1. Introduction to EMS Systems Chapter 1

2. Components of Emergency Medical Services (EMS) System  Care begins at the emergency scene  Formal transfer of care takes place at the hospital (in the ER or ED)  Medical facility ensures smooth transition and continuation of care

3. Resources in EMS System  Ambulances  Law enforcement  Fire department  Hospitals  Communication centers  Air medical transport  Rescue squads  Specially trained personnel

4. Chain of Events in EMS System  Call for EMS – usually a bystander makes call to 911  Public safety answering point- location where emergency calls are answered  Emergency medical dispatcher- person trained to answer and prioritize calls  Enhanced 911- communication center automatically receives caller information (phone #, address)  Personnel and other resources dispatched to the scene (Most emergency calls end up in ER, but not all)

5. Medical Oversight  Medical director- physician who assumes responsibility for direction of all patient care of EMS system  Protocols- written guidelines that direct care that EMS personnel provide to patients. Ex: protocols for chest pain, difficulty breathing, cardiac arrest, etc. Also referred to as standing orders (off-line or indirect medical direction)  Procedures not covered under standing orders require medical direction by phone, which is on-line or direct medical direction

6.  EMS personnel must provide care that is within their scope of practice (protocols and guidelines set by local, state, or regional regulations  Department of Transportation set national standard curriculum for EMS responders

7. Types of EMS Responders Paramedic Advanced Emergency Medical Technician Emergency Medical Technician Emergency Medical Responders

8. Emergency Medical Responder (EMR)  Previously referred to as First Responder  Training emphasizes scene safety, and how to provide immediate care for life- threatening injuries/illnesses  Assist ambulance personnel whey arrive  Police officers, firefighters

9. Emergency Medical Technician (EMT)  Minimum level of certification for ambulance personnel  Training emphasizes assessment, care, and transportation of ill or injured patients.  Assists with administrations of common medications.  Formerly called EMT-Basic

10. Advance Emergency Medical Technician (AEMT)  Basic-level EMT with additional training in certain skills, such as starting IV, inserting advanced airways, medication administration  Formerly EMT-Intermediate

11. Paramedic  Highest level of training for ambulance personnel  Trained to insert endotracheal tubes, start IVs, interpret EKGs, monitor cardiac rhythms, cardiac defibrillation  Formerly EMT-Paramedic

12. Roles and Responsibilities of EMR  Personal safety- #1 priority  Is the scene safe? Do not approach victim if area is not safe. Ex: violence, burning building  Avoid contact with infectious material by using personal protective equipment (PPE)  Disposable gloves  Barrier devices (face masks)  Protective eye wear (goggles, face shields)  Gowns or aprons

13.  Patient-related duties  Size up scene  Determine patient’s chief complaint or injury  Lift, move, reposition patient ONLY if necessary  Transfer patient and patient information  Protect patient’s privacy and maintain confidentiality  Be patient’s advocate

14. Traits of an EMR  Willingness to take on certain duties/responsibilities  Study to be up to date on licensure  Respectful of others  Ability to overlook rude behavior  Ability to respect others’ cultures, beliefs, socioeconomic background, age, gender, etc.