Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Paramedic Care: Principles & Practice Volume 1 Introduction to Advanced Prehospital Care

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Chapter 4 Roles and Responsibilities of the Paramedic

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Topics Primary Responsibilities of the Paramedic Personal and Professional Development Professional Ethics Professional Attitudes Professional Attributes Continuing Education

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Primary Responsibilities of the Paramedic

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Primary Responsibilities of the Paramedic Preparation Response Scene size-up Patient assessment Treatment and management Disposition and transfer Documentation Clean-up, maintenance, and review

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Preparation The paramedic must be physically, mentally, and emotionally able to meet job demands. The paramedic must be familiar with inspection and routine maintenance of the emergency vehicle. © CraigJackson/In the Dark Photography

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Preparation A paramedic must be familiar with: –All local EMS protocols, policies, and procedures –Communications system hardware (radios) and software –Local geography –Support agencies

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Response Personal safety is your number one priority. Get to the scene in a timely manner. Anticipate potential high-risk situations based on dispatch information and experience –Request any additional personnel or equipment enroute when possible.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Scene Size-Up Identify all potential hazards. When safe, determine the number of patients. Identify the mechanism of injury or nature of illness. © Mark C. Ide

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Patient Assessment One of the most critical skills you will learn is patient assessment –Initial assessment –Physical examination –Patient history –Ongoing assessment

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Recognition of Illness or Injury First aspect of patient prioritization –Utilizes findings from the scene size up and initial assessment Priority is usually based on the urgency for transport

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Patient Management Protocols ensure consistent patient care –Specify when communication with medical direction will be necessary Management includes movement of the patient from one location to another.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Appropriate Disposition Transportation –Time and distance are key –Air medical vs. ground ambulance Receiving facility –Know the capabilities of the hospitals in your area –Trauma Level I, II, and III –Specialty centers

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Appropriate Disposition Other types of patient disposition –Paramedics may provide primary care Allows transfer to facilities other than hospitals –“Treat and release” Patient in no need of emergency care and is released via Medical Control to other care Managed care may necessitate this disposition

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Patient Transfer When transporting, you share responsibility for the treatment and care of the patient. Before moving a patient from a facility, request a verbal report from the primary care provider. At the destination provide a report to the receiving care provider.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Documentation Complete a patient care report as soon as possible after care has been provided. It is necessary to ensure continuity of care. Be complete, neat, and legible.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Returning to Service Prepare the unit to return to service: Clean and decontaminate Restock Refuel Review the call with crew members Be aware of signs of critical incident stress

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Additional Responsibilities Community involvement Support for primary care Citizen involvement in EMS Personal and professional development

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Community Involvement Primary role in educating community –Recognizing an emergency, how to provide basic life support (BLS), and how to access the EMS system Educational programs can encourage positive health practices in the community. Conduct illness and injury risk surveys

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Community Involvement Benefits of Community Involvement –Enhances the visibility of EMS –Promotes a positive image –Puts forth EMS personnel as positive role models Improves the integration of EMS with other health care and public safety agencies

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Support for Primary Care Help develop services that decrease the need for EMS. Establish protocols that specify the mode of transportation for non-emergency patients. Team up with hospitals to provide an alternative to the emergency department.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Citizen Involvement in EMS Gives outsiders an “insider’s” view Members of the community should be used in the development, evaluation, and regulation of the EMS system –Their needs are your priority

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Personal and Professional Development

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Personal and Professional Development Personal and professional development is your responsibility. Keep updated with journals, seminars, computer newsgroups, and other learning experiences. Explore alternative or nontraditional career paths.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professionalism Profession refers to the existence of a specialized body of knowledge or skills. Professionalism refers to the conduct or qualities that characterize a practitioner in a particular field or occupation –Requires an understanding of what distinguishes the professional from the nonprofessional

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Ethics

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Ethics Ethics are the rules or standards that govern the conduct of members of a particular group or profession. The “Oath of Geneva”

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Ethics 1978 “EMT Code of Ethics” –National Association of Emergency Medical Technicians Details the guiding principles in emergency medical field

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attitudes

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attitudes A commitment to excellence is a daily activity. True professionals establish excellence as their goal. Professionals set high standards for themselves, their crew, their agency, and their system. A professional paramedic is responsible for acting in a professional manner both on and off duty.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Leadership Integrity Empathy Self-motivation Professional appearance and hygiene Communication skills Time management skills Diplomacy in teamwork Respect Patient advocacy Careful delivery of service

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Leadership –Develop a leadership style that suits your personality and will get the job done. Integrity –The single most important behavior that you will be judged by is honesty. –You must be trustworthy. Empathy –To identify with and understand the circumstances, feelings, and motives of others

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Self-motivation –You should be able to motivate yourself and establish a positive work ethic. –Self-motivation is an internal drive for excellence. Appearance and personal hygiene Self-confidence –Accurately assess your strengths and limitations.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Communication –The prehospital environment requires constant communication with the patient, family, and bystanders. –Speaking clearly, listening actively, and writing legibly Time Management –Plan ahead, prioritize tasks, and organize them to make maximum use of time.

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Teamwork and Diplomacy –Diplomacy requires the paramedic to place the interest of the patient or team ahead of his own interests. Respect –To show and feel regard, consideration, and appreciation for others Patient Advocacy –To defend your patient, protect them, and act in their best interests

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Professional Attributes Careful Delivery of Service –The paramedic is expected to deliver the highest quality of patient care with very close attention to detail. –Review of individual performance—and attitude

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Continuing Education

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Continuing Education Maintaining certification is the responsibility of the paramedic. Benefits to participating in continuing education: –Expansion of the paramedic’s own personal knowledge and skills –Keep up with advanced equipment and procedures –Opportunity to review material and address weak points in patient care

Bledsoe et al., Paramedic Care: Principles & Practice, Volume 1: Introduction to Advanced Prehospital Care, 3rd Ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ Summary Primary Responsibilities of the Paramedic Personal and Professional Development Professional Ethics Professional Attitudes Professional Attributes Continuing Education