Chapter 1 Emergency Medical Care Systems,Research,and Public Health

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Discuss the differences between 911 and non-911 EMS access systems,including the features and benefits of911 systems.

911- is the universal phone number used nationwide to access emergency services, including police,fire, and EMS non-911 or E911- is the most common used. Provide automatic location identification, which indicate the exact address and phone number from which the call is being made.

Discuss the steps you can take to minimize injuries in EMS.

Develop clear protocols, light the scene effectively, try to minimize interruptions during assessment and emergency care, clearly marl all drugs and packages, reflect on all actions, question all assumptions, use decision aids if necessary, ask for assistance if you need it.

Explain EMT roles in quality improvement.

Document carefully, perform reviews and audits, obtain feedback, maintain equipment, participate in continuing education, maintain skills.

Describe the key historical events that have shaped the development of the emergency medical services (EMS) system.

During the Korean and Vietnam conflicts. It become obvious that injured soldiers benefited from emergency care in the field prior to transport.

Describe the relationship between EMS and public health.

EMT is apart of the public health team. Public health deals with protecting the health of the entire population.

Give examples of how an EMT carries out their responsibilities and roles.

EMT responsibilities include; personal safety and the safety of others, patient assessment and emergency medical care, safe lifting and moving, patient transport and transfer, record keeping and data collection, and patient advocacy.

Explain the importance of EMT understanding of the healthcare resources available in the community.

Here, patients are stabilized for further care. Some patients may need to be transferred to a special facility. You will be in a position to service liason between the community medical service and public safety workers.

Discuss the medical direction/ oversight and quality improvement in EMS.

Medical direction is policies, procedures, and practices available either offline or online. These guidlelines are referred to as protocol. Oversight is a medical physician who is legally responsible for EMS.Quality improvement is a system a internal and external reviews and audits of an EMS system to ensure high quality of care.

Identify activities in EMS that pose high risk of mistakes and injuries.

Transfer of care, poor communication, carrying and moving patients, involvement in ambulance crashes, lack of spinal immobilaztion.

List the 10 greatest public health achievements on the United States.

Vaccinations, motor vehicle safety, workplace safety, control of infectious diseases, reduction in death from coronary heart disease and strokes, safer and more healthful foods, decline in maternal and infant mortality, use of barrier devices during sexual contact, fluoridation of drinking water, reduction in use of tobacco products.

Describe the expectations of EMT in terms of professional attributes.

Appearance, knowledge, skills, ability to meet physical demands, general interests, and temperment, and maintenance of certification and licensure.

Compare and contrast the scopes of practice of the four levels of EMS

Emergency Medical Responder (EMR)- provides immediate lifesaving care. EMR use airway, ventilation,and oxygen therapy devices, take vital signs,and provide stabilization. Emergency Medical Technician (EMT)- Same as EMR but also provide transport and medical care. advanced oxygen therapy,and ventilation equipment,pulse oximetry, use of automatic blood pressure . Advanced Emergency Medical Technician (AEMT)-Provides all of the skills of EMT with the addition of the use of advance airway devices,monitoring of blood glucose levels,initiation of intravenous and intraosseous infusions,and limited medications. Paramedic-all the things an EMT and AEMT do with the addition of advanced assessment, form a field impression, and their care is to reduce disability and death in patients.

Discuss the steps and limitations of evidence based decision making.

Formulate a question, search medical literature, appraise the evidence, If evidence supports a change in practice, change the protocol and implement the change on pre-hospital care.

Briefly explain each of the components of the Technical Assistance Program Assessment Standard

Regulation and policy- each state must have laws, regulations, policies,and procedures that govern its EMS system.. Resource management-central control of EMS resources so that each locality and all patients have equal access to acceptable emergency care. Human resource and training-personnel who staff ambulances and transport patients must be trained to at least EMT level. Transportation-Patients must be provided with safe reliable transportation by ground or air ambulance. Facilities-All seriously ill or injured patient must be delivered in a timely mannerto an appropriate medical facility . Communication-system and communications must be in place to provide public access to the system to provide communication among dispatch,EMS personnel,and hospital. Public information and education-EMS personnel should participate in programs designed to educate the public in the prevention of injuries and how to properly and appropriately access the EMS system. Medical direction-Physician as a medical director to provide medical oversight that includes overseeing the patient care and delegating appropriate medical practices to EMT's and others EMS personnel. Trauma systems-develop a system of specialized care for trauma patients. Evaluation-quality improvement system for the continuing evaluation and upgrading of the system.