INTRODUCTION TO EMERGENCY MEDICAL CARE

1
INTRODUCTION TO EMERGENCY MEDICAL CARE

• Temple College
• EMS Professions
• ECA
• Updated Spring 2011

2
Origins of EMS

• Trauma
• Accidental Death Disability The Neglected
  Disease of Modern Society
• Sudden Death

3
Federal Legislation

• Department of Transportation (DOT)
• Highway Safety Act of 1966
• Department of Health and Human Services (DHHS)
• Emergency Medical Act of 1973
• 13 Components

4
Texas Legislation

• Texas Health Safety Code Title 9, Safety,
  Chapter 773. Emergency Medical Services .
• Grants Authority to DSHS
• Create Rules
• Texas Administrative Code, Title 25, Part 1,
  Chapter 157

5
National Standard Curriculum

• Developed by DOT
• First developed in early 1970s
• Texas Current 1994
• Purpose
• Standardization of Training Programs
• Standardization of Levels of Certification
• Standardization of Patient Care
• 2009 National EMS Education Standards

6
EMS System

• Differ by City, County, and State
• Transporting
• Ground
• Air
• Non-Transporting
• First Responders
• All contain similar components

7
Medical Direction

• The process used by the Medical community to
  assure quality and accountability in the delivery
  of pre-hospital care
• On-line
• Off-line
• Protocols
• Quality Improvement

8
Communication Systems

• System Communication
• Radio
• Cellular
• Data
• System Access
• 911
• Other easily remembered numbers

9
Dispatch Center

• Design
• Equipment
• Staffing Training
• Policies Procedures
• Link between public and System Components

10
Ambulance Service

• System Design
• Equipment
• Maintenance
• Education
• Initial
• Continuing Education

11
Related Agencies

• First Responders
• Law Enforcement
• Police
• Sheriff's Department
• Department of Public Safety
• Federal
• Public Health

12
Other Agencies

• Regional Organizations
• Federal Agencies
• Texas Department of State Health Services

13
Administration

• Advisory Council/Governing Board
• Management
• Well Educated
• Initial
• Continuing Education
• Well Supported
• Budget
• by Upper Level Management

14
Public

• Public Information Education

15
Health Care

• Categorized Hospital Emergency Capabilities
• Rapport with Other Healthcare Professionals
• Funding
• Reports Records

16
Continuum of Care

• 1st Phase - Out of Hospital Care
• 2nd Phase - Emergency Department Care
• 3rd Phase - Definitive Care

17
Disaster Plans

• Major Incident Response
• Designed by EMS
• Designed to Integrate with Other Agencies

18
Quality Improvement

• Protocol Review/Update
• Remedial or Continuing Education
• Risk Management/Loss Control
• Outcome Studies
• System Status Management

19
Roles and Responsibilities

• Safety
• Levels of Training

20
Levels of Training

• ECA (EMR)
• EMT-Basic (EMT)
• EMT-Intermediate (AEMT)
• E MT-Paramedic (Paramedic)

21
Safety

• Priorities
• Yourself
• Partner
• By-standers
• Patient

22
Safe Behaviors

• Health
• No Destructive Activities
• Rest
• Conditioning
• Do not push body past limitations
• (Mentally and Physically)
• Wear Personal Protective Equipment
• Survey Scene
• Look for Hazards
• Listen to Others

23
ECA Patient Care

• Patient Assessment
• Basic Life Support
• Mechanical Aids to Breathing
• Pulse-Oximetry
• Semi-Automatic External Defibrillator
• Bandaging Splinting
• Emergency Childbirth
• Spinal Immobilization

24
EMT Care

• Pneumatic Anti-Shock Garment (PASG or MAST)
• Traction Splinting
• Advanced Airway (Optional)

25
EMT Medications

• Oxygen
• Hand-held Metered Dose Nebulizers
• Epinephrine Auto-injectors (Epi pens)
• Nitroglycerin
• Aspirin
• Charcoal
• Oral Glucose

26
Additional Roles Responsibilities

• Extrication Rescue
• Transport
• Transfer of Care
• Communications
• Records Reports

27
Roles Responsibilities

• Patient Advocacy
• Maintenance
• Vehicle Maintenance
• Equipment Maintenance
• Self

28
EMT-Intermediate (AEMT) Care

• All EMT Skills/Knowledge
• Advanced Airway
• Esophageal Airways
• Endotracheal Intubation (Oral Nasal)
• Cricothyrotomy (Needle Surgical)
• Vascular Access
• Intravenous
• Intraosseus

29
EMT-Intermediate (AEMT)

• Drug Therapy
• D50W
• Narcan
• Gastric Tube Placement (Oral Nasal)
• Pleural Decompression

30
EMT-Paramedic

• All EMT-I Skills/Knowledge
• Additional Assessment Skills
• EKG Interpretation
• Defibrillation/Cardioversion/Pacemaker
• IV Infusion Pumps
• Mechanical Ventilators
• Urinary catherization

31
Professionalism
32
Profession

• A field of practice that
• - requires specialized education and/or
  licensure
• - is formally recognized by accreditation and
  certification
• - involves competency that is unique to the
  occupation
• - is regulated internally or externally

33
Think of a Profession

• What characteristics of this group demonstrates
  professionalism?

34
Professionalism

• Appearance
• Attitude
• Interaction with others
• Manner
• Speech
• Writing
• Knowledge Skills
• Participation in CE
• Participation in QI

35
How do others perceive your actions?
36
Personal Attitude Conduct

• Confidence
• Compassion
• Empathy
• Leadership
• Sound Judgment
• Good Moral Character
• Stability
• Adaptability

37
Responsibilities Expectations

• Work hard ALWAYS! Demonstrate your eagerness
  to learn perform well.
• Be respectful, considerate and NICE to everyone
  you encounter.
• Be professional in everything you do. Gain
  respect through appearance, knowledge behavior.
• Life Long Commitment to Learning

38
Texas ECA Certification

• Requirements
• Successfully complete a Texas DSHS approved ECA
  course
• Schedule exam with NREMT
• Submit to Texas DHSH
• Results from Nation Registry ECA Exam
• Fingerprint
• Completed DSHS EMS Personnel Application
• Application fees (if not exempt)

39
ECA Application

• Access via DSHS Website
• Finger Print processing takes time
• Encouraged to begin now!