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From EMT History to Disaster Medicine

From EMT History to Disaster Medicine. Wang, Tzong-Luen, MD, PhD Shin-Kong Wu Ho-Su Memorial Hospital Taiwan Society of Disaster Medicine. EMT History. CPR: Cardiopulmonary Resuscitation. 儘早 儘早 儘早 儘早 求救 心肺復甦術 去顫電擊 高級醫療照護.

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From EMT History to Disaster Medicine

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  1. From EMT History to Disaster Medicine Wang, Tzong-Luen, MD, PhD Shin-Kong Wu Ho-Su Memorial Hospital Taiwan Society of Disaster Medicine

  2. EMT History

  3. CPR: Cardiopulmonary Resuscitation 儘早 儘早 儘早 儘早 求救 心肺復甦術 去顫電擊 高級醫療照護

  4. CPR: Comprehensive Practice of Resuscitation EMT

  5. Fifteen Required Components of the EMS System • Manpower • Training • Communications • Transportation • Facilities • Critical care units • Public safety agencies • Consumers

  6. Fifteen Required Components of the EMS System • Access to care • Transfer of patients • Medical record-keeping • Consumer information and education • Review and evaluation • Disaster linkage • Mutual aid

  7. EMT History • 1958: Dr. Peter Safar demonstrates the efficacy of mouth-to-mouth ventilation.

  8. EMT History • 1960: Cardiopulmonary resuscitation (CPR) is shown to be efficacious.

  9. EMT History • 1967: Dr. Eugene Nagel trains Miami firefighters as "paramedics" at the University of Miami School of Medicine.

  10. EMT History • 1968: The American Telephone and Telegraph Company designates "911" as the universal emergency telephone number.

  11. EMT History • 1969: The USDOT and NHTSA develop the basic training course for EMTs.

  12. EMT History • 1969: The Committee on Ambulance Design develops Ambulance Design Criteria, a report to the USDOT and the NHTSA to complement the NASNRC's Medical Requirements for Ambulance Design and Equipment(1968). This document recommends ambulance design standards and emergency equipment. The NHTSA agrees to issue matching federal funds to states that purchase vehicles meeting these standards.

  13. EMT History • 1970: The National Registry of Emergency Medical Technicians (NREMT) is organized to standardize education, examinations, and certification of EMTs on a national level.

  14. EMT History • 1972: President Nixon directs the U.S. Department of Health, Education, and Welfare to develop new ways to organize EMS, which results in $8.5 million in contracts being awarded to develop a model EMS system.

  15. EMT History • 1972: The University of Cincinnati establishes the first residency program to train new physicians exclusively for the practice of emergency medicine.

  16. EMT History • 1973: The "Star of Life" is adopted as the official symbol for EMS.

  17. EMT History • 1974: President Gerald Ford proclaims the first National EMS Week.

  18. EMT History • 1975: The National Association of Emergency Medical Technicians (NAEMT) is founded.

  19. EMT History • 1975: The American Medical Association (AMA) accepts and approves the EMT-Paramedic role as an emergency health occupation.

  20. EMT History • 1977: More than 40 EMT training agencies throughout the United States develop and test the national training standards for the paramedic for 2 years.

  21. EMT History • 1980: The USDHHS releases the Position Paper on Trauma Center Designation, which describes trauma centers within EMS systems. Facilities are also categorized

  22. EMT History • 1984: The EMS for Children program, under the Public Health Act, provides funding for enhancing the EMS system to better serve pediatric patients.

  23. EMT History • 1986: The 1979 Public Safety. Officer's Act (SB 1479) is amended to expand the $50/000 compensation to include survivors of rescue squads, ambulance crew members, and public safety department volunteers killed in the line of duty (amended in 1990).

  24. EMT History • 1990: President George Bush signs the Trauma Care Systems Planning and Development Act (HR 1602), which provides for annual grants to states based on geographical and population size to help establish and improve trauma systems. In 1995, Congress does not reauthorize funding for this act.

  25. EMT History • 1991: Occupational Exposure to Blood-Borne Pathogens; Final Rule (CFR 29 1910.1030) establishes standards for workplace protection from blood-borne diseases.

  26. Emergency Medical Services System

  27. EMT History in Taiwan

  28. EMT History in Taiwan • 1968 First Ambulance as a Taxi • 1981 Ambulance Governing Rules • 1989 EMS developed (two-tier) • 1990 2nd EMS Enhancement Plan • EMT 1 and EMT 2 • 1995 Emergent Medical Law • 1998 one-tier EMT in Tauyuan • 1999 one-tier EMT in Taipei • 2002 Paramedics in Taipei

  29. EMT History in Taiwan Long long ago

  30. EMT History in Taiwan 1999. 6.

  31. EMT History in Taiwan 1999. 9. 21

  32. EMT History in Taiwan 2000: Taipei USAR

  33. EMT History in Taiwan • 聯合演習 2001.12

  34. EMT History in Taiwan • 金鳳凰專責救難隊四週年 2003. 7. 15

  35. EMT History in Taiwan • 蘆洲大火 2003. 8. 31 • What’s wrong!?

  36. Disaster Medicine

  37. 2001年 怪颱納莉 輕度颱風納莉侵襲台灣，豐沛的雨量造成台灣重大傷亡損失，根據中央災害應變中心統計，截至晚間十一時為止，已有三十人死亡，六人失蹤、九十四人受傷，台北市死亡人數增十二人、台北縣增為十人、基隆市為八人。 　　消防署納莉颱風中央災害應變中心表示，目前已知確定死亡的人員包含於台北市死亡十二人，包含內湖區麗山街三三八巷一處民宅溺斃的招鳳文、招鳳川兄弟、於台北市大湖山莊街一百九十號地下室溺斃的男子劉鎮榮、於台北市北投區溫泉路遭土石流掩埋的女子黃薾凡，另外在北投溫泉路、士林格致路遭土石流活埋的五人及在中山北路、研究院路、東新街死亡的三人，身份都有待追查。

  38. 白河地震

  39. 台灣歷年死傷最慘重之災難排名

  40. Hurricane Mitch

  41. Earthquakes

  42. Volcanic hazards

  43. Windstorms

  44. Flood

  45. Tsunami

  46. Instability-related hazards

  47. Hazard and risk

  48. Risk perception

  49. losses Physical damage to property Increasing mental illness direct indirect Fertile ash deposits More stringent insurance conditions gains The effects of disasters:Montserrat volcanic crisis

  50. Natural disasters in time & space - I • Major natural disasters are strongly constrained in space and time • The bigger the event, the lower the FREQUENCY and the longer the RECURRENCE INTERVAL (return time) • MEGADISASTERS are very rare: none experienced in modern times

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