1. EMS management 1 ems 484 Dr.Maha Khalid

2. Contents : Definition of EMS System. Out-of-Hospital Components of an EMS System. In-Hospital Components of an EMS System. BLS. ALS Important milestone in the evolution of EMS The 15 components of EMS System. Continued Development of 14 EMS Attributes. Medical Direction

3. Bledsoe et al., Essentials of Paramedic Care: Division 1 Definition of EMS System A comprehensive network of personnel, equipment, and resources established to deliver aid and emergency medical care to the community

4. Bledsoe et al., Essentials of Paramedic Care: Division 1 © Members of the Community Communications System EMS Providers Public UtilitiesPoison Control Centers Fire Rescue Hazmat Out-of-Hospital Components of an EMS System

5. Bledsoe et al., Essentials of Paramedic Emergency Nurses Emergency and Specialty Physicians Ancillary Services Rehabilitation Services In-Hospital Components of an EMS System

6. Bledsoe et al., Essentials of Paramedic Care: Division 1 © 2007 by Pearson Education, Inc. Upper Saddle River, NJ BLS Refers to the basic life-saving procedures such as artificial ventilation and cardiopulmonary resuscitation

7. Bledsoe et al., Essentials of Paramedic ALS Refers to advanced life-saving procedures such as intravenous therapy, drug therapy, intubation, and defibrillation

8. Bledsoe et al., Essentials of Paramedic Care: Division 1 Some systems are tiered: BLS arrives first and then, if required, ALS arrives later.

9. Bledsoe et al., Essentials of Paramedic Care: Division 1 IMPORTANT MILESTONE IN THE EVOLUTION OF ems EMS systems have developed from the traditional and scientific beliefs of many cultures.

10. Bledsoe et al., Essentials of Paramedic Care: Division 1 Ancient Times First “protocols” established in Mesopotamia Evidence of medications, patient assessment techniques, and bandages

11. Bledsoe et al., Essentials of Paramedic Care: Division 1 18th and 19th Centuries Napoleonic Wars First efforts of field care developed by one of Napoleon’s surgeons. Triage, a method of sorting patients by severity, developed. U.S. Civil War Triage and transport of wounded soldiers Improvised hospitals in houses, barns, and churches First civilian ambulance service Cincinnati, Ohio (1865) New York City Health Department Ambulance Service (1869)

12. Bledsoe et al., Essentials of Paramedic 20th Century World War II Transportation to appropriate facilities Battlefield ambulances Vietnam and Korean conflicts Soldiers treated in battlefield Evacuation by helicopter

13. Bledsoe et al., Essentials of Paramedic Post-1960s Developments Mortician-operated ambulances withdrew due to costs and demand for additional services. Fire and police departments began providing EMS. Growth of volunteer and independent local EMS provider agencies.

14. Bledsoe et al., Essentials of Paramedic 1966 The National Highway Safety Act established the Department of Transportation, which provided grants for EMS. Publication of Accidental Death and Disability: The Neglected Disease of Modern Society Highlighted deficiencies in prehospital emergency care Set guidelines for development of EMS systems, training, ambulances, equipment

15. Bledsoe et al., Essentials of Paramedic 1969 The EMT-Ambulance program was made public. The first paramedic curriculum followed in 1977.

16. Bledsoe et al., Essentials of Paramedic 1971 White House issued $9 million in EMS grants for EMS demonstration projects. Designed to be models for subsequent system development

17. Bledsoe et al., Essentials of Paramedic 1972 The Department of Health, Education, & Welfare funded initiatives to develop regional systems.

18. Bledsoe et al., Essentials of Paramedic EMS Systems Act of 1973 Provided funding for a series of trauma projects $300 million allocated to study EMS planning, operations, expansion, and research Continued funding for regional systems until 1981

19. Bledsoe et al., Essentials of Paramedic ManpowerTraining Communications Transportation Emergency Facilities Critical Care Units Public Safety Agencies Consumer Participation Access to Care Patient Transfer Standardized Recordkeeping Public Information and Education System Review and Evaluation Disaster Management Plans Mutual Aid To be eligible for funding a system must address: (The 15 components of EMS System )

20. Bledsoe et al., Essentials of Paramedic Two Items the Legislation Omitted System finance Medical direction

21. Bledsoe et al., Essentials of Paramedic 1977 First EMT-Paramedic curriculum was developed.

22. Bledsoe et al., Essentials of Paramedic 1981 The passage of the Consolidated Omnibus Budget Reconciliation Act (COBRA) wiped out federal EMS funding.

23. Bledsoe et al., Essentials of Paramedic 1988 Regulation and policy Resources management Human resources/training Transportation Facilities Communications Trauma systems Public information and education Medical direction Evaluation

24. Bledsoe et al., Essentials of Paramedic Care: Division 1 © 2007 by Pearson Education, Inc. Upper Saddle River, NJ EMS Agenda for the Future Published in 1996 as a comprehensive evaluation of the history of EMS Casts a vision for the future for EMS in the United States

25. Bledsoe et al., Essentials of Paramedic Continued Development of 14 EMS Attributes Integration of health services EMS research Legislation and regulation System finance Human resources Medical direction Education systems Public education Prevention Public access Communication systems Clinical care Information systems Evaluation

26. Bledsoe et al., Essentials of Paramedic Today’s EMS System Every EMS system must develop a system that best meets its needs. State- and regional-level EMS systems are often responsible for planning, developing protocols, and establishing standards.

27. Bledsoe et al., Essentials of Paramedic Care: Division 1 Medical Direction (1 of 2) A medical director is a physician who is legally responsible for all clinical aspects of the system.

28. Bledsoe et al., Essentials of Paramedic Medical Direction (2 of 2) The medical director’s role in a system is to: Educate and train personnel Participate in personnel and equipment selection Develop clinical protocols Participate in quality improvement and problem resolution Provide direct input into patient care Interface with the EMS system Advocate within the medical community Serve as the “medical conscience” of the EMS system

29. Bledsoe et al., Essentials of Paramedic Care: Division 1 The medical director can provide on-line guidance to EMS personnel in the field. This is known as on-line medical direction. © Kenneth Kerr

30. Bledsoe et al., Essentials of Paramedic Care: Division 1 Off-line medical direction refers to medical policies, procedures, and practices that medical direction has set up in advance of a call, such as standard protocols or standing orders.

31. Bledsoe et al., Essentials of Paramedic Care: Division 1 Protocols are the policies and procedures for all elements of an EMS system.