– Some patients are in life-threatening situations.
– Others require only supportive care.
– The skills to deliver this care are found within
this text.
 AEMT Training: Focus and
Requirements (2 of 2)
• Some of the subjects discussed include:
– Scene size-up
– Patient assessment
– Treatment
– Packaging
– EMS as a career
Licensure Requirements (1 of 5)

• Requirements differ state to state; general

requirements to be an AEMT are:
– High school diploma or equivalent
– Proof of immunization against certain
communicable diseases
– Valid driver’s license
Licensure Requirements (2 of 5)

• AEMT requirements (cont’d):

– Successful completion of:
• BLS/CPR course
• State-approved AEMT course
• State-approved written certification exam
• State-approved practical certification exam
Licensure Requirements (3 of 5)

• AEMT requirements (cont’d):

– Demonstrated ability to meet mental and
physical criteria to perform the job
– Compliance with other state, local, and employer
provisions
Licensure Requirements (4 of 5)

• State-recognized written and practical exam

may be the National Registry Exam based
on the individual state.
– Requires re-registration every 2 years
– Most states recognize NREMT certification
– Provides reciprocity
Licensure Requirements (5 of 5)

• Americans With Disabilities Act (ADA)

– Protects people with disabilities from being
denied access to programs and services
provided by state and local governments
– Prohibits employers from failing to provide full
and equal employment to the disabled

• States may exclude certain people from

AEMT certification, such as those convicted
of certain felonies.
 History of EMS
(1 of 4)

• Origins of EMS include:

– Volunteer ambulances in WWI
– Specially trained field care providers in WWII
– Field medic and rapid helicopter evacuation in
Korean conflict
– Advances in trauma care resulting from casualty
experiences in Korean and Vietnam conflicts
 History of EMS
(2 of 4)

• As late as the early 1960s, emergency

ambulance service and care varied widely in
the United States.
• Modern EMS originated in 1966 with the
publication of Accidental Death and
Disability: The Neglected Disease of Modern
Society.
– Congress mandated federal changes.
– DOT published first EMT training curriculum in
early 1970s.
 History of EMS
(3 of 4)

• The AAOS prepared the first EMT textbook

in 1971.
– Your textbook is the AEMT level of that book.

• Through the 1970s, EMS system developed.

 History of EMS
(4 of 4)

• Availability of ALS-level care grew.

– Definitions of EMS providers began to vary.
– Efforts are underway to standardize levels of
EMS education nationally.
 Levels of Training

• Licensure is a state • State level:

function – Laws regulate EMS
– Creates some provider
variation between operations.
AEMTs • Local level:
• Federal level: – Medical director
– National EMS decides day-to-day
Scope of Practice limits.
Model provides
guidelines for EMS
skills at each level.
Public BLS and Immediate Aid

• Millions of laypeople are trained in

BLS/CPR.
– Many have taken basic first aid courses.

• Designed to provide necessary critical care

before responders can arrive
– Teachers, coaches, babysitters, etc.
– People who regularly accompany groups on trips
to remote locations are trained in first aid.
 Automated External
Defibrillators (AEDs)
• Detect treatable life-threatening cardiac
arrhythmias and deliver appropriate
electrical shock
• Designed to be used by untrained laypeople
• Included in every prehospital emergency
training
Emergency Medical
Responders (1 of 2)
• In EMS because
presence of trained
person on scene
cannot be ensured
• EMRs include:
– Law enforcement
officers
Courtesy of Robert Kaufmann/FEMA – Fire fighters
– Park rangers
– Ski patrollers
 Emergency Medical
Responders (2 of 2)
• Trained to initiate immediate care and assist
other EMS personnel on their arrival
• Good Samaritans trained in first aid and
CPR often show up at a scene.
– They can provide valuable assistance.
– They can also interfere with operations and
endanger themselves and others.
– Identify during scene size-up.
 Emergency Medical
Technicians
• EMT course requires about 150 hours.
– More in some states
– Includes the essential knowledge and skills to
provide basic emergency care

• On arrival at scene, EMT and other

providers assume responsibility for
assessment, care, packaging, and
transport of patient.
Advanced Emergency Medical
Technicians
• AEMT course
provides knowledge
and skills in specific
aspects of limited
ALS.
• Depending on area,
the student is:
– Building on EMT
training
– Entry level
Paramedics

• Extensive course of
training
– 800 to 1500 hours
or more
– May be offered
within context of
associate or
bachelor degree
program
• Wide range of ALS
skills
 Components of the
EMS System
• Modern-day EMS system is a complex
network of coordinated services.
– These services work in unison to meet needs of
the community.
– As an AEMT, you are part of this network and
must stay active.
 Public Access (1 of 3)

• Easy access to help

in an emergency is
essential.
• 9-1-1 system is
usually the public
safety access point.
– Trained dispatchers
obtain information
and dispatch
responders.
 Public Access (2 of 3)

• Enhanced 9-1-1 systems provide additional

data, like address, phone number of caller.
• Training the public on how to summon an
EMS unit is an important part of the public
education responsibility.
 Public Access (3 of 3)

• EMD system assists dispatchers in giving

callers instructions until EMS arrival.
– Reality of call may differ from dispatch
description.
 Communication Systems

• From caller information, dispatcher selects

parts of emergency system to activate.
• EMS may be:
– Part of fire department
– Part of police department
– Independent

• New technology helps responders locate

their patients.
– Stay current on local resources.
 Clinical Care (1 of 2)

• You will use a wide range of equipment.

• Check equipment before going on duty to
ensure:
– It is in the assigned place.
– It is working properly.
– You are familiar with the specific model.
 Clinical Care (2 of 2)

• You may be called on to drive the

ambulance.
– Become familiar with roads in PSA or sector.
– Before going on duty, check:
• Equipment and supplies
• Communications equipment
• Vehicle, for key fluids and condition of tires
• Driver’s controls
• Built-in units and controls in patient compartment
Medical Direction and
Control (1 of 2)
• Physician medical
director authorizes
providers to give
medical care in
field.
• Appropriate care is
described in
© Andrei Malov/Dreamstime.com
standing orders and
protocols.
 Medical Direction and
Control (2 of 2)
• Medical director acts as liaison among
medical community, hospitals, and AEMTs.
• Medical control can be off-line or online.
– Online (direct)
• Physician directions given over the phone or radio
• Can be communicated by designee
– Off-line (indirect)
• Standing orders, training, supervision
 Legislation and Regulation

• Training, protocols, and practice follow state

legislation, rules, regulations, and
guidelines.
– Medical directors, along with EMS supervisors
and others, develop protocols for service areas.
– EMS services are usually administered by senior
EMS official.
– Daily operation and direction of service are
provided by an appointed chief executive officer.
 Evaluation (1 of 2)

• Medical director maintains quality control.

– Reviews patient care reports with other staff

• CQI, also known as QA, reviews and audits

all aspects of an EMS call.
– Review meetings are held and feedback given.

• Refresher training and continuing education

is important.
– Skill decay can occur.
 Evaluation (2 of 2)

• Eliminating errors is the goal. For example:

– Understand the circumstances and main
sources of errors.
– Be aware of your environment.
– Handing off patients is a high-risk activity
– When you are about to perform a skill, ask
yourself, “Why am I doing this?”
– Use “cheat sheets.”
– Use downtime to refresh infrequently used skills.
– Discuss troublesome calls with your partner.
Transport to Specialty Centers

• Some centers focus on specific types of

care, such as trauma, or specific types of
patients, such as children.
• Transport time may be longer.
– But patients will receive definitive care more
quickly.

• Know location of specialty centers and

protocol for transport.
 Interfacility Transports

– Provided to
nonambulatory patients
or patients requiring
medical monitoring
– May be between
hospitals, skilled nursing
facilities, home
residence
– AEMTs are responsible
for health and well-being
of patient during
transport.
 Working With Hospital Staff

• Become familiar with hospital by observing:

– Equipment and how it is used
– Functions of staff members
– Policies and procedures in emergency areas
• AEMTs may consult medical staff by radio.
• Best patient care occurs with rapport
between all emergency care providers.
Working With Public Safety
Agencies
• Some public safety
workers have EMS
training.
– Become familiar
with their roles and
responsibilities.
– They may be better
prepared to perform
certain functions.
Courtesy of MIEMSS
– Best patient care is
achieved through
cooperation.
 Prevention and Public
Education (1 of 2)
• Focus is on public health.
– Works to prevent injury by being proactive

• EMS works with public health agencies on:

– Primary prevention
– Secondary prevention

• AEMTs may be involved in illness and injury

surveillance.
 Prevention and Public
Education (2 of 2)
• AEMTs can help educate the public.
– One-on-one after an accident
– By going to local schools
– Working with health care institutions
– Teaching people immediate aid skills

• Public education increases respect and can

lead to increased funding.
 EMS Research

• Provides scientific basis for standards

– Evidence-based decision making is becoming an
integral part of functioning in EMS.

• AEMTs may be involved in research through

gathering data.
• Important to stay current on latest research
– Make sure you understand what results mean.
– Be skeptical and ask questions.
Roles and Responsibilities
of AEMTs
Professional Attributes (1 of 2)

• Integrity
• Empathy
• Self-motivation
• Appearance and
hygiene
• Self-confidence
• Time management
 Professional Attributes (2 of 2)

• Communications
• Teamwork and diplomacy
• Respect
• Patient advocacy
• Careful delivery of care
 Patient Interaction

• Every patient is entitled to compassion,

respect, and the best care.
• Remember: whether paid or volunteer, you
are a health care professional.
– Bound by patient confidentiality

• Be familiar with the HIPAA requirements.

 Summary (1 of 10)

• EMS is the system that provides the

emergency medical care needed by people
who have been injured or have an acute
medical emergency.
• The standards for prehospital emergency
care and the people who provide it are
governed by the laws in each state and are
typically regulated by a state office of EMS.
 Summary (2 of 10)

• The AEMT course that you are now taking

will present the information and skills that
you will need to pass the required
examination needed to become a licensed
AEMT.
• The EMS ambulance is staffed by providers
who have been trained to the EMT, AEMT,
or paramedic level according to
recommended national standards and have
been licensed by the state.
 Summary (3 of 10)

• An EMT has training in basic emergency

care skills, including automated external
defibrillation, use of airway adjuncts, and
assisting patients with certain medications.
• An AEMT has training in specific aspects of
advanced life support (ALS), such as with
intravenous therapy and the administration
of certain emergency medications.
 Summary (4 of 10)

• A paramedic has extensive training in ALS,

including endotracheal intubation,
emergency pharmacology, cardiac
monitoring, and other advanced
assessment and treatment skills.
• When the dispatcher at the 9-1-1
emergency communications center receives
a call for emergency care, he or she
dispatches to the scene the designated
EMS ambulance squad and any fire,
rescue, or police units that may be needed.
 Summary (5 of 10)

• Emergency medical responders, such as

law enforcement officers, fire fighters, park
rangers, ski patrollers, or other organized
rescuers often arrive at the scene before
the ambulance and AEMTs.
 Summary (6 of 10)

• Key components of an AEMT’s job include

scene size-up, patient assessment,
treatment, and packaging. After assessing
the scene and the patient, you will provide
the emergency care and transport that is
indicated by your findings and ordered by
your medical director in the service’s
standing order protocols or the physician
who is providing online medical direction.
 Summary (7 of 10)

• As an AEMT, you will work in a primary

service area and will have the responsibility
of ensuring that all equipment and supplies
are functional and ready for use.
• Each EMS system has a physician medical
director who authorizes the providers in the
service to provide medical care in the field.
Medical control is off-line (indirect) or online
(direct).
 Summary (8 of 10)

• Continuous quality improvement is a

circular system of continuous internal and
external reviews and audits of all aspects of
an EMS call.
• It is important to determine ways to reduce
human error by ensuring that you
understand your protocols, ensuring that
your environment is organized and
functional, and acting as a patient advocate.
 Summary (9 of 10)

• As an AEMT, you will work with many other

professionals, including hospital staff and
public safety personnel. Remember that the
best, most efficient patient care is achieved
through cooperation among agencies.
• EMS research and evidence-based decision
making are beginning to have a role in
functioning as an EMS provider. Stay aware
of research, and focus patient care on
procedures that have proven useful in
improving patient outcomes.
 Summary (10 of 10)

• AEMT attributes include compassion and

motivation to reduce suffering, pain, and
death in people who are injured or acutely
ill; a desire to provide each patient with the
best possible care; commitment to obtain
the knowledge and skills that this requires;
and the drive to continually increase
knowledge, skills, and ability.
 Review

1. Which of the following is an example of care

that is provided using standing orders?
A. Medical control is contacted by the AEMT after a
patient with chest pain refuses EMS care.
B. The AEMT defibrillates a cardiac arrest patient,
begins CPR, and then contacts medical control.
C. A physician gives the AEMT an order via radio to
administer oral glucose to a diabetic patient.
D. Following an overdose, the AEMT contacts the
medical director for permission to give activated
charcoal.
 Review

Answer: B.
Rationale: Standing orders, a form of
off-line (indirect) medical control, involve
performing certain life-saving interventions
(ie, CPR, defibrillation, bleeding control)
before contacting a physician for further
instructions.
 Review (1 of 2 )

1. Which of the following is an example of care

that is provided using standing orders?
A. Medical control is contacted by the AEMT after a
patient with chest pain refuses EMS care.
Rationale: This is an example of online medical
control given via the phone or radio.

B. The AEMT defibrillates a cardiac arrest patient,

begins CPR, and then contacts medical control.
Rationale: Correct answer
 Review (2 of 2 )

1. Which of the following is an example of care

that is provided using standard orders?
C. A physician gives the AEMT an order via radio to
administer oral glucose to a diabetic patient.
Rationale: This is an example of online medical
control given via the phone or radio.

D. Following an overdose, the AEMT contacts the

medical director for permission to give activated
charcoal.
Rationale: This is an example of online medical
control given via the phone or radio.
 Review

2. Quality control in an EMS system is the

ultimate responsibility of the:
A. paramedic.
B. lead AEMT.
C. medical director.
D. EMS administrator.
 Review

Answer: C.
Rationale: The medical director is
responsible for maintaining quality control,
which ensures that all staff members who are
involved in caring for patients meet the
standard of care on every call.
 Review (1 of 2)

2. Quality control in an EMS system is the

ultimate responsibility of the:
A. paramedic.
Rationale: A paramedic has the knowledge
and mastery of BLS and ALS skills.
B. lead AEMT.
Rationale: This is the senior AEMT with a
service or company.
 Review (2 of 2)

2. Quality control in an EMS system is the

ultimate responsibility of the:
C. medical director.
Rationale: Correct answer
D. EMS administrator.
Rationale: The EMS administrator sees to the
daily operations and overall direction of the
service or company.
 Review

3. Upon arriving at the scene of a domestic

dispute, you hear yelling and the sound of
breaking glass from inside the residence.
You should:
A. immediately gain access to the patient.
B. carefully enter the house and then call the
police.
C. retreat to a safe place until the police arrive.
D. tell the patient to exit the residence so you can
provide care.
 Review

Answer: C.
Rationale: Never enter a scene in which
signs of violence are present, including
yelling, screaming, or the sound of breaking
glass. Law enforcement must secure the
scene prior to the AEMT’s entry.
 Review (1 of 2)

3. Upon arriving at the scene of a domestic dispute,

you hear yelling and the sound of breaking glass
from inside the residence. You should:
A. immediately gain access to the patient.
Rationale: Never enter a scene in which signs of
violence are present. Law enforcement must secure
the scene.
B. carefully enter the house and then call the police.
Rationale: Never enter a scene in which signs of
violence are present. Law enforcement must secure
the scene.
 Review (2 of 2)

3. Upon arriving at the scene of a domestic

dispute, you hear yelling and the sound of
breaking glass from inside the residence.
You should:
C. retreat to a safe place until the police arrive.
Rationale: Correct answer
D. tell the patient to exit the residence so you can
provide care.
Rationale: Never enter a scene in which signs
of violence are present. Law enforcement must
secure the scene.
 Review

4. Which of the following is NOT a component

of continuous quality improvement (CQI)?
A. Periodic review of run reports
B. Discussion of needs for improvement
C. Negative feedback to those who make
mistakes while on a call
D. Remedial training as deemed necessary by the
medical director
 Review

Answer: C.
Rationale: The purpose of CQI is to ensure
that the standard of care is provided on all
calls. This involves periodic run report
reviews, discussing needs for improvement,
and providing remedial training as deemed
necessary by the medical director. Positive
feedback should be provided during this
process.
 Review
4. Which of the following is NOT a component of
continuous quality improvement (CQI)?
A. Periodic review of run reports
Rationale: This is a part of CQI.
B. Discussion of needs for improvement
Rationale: This is a part of CQI.
C. Negative feedback to those who make mistakes
while on a call
Rationale: Correct answer
D. Remedial training as deemed necessary by the
medical director
Rationale: This is a part of CQI.
 Review

5. All of the following are responsibilities of

the EMS medical director, EXCEPT:
A. evaluating patient insurance information.
B. serving as liaison with the medical community.
C. ensuring that the appropriate standards are
met by AEMTs.
D. ensuring appropriate AEMT education and
continuing training.
 Review

Answer: A.
Rationale: Responsibilities of the medical
director include serving as liaison with the
medical community, ensuring that appropriate
standards are met by EMS personnel, and
ensuring appropriate AEMT education and
continuing training. Insurance matters are
handled by the EMS billing department.
 Review (1 of 2)

5. All of the following are responsibilities of the

EMS medical director, EXCEPT:
A. evaluating patient insurance information.
Rationale: Correct answer
B. serving as liaison with the medical community.
Rationale: This is the responsibility of the
medical director.
 Review (2 of 2)

5. All of the following are responsibilities of the

EMS medical director, EXCEPT:
C. ensuring that the appropriate standards are met
by AEMTs.
Rationale: This is the responsibility of the
medical director.
D. ensuring appropriate EMT education and
continuing training.
Rationale: This is the responsibility of the
medical director.
 Review

6. Which of the following situations would

MOST likely disqualify a person for EMS
certification?
A. A misdemeanor at the age of 17
B. Driving under the influence of alcohol
C. Possessing a valid driver’s license from
another state
D. A mild hearing impairment that is corrected
with hearing aids
 Review

Answer: B.
Rationale: In most states, a person may be
denied EMS certification for being convicted
of a felony, such as driving under the
influence of alcohol or other drugs.
 Review (1 of 2)

6. Which of the following situations would

MOST likely disqualify a person for EMS
certification?
A. A misdemeanor at the age of 17
Rationale: Most states seal misdemeanor
juvenile records, so it would not likely disqualify
a person.
B. Driving under the influence of alcohol
Rationale: Correct answer
 Review (2 of 2)
6. Which of the following situations would
MOST likely disqualify a person for EMS
certification?
C. Possessing a valid driver’s license from another
state
Rationale: Most states require providers to
have a valid in-state driver’s license.
D. A mild hearing impairment that is corrected with
hearing aids
Rationale: If the performance of tasks are not
impaired, it would not disqualify a person.
 Review

7. Which of the following should be the

AEMT’s highest priority?
A. Controlling severe bleeding
B. Maintaining a patient’s airway
C. Ensuring the safety of his or her partner
D. Sizing up every scene prior to entering
 Review

Answer: D.
Rationale: Personal safety is of utmost
concern for the AEMT. This involves sizing up
a scene to determine whether or not the scene
is safe to enter. This will ensure the safety of
all personnel.
 Review (1 of 2)

7. Which of the following should be the

AEMT’s highest priority?
A. Controlling severe bleeding
Rationale: This is the priority once the patient’s
airway and breathing have been addressed.
B. Maintaining a patient’s airway
Rationale: This is the most important priority
once patient contact is made.
 Review (2 of 2)

7. Which of the following should be the

AEMT’s highest priority?
C. Ensuring the safety of his or her partner
Rationale: Safety is first determined during
scene size-up. You do not enter an unsafe
scene.
D. Sizing up every scene prior to entering
Rationale: Correct answer
 Review

8. A patient who requires cardiac monitoring

in the field would require, at a minimum,
which level of EMS provider?
A. EMR
B. EMT
C. Paramedic
D. AEMT
 Review

Answer: C.
Rationale: Of all levels of EMS provider, the
paramedic is trained in advanced medical care,
including cardiac monitoring, IV therapy, and
the administration of a variety of emergency
drugs.
 Review (1 of 2)

8. A patient who requires cardiac monitoring in

the field would require, at a minimum, which
level of EMS provider?
A. EMR
Rationale: This level is trained to initiate BLS
before an ambulance arrives.
B. EMT
Rationale: This level has the knowledge and
skills to provide basic emergency care.
 Review (2 of 2)

8. A patient who requires cardiac monitoring in

the field would require, at a minimum, which
level of EMS provider?
C. Paramedic
Rationale: Correct answer
D. AEMT
Rationale: This level can interpret cardiac
rhythms but cannot perform cardiac monitoring.
 Review

9. Which of the following is a professional

responsibility of the AEMT?
A. Telling the family of a dying patient that
everything will be okay
B. Maintaining only the skills that he or she feels
uncomfortable with
C. Maintaining a professional demeanor even
under the most stressful situations
D. Advising an emergency department nurse that
patient reports are only given to a physician
 Review

Answer: C.
Rationale: Because the public relies upon the
AEMT to remain calm when others cannot, he
or she must project a professional and calm
demeanor even when under extreme stress.
 Review (1 of 2)

9. Which of the following is a professional

responsibility of the AEMT?
A. Telling the family of a dying patient that
everything will be okay
Rationale: Discussions about dying patients are
handled by providers of a higher level.
B. Maintaining only the skills that he or she feels
uncomfortable with
Rationale: The quality of care depends upon
your ability, so you must maintain all of your
skills.
 Review (2 of 2)

9. Which of the following is a professional

responsibility of the AEMT?
C. Maintaining a professional demeanor even
under the most stressful situations
Rationale: Correct answer
D. Advising an emergency department nurse that
patient reports are only given to a physician
Rationale: You must give your report to the
receiving hospital emergency department staff,
including a nurse.
 Review

10. Emergency patient care occurs in

progressive phases. What occurs first?
A. Activation of EMS
B. Initial prehospital care
C. The patient receives definitive care
D. Incident recognition
 Review

Answer: D.
Rationale: Someone must recognize an
emergency before EMS can be activated.
 Review (1 of 2)

10. Emergency patient care occurs in

progressive phases. What occurs first?
A. Activation of EMS
Rationale: This occurs once an incident is
recognized.
B. Initial prehospital care
Rationale: This occurs when the AEMT arrives
on scene.
 Review (2 of 2)

10. Emergency patient care occurs in

progressive phases. What occurs first?
C. The patient receives definitive care
Rationale: This occurs when the AEMT and
patient reach the hospital.
D. Incident recognition
Rationale: Correct answer
 Credits

• Chapter Opener: Courtesy of Jason

Pack/FEMA
• Background slide images: (yellow) © Mark
C. Ide; (light blue) © Jones & Bartlett
Learning. Courtesy of MIEMSS
• Review slide image: Courtesy of Rhonda
Beck