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EMS Systems & The Roles of The Advanced EMS Professional. Past, Present & Future. EMS Systems. EMS History Key Elements of a Modern EMS System Critical Players in the EMS System Levels of Education & Training Attributes of the Paramedic. EMS History.
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EMS Systems & The Roles of The Advanced EMS Professional Past, Present & Future
EMS Systems • EMS History • Key Elements of a Modern EMS System • Critical Players in the EMS System • Levels of Education & Training • Attributes of the Paramedic
EMS History • Emergency Medicine and Ambulance services predate Modern EMS • 1950s – 1960s: Creation of CPR • 1966: Modern EMS born with Highway Safety Act and “The White Paper” • 1973: EMSS Act: 15 Components • 1968-1970: First Paramedic Programs • 1977, 1985 & 1998: Paramedic Curricula
Key Elements in a Modern EMS System • “a comprehensive network of personnel, equipment, and resources established for the purpose of delivering aid and emergency medical care to the community” (Bledsoe, ParamedicCare, p. 46) • Personnel, Equipment & Resource Examples
Regulation & Policy Resources Management Human Resources & Training Facilities Communications Trauma Systems Public Information & Education Medical Direction Evaluation EMS System Components
EMS Personnel First responders BLS responders Advanced responders EMS MD EMS Dispatchers Public Safety Orgs Specialized Resources Medical Educators Citizens Regulatory Agencies EMS System Leaders Receiving Facilities Receiving Physicians Health Care staff Researchers Community Leaders Critical Players in the EMS System
EMS Credentialing Process • Certification • Agency or association grants recognition • Licensure • Governmental agency’s competency standards are met • National Registry • National organization grants standardized recognition • Reciprocity • Agency grants certification/licensure to person with equivalent certification/licensure from another agency
Certification Levels of EMS Education & Training • National EMS Certification Levels • BLS • First responder • EMT-B • ALS • EMT-I • Paramedic • Current Texas Requirements • Future Level/Role?
Medical Direction • Required for ALS providers and many BLS providers • Providers are the designated agent of the medical director • Texas: EMS patient contact establishes a patient-physician relationship • Medical Director grants authority to practice within a specific EMS system • Scope of Practice in Texas?
On-Line Direct Orders from a qualified physician Occurs at the time of need Intervener physician Off-Line In form of policies, standing orders, protocols, etc. Established prior to the time of need Includes clinical review processes Should allow for flexibility Medical Control/Direction
Attributes of the Professional Paramedic • Group Discussion:What are the characteristics, skills, tools, or behaviors that a Professional Paramedic should have?
Key Topics to Discuss • The Paramedic: Health Care Provider or Emergency Worker? • Emerging Role Issues for the Paramedic • The Various Roles of the Paramedic • Paramedic Education & Training
The Paramedic: Health Care Provider or Emergency Worker • What roles does the paramedic play in the: • Health care system? • Public safety network? • What tasks does the paramedic perform related to: • The delivery of health care? • The protection of and service to the public? • Prevention of disease and injury?
Emerging Role Issues for the Paramedic • Disposition • Primary care • Transport to non-emergency facilities • Treatment without transport • Public Health & Preparation • Community Injury & Illness Prevention • Community training and education • Follow-up care • Research & Education
Emergency responder Field Triage specialist Diagnostician (limited) Emergency health care provider Transporter Record keeper Data Manager Primary care provider EMS Profession Advocate Patient advocate Emergency Planner EMS Educator Public Educator Community servant Clinical Researcher Life-long Student Define tasks associated with each of these paramedic roles?
Initial vs. Continuing Education • Education vs. Training • Initial EMS Education • Continuing Medical Education • Medicine not just EMS • Should benefit the patient or community • If Education has no value, it is WORTHLESS! • The things we hold to be most valuable have a cost: usually effort, sacrifice and dedication.