1. EMS Systems & The Roles of The Advanced EMS Professional Past, Present & Future

2. EMS Systems EMS History Key Elements of a Modern EMS System Critical Players in the EMS System Levels of Education & Training Attributes of the Paramedic

3. EMS History Emergency Medicine and Ambulance services predate Modern EMS 1950s – 1960s: Creation of CPR 1966: Modern EMS born with Highway Safety Act and “The White Paper” 1973: EMSS Act: 15 Components 1968-1970: First Paramedic Programs 1977, 1985 & 1998: Paramedic Curricula

4. Key Elements in a Modern EMS System “a comprehensive network of personnel, equipment, and resources established for the purpose of delivering aid and emergency medical care to the community” (Bledsoe, Paramedic Care, p. 46) Personnel, Equipment & Resource Examples

5. EMS System Components Regulation & Policy Resources Management Human Resources & Training Facilities Communications Trauma Systems Public Information & Education Medical Direction Evaluation

6. Critical Players in the EMS System EMS Personnel –First responders –BLS responders –Advanced responders EMS MD EMS Dispatchers Public Safety Orgs Specialized Resources Medical Educators Citizens Regulatory Agencies EMS System Leaders Receiving Facilities Receiving Physicians Health Care staff Researchers Community Leaders

7. EMS Credentialing Process Certification –Agency or association grants recognition Licensure –Governmental agency’s competency standards are met National Registry –National organization grants standardized recognition Reciprocity –Agency grants certification/licensure to person with equivalent certification/licensure from another agency

8. Certification Levels of EMS Education & Training National EMS Certification Levels –BLS First responder EMT-B –ALS EMT-I Paramedic Current Texas Requirements Future Level/Role?

9. Medical Direction Required for ALS providers and many BLS providers Providers are the designated agent of the medical director Texas: EMS patient contact establishes a patient-physician relationship Medical Director grants authority to practice within a specific EMS system Scope of Practice in Texas?

10. Medical Control/Direction On-Line –Direct Orders from a qualified physician –Occurs at the time of need –Intervener physician Off-Line –In form of policies, standing orders, protocols, etc. –Established prior to the time of need –Includes clinical review processes –Should allow for flexibility

11. Attributes of the Professional Paramedic Group Discussion: What are the characteristics, skills, tools, or behaviors that a Professional Paramedic should have?

12. The Roles of the Advanced EMS Professional

13. Key Topics to Discuss The Paramedic: Health Care Provider or Emergency Worker? Emerging Role Issues for the Paramedic The Various Roles of the Paramedic Paramedic Education & Training

14. The Paramedic: Health Care Provider or Emergency Worker What roles does the paramedic play in the: –Health care system? –Public safety network? What tasks does the paramedic perform related to: –The delivery of health care? –The protection of and service to the public? –Prevention of disease and injury?

15. Emerging Role Issues for the Paramedic Disposition –Primary care –Transport to non-emergency facilities –Treatment without transport Public Health & Preparation –Community Injury & Illness Prevention –Community training and education –Follow-up care Research & Education

16. Define tasks associated with each of these paramedic roles? Emergency responder Field Triage specialist Diagnostician (limited) Emergency health care provider Transporter Record keeper Data Manager Primary care provider EMS Profession Advocate Patient advocate Emergency Planner EMS Educator Public Educator Community servant Clinical Researcher Life-long Student

17. Initial vs. Continuing Education Education vs. Training Initial EMS Education Continuing Medical Education –Medicine not just EMS –Should benefit the patient or community If Education has no value, it is WORTHLESS! –The things we hold to be most valuable have a cost: usually effort, sacrifice and dedication.