1. Emergency Medical Care
Chapter 1

2. Brief History Local funeral homes provided service
EMS-allows for prehospital care
Korean & Vietnam war-soldiers benefited from field care prior transport
Modern EMS started about 1960’s

3. Accidental Death & Disability: The Neglected Disease of modern society
Aka: white paper
Identifies
deaths & injuries r/t MVA’s
Severe deficiencies in delivery of prehospital care
Recommendations for ambulance systems, training requirements, & provisional prehospital care

4. Significant Developments
Highway Safety Act of 1966
Required states establish highway safety protocols
American Heart Association
Teaching CPR & BLS
National Registry of EMT’s
Defined issues for education & training
National Highway Traffic Safety Administration
Very involved in EMS
Developed national curriculum for EMT

5. Access to EMS 911 Universal number E-911
Automatic number identification
Automatic location identification

6. Levels of Training
EMR
EMT
AEMT
Paramedic

7. Health Care System Closest facilities?
Trauma center
Burn center
Obstetrical center
Pediatric center
Poison center
Stroke center
Cardiac center
Hyperbaric center
Spine injury center
Psychiatric center
Poky, Boise
Salt Lake
CRMC, SLMVRMC
Primary
Salt lake
SLMVRMC, Boise, Poke
Poky
Poky, Boise, SLC
Canyon View, Boise, Poky

8. Roles & Responsibilities
Personal safety & safety of others
Pt assessment & emergency care
Safe lifting & moving
Transport & transfer of care
Record keeping & data collection
Patient advocacy

9. Professional attributes
Appearance
Knowledge & skills
Physical demands
Personal traits
Maintain certification & licensure

10. State EMS Agency Role Medical director Medical direction Protocols
Off-line direction
On-line directions
Standing orders
Medical oversight

11. Quality Improvement Aka: continuous quality improvement Role:
Document carefully
Perform reviews & audits
Obtain feedback
Maintain equipment
Participate in continuing education
Maintain skills

12. Issues in patient safety
High risk safety
Hand-off of care
Poor communication
Improper body mechanics
Ambulance crash
Improper spinal immobilization

13. Preventing errors Develop clear protocols Light scene effectively
Minimize interruptions
Clearly mark medications
Reflect on all actions
Question all assumptions
Use decision aids if necessary
Ask for assistance

14. Research & public health
Evidence based medicine
Steps for evidence based decision making
Formulate question
Search medical literature
Appraise the evidence for validity & reliability
If evidence supports change, change protocols/implement new practice

15. Public health Educating public 10 greatest Health achievements
Vaccinations
Motor-vehicle safety
Workplace safety
Control of infectious disease
Reduce deaths from CAD & CVA
Safer & healthier foods
Decline in maternal & infant deaths
Contraceptive devices
Fluoride in drinking water
Reduction of use of tobacco products

16. EMT role in public health
Health prevention & promotion through primary prevention (vaccines, education), secondary prevention of complications of disease, health screening
Disease surveillance by identifying & reporting certain diseases
Injury prevention education