Chapter 1. Emergency Medical Care Systems, Research, and Public Health. Copyright 2010 by Pearson Education, Inc. All rights reserved.
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1 Chapter 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved.
2 Objectives 1. Define key terms introduced in this chapter. 2. Describe the key historical events that have shaped the development of the emergency medical services (EMS) system, including (slides 17-19): a. Lessons learned in trauma care from experiences in the Korean and Vietnam conflicts b. Publication of Accidental Death and Disability: The Neglected Disease of Modern Society c. Highway Safety Act of 1966 d. Emergency Medical Services System Act of 1973 e. Public CPR courses f. Publication of the National Emergency Medical Services Education and Practice Blueprint
3 Objectives 2. Describe the key historical events that have shaped the development of the emergency medical services (EMS) system, including (slides 17-19): g. Publication of EMS Agenda for the Future and The EMS Education Agenda for the Future: A Systems Approach h. Development of National EMS Core Content, National EMS Scope of Practice Model, and National EMS Education Standards i. The Institute of Medicine report The Future of EMS Care: EMS at the Crossroads
4 Objectives 3. Briefly explain each of the components of the Technical Assistance Program Assessment Standards (slides 20-21): a. Regulation and policy b. Resource management c. Human resources and training d. Transportation e. Facilities f. Communications g. Public information and education h. Medical direction i. Trauma systems j. Evaluation
5 Objectives 4. Discuss the differences between 911 and non-911 EMS access systems, including the features and benefits of 911 systems (slides 23-24). 5. Compare and contrast the scopes of practice of the following levels of EMS providers (slides 25-26): a. Emergency Medical Responder (EMR) b. Emergency Medical Technician (EMT) c. Advanced Emergency Medical Technician (AEMT) d. Paramedic 6. Explain the importance of the EMT s understanding of the health care resources available in the community (slides 27-29).
6 Objectives 7. Give examples of how EMTs can carry out each of the following roles and responsibilities (slides 31-43): a. Personal safety and the safety of others b. Patient assessment and emergency care c. Safe lifting and moving d. Transport and transfer of care e. Record keeping and data collection f. Patient advocacy
7 Objectives 8. Describe the expectations of EMTs in terms of each of the following professional attributes (slides 44-53): a. Appearance b. Knowledge and skills c. Physical demands d. Personal traits e. Maintaining certification and licensure
8 Objectives 9. Discuss the purposes of medical direction/oversight in the EMS system (slides 54-55). 10. Describe the purpose of quality improvement/ continuous quality improvement programs in EMS (slide 56). 11. Explain the EMT s roles and responsibilities in quality improvement (slide 57). 12. Identify activities in EMS that pose a high risk of mistakes and injuries (slides 59-60). 13. Discuss steps that you can take to minimize mistakes and injuries in EMS (slides 59-60).
9 Objectives 14. Discuss the steps of evidence-based decision making (slides 60-61). 15. Explain the limitations of evidence-based decision making in EMS (slide 60). 16. Describe the relationship between EMS and public health (slides 62-63). 17. List the ten greatest public health achievements in the United States in the 20th century.
10 Multimedia Directory Slide 29 EMS and the Community Video Slide 64 Healthy People 2010 Video
11 Topics " The Emergency Medical Services System " The EMT " Research and EMS Care " Public Health
12 Dispatch
13 EMS Unit 121 Respond to Pine Lake Road in Perry Township for an elderly male who has fallen. Perry Township Fire Department is also en route. Time out 1032
14 Upon Arrival 65-year-old male fell approximately 30 feet down embankment Conscious; states injured right arm and leg Rescue preparing to extricate patient
15 How would you proceed?
16 The Emergency Medical Services System Back to Topics
17 A Brief History Back to Objectives
18 A Brief History Korean and Vietnam War White paper Highway Safety Act of 1966 Emergency Medical Services System Act of 1973 American Heart Association CPR
19 A Brief History National Emergency Medical Services Education and Practice Blueprint in 1993 EMS Agenda for the Future EMS Education Agenda for the Future National EMS Core Content in 2005 National EMS Scope of Practice Model The Future of EMS Care: EMS at the Crossroads National EMS Education Standards
20 Technical Assistance Program Assessment Standards Back to Objectives
21 Standards Regulation and Policy Resource Management Human Resources and Training Transportation Facilities
22 Standards Communications Public Information and Education Medical Direction Trauma Systems Evaluation
23 Technical Assistance Program Assessment Standards Access to the EMS system Back to Objectives
24 E911 Cell phones
25 Technical Assistance Program Assessment Standards Levels of Training Back to Objectives
26 Emergency Medical Responder Emergency Medical Technician Advanced Emergency Medical Technician Paramedic
27 Technical Assistance Program Assessment Standards The Health Care System Back to Objectives
28 Specialty Facilities Trauma Burn Obstetric Pediatric Poison Stroke Hyperbaric Cardiac Spine Psychiatric
29 EMS and Community Video Click here to view a video on the topic of EMS, the Community, and Children. Return to Directory
30 The EMT Back to Topics
31 Roles and Responsibilities Back to Objectives
32 Personal safety Safety of others Patient assessment Emergency care Safe lifting and moving Transport and transfer of care Record keeping and data collection Patient advocacy
33 Roles and Responsibilities Personal Safety and the Safety of Others
34 Remember You cannot help the patient, other rescuers, or yourself if you are injured.
35 Scene safety Personal safety Driving safety Patient safety
36 Roles and Responsibilities Patient Assessment and Emergency Care
37 Primary assessment Secondary assessment Beware of changing conditions
38 Roles and Responsibilities Safe Lifting and Moving
39 Safety in movement and equipment Proper body mechanics
40 Roles and Responsibilities Transport and Transfer of Care
41 Transport Facility determination Transport code Drive safely Report to hospital staff
42 Roles and Responsibilities Record Keeping, Data Collection, and Patient Advocacy
43 Complete report Become a patient advocate Be truthful Protect privacy
44 Professional Attributes Appearance Back to Objectives
45 Appearance Groomed Neat, clean appearance In uniform Prepared
46 Professional Attributes Knowledge and Skills
47 Knowledge and Skills Safety Traffic laws Medications Use of equipment Territory Cleaning of equipment
48 Professional Attributes Physical Demands
49 Must be able to lift 125 pounds Good vision Communication skills Hearing Physical Demands ( Craig Jackson/In the Dark Photography)
50 Professional Attributes Personal Traits
51 Personal Traits Calm and reassuring Leadership Good judgment Good moral character Stability and adaptability Ability to listen Resourcefulness Cooperativeness
52 Professional Attributes Maintenance of Certification and Licensure
53 Maintenance of Certification and Licensure Continuing education Skill competency Avoiding criminal or unethical behavior Submitting all fees
54 Medical Direction and Oversight Back to Objectives
55 Medical director Protocols Off-line medical direction On-line medical direction Standing orders Medical oversight
56 Quality Improvement Back to Objectives
57 Back to Objectives
58 Issues in Patient Safety
59 Transfer of care Medical errors Carrying patients Ambulance crashes Lack of spine immobilization High-Risk Activities Back to Objectives
60 Research and EMS Care Back to Topics
61 Evidence-Based Medicine Formulate a question Search medical literature Appraise the evidence for validity and reliability If the evidence supports it, change protocols Back to Objectives
62 Public Health Back to Topics
63 Roles of EMS in Public Health Back to Objectives Health prevention and promotion Disease surveillance Injury prevention
64 Healthy People 2010 Click here to view a video on the Healthy People 2010 initiative. Return to Directory
65 Follow-Up
66 Primary Assessment 65-year-old male, Edgar Robinson Chief complaint: right wrist and right thigh pain Respiration: 24 per minute Pulse: 90 beats per minute Skin warm and dry
67 Secondary Assessment S: Abrasions to arms Pain and deformity of right wrist Deformity, swelling, abrasions, pain in right thigh No feeling or movement of right toes Pulses present in foot Denies losing consciousness
68 Secondary Assessment A: Sulfa drugs M: Metroprolol P: HBP
69 Treatment and Reassessment O 2 via nonrebreather mask Traction splint right leg Wheeled stretcher Reassess patient every five minutes Transfer care without incident
70 Critical Thinking Scenario 78-year-old male patient who appears to be suffering a stroke Patient is unable to speak and appears agitated The patient s niece requests transport to a small local hospital near his residence A designated stroke center is 20 minutes from your location
71 Critical Thinking Questions 1. What are your responsibilities while on this call? 2. How can you serve as the patient s advocate? 3. How can you use medical direction in this situation?
72 Reinforce and Review Please visit and follow the mybradykit links to access content for the text.
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