Chapter 1 notes EMT - Mike Smith EMS Instructor PDF

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Mike Smith EMS Instructor...

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Gina Alaniz EMS 111 Mike Smith Chapter 1 Notes: Preparatory and Public Health Intro: NHTSA developed the Technical Assistance program assessments standards as recommended guidelines for EMS systems. Independent of federal government control. Most EMS systems are accessed using the universal number 911. Quick access via the number has decreased response times. Enhanced 911 systems provide the name, geo location, and phone number for the landline the call was dialed through. The downfall is there are more restrictions through internet call, also cellphones ping their location to the closest cell phone tower. The 4 levels of EMS training in the national EMS scope of practice model are: EMR, EMT, AEMT and Paramedic. EMT has multiple roles and responsibilities: Safety, Patient Assessment, Emergency care, Transport and transfer care, patient advocacy, professional appearance, knowledge and skills, ability to handle physical demands, and positive personality traits. Many of these roles and responsibilities are important to be an EMT. Medical oversight is key to any EMS system, an EMT cannot function without medical direction. One aspect of medical direction is to develop standing orders and protocols. Medical direction maybe offline in the form of patient care orders, or online, in which EMS personnel communicate directly with the physician or a designee for oral patient care orders.

To improve the EMS system, a Quality Insurance check must be performed to spot any weak link or shortcoming. QI is a continuous process that involves all aspects of the system, including the personnel providing the care. Patient safety is also key in EMS practice. Prehospital care continues to evolve due to current research. New techniques and treatments are not used unless adequate research supports their effectiveness. Techniques used in the past and current are now supported, changed or eliminated due to evidence-based guidelines. More research is necessary for EMS. MIH and CP are broadening the focus of EMS to include patient education, preventative care, chronic disease management, post discharge follow up and alternative healthcare for patients. This increased EMS value in the overall health care system. Scene Size up: 

Number of patients

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Mechanism of Injury/Nature of Illness

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Resource Determination

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Standard Precautions Determination such as gloves/mask.

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Scene Safety

Prime examples of different level care facilities that specialize in certain medical emergencies are: 

NICU/ICU

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L and D

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Medsurg

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Burn units

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Neuro

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Oncology

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Pediatrics

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Neuro

An EMT’s role in QI is a part of every call for the EMT. 

Scene size up

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Assessment

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Secondary Assessment

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Reassessment

The EMS physician medical director’s main responsibility is to oversee all medical aspects of EMS in an effort to assure it’s quality of patient care. Also here are three prime examples of showing patient advocacy: 

Caring touch

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Seek to understand before being understood

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Talk to the patient with respect and no presumption

Vocab List: 

Indirect Medical Oversight: Routine duties and responsibilities of the EMS medical direction, including the creation of protocols and standing orders.

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EMR: Is the first person on scene with emergency care training.

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QI: A system of internal and external reviews and audits of an EMS system to ensure a high quality of care, it is a continual and repeated process.

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Medical Direction: Medical policies, procedures and practices that are available to EMS providers either offline or online.

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Direct Medical Oversight: Real time oversight provided by a physician to an EMS provider seeking immediate feedback; or direction, whether off or on scene.

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Prehospital care: EMS treatment given to patients before they’re transported to a hospital or facility.

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Standing Orders: Preauthorized treatment procedures and treatment protocols.

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EMT: Provides basic EMS and transportation to patients who access the EMS system includes, oxygen therapy and ventilator, pulse oximetry, use of blood pressure monitoring equipment, and limited medicine administration.

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Online Medical Direction: Direct orders from a physician to prehospital care provider given by radio and or telephone.

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ADA: Federal law passed in 1990 that protects individuals with a documented disability from being denied initial or continued employment based on their disability.

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On Scene Medical Direction: Medical direction provided by an EMS medical director physician who’s on scene with the EMS crew.

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Protocols: The policies and procedures for all components of the EMS system, AKA orders.

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Medical Oversight: The medical director’s broad responsibilities.

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CP: Services provided by the EMS agency and personnel that are administratively and clinically integrated with other healthcare entities.

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Paramedic: This individual provides the highest level of prehospital care, including advanced assessments and care, form of field impression, and invasive drug interventions.

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Offline Medical Direction: Medical policies, procedures and practices that medical direction has established as written guidelines.

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Evidence based guidelines: Development of medical guidelines based on scientific evidence and research studies.

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Evidence based medicine: Medical practice based on scientific evidence that certain procedures, medications, and equipment that improve the patient’s outcome.

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EMS System: Emergency medical service system

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Medical director: Physician legally responsible for the clinical and patient care aspects of an EMS system.

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MIH: Provision by a variety of healthcare entities and practitioners of patient-centered healthcare in and out of hospital environment using mobile technology and resources and integrated administration or clinical with the EMS system.

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AEMT: They are responsible for EMT duties with the addition of usage of airway devices, monitoring blood glucose levels, initiation of intravenous and intraosseous infusions, and administration of a select number of medicines....