Chapter 1 Emergency Medical Responder and Emergency Medical Services EMR 1-1 1-

Introduction The EMR is an essential part of the Emergency Medical Services (EMS) EMRs are often the first trained providers to arrive on the scene Training includes knowledge and skills in basic medical and trauma assessment and management Along with being trained, the EMR needs to be professional EMR must follow the legal and ethical scope of practice Cont. 1-

Emergency Medical Services (EMS) Components Learning Objective 1 Emergency Medical Services (EMS) Components EMERGENCY MEDICAL SERVICES Network of professionals Level of service dispatched to an emergency call varies The EMS system is initiated with a call for service Level of care a patient receives en route depends on several factors Cont. EMR 1-3

Emergency Medical Services (EMS) Components Learning Objective 1 Emergency Medical Services (EMS) Components EMERGENCY MEDICAL SERVICES EMR 1-4

Emergency Medical Services (EMS) Components Learning Objective 1 Emergency Medical Services (EMS) Components COMPONENTS Public EMS Fire base EMS Private EMS Third service Other EMS response positions EMR 1-5

Public Safety Answering Points (PSAP) Learning Objective 2 Public Safety Answering Points (PSAP) PUBLIC SAFETY ANSWERING POINTS Dispatch is most often initiated with a 9-1-1 call Center is a local dispatch office staffed with professionals PSAPs may be part of a sheriff’s office, local fire or police department, or similar organization Large cities may have their own call centers EMR 1-6

Public Safety Answering Points (PSAP) Learning Objective 2 Public Safety Answering Points (PSAP) THE 9-1-1 SYSTEM The U.S. national emergency number Prefix may be required to reach an outside line ENHANCED 9-1-1 Hard-wired telephones have enhanced 9-1-1 Operator immediately sees name and address Address is relayed to the responding agency EMR 1-7

Public Safety Answering Points (PSAP) Learning Objective 2 Public Safety Answering Points (PSAP) TECHNOLOGY AND 9-1-1 Cell phones and global positioning satellite (GPS) Calls are routed to the closet PSAP tower Tower may be in a different jurisdiction or state Difficulties for emergency personnel to respond EMR 1-8

Define Medical Oversight Learning Objective 3 Define Medical Oversight AUTHORIZATION TO PRACTICE Each state independently regulates the practice of medicine EMR professionals are certified to practice in a specific area State County Region EMR 1-9

Define Medical Oversight Learning Objective 3 Define Medical Oversight MEDICAL DIRECTOR Usually a Doctor of Osteopathy (DO) or a Medical Doctor (MD) Directs on-scene activities Establishes protocols for EMS Grants variances to standard scope of practice Provides advice and medical oversight EMR 1-10

Define Medical Oversight Learning Objective 3 Define Medical Oversight PROTOCOLS Medical guidelines Form a decision tree Provides procedures to perform and techniques to use Can be expanded or restricted Medical director’s responsibility of protocols Training Performance of skills EMR 1-11

Quality Improvement and Quality Assurance Learning Objective 4 Quality Improvement and Quality Assurance QUALITY MANAGEMENT Ensures quality of the service Means by which to achieve highest quality of service Patient safety and the reduction of errors Two components Quality assurance Quality improvement EMR 1-12

Quality Improvement and Quality Assurance Learning Objective 4 Quality Improvement and Quality Assurance QUALITY ASSURANCE Monitor and evaluate all aspects of EMS services Improve the quality care the EMS system provides QUALITY IMPROVEMENT Formal review and analysis of performance and processes Goal of reducing medical errors EMR 1-13

Quality Improvement and Quality Assurance Learning Objective 4 Quality Improvement and Quality Assurance POLICIES What is expected and what is not allowed Typical policies PROCEDURES Employer-required steps to follow when providing patient care Common procedures EMR 1-14

Quality Improvement and Quality Assurance Learning Objective 4 Quality Improvement and Quality Assurance SUNSET CLAUSE Requires policies and procedures to be reviewed Every three to five years or as they expire Each agency writes, revises, and enacts its own set of policies and procedures Ask for clarification when unsure about a policy or procedure EMR 1-15

Role of an Emergency Medical Responder (EMR) Learning Objective 5 Role of an Emergency Medical Responder (EMR) ROLES AND RESPONSIBILITIES Readiness Classroom and hands-on training Safety Personal safety first Caring for patients Communication Cont. EMR 1-16

Role of an Emergency Medical Responder (EMR) Learning Objective 5 Role of an Emergency Medical Responder (EMR) ROLES AND RESPONSIBILITIES Patient advocacy Continuous care and transfer Patient confidentiality Professionalism Education and training EMR 1-17

Role of an Emergency Medical Responder (EMR) Learning Objective 5 Role of an Emergency Medical Responder (EMR) EMS TRAINING LEVELS Emergency medical responder (EMR) Entry level for EMS Emergency medical technician (EMT) Advanced emergency medical technician (AEMT) Paramedic Highest level of training for prehospital providers EMR 1-18

Ethics with Patients, Health Care Professionals, and the Public Learning Objective 6 Ethics with Patients, Health Care Professionals, and the Public CHARACTER Core values are basic personal beliefs and behaviors Directs everything you do in your profession ETHICAL BEHAVIOR Doing what is right based on a set of moral principles and values EMRs need to rely on core values EMR 1-19

Ethics with Patients, Health Care Professionals, and the Public Learning Objective 6 Ethics with Patients, Health Care Professionals, and the Public ADDITIONAL RESPONSIBILITIES TO CONSIDER Bystanders Connection to patient Witnessed the incident Technology Pictures Video Text messages EMR 1-20

Identify Three Types of Medical Errors Learning Objective 7 Identify Three Types of Medical Errors MEDICAL ERRORS Skill-based errors Knowledge-based errors Rule-based errors Research activities Legal considerations EMR 1-21

Explain the Three Types of Consents Learning Objective 8 Explain the Three Types of Consents CONSENT Informed consent Expressed consent Implied consent Treatment of minors and emancipated minors In loco parentis Emancipated minor EMR 1-22

Differentiate Abandonment and Negligence Learning Objective 9 Differentiate Abandonment and Negligence ABANDONMENT Leaving patient still in need of care, unsupervised Failure to do so is a crime NEGLIGENCE Not upholding accepted medical practice Common elements found in cases of negligence EMR 1-23

Differentiate Abandonment and Negligence Learning Objective 9 Differentiate Abandonment and Negligence ASSAULT A patient is afraid that he or she may be touched without having given consent BATTERY Actually unlawfully touching the patient against his or her wishes EMR 1-24

Explain the Good Samaritan Law Learning Objective 10 Explain the Good Samaritan Law GOOD SAMARITAN LAW Meant to provide legal protection for a person who voluntarily assists an injured or ill person Rescuer is not expecting a reward Rescuer provides care in good faith Ways to protect yourself from legal liability EMR 1-25

Define Culture of Emergency Services Learning Objective 11 Define Culture of Emergency Services CULTURE OF EMS Structure and history of an EMS agency EMR must respect and understand this culture Industrial response teams have a distinct culture The most important component will always be the successful treatment of the patients EMR 1-26

Summary Standards to become an EMR are meant to establish minimum requirements EMR must see this level is a starting point An EMR will have the opportunity to compile the skills that best serve the community EMRs must demonstrate ethical behavior and professionalism Above all, provide quality patient care within the individual’s scope of practice EMR 1-27 1-