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Chapter 1
EMS Systems
Emergency Medical Services (EMS)
Systems
Define EMS systems.
Describe History of EMS.
Describe Roles/responsibilities of EMS personnel.
Discuss the purpose of the EMS Quality improvement
OBJECTIVES OF EMS
System consists of a team of health care professionals who in each area ,are responsible for and provide emergency care and transportation to the sick and injured patients
DEFINITION OF The EMS System
1485
◦First use of an ambulance
◦Transport only 1800s
◦First use of ambulance/ attendant to care for injuries on site
1926
◦Service started
◦similar to present day
1940s
◦EMS turned over to fire and police departments
The History of EMS
Certification examination:
◦ Ensures all health care providers have the same basic level of
knowledge and skill
◦ Once you pass certification you can apply for state licensure.
Licensure, Certification, and Registration
Licensure:
Also known as
certification
Unlawful to practice
without licensure
Holding a license shows
you:
Completed initial
education Met the requirements to
achieve the license Paramedics are required
to receive medical direction.
Licensure, Certification, and Registration
1. EMT-B (Basic)
2. EMT-I/85 (Intermediate)3. EMT-I/99 (Intermediate or
Advanced)4. EMT-P (Paramedic )
EMT LEVELS
As a paramedic, you must:◦ Develop care plan
◦ Decide on transport method
◦ Determine receiving facility
◦ Be active in your community.
The EMS System
1/ First Responder
♦ Scene assessment ♦ Patient assessment ♦ CPR ♦ Oxygen therapy ♦ Patient stabilization and movement ♦ Splinting ♦ Bandaging
2/ Emergency Medical Technician- Basic
♦ Non-visualized airways ♦ Spinal immobilization ♦ Medications patient assisted medications (inhalers)) ♦ Intravenous line mainten
3/ Emergency MedicalTechnician – Intermediate
♦ Endotracheal intubation ♦ Intravenous and nebulizer medications (limited to 23) ♦ Expanded 3-lead ECG interpretations ♦ External cardiac pacing ♦ Needle chest decompression ♦ Cardioversion
4/Emergency Medical Technician – Basic Advanced
♦ Intravenous therapy initiation ♦ Automated or manual defibrillation ♦ ECG interpretation ( ventricular tachycardia, ventricular fibrillation, pulseless electrical activity)
5/ Paramedic
♦ Expanded anatomy and physiology ♦ Intravenous therapy ♦ Injectable and narcotic analgesic medications as trained and approved by physician medical director ♦ Surgical airway ♦ Cardiac monitoring and external pacing ♦ Chest decompression ♦ 12-lead ECG interpretation
Public safety agents◦ Some have EMS
training Can better perform
certain functions than you
◦ Interagency cooperation benefits patient
Working With Other Professionals
© Mark C. Ide
Roles and Responsibilities
© D
an M
yers
Teach the community about prevention of injury and illness.◦ Appropriate use of
EMS◦ CPR training
Roles and Responsibilities
Courtesy of Captain David Jackson, Saginaw Township Fire Department
A-Preparation -physical, mental ,emotional -Knowledge and skill abilities-equipment appropriate and in working order B- Response-timely-safe C- Scene management -safety of you and your team -assessing situation -personal protective equipment
Role and responsibility
Patient assessment and care
-appropriate ,organized assessment
• -recognize and prioritize patient need
• Patient transfer and report
• -give brief ,concise ,hand –off report
• -protect patient privacy
• Documentation
• -fill out patient care report
• Return to service
• Restock and prepare unit
Continuous quality improvement (CQI)
◦ Tool to continually evaluate care
◦ Quality control
◦ Process of assessing current practices, looking
for ways to improve
◦ Dynamic process
Improving System Quality
Review ambulance runs when possible.
Focus of CQI is improving care
CQI can be a peer review.◦ Be professional◦ Should be a
constructive process
Improving System Quality
CQI programs help
prevent problems
by:
◦ Evaluating day-to-
day operations
◦ Identifying possible
stress points
Look for ways to
eliminate human
error.
◦ Ensure adequate
lighting
◦ Limit interruptions
◦ Store medications
properly
Improving System Quality
Ways to eliminate human error
◦ Be careful when handing patients off.
◦ Three main sources of errors:
Rules-based failure
Knowledge-based failure
Skills-based failure
Improving System Quality
Ways to eliminate human error
◦ Agencies need clear protocols.
◦ Be aware of your environment.
◦ Ask yourself “Why am I doing this?”
◦ Use cheat sheets.
◦ Be conscientious of protocols.
Improving System Quality
THANK YOU