EMS SYSTEMS

1. EMS SYSTEMS Components of an EMS System

2. Today’s EMS System • Every EMS system must develop an EMS system that best meets its needs. • Provincial and regional-level EMS systems are often responsible for planning, developing protocols, and establishing standards.

3. What Constitutes an EMS System • By accepted definition, an EMS System is: • A comprehensive network of personnel, equipment, and resources established to deliver aid and emergency medical care to the community.

4. OUT-OF-HOSPITAL COMPONENTS OF AN EMS SYSTEM

5. IN-HOSPITAL COMPONENTS OF AN EMS SYSTEM

6. Some Systems are tiered in which BLS arrives first and then, if required, ALS arrives later.

7. Medical Direction • A medical director is a physician who is legally responsible for all clinical aspects of the system. • Ontario Base Hospital Group.

8. Medical Direction • The medical director’s role in a system is to: • educate and train personnel • participate in equipment and personnel selection • develop clinical protocols • participate in problem resolution and QA/QI • provide direct input into patient care • interface with the EMS system • advocate within the medical community • serve as the “medical conscience” of the EMS system • Certify and License personnel to practice

9. The Medical Director can provide on-line guidance to EMS personnel in the field. This is known as on-line medical direction.

10. Off-line medical direction refers to medical policies, procedures, and practices that medical direction has set up in advance of a call, such as standard protocolsor standing orders.

11. Protocols are the policies and procedures for all elements of an EMS system.

12. Protocols are designed around the four “T’s” of emergency care. • Triage • Treatment • Transport • Transfer

13. Patient Transportation • Patients should be taken to the nearest facility whenever possible. • Medical direction should designate the facility. • Patients may be transported by ground or air.

14. The helicopter has become an integral part of prehospital care.

15. Military helicopters frequently assist civilian EMS systems.

16. A Type-I Ambulance

17. A Type II Ambulance

18. A Type III Ambulance

19. An Emergency Response Unit

20. Air Ambulance

21. Not all receiving facilities are equal in emergency and support service capabilities. Local systems and regions categorize hospitals based on capabilities.

22. American Trauma Center Levels • Level I – provides the highest level of trauma care • Level II – may not have specialty paediatrics or a neurosurgeon on site • Level III – generally does not have immediate surgical facilities available

23. Canadian Trauma Centre Levels • Tertiary Trauma Centre (TTC) • District Trauma Centre (DTC) • Primary Trauma Centre (PTC)

24. Mutual Aid and Mass-Casualty Preparation • A formalized mutual aid agreementensures that help is available when needed. • Agreements should be betweenneighbouring departments, municipalities, systems, or provinces. • Each system should also put a disaster plan in place for catastrophes that can overwhelm available resources.

25. KEY POINT An EMS system should have a disaster plan in place that is practiced frequently.

26. Quality Assurance and Improvement • Quality Assurance is designed tomaintain continuous monitoring andmeasurement of the quality ofclinical care. • Continuous Quality Improvement (CQI) is designed to refine and improve an EMS system, emphasizing customer satisfaction.

27. An EMS system must be designed to meet the needs of the patient. Therefore, the only acceptable quality of an EMS system is EXCELLENCE!

28. Customer satisfaction can be created or destroyed with a simple word or deed. Service Quality

29. Public Education • An essential and often overlooked component of EMS is the public. • EMS systems should develop plans to educate the public on recognizing an emergency. • … accessing the system. • … initiating BLS procedures.

30. Communications A coordinated, flexible communications plan should include: • Citizen Access • Single Control Centre • Operation Communication Capabilities • Medical Communication Capabilities • Communications Hardware • Communications Software

31. Education and Certification • Two kinds of EMS education are initial and continuing education. • Initial education is the original training course for pre-hospital providers. • Continuing education programs include refresher courses for recertification and periodic in-service training sessions.

32. Initial Education • Ideally based on the PAC NOCP’s • establishes the minimum competencies for the course • CMA accredits education courses • http://www.paramedic.ca/nocp.html • Not all programs follow NOCP

33. Once the initial education is completed, the paramedic will become either certified or licensed.

34. Certification vs. Licensure • Certification is the process by which an agency grants recognition to an individual who has met its qualifications. • Licensure is the process of occupational regulation.

35. 4 Certification Levels • Emergency Medical Responder • Primary Care Paramedic • Advanced Care Paramedic • Critical Care Paramedic

36. The First Responder is usually the first EMS-trained provider to arrive on the scene.

37. The PCP is trained to do all that a first responder can do, plus other complex skills.

38. The ACP Should Possess All the Skills of a PCP and Be Competent in Advanced Airway, IV Therapy, and Other Skills.

39. The CCP is the most advanced EMS provider.

40. Paramedic Association of Canada • Canada’s only national organization • ‘May’ Regulate Practice • ‘May’ Approve Training Programs

41. For next Week National Groups and Associations