What is your role in the EMS System?

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Chapter 1

• What is your role in the EMS System?

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• Have you or anyone you know been involved in a
  serious accident?

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Chapter 1Objectives

1. Name the six parts of the EMS system.
2. Describe the function of each part of the EMS
   system.
3. Evaluate your role in the EMS system.
4. Identify the most important action you could take
   in an emergency situation.
5. List 5 common barriers to action that may prevent
   people from responding to emergencies.
6. Explain ways bystanders can help at the scene of
   an emergency.

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What is an emergency?

• An emergency is a situation demanding immediate
  action.
• An emergency can happen at any time or at any
  place, it is not a clear-cut situation.
• Your response may be the difference between
• life or death
• temporary or permanent disability
• short or long term recovery

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Types of Emergencies

• There are two types of emergencies that require
  first aid
• Sudden illness is a physical condition that
  requires immediate medical attention. Examples of
  sudden illness include a heart attack and a
  severe allergic reaction.
• Injury is damage to the body from an external
  force, such as a broken bone from a fall.

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Types of Emergencies(Continued)

• Emergencies can also be categorized as
  life-threatening and non-life-threatening.
• A life-threatening emergency is an illness or
  injury that impairs a victims ability to
  circulate oxygenated blood to all parts of his or
  her body.
• A non-life-threatening emergency is a situation
  that does not have immediate impact on a victims
  ability to circulate oxygenated blood , but still
  requires medical attention.

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What is First Aid?

• First Aid is the Immediate care given to a victim
  of injury or sudden illness until more advanced
  care can be obtained.

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The EMS System

• The emergency medical services (EMS) system is a
  network of community-based personnel often
  dispatched through a local emergency number who
  provide emergency care for ill or injured
  victims.
• Think of the EMS system as a chain made up of
  several links. Each link depends on the others
  for success.
• When the EMS system works correctly, a victim
  moves through each link in the chain, beginning
  with the actions of a responsible citizen and
  ending with care being provided to attempt to
  restore the victim to health.
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The EMS System (Continued)

• There are six parts of the EMS system
• The Citizen Responder
• The EMS Dispatcher
• The First Responder
• The Emergency Medical Technician (EMT)
• Hospital Care Providers
• Rehabilitation

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The Citizen Responder

• As a citizen responder, you are the first and
  most crucial link in the EMS system.
• A citizen responder is a lay person (someone who
  does not have special or advanced medical
  training/skills) who recognizes an emergency and
  decides to help.
• The CR must first recognize that the illness or
  injury that has occurred is an emergency.
• He/she must then activate EMS with a 911 call.

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The EMS Dispatcher

• The 2nd link in system.
• The dispatcher receives the call and quickly
  determines what help is needed.
• Some dispatchers are trained EMT's.

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The First Responder

• The 3rd link in the EMS system.
• A first responder is a person trained in
  emergency care who may be called upon.
• Usually the first person to arrive on scene who
  is trained to provide a higher level of care.
• The FR provides a critical transition between the
  CRs basic level of care and the care provided by
  more advanced EMS professionals.
• A FR can be a law enforcement officer, fire
  fighter, or a lifeguard.

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The Emergency Medical Technician (EMT)

• The 4th link in the EMS system.
• An EMT is a person who has successfully completed
  a state-approved emergency medical technician
  training program.
• They are capable of providing more advanced care.
• At the scene, they serve as "eyes ears" of
  hospital.
• The first four links of the EMS system give
  victims of injury or sudden illness the best
  possible out-of-hospital medical care.

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Hospital Care Providers

• The 5th link of the EMS system.
• It begins once the victim arrives at hospital.
• They provide the most advanced care.
• ER doctors/nurses, X-ray techs, specialists, etc.

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Rehabilitation

• The sixth and final link to the EMS system.
• The goal of rehabilitation is to return the
  victim to his or her previous state of health.
• These professionals include family physicians,
  consulting specialists, social workers, and
  physical/occupational therapists.

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Your role in the EMS system

1. Recognize that an emergency exists.
2. Decide to act.
3. Call EMS professional (9-1-1).
4. Provide first aid until help arrives.

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Recognizing Emergencies

• Recognizing an emergency is the first step in
  responding.
• A medical emergency is a sudden illness that
  requires immediate medical attention, such as a
  heart attack.
• An injury is damage to the body from an external
  force, for example, such as occurs with a fall or
  extremes of temperature.
• Some emergencies are more obvious than others
• Common indicators include unusual noises, sights,
  odors, and appearance or behavior.

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Unusual Noises

• Screams, moans, yells, calls for help
• Breaking glass, crashing sounds, screeching tires
• Abrupt/loud unidentifiable sounds
• Silence

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Unusual Sights

• Things that look out of the ordinary
• A stalled vehicle
• An overturned pot
• Spilled medicine container
• Broken glass
• Downed electrical wires.

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Unusual odors

• Smells that are stronger than normal
• Gasoline at a gas station
• Chlorine at swimming pools
• Smoke
• Unrecognizable odors

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Unusual Appearance or Behavior

• Unconscious
• Difficult breathing
• Clutching chest/throat
• Slurred, confused, or hesitant speech
• Unexplainable confusion/drowsiness
• Sweating for no apparent reason
• Skin color is unusual

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Deciding to Act

• How do you feel about what you just saw?
• How many of you feel you would respond to this
  emergency?
• Those of you who would not respond, why not?
• Can anyone think of any reasons that might
  discourage a person from responding?

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Barriers to action

• Sometimes people fail to recognize an emergency.
  At other times, people recognize an emergency but
  are reluctant to act.
• Reasons people give for not helping are called
  barriers to action.
• Common barriers include
• The presence of bystanders.
• Uncertainty about the victim.
• The nature of the injury or illness.
• Fear of disease transmission.
• Fear of not knowing what to do or of doing
  something wrong.

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Presence of Bystanders

• Bystanders can cause confusion at an emergency
  scene.
• Never assume that just because a crowd has
  gathered that someone is caring for the victim.
• You may feel embarrassed about coming forward in
  front of strangers. Do not let this feeling deter
  you from helping. You may be the only one who
  knows first aid.

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Presence of Bystanders(Continued)

• If someone else is already giving care, offer to
  help.
• Untrained bystanders may be a great help in an
  emergency. They can
• Call for an ambulance.
• Meet the ambulance and direct EMS personnel to
  the victim.
• Direct traffic away from the accident scene.
• Help provide care.
• Retrieve necessary equipment and supplies.
• Provide information about the victim regarding
  his or her medical condition or the cause of
  injury.
• Comfort and reassure victims.

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Uncertainty About the Victim

• Since most emergencies happen in or near the
  home, you are more likely to give care to a
  friend or family member than to a stranger.
• If you do not know the victim, you may feel
  uncomfortable touching a stranger. How the victim
  may look or act may also make you feel
  uncomfortable.
• Sometimes victims of injury or illness may act
  strangely or be uncooperative. If at any time you
  feel threatened, retreat to safety and call 9-1-1
  or the local emergency number.

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Nature of the Illness or Injury

• An injury or illness may sometimes be very
  unpleasant to handle.
• You cannot always predict how you will respond to
  disturbing factors, such as blood, vomit,
  unpleasant odors, or torn or burned skin.
• Sometimes you may need to compose yourself before
  acting. Take a few deep breaths and then provide
  care.

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Fear of Disease Transmission

• Although there is general concern for disease
  transmission in a first aid situation, the actual
  risk is much smaller than you may think.
• Giving first aid in and of itself will not cause
  you to become infected with a disease.
• Four conditions must be present for a disease to
  be transmitted. If any of these conditions is
  absent, disease transmission is not possible. The
  conditions are
• The injured or ill person must be infected with a
  disease.
• The rescuer providing first aid must be exposed
  to an infected person's body substances.
• The rescuer must come in contact with infected
  substances through breaks or cuts in his or her
  skin or through the mucous membranes of the mouth
  or eyes.
• There must be sufficient amounts of body
  substances that contain enough pathogens to cause
  infection.

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Fear of Disease Transmission(Continued)

• Diseases that can pass from one person to another
  are called infectious diseases and can develop
  when pathogens enter the body.
• In situations that require first aid, diseases
  can be transmitted by touching, breathing, and
  biting.

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Fear of not knowing what to do or of doing
something wrong

• Doing the wrong thing and possibly making the
  situation worse is a common fear.
• Always remember that the worst thing to do is
  nothing.
• Sometimes people worry about being sued. Do not
  let this overly concern you. Lawsuits against
  those who give emergency care are highly unusual
  and rarely successful.
• Most states have enacted Good Samaritan Laws that
  protect citizen responders who voluntarily give
  first aid in good faith.

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GOOD SAMARITAN LAWS

• Gives legal protection to people who willingly
  provide medical care to ill or injured people
  with out accepting anything in return.
• This law does not apply to people when responses
  are grossly or willfully negligent or reckless or
  when the rescuer abandoned the victim after
  initiating care.

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Help may be given

• When
• The victim is or says the following
• "you can help me"
• Victim is unconscious
• Victim becomes unconscious after refusing care
• Victim's state of mind is such that they may not
  know/understand the seriousness of injuries
• Victim is a small unattended child

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Help cannot be given

• When
• The victim is conscious, alert, understands what
  is going on, and refuses your help.
• Call 911 if injuries warrant it.
• LAWS MAY VARY FROM STATE TO STATE

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Helping at an emergency scene

• Providing help at an emergency scene does not
  always mean providing direct care for the
  victims.
• In what other ways can you give help?

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Other ways to give help

• Keeping the scene safe
• Finding out what is wrong
• Getting professional help
• Giving care

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Important note

• Different situations may change the order in
  which things are done. For instance, if the scene
  is un- safe, you should call the emergency number
  first. In a situation where the scene is safe,
  you might not call 9-1-1 until you check the
  victims. Sometimes these actions can happen
  simultaneously. For instance, you might send
  someone else to call the emergency number while
  you check the injured or ill person(s).
• As a rule, the safety of the rescuers, victims,
  and bystanders should always be foremost, and
  life-threatening conditions should be cared for
  before conditions of lesser urgency.

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Closing

• Emergency scenes can be overwhelming and
  confusing.
• Deciding to act is not always an easy decision to
  make.
• The presence of a crowd does not mean that
  someone is helping.
• It is not always easy to determine how to help in
  an emergency.
• There are many ways to help besides providing
  first aid care.
• The decision to act is yours and yours alone.
• Your decision to respond should be guided by your
  own values, as well as the knowledge of the risks
  that may be present.

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Closing

• Regardless of your decision, calling EMS
  personnel is the most important action you can
  take when you recognize that an emergency has
  occurred.
• In the next lesson, you will learn the Emergency
  Action Steps, which will provide a basic plan of
  action for any emergency situation.