2. Emergency Medical Technician-Basic
Course #B

3. Introduction to Emergency Medical Care
Chapter 1
The EMS System
The White Paper
Components
*Medical Director
*Medical Direction

4. The EMS System
Comprehensive Network of personnel, equipment and resources
In-hospital and out-of-hospital
Out-of hospital
Community (CPR)
Dispatch Centers and Dispatchers
EMS Providers
Fire/Rescue and Hazmat
Public Utilities
Resource Centers i.e. poison control center

5. In-hospital
Emergency nurses
Emergency and specialty physicians
Ancillary services
Rehab services

6. First Responders
Transport

7. History of EMS Biblical times Good Samaritan
Sumerians inscribed clay tablets that provided step-by step instructions for care based on symptoms given
Also instruction on how to create and adm. Medications
Similar to EMS protocols today

8. The most significant difference between these first protocols and EMS today is a physical exam
Egyptologist Edwin Smith
1862 purchases a papyrus scroll dating to about 1500 B.C.E.
Contained 48 medical case histories arranged in head-to-toe order of severity
Very similar to our PA today

9. “Book of Wounds”
One section of the scroll
Explains the treatment of injuries such as fractures and dislocations
King Hammurabi
King of Babylon
“Code of Hammurabi

10. 18th and 19th Centuries
Napoleonic Wars
Chief surgeon Jean Larrey formed the
ambulance volante
or flying ambulance which focused on providing emergency surgery as close to the battlefield as possible
Horse drawn cart
First to use triage and transport

11. Clara Barton during the Civil War
First civilian ambulance service
1865
Cincinnati Ohio
1869 the New York City Health Dept. Ambulance Service operated out of Bellevue Hospital
Specially designed horse-drawn carts

12. Staffed with physician interns
20th Century
WWI average evacuation time of 18 hrs.
WWII – battlefield ambulance corp
Transported from front line to high level care
There were still delays, often days

13. Korean and Vietnam Conflicts
Advances were made
Battlefield treatment the air evac
In Vietnam often within 10 to 20 minutes
Throughout history significant advances occurred during wartime

14. To 1960 few places in the US had adequate pre-hospital care
Emergency care began in the E.R.
Rescue techniques were crude
Ambulance personnel poorly educated
Equipment miminal

15. No radio communication between agencies
No medical direction
This brings us to

16. THE WHITE PAPER
1966
“Accidental Death and Disability: The Neglected Disease of Modern Society”
Published by National Academy of Sciences, National Resource Council

17. Medical Director

18. Medical Direction
Off-line
On-line

19. Well-Being of the EMT-B
Chapter 2
Personal Protection Equipment (PPE)
Diseases of Concern

20. Diseases of Concern West Nile Virus
Severe Acute Respiratory Syndrome (sars)
Avian Flu

21. Communicable Diseases of Concern
Hepatitis TB
HIV/AIDS

22. Infection Control and the Law
Ryan White CARE Act

23. Emotion and Stress
Physiological Aspects
General Adaptation Syndrome c

24. 3 stages
Alarm Reaction: Fight or flight
Resistance: State of normalcy; coping
Exhaustion: Serious illness as a result of the stressor; rare

25. Stress Types Causes Signs and Symptoms Dealing CISM
Acute Stress Reaction: Immediately after or simultaneously at the time of the disaster etc.
Delayed Stress Reaction: PTSD; triggered by a specific incident
Cumulative Stress Reaction: Burnout; boredom, apathy Not triggered by a specific incident.

26. Acute Stress Reaction: Immediately after or simultaneously at the time of the disaster etc.
Delayed Stress Reaction: PTSD; triggered by a specific incident

27. Death and Dying Stages Denial Anger Bargaining Depression Acceptance
Dealing

28. Scene Safety

29. Medical/Legal and Ethical Issues
Scope of Practice
Consent and refusal
Other legal aspects

30. The Human Body (introduction)
Anatomical Terms
Body Systems
[A] only

31. Anatomical Terms
Anatomical Position
Midline
Medial
Lateral
Bilateral

32. Descriptive anatomical terms Anterior Posterior Ventral Dorsal
Superior
Inferior
Proximal
Distal
Palmar
Plantar
Mid-Clavicular Line
Abdominal Quadrants
Ventral: Front of the body
Dorsal: Back of the body, or back of hand or foot
Palmar: Palm of the hand
Plantar: Sole of the foot
Mid-clavicular: Center of the clavicle and the nipple below

34. Positional Terms Prone Supine Fowler’s Trendelenberg
Fowler’s Position: Elevating the head at a 45 to 60 degree angle

35. Fowler’s Position: Elevating the head at a 45 to 60 degree angle