Chapter 1 EMT Objectives

Describe the levels of EMT training in terms of skill sets needed for each of the following: EMR

1. Generally are first responders such as law enforcement officers and firefighters 2. EMR training provides these individuals with the skills necessary to initiate immediate care and assist EMTs upon their arrival.

Describe the levels of EMT training in terms of skill sets needed for each of the following: AEMT

1. The AEMT course adds knowledge and skills in specific aspects of ALS for those individuals who are trained and have experience as EMTs: a. IV therapy b. Advanced airway adjuncts c. Administration of a limited number of medications

Discuss the purpose of the EMS continuous quality improvement (CQI) process. (pp 20- 21)

-Continuous quality improvement (CQI) reviews and performs audits of the EMS system to identify areas of improvement and/or assign remedial training. -Continuous quality improvement is a circular system of continuous internal and external reviews and audits of all aspects of an EMS system. By looking at all the components of an EMS system, the CQI process seeks to identify areas that need improvement and enables the problems to be resolved through remediation and training rather than through punitive measures.

Understand the impact of the Health Insurance Portability and Accountability Act (HIPAA) on patient privacy. (p 27)

-Protection of patient privacy has drawn national attention with the passage of the Health Insurance Portability and Accountability Act (HIPAA). -Secure signatures on certain documents such as HIPAA notifications

Define emergency medical services (EMS) systems. (p 5)

1. Consists of a team of health care professionals 2. Provides prehospital emergency care and transport 3. Is governed by state laws

Name the four levels of EMT training and licensure. (pp 6-8)

1. EMR 2. EMT 3. AEMT 4. Paramedic

Describe the levels of EMT training in terms of skill sets needed for each of the following: paramedic

1. Extensive course of training: a. Course hours range from 1,000 to more than 1,300 hours, divided between classroom and internship training. b. The course may be offered within the context of an associate's or bachelor's degree college program. 2. Training covers a wide range of ALS skills: a. Endotracheal intubation b. Emergency pharmacology c. Cardiac monitoring d. Other advanced assessment and treatment skills

Describe EMT licensure criteria; including how the Americans with Disabilities Act (ADA) applies to employment as an EMT. (p 8)

1. High school diploma or equivalent 2. Proof of immunization against certain communicable diseases 3. Successful completion of a background check and drug screening 4. Valid driver's license 5. Successful completion of a recognized health care provider BLS/cardiopulmonary resuscitation (CPR) course 6. Successful completion of a state-approved EMT course 7. Successful completion of a state-recognized written certification exam 8. Successful completion of a state-recognized practical certification exam 9. Demonstration of the mental and physical ability necessary to safely and properly perform all the tasks and functions described in the defined role of an EMT 10. Compliance with other state, local, and employer provisions Americans with Disabilities Act (ADA) of 1990 1. Protects people who have a disability from being denied access to programs and services that are provided by state or local governments 2. Prohibits employers from failing to provide full and equal employment to the disabled

Describe the attributes an EMT is expected to possess. (p 27)

1. Integrity: adhering to a code of fair and honest behavior 2. Empathy: being aware of and thoughtful toward the needs of others 3. Self-motivation: discovering problems and solving them without someone directing you 4. Appearance and hygiene: using your persona to project a sense of trust, professionalism, knowledge, and compassion 5. Self-confidence: knowing what you know and knowing what you do not know; being able to ask for help 6. Time management: performing or delegating multiple tasks while ensuring efficiency and safety 7. Communications: understanding others and making yourself understood to others 8. Teamwork and diplomacy: being able to work with others; knowing your place within a team; communicating while giving respect to the listener 9. Respect: placing others in high regard or importance; understanding that others are more important than you 10. Patient advocacy: constantly keeping the needs of the patient at the center of care 11. Careful delivery of care: paying attention to detail; making sure that what is being done for the patient is done as safely as possible

Describe the roles and responsibilities of the EMT

1. Keep vehicles and equipment ready for an emergency. 2. Ensure the safety of yourself, your partner, the patient, and bystanders. 3. Operate the emergency vehicle. 4. Be an on-scene leader. Emergency Care and Transportation of the Sick and Injured, Eleventh Edition Chapter 1: EMS Systems 5. Perform an evaluation of the scene. 6. Call for additional resources as needed. 7. Gain patient access. 8. Perform a patient assessment. 9. Give emergency medical care to the patient while awaiting the arrival of additional medical resources. 10. Give emotional support to the patient, the patient's family, and other responders. 11. Maintain continuity of care by working with other medical professionals. 12. Resolve emergency incidents. 13. Uphold medical and legal standards. 14. Ensure and protect patient privacy. 15. Give administrative support. 16. Constantly continue your professional development. 17. Cultivate and sustain community relations. 18. Give back to the profession.

Define mobile integrated healthcare and community paramedicine. (p 19)

1. Mobile integrated health care (MIH) is a new method of delivering health care that utilizes the prehospital spectrum. 2. MIH evolved as a result of the Patient Protection and Affordable Care Act, with the goal to facilitate improved access to health care at an affordable price. 3. In the MIH model, health care is provided within the community, rather than at a physician's office or hospital, by an integrated team of health care professionals. 4. This new branch of health care is causing the evolution of additional training levels for EMS providers. a. One new aspect is ***community paramedicine***, in which experienced paramedics receive advanced training to equip them to provide services within a community. b. In addition to the patient care services a paramedic would typically provide, services provided by community paramedics may include: i. Performing health evaluations ii. Monitoring chronic illnesses or conditions iii. Obtaining laboratory samples iv. Administering immunizations

Name the 14 components of the EMS system. (pp 15-26)

1. Public access 2. Clinical care 3. Medical direction 4. Integration of health services 5. Information systems 6. Prevention 7. EMS research 8. Communication systems 9. Human resources Emergency Care and Transportation of the Sick and Injured, Eleventh Edition Chapter 1: EMS Systems 10. Legislation and regulation 11. Evaluation 12. System finance 13. Public education 14. Education systems B. Public access and communication systems 1. Easy access to help in an emergency is essential. 2. The 911 system is the public safety access point 3. At the communication center, trained dispatchers obtain information and dispatch the ambulance crew and other equipment and responders. 4. An emergency medical dispatch (EMD) system has been developed to assist dispatchers in providing callers with vital medical instructions until EMS arrival. 5. New technology can help responders locate their patients. a. Example: cellular telephones linked to Global Positioning System (GPS) units

Describe the levels of EMT training in terms of skill sets needed for each of the following: EMT

1. The EMT course requires about 150 hours, and even more hours in some states. 2. The EMT possesses the knowledge and skills to provide basic emergency care. 3. On arrival at the scene, the EMT assumes responsibility for the assessment, care, package, and transport of the patient.

Describe how medical direction of an EMS system works, and the EMT's role in the process. (p 18)

1. The physician medical director authorizes EMTs to provide medical care in the field. 2. The medical director is the ongoing working liaison between the medical community, hospitals, and the EMTs in the service. 3. Appropriate care is described in standing orders and protocols. a. Protocols are described in a comprehensive guide delineating the EMT's scope of practice. b. Standing orders are part of protocols and designate what the EMT is required to do for a specific complaint or condition. 4. Providers are not required to consult medical direction before implementing standing orders. 5. Medical control can be off-line or online. a. Off-line (indirect) i. Standing orders, training, supervision b. Online (direct) i. Physician directions given over the phone or radio

Discuss the historic background of the development of the EMS system. (pp 9-10)

1. There is a long tradition of people providing emergency medical care to their fellow human beings. 2. Origins of EMS: a. Volunteer ambulances in World War I b. Field care in World War II c. Field medic and rapid helicopter evacuation in Korean conflict 4. EMS as we know it today originated in 1966 with the publication of Accidental Death and Disability: The Neglected Disease of Modern Society (more commonly known as "The White Paper"). 5. DOT published the first EMT training curriculum in the early 1970s. 6. The American Academy of Orthopaedic Surgeons prepared and published the first EMT textbook in 1971. It was the predecessor to the text you are currently using. 7. Efforts are under way to standardize levels of EMS education nationally. a. In the late 1970s, the DOT developed a recommended National Standard Curriculum. b. During the 1980s, many areas enhanced the EMT National Standard Curriculum by adding EMTs with advanced levels of training who could provide key components of ALS care and advanced life-saving procedures. c. In the 1990s, the NHTSA developed the EMS Agenda for the Future, a document with a plan to standardize the levels of EMS education and providers.