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Introductionto AdvancedPrehospital Care

ObjectivesPart 1: Introduction to Advanced Prehospital Care

(begins on p. 6)

After reading Part 1 of this chapter, you should be able to:

1. Describe the relationship between the paramedic and other members of the alliedhealth professions. (pp. 6–7)

2. Identify the attributes and characteristics of the paramedic. (p. 7)3. Explain the elements of paramedic education and practice that support its

stature as a profession. (p. 7)4. Define and give examples of the expanded scope of practice for the paramedic.

(p. 8)

Part 2: EMS Systems (begins on p. 8)

After reading Part 2 of this chapter, you should be able to:

1. Describe key historical events that influenced the national development ofEmergency Medical Services (EMS) systems. (pp. 9–12)

2. Define the following terms:certification (p. 16), EMS systems (p. 8), ethics (p. 53), health care professional(p. 17), licensure (p. 16), medical direction (pp. 13–14), peer review (p. 21),profession (p. 16), professionalism (p. 21), protocols (p. 14), and registration(p. 16).

3. Identify national groups important to the development, education, andimplementation of EMS as well as the role of national associations, the NationalRegistry of EMTs, and the roles of various EMS standard-setting agencies.(pp. 17–18)

4. Identify the standards (components) of an EMS system as defined by theNational Highway Traffic Safety Administration. (p. 11)

Chapter

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5. Differentiate among EMS provider levels: First Responder, Emergency MedicalTechnician-Basic, Emergency Medical Technician-Intermediate, and EmergencyMedical Technician-Paramedic. (p. 17)

6. Describe what is meant by “citizen involvement in the EMS system.” (p. 14)7. Discuss the role of the EMS physician in providing medical direction, prehospital

and out-of-hospital care as an extension of the physician, the benefits of on-lineand off-line medical direction, and the process for the development of local poli-cies and protocols. (pp. 13–14)

8. Describe the relationship between a physician on the scene, the paramedic on the scene, and the EMS physician providing on-line medical direction.(p. 13)

9. Describe the components of continuous quality improvement and analyze its con-tribution to system improvement, continuing medical education, and research.(pp. 20–21)

10. Describe the importance, basic principles, process of evaluating and interpreting,and benefits of research. (pp. 21–23)

Part 3: Roles and Responsibilities of the Paramedic(begins on p. 23)

After reading Part 3 of this chapter, you should be able to:

1. Describe the attributes of a paramedic as a health care professional. (pp. 27–30)2. Describe the benefits of paramedic continuing education and the importance of

maintaining one’s paramedic license/certification. (pp. 30–31)3. List the primary and additional responsibilities of paramedics. (pp. 23–27)4. Define the role of the paramedic relative to the safety of the crew, the patient, and

bystanders. (p. 25)5. Describe the role of the paramedic in health education activities related to illness

and injury prevention. (p. 26)6. Describe examples of professional behaviors in the following areas: integrity,

empathy, self-motivation, appearance and personal hygiene, self-confidence,communications, time management, teamwork and diplomacy, respect, patientadvocacy, and careful delivery of service. (pp. 28–30)

7. Identify the benefits of paramedics teaching in their community. (p. 26)8. Analyze how the paramedic can benefit the health care system by supporting pri-

mary care for patients in the prehospital setting. (p. 25)9. Describe how professionalism applies to the paramedic while on and off duty.

(p. 28)

Part 4: The Well-Being of the Paramedic (begins on p. 31)

After reading Part 4 of this chapter, you should be able to:

1. Discuss the concept of wellness and its benefits, components of wellness, androle of the paramedic in promoting wellness. (p. 31)

2. Discuss how cardiovascular endurance, weight control, muscle strength, and flex-ibility contribute to physical fitness. (pp. 31–34)

3. Describe the impact of shift work on circadian rhythms. (pp. 42–43)4. Discuss the contributions that periodic risk assessments and warning sign recogni-

tion make to cancer and cardiovascular disease prevention. (pp. 32–33)

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5. Differentiate proper from improper body mechanics for lifting and moving patientsin emergency and nonemergency situations. (pp. 33–34)

6. Describe the problems that a paramedic might encounter in a hostile situationand the techniques used to manage the situation. (pp. 45–50)

7. Describe the considerations that should be given to using escorts, dealing withadverse environmental conditions, using lights and siren, proceeding through in-tersections, and parking at an emergency scene. (pp. 46–47)

8. Discuss the concept of “due regard for the safety of all others” while operating anemergency vehicle. (p. 47)

9. Describe the equipment available in a variety of adverse situations for self-protection, including body substance isolation steps for protection from airborneand bloodborne pathogens. (pp. 35–38, 45, 46–47)

10. Given a scenario where equipment and supplies have been exposed to body sub-stances, plan for the proper cleaning, disinfection, and disposal of the items.(p. 37)

11. Describe the benefits and methods of smoking cessation. (p. 33)12. Identify and describe the three phases of the stress response, factors that trigger the

stress response, and causes of stress in EMS. (pp. 41–43)13. Differentiate between normal/healthy and detrimental physiological and psycho-

logical reactions to anxiety and stress. (pp. 43–44)14. Describe behavior that is a manifestation of stress in patients and those close

to them, and describe how that behavior relates to paramedic stress.(pp. 44–45)

15. Identify and describe the defense mechanisms and management techniquescommonly used to deal with stress, discuss research about possible problemsin the use of critical incident stress management (CISM), and identify the ap-propriate mental health services that should be available to EMS personnel.(pp. 44–45)

16. Given a scenario involving a stressful situation, formulate a strategy to help adaptto the stress. (pp. 44–45)

17. Describe the stages of the grieving process (Kübler-Ross) and the unique chal-lenges for paramedics in dealing with themselves, adults, children, and other spe-cial populations related to their understanding or experience of death and dying.(pp. 38–41)

18. Given photos of various motor-vehicle collisions, assess scene safety and pro-pose ways to make the scene safer. (pp. 46–47)

Part 5: Illness and Injury Prevention (begins on p. 47)

After reading Part 5 of this chapter, you should be able to:

1. Describe the incidence; morbidity; and mortality; and the human, environmental,and socioeconomic impact of unintentional and alleged unintentional injuries.(pp. 47–48)

2. Identify health hazards and potential crime areas within the community.(pp. 50–51)

3. Identify local municipal and community resources available for physical, socio-economic crises. (pp. 48–49, 52–53)

4. List the general and specific environmental parameters that should be inspectedto assess a patient’s need for preventive information and direction. (pp. 50–53)

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5. Identify the role of EMS in local municipal and community prevention programs.(pp. 47, 48–53)

6. Identify the injury and illness prevention programs that promote safety for all agepopulations. (pp. 50–53)

7. Identify patient situations where the paramedic can intervene in a preventive man-ner. (pp. 50–53)

8. Document primary and secondary injury prevention data. (pp. 50–53)

Part 6: Ethics in Advanced Prehospital Care (begins on p. 53)

After reading Part 6 of this chapter, you should be able to:

1. Define ethics and morals and distinguish between ethical and moral decisions inemergency medical service. (pp. 53–54)

2. Identify the premise that should underlie the paramedic’s ethical decisions inprehospital care. (pp. 54–55)

3. Analyze the relationship between the law and ethics in EMS. (p. 53)4. Compare and contrast the criteria used in allocating scarce EMS resources.

(pp. 59–60)5. Identify issues surrounding advance directives in making a prehospital resuscita-

tion decision and describe the criteria necessary to honor an advance directive inyour state. (pp. 56–58)

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