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Introduction to Emergency Medical Care. History of EMS. Developed during warfare in the 20 th century By 1960, domestic emergency care lagged behind Staffed emergency departments were often linked to large urban areas Funeral homes provided most emergency transport with no training. - PowerPoint PPT Presentation
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Introduction to Introduction to Emergency Medical CareEmergency Medical Care
History of EMSHistory of EMS
Developed during warfare in the 20Developed during warfare in the 20thth centurycenturyBy 1960, domestic emergency care lagged By 1960, domestic emergency care lagged behindbehindStaffed emergency departments were Staffed emergency departments were often linked to large urban areasoften linked to large urban areasFuneral homes provided most emergency Funeral homes provided most emergency transport with no trainingtransport with no training
History of EMSHistory of EMS
1966 publication of 1966 publication of Accidental death and Accidental death and Disability: The Neglected Disease of Disability: The Neglected Disease of Modern SocietyModern Society recommended: recommended:– Development of trainingDevelopment of training– Federal guidelines and policiesFederal guidelines and policies– Provide emergency care and transportProvide emergency care and transport– Established staffed emergency roomsEstablished staffed emergency rooms
History of EMSHistory of EMS
Highway safety Act and the Emergency Highway safety Act and the Emergency Medical Act created federal fundingMedical Act created federal fundingDOT developed first National Standard DOT developed first National Standard Curriculum for EMT training (early 70’s)Curriculum for EMT training (early 70’s)By 1980 EMS is established in most of the By 1980 EMS is established in most of the United StatesUnited States
Layers of TrainingLayers of Training
Lay ResponderLay ResponderFirst ResponderFirst Responder
EMT-BasicEMT-BasicEMT-IntermediateEMT-IntermediateEMT-ParamedicEMT-Paramedic
King County EMS King County EMS SystemSystem
King CountyKing County
King County coverage area
map.
King CountyKing CountyDispatch Centers follow Criteria-Based Guidelines.• Seattle• Eastside
Communications• Port of Seattle• Valley
Communications• Enumclaw
King CountyKing County
Fire/EMS Agencies.• 38 Fire
Departments• 4000 EMTs
King CountyKing County
Medic One.
• 5 agencies• 250 paramedics
King CountyKing County
Hospitals
• Medical control hospitals
• Other hospitals
Layers of CareLayers of Care• Citizens• Emergency dispatchers• EMTs• Paramedics• Emergency Departments
Chain of AccountabilityChain of Accountability
• Washington State RCW and WAC
• County Medical Program Director
• Program Medical Directors• Emergency physicians at
medical control hospitals • EMTs and paramedics
Roles & ResponsibilitiesRoles & Responsibilities
Personal SafetyPersonal Safety– Safety of self, crew, patient, and bystandersSafety of self, crew, patient, and bystanders
Patient AssessmentPatient Assessment– Patient car based on assessment findingsPatient car based on assessment findings
Lifting and moving patients safelyLifting and moving patients safelyTransport and transfer of careTransport and transfer of careRecord keeping/data collectionRecord keeping/data collectionPatient AdvocacyPatient Advocacy
EMT Top 10 ListEMT Top 10 List
10. Be Professional10. Be Professional
Act the partAct the partFocus on the patient’s problemFocus on the patient’s problemListen to the patient!Listen to the patient!Keep family informedKeep family informedBedside mannerBedside mannerRespect privacy of patientRespect privacy of patient– ConfidentialityConfidentiality
9. Always Be a Student9. Always Be a Student
Certification every 3 years, on-going Certification every 3 years, on-going through CBTthrough CBTEMS Online resource websiteEMS Online resource websiteRemember every patient can teach you Remember every patient can teach you somethingsomethingDon’t forget to talk with the doctorDon’t forget to talk with the doctorThe day you stop learning is the day you The day you stop learning is the day you retire from this professionretire from this profession
8. Document Everything8. Document Everything
Documentation is your friend and will Documentation is your friend and will protect you when you memory failsprotect you when you memory failsVital signsVital signsPatient informationPatient informationDescriptive narrativesDescriptive narrativesAlways document unusual situationsAlways document unusual situationsIf you did not document it, it did not If you did not document it, it did not happen!happen!
7. Embrace Change7. Embrace Change
New protocols and guidelines for CPR, New protocols and guidelines for CPR, FBAO, and resuscitationFBAO, and resuscitationROCROCSPHERESPHEREAlert CardsAlert CardsNew protocols and procedures!New protocols and procedures!
6. Follow Established Guidelines6. Follow Established Guidelines
US Department of Transportation US Department of Transportation curriculumcurriculumWashington State certificationWashington State certificationKing County guidelines (blue book King County guidelines (blue book protocols)protocols)Local policies as outlined by agencyLocal policies as outlined by agency
5. Seek Help5. Seek Help
Stay humbleStay humbleHelp from your partnersHelp from your partners
Help from your paramedicsHelp from your paramedicsHelp from hospital controlHelp from hospital control
4. Be Safe4. Be Safe
Above all else, your safety is tantamount Above all else, your safety is tantamount to all that we do.to all that we do.Take care of yourselfTake care of yourselfRemember to be proactive in the use of Remember to be proactive in the use of PPE/BSIPPE/BSIDrive safely…it’s not your emergencyDrive safely…it’s not your emergencyEveryone goes home at the end of the Everyone goes home at the end of the shiftshift
3. Stick to the Basics3. Stick to the Basics
SICK or NOT SICK!SICK or NOT SICK!Vital signs, MOI, NOI, IOSVital signs, MOI, NOI, IOSCommon sense and good judgmentCommon sense and good judgmentRemember, it’s okay if you cannot Remember, it’s okay if you cannot diagnose what is wrong with the patient, diagnose what is wrong with the patient, it’s not okay if you fail to take care of what it’s not okay if you fail to take care of what you know how to take care.you know how to take care.
2. Take Pride in our System2. Take Pride in our System
International reputationInternational reputationHighest cardiac arrest survival rate in the Highest cardiac arrest survival rate in the worldworldHighest rates of bystander CPRHighest rates of bystander CPRHighest taxpayer support (Medic 1 Levy)Highest taxpayer support (Medic 1 Levy)Highest trained paramedics in the worldHighest trained paramedics in the worldBest EMT trainingBest EMT training
1. Take Pride in Yourself1. Take Pride in Yourself
Helping others is a proud and noble Helping others is a proud and noble professionprofessionProvide care, comfort, and compassion to Provide care, comfort, and compassion to all patients…equallyall patients…equallyExceed expectations, strive to be your Exceed expectations, strive to be your best in every situationbest in every situationApproach each day with courage and Approach each day with courage and convictionconviction
EMT Well-BeingEMT Well-Being
The Well- Being of the EMTThe Well- Being of the EMT
Personal health, safety, and well-being are Personal health, safety, and well-being are vital to any EMS operationvital to any EMS operationIntrinsic dangers and hazards of our Intrinsic dangers and hazards of our occupation vary greatly from call to calloccupation vary greatly from call to callYou will be constantly faced with mental You will be constantly faced with mental and physical stresses on the joband physical stresses on the jobEven the most experienced provides have Even the most experienced provides have difficulty overcoming personal reactions difficulty overcoming personal reactions
Understand the causes of stress Understand the causes of stress to prevent it from negatively to prevent it from negatively
affecting you!affecting you!
Remember, if you cannot take Remember, if you cannot take care of yourself, how will you care of yourself, how will you
take care of others?take care of others?
Stressful SituationsStressful Situations
Death and dyingDeath and dyingMass-casualty incidentsMass-casualty incidentsSevere traumaSevere traumaAbuseAbuseCo-worker death or injuryCo-worker death or injuryVehicle accident caused by EMS Vehicle accident caused by EMS personnelpersonnelViolent scenesViolent scenes
Warning SignsWarning Signs
PhysicalPhysical– FatigueFatigue– Changes in Changes in
appetiteappetite– HeadachesHeadaches– InsomniaInsomnia– IrritabilityIrritability
Warning SignsWarning Signs
Psychological:Psychological:– FearFear– DepressionDepression– AngerAnger– FrustrationFrustration– Inability to copeInability to cope
Stress ManagementStress Management
Understand the effects of stressUnderstand the effects of stressFind balance in your lifeFind balance in your lifeChange or eliminate stressorsChange or eliminate stressorsAvoid complaining or worrying about Avoid complaining or worrying about things you cannot changethings you cannot changeExpand your social support systemExpand your social support systemTake care of yourself: diet, exercise, sleepTake care of yourself: diet, exercise, sleep
Stress Management ResourcesStress Management Resources
Partners and co-workersPartners and co-workers– Be open with and aware of each otherBe open with and aware of each other
Family membersFamily membersChaplainsChaplainsWellness Counseling and EAPWellness Counseling and EAPCISMCISM
Critical Incident Stress DebriefingCritical Incident Stress Debriefing
Held within 48-72 hours of a major incidentHeld within 48-72 hours of a major incidentAll information is confidentialAll information is confidentialCISD leaders and mental health CISD leaders and mental health professionals offer suggestions for professionals offer suggestions for overcoming stressovercoming stressCan be initiated by anyoneCan be initiated by anyone
CISM SystemCISM System
Pre-incident stress Pre-incident stress educationeducationPeer supportPeer supportCISDCISDFollow-up servicesFollow-up servicesSpouse and family Spouse and family support systemsupport system
Scene SafetyScene Safety
Hazardous materialsHazardous materials– Identification and isolationIdentification and isolation
ElectricityElectricity– Live electricity is difficult to seeLive electricity is difficult to see– Power off at sourcePower off at source
FireFire– Protective gearProtective gear– Do only what you have been trained to do!Do only what you have been trained to do!
Scene SafetyScene Safety
Violent ScenesViolent Scenes– Civil disturbances, domestic disputes, crime Civil disturbances, domestic disputes, crime
scenes, large gatherings (mobs)scenes, large gatherings (mobs)
Motor vehicle accidentsMotor vehicle accidents– Safety at sceneSafety at scene
Highways, streets, and roadsHighways, streets, and roads– Moving traffic is a major hazard!Moving traffic is a major hazard!
Body Substance IsolationBody Substance Isolation
Minimum protection Minimum protection on all calls: gloves on all calls: gloves and eye protectionand eye protectionMask and gowns per Mask and gowns per RGT policyRGT policyHand washing and Hand washing and sanitizer usesanitizer useSharps disposalSharps disposal
Body Substance IsolationBody Substance Isolation
Always use Body Substance isolation Always use Body Substance isolation precautionsprecautionsAlways us a barrier between yourself and Always us a barrier between yourself and the patientthe patientAlways wash/sanitize your hands after Always wash/sanitize your hands after each patient contacteach patient contactMake certain immunizations are up to dateMake certain immunizations are up to dateBe careful handling sharpsBe careful handling sharps
Remember, to always take Remember, to always take care of yourself first…care of yourself first…
...BSI and Scene Safety...BSI and Scene Safety
