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Introduction To Emergency care Emergency Medical Technician Programme
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Objectives Healthcare Providers Components of the Pre-Hospital Emergency Care System Roles and Responsibilities
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Objectives Professional attributes required Medical direction Well being of the E.M.T.
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Healthcare providers
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Cardiac First Responder Occupational First Aid Emergency First Responders Emergency Medical Technicians Paramedic Advanced Paramedic Nurses Allied Health Staff Doctors / Surgeons
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Components
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Bystander Medical dispatcher First Aid / CFR Emergency First Responder Emergency Medical Technician Paramedic Advanced Paramedic Emergency hospital staff
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Bystander 999 0R 112
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Bystander Your telephone number Exact location Type of emergency Number of casualties Details of any hazards STAY CALM
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Medical dispatcher Medical Priority Dispatch System Information on patient care “on screen”
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First aid Most businesses will have an Occupational First Aid or CFR response
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First responder EMPHASIS Activating EMS Care for life threatening injuries Control of scene Prepare for arrival of EMT – EMT/P – EMT/AP
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Emergency medical technician
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EMT – EMT/P – EMT/AP Firefighter
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Advanced provider
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Emergency hospital staff
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Trauma Centers Burn Centers Pediatric Centers Poison Control Centers
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Roles and responsibilities of the EMT
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Personal safety Number 1 priority
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Safety of patient
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Patient assessment
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Patient care
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Moving & lifting
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Transportation
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Transfer of care
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Keeping of records Patient Care Report Legal Document
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Importance of documentation Provides a written legal record of the incident Data collection Quality improvement (Audit process) Professionalism
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EXAMPLE OF A P.R.F.
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Records and reports Patient Care Report is considered a legal document ! Don’t leave any blanks Should be written at time of handover or en route to hospital if situation allows
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Records and reports Be honest, never record observations not made One line through error to keep it legible, then initial, (example on next slide)
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PCR completion Guide
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Patient advocacy
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Professional Attributes
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Professional attributes Appearance & personal hygiene Attitude / honesty Knowledge and effectiveness ( skills ) Attention to patients needs Health & Fitness
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Medical direction
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On line medical direction Off-line Medical Direction Your own organisations protocols Standing orders Critical Practice Guidelines
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Example of “on-line medical direction” DOCTOR E.M.T.
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Example of “off-line medical direction”
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Well being of the EMT.
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Well being of the EMT Emotional stress Scene safety Standard Precautions
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STRESS What is stress? “A bodily or mental tension caused by physical, chemical, or emotional factors” Also involves a person’s response to events that are threatening or challenging.
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Emotional stress EMS is a Stressful profession!
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Multiple-patient incidents can be particularly stressful
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Other examples Infant and child trauma Traumatic amputation Death or injury of co-worker or other public safety personnel
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Other examples Emergency response to illness or injury of friend or family member Multiple Casualty Incidents ( MCI )
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Signs of stress Irritability with co-workers, family, friends or patients Inability to concentrate / Indecisiveness Physical exhaustion Difficulty sleeping or nightmares Anxiety / guilt
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Signs of stress Loss of interest in sex Isolation / depression Loss of interest in work Increased substance use or abuse (alcohol, medications, illegal drugs)
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Stress reduction techniques Get Professional Counseling Eat Healthy Eat Healthy Stop Smoking Exercise Regularly Exercise Regularly Rest & Relax Balance Activities Change Work Schedule
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Critical incident: A situation causing unusually strong emotional reactions which interfere with one’s ability to function immediately or in the future
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Post Traumatic Stress Disorder (PTSD) A serious condition involving illness, personality changes, and self-destructive behaviour Occurs after being exposed to a critical incident or disturbing event.
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Critical Incident Stress Management (CISM)
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Debriefing Session Trained counselors Within 24 - 72 hours post-incident Open discussion (feelings, fears, reactions) All information confidential
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Debriefing Not an investigation or interrogation CISM team offers suggestions on overcoming stress
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Scene safety
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Scene Safety is a term used to describe overall safety of the of the scene. It includes the following 1.Traffic 2.Crime scene 3.Hostile crowds / violence 4.Hazardous materials 5.Fire & explosion risk
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Scene safety
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When the scene is unsafe Leave the scene immediately! Get far enough away Radio for Garda (their responsibility when violence is concerned)
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Scene Safety Policeman exposed to Ammonia gas
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Standard precautions Standard Precautions Is a term used to describe precautions that should be taken with all patients. It includes the use of 1.Hand washing 2.Face mask 3.Gloves / gowns 4.Eye protection Personal Protective Equipment
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Standard precautions Local Protocol Infection Control Document Protects the EMT and the patient Assume all body substance are infectious
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Body Substance Isolation Body Substance Isolation (BSI) Precautions are designed to prevent contact with potentially harmful body substances
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Wash hands thoroughly, even if gloves were used
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Good hand washing technique 1.Rub palm to palm 2.Rub back of both hands 3.Rub palm to palm with fingers interlaced 4.Rub backs of fingers interlocked 5.Rub thumbs 6.Rub fingers tips
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Good hand washing technique 7.Rinse thoroughly under running water 8.Dry with disposable paper towel, preferable to warm air or fabric towels which may harbour micro-organisms.
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Wear latex, vinyl, or synthetic gloves
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Protective gloves must be worn Gloves must be discarded after individual patient care as healthcare risk waste One patient = one set of gloves Thoroughly wash hands after removal of gloves
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Use protective eyewear
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Gowns protect clothing from fluid splatter
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Respirator protects you from tuberculosis
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Infectious disease prevention Preventive vaccines Immune status verification Regular testing
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Recommended immunisations Tetanus prophylaxis (every 10 years) Hepatitis vaccines Influenza vaccine (annually) MMR - Rubella, mumps & measles vaccine
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Violence / Aggression Violence and aggression can stem from a number of causes Mental illness Drink / drugs Effects of injury Stress / Frustration
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Violence / Aggression The GARDA are responsible for securing the scene from violence
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Violence / Aggression
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EMS personnel should NOT ENTER a VIOLENT SCENE until the Garda have determined it to be safe!
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Violence / Aggression Managing a violent situation Answer questions politely Do not go on the offensive Do not demonstrate annoyance Do not touch the person / retaliate Do not debate Do not make assumptions
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Biohazards & chemical hazards are covered later in course
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Any Questions
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