Chapter 3 Interfacing with EMS and Other Medical Personnel

Chapter 3: Interfacing with EMS and Other Medical Personnel 2 Differentiate the roles and responsibilities of the OEC technician and the EMT-B from other prehospital care providers. Define medical direction and discuss the OEC technician’s role in the process. Compare the OEC program with the urban EMS system. Objectives (1 of 2)

Chapter 3: Interfacing with EMS and Other Medical Personnel 3 Characterize the various methods used to access the following systems in your patrol or community. –Incident Command System –Local law enforcement –Search and rescue interface –Ambulance interface –EMS system Objectives (2 of 2)

Chapter 3: Interfacing with EMS and Other Medical Personnel 4 The EMS System Each state is slightly different. OEC is not subject to state licensing. Components of the system: –On-scene medical stabilization –Transport to definitive care

Chapter 3: Interfacing with EMS and Other Medical Personnel 5 History of EMS National Traffic and Motor Vehicle Safety Act of 1966 Highway Safety Act of 1966 Emergency Medical System Act of 1973 –Listed essential components of EMS 1996 EMS Agenda for the Future –New essential components of EMS

Chapter 3: Interfacing with EMS and Other Medical Personnel 6 State EMS Offices Lead agency that establishes and enforces standards Various regional and local authorities may co-exist and have similar duties. NSP communicates with all state EMS offices annually.

Chapter 3: Interfacing with EMS and Other Medical Personnel 7 State and Regional Protocols Protocol-driven medical control –On-line communication with control facility  Direct orders are issued. –Off-line medical control  Written set of procedures for usual situations –Most systems are a combination.

Chapter 3: Interfacing with EMS and Other Medical Personnel 8 National Training Curriculums National Highway Traffic Safety Administration (NHTSA) is governing agency Training levels –First Responder –EMT-Basic (EMT-B) –EMT-Intermediate (EMT-I) –EMT-Paramedic (EMT-P)

Chapter 3: Interfacing with EMS and Other Medical Personnel 9 The OEC System BLS vs. ALS OEC vs. urban EMS Standard of training vs. standard of care

Chapter 3: Interfacing with EMS and Other Medical Personnel 10 Comparison of OEC and EMS (1 of 2) OECEMS OEC technicians do not require state or local licensing. No formal licensing within the local EMS system Each state’s licensing for EMS providers is slightly different. US DOT curriculum—BLS (some ALS) Protocol driven US DOT curriculum—BLS through ALS for various EMT- level training Protocol driven with medical control

Chapter 3: Interfacing with EMS and Other Medical Personnel 11 OECEMS First response to emergency circumstances in nonurban, outdoor environment (stabilizing and transport and transfer) to enter the local EMS system Typically, urban, on-scene medical stabilization with transport to definitive care Continuing Education (CE) 1/3 of curriculum annually in refresher program (some content applies to EMS CE- approved hours; however, varies by state) Continuing Education (CE) Content and hours generally specified by state licensing agency Comparison of OEC and EMS (2 of 2)

Chapter 3: Interfacing with EMS and Other Medical Personnel 12 Standard of Care (1 of 2) Standard imposed by local custom –Often based on locally accepted protocols Standard imposed by the law –May be imposed by statutes, ordinances, administrative guidelines, or case law

Chapter 3: Interfacing with EMS and Other Medical Personnel 13 Standard of Care (2 of 2) Professional or institutional standards –Recommendations published by organizations and societies –Specific rules and procedures of your service or organization

Chapter 3: Interfacing with EMS and Other Medical Personnel 14 Role of Ski Patrollers First responder –Assess situations and provide treatment Local ski patrol organization Ski area policy and procedures

Chapter 3: Interfacing with EMS and Other Medical Personnel 15 Ski Patrol Operations (1 of 2) Dispatch Notification Initial assessment Initial transport

Chapter 3: Interfacing with EMS and Other Medical Personnel 16 Ski Patrol Operations (2 of 2) Ongoing assessment and care in an aid room Resort medical clinics Documentation Formal EMS transfer and transport

Chapter 3: Interfacing with EMS and Other Medical Personnel 17 Ambulance Interface (1 of 2) Expectations Responsibilities and protocols Training and staffing

Chapter 3: Interfacing with EMS and Other Medical Personnel 18 Ambulance Interface (2 of 2) Problem resolution Continuing education interface Medical director

Chapter 3: Interfacing with EMS and Other Medical Personnel 19 Physician Involvement Can be challenging –Define responsibility to care –Invite participation Physician-patrollers –Asset –Legal constraints

Chapter 3: Interfacing with EMS and Other Medical Personnel 20 Medical Control Medical director Patrol protocols Physician patrols