Chapter 1

1. Chapter 1 What is your role in the EMS System?

2. Have you or anyone you know been involved in a serious accident? http://www.instructorscorner.org/media/videos/a2.html

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

4. 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

5. 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.

6. 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 victim’s 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 victim’s ability to circulate oxygenated blood , but still requires medical attention.

7. 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. http://www.instructorscorner.org/media/videos/e2.html

8. 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. http://www.instructorscorner.org/media/videos/k2.html

9. 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 http://www.instructorscorner.org/media/videos/k33.html

10. 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.

11. 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.

12. 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 CR’s 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.

13. 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.

14. 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.

15. 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.

16. Your role in the EMS system • Recognize that an emergency exists. • Decide to act. • Call EMS professional (9-1-1). • Provide first aid until help arrives.

17. 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.

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

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

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

21. 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

22. 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? http://www.instructorscorner.org/media/videos/a1.html

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

28. 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.

29. 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.

30. 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.

31. 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.

32. 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

33. 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

34. 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?

35. Other ways to give help • Keeping the scene safe • Finding out what is wrong • Getting professional help • Giving care

36. 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.

37. 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.

38. 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.