INTRODUCTION TO EMERGENCY MEDICAL CARE

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INTRODUCTION TO EMERGENCY MEDICAL CARE

• EMERGENCY MEDICAL TECHNICIAN - BASIC

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Origins of EMS

• Accidental Death Disability The Neglected
  Disease of Modern Society
  
• Department of Transportation (DOT)
• Highway Safety Act of 1966
• Department of Health and Human Services (DHHS)
• Emergency Medical Act of 1973

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National Standard Curriculum

• Developed by DOT
• First developed in early 1970s
• Current - 1994
• Purpose
• Standardization of Training Programs
• Standardization of Levels of Certification
• Standardization of Patient Care

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Components of an EMS System

• Advisory Council
• 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

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Components of an EMS System

• EMT Training
• Initial
• Continuing Education
• Instructor Training

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Components of an EMS System

• Communications Systems
• System Communication
• Radio
• Cellular
• System Access
• 911
• Other easily remembered numbers

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Components of an EMS System

• Dispatch Center
• Well Designed
• Well Equipped
• Well Staffed Trained
• Policies Procedures

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Components of an EMS System

• Ambulance Service
• Well Designed
• Well Equipped
• Well Maintained
• Well Trained Staff
• Initial
• Continuing Education

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Components of an EMS System

• Rapport with Other Healthcare Professionals
• Reports Records
• System Evaluation
• Quality Improvement
• Protocol Review/Update
• Run Review
• Remedial or Continuing Education

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Components of an EMS System

• System Evaluation (Cont.)
• Risk Management/Loss Control
• Outcome Studies
• System Status Management
• Disaster Plans
• Major Incident Response
• Designed by EMS
• Designed to Integrate with Other Agencies

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Components of an EMS System

• Public Information Education
• Categorized Hospital Emergency Capabilities
• Funding

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Components of an EMS System

• Management
• Well Educated
• Initial
• Continuing Education
• Well Supported
• by Upper Level Management

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Continuum of Care

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

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EMS RELATED AGENCIES

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

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EMS RELATED AGENCIES

• Fire Department
• Regional Organizations
• Texas Department of Health

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Roles Responsibilities

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

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Roles Responsibilities

• Safety (cont.)
• 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

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Roles Responsibilities

• Patient Care
• Patient Assessment
• Basic Life Support
• Mechanical Aids to Breathing
• Pulse-Oximetry
• Semi-Automatic External Defibrillator
• Pneumatic Anti-Shock Garment (PASG or MAST)

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Roles Responsibilities

• Patient Care (cont.)
• Hand-held Metered Dose Nebulizers
• Epinephrine Auto-injectors (Epi pens)
• Nitroglycerin
• Aspirin
• Charcoal

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Roles Responsibilities

• Patient Care (cont.)
• Oral Glucose
• Bandaging Splinting / Traction Splinting
• Emergency Childbirth
• Spinal Immobilization
• Advanced Airway (Optional)

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EMT-Intermediate Roles
Responsibilities

• Patient Care - Intermediate
• Intermediate Patient Assessment
• Advanced Airway
• Esophageal Airways
• Endotracheal Intubation (Oral Nasal)
• Cricothyrotomy (Needle Surgical)
• End-tidal CO2 Monitoring

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EMT-Intermediate Roles
Responsibilities

• Patient Care - Intermediate (Cont.)
• Vascular Access
• Intravenous
• Intraosseus
• Gastric Tube Placement (Oral Nasal)
• Pleural Decompression

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EMT-Intermediate Roles
Responsibilities

• Patient Care - Intermediate
• Drug Therapy
• D50W
• Narcan
• Intermediate Recordkeeping
• Intermediate Radio Communication

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EMT-Paramedic Roles
Responsibilities

• Patient Care - Paramedic
• Advanced Patient Assessment
• Drug Administration Techniques
• EKG Interpretation
• Defibrillation/Cardioversion

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EMT-Paramedic Roles
Responsibilities

• Patient Care - Paramedic (Cont.)
• External Pacemakers
• IV Infusion Pumps
• Mechanical Ventilators
• Urinary catherization

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Roles Responsibilities

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

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Roles Responsibilities

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

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Personal Attitude Conduct

• Professionalism
• Appearance
• Attitude
• Manner
• Speech
• Writing
• Knowledge Skills
• Participation in CE
• Participation in QI

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Personal Attitude Conduct

• Confidence
• Compassion
• Empathy
• Leadership

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Personal Attitude Conduct

• Sound Judgement
• Good Moral Character
• Stability
• Adaptability

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Texas EMT Certification

• Requirements
• Successfully complete a TDH approved EMT- Basic
  course
  
• Submit to TDH
• Course Completion Certificate
• Completed TDH EMS Personnel Application
• TDH application fees (if not exempt)
• Schedule state exam appointment with TDH regional
  office