INTRODUCTION TO EMERGENCY MEDICAL CARE

1. INTRODUCTION TO EMERGENCY MEDICAL CARE Temple College EMS Professions ECA Updated Spring 2011

2. Origins of EMS • Trauma • Accidental Death & Disability: The Neglected Disease of Modern Society • Sudden Death

3. Federal Legislation • Department of Transportation (DOT) • Highway Safety Act of 1966 • Department of Health and Human Services (DHHS) • Emergency Medical Act of 1973 • 13 Components

4. Texas Legislation • Texas Health & Safety Code; Title 9, Safety, Chapter 773. Emergency Medical Services . • Grants Authority to DSHS • Create Rules • Texas Administrative Code, Title 25, Part 1, Chapter 157

5. National Standard Curriculum • Developed by DOT • First developed in early 1970’s • Texas Current – 1994 • Purpose • Standardization of Training Programs • Standardization of Levels of Certification • Standardization of Patient Care • 2009 National EMS Education Standards

6. EMS System • Differ by City, County, and State • Transporting • Ground • Air • Non-Transporting • First Responders • All contain similar components

7. Medical Direction • The process used by the Medical community to assure quality and accountability in the delivery of pre-hospital care • On-line • Off-line • Protocols • Quality Improvement

8. Communication Systems • System Communication • Radio • Cellular • Data • System Access • 911 • Other easily remembered numbers

9. Dispatch Center • Design • Equipment • Staffing & Training • Policies & Procedures • Link between public and System Components

10. Ambulance Service • System Design • Equipment • Maintenance • Education • Initial • Continuing Education

11. Related Agencies • First Responders • Law Enforcement • Police • Sheriff's Department • Department of Public Safety • Federal • Public Health

12. Other Agencies • Regional Organizations • Federal Agencies • Texas Department of State Health Services

13. Administration • Advisory Council/Governing Board • Management • Well Educated • Initial • Continuing Education • Well Supported • Budget • by Upper Level Management

14. Public • Public Information & Education

15. Health Care • Categorized Hospital Emergency Capabilities • Rapport with Other Healthcare Professionals • Funding • Reports & Records

16. Continuum of Care • 1st Phase - Out of Hospital Care • 2nd Phase - Emergency Department Care • 3rd Phase - Definitive Care

17. Disaster Plans • Major Incident Response • Designed by EMS • Designed to Integrate with Other Agencies

18. Quality Improvement • Protocol Review/Update • Remedial or Continuing Education • Risk Management/Loss Control • Outcome Studies • System Status Management

19. Roles and Responsibilities • Safety • Levels of Training

20. Levels of Training • ECA (EMR) • EMT-Basic (EMT) • EMT-Intermediate (AEMT) • E MT-Paramedic (Paramedic)

21. Safety • Priorities • Yourself • Partner • By-standers • Patient

22. Safe Behaviors • Health • No Destructive Activities • Rest • Conditioning • Do not push body past limitations • (Mentally and Physically) • Wear Personal Protective Equipment • Survey Scene • Look for Hazards • Listen to Others

23. ECA Patient Care • Patient Assessment • Basic Life Support • Mechanical Aids to Breathing • Pulse-Oximetry • Semi-Automatic External Defibrillator • Bandaging & Splinting • Emergency Childbirth • Spinal Immobilization

24. EMT Care • Pneumatic Anti-Shock Garment (PASG or MAST) • Traction Splinting • Advanced Airway (Optional)

25. EMT Medications • Oxygen • Hand-held Metered Dose Nebulizers • Epinephrine Auto-injectors (Epi pens) • Nitroglycerin • Aspirin • Charcoal • Oral Glucose

26. Additional Roles & Responsibilities • Extrication & Rescue • Transport • Transfer of Care • Communications • Records & Reports

27. Roles & Responsibilities • Patient Advocacy • Maintenance • Vehicle Maintenance • Equipment Maintenance • Self

28. EMT-Intermediate (AEMT) Care • All EMT Skills/Knowledge • Advanced Airway • Esophageal Airways • Endotracheal Intubation (Oral & Nasal) • Cricothyrotomy (Needle & Surgical) • Vascular Access • Intravenous • Intraosseus

29. EMT-Intermediate (AEMT) • Drug Therapy • D50W • Narcan • Gastric Tube Placement (Oral & Nasal) • Pleural Decompression

30. EMT-Paramedic • All EMT-I Skills/Knowledge • Additional Assessment Skills • EKG Interpretation • Defibrillation/Cardioversion/Pacemaker • IV Infusion Pumps • Mechanical Ventilators • Urinary catherization

31. Professionalism

32. Profession • A field of practice that: - requires specialized education and/or licensure - is formally recognized by accreditation and certification - involves competency that is unique to the occupation - is regulated internally or externally

33. Think of a “Profession” What characteristics of this group demonstrates professionalism?

34. Professionalism • Appearance • Attitude • Interaction with others • Manner • Speech • Writing • Knowledge & Skills • Participation in CE • Participation in QI

35. How do others perceive your actions?

36. Personal Attitude & Conduct • Confidence • Compassion • Empathy • Leadership • Sound Judgment • Good Moral Character • Stability • Adaptability

37. Responsibilities & Expectations • Work hard – ALWAYS! Demonstrate your eagerness to learn & perform well. • Be respectful, considerate and NICE to everyone you encounter. • Be professional in everything you do. Gain respect through appearance, knowledge & behavior. • Life Long Commitment to Learning

38. Texas ECA Certification • Requirements • Successfully complete a Texas DSHS approved ECA course • Schedule exam with NREMT • Submit to Texas DHSH: • Results from Nation Registry ECA Exam • Fingerprint • Completed DSHS EMS Personnel Application • Application fees (if not exempt)

39. ECA Application • Access via DSHS Website • Finger Print processing takes time • Encouraged to begin now!