INTRODUCTION TO
EMERGENCY MEDICAL
CARE
EMERGENCY MEDICAL
TECHNICIAN - BASIC
Origins of EMS
• Accidental Death & Disability: The
Neglected Disease of Modern Society
• Department of Transportation (DOT)
– Highway Safety Act of 1966
• Department of Health and Human Services
(DHHS)
– Emergency Medical Act of 1973
National Standard Curriculum
• Developed by DOT
– First developed in early 1970’s
– Current - 1994
• Purpose
– Standardization of Training Programs
– Standardization of Levels of Certification
– Standardization of Patient Care
Components of an EMS System
• Advisory Council
• 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
Components of an EMS System
• EMT Training
– Initial
– Continuing Education
• Instructor Training
Components of an EMS System
• Communications Systems
– System Communication
• Radio
• Cellular
– System Access
• 911
• Other easily remembered numbers
Components of an EMS System
• Dispatch Center
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Well Designed
Well Equipped
Well Staffed & Trained
Policies & Procedures
Components of an EMS System
• Ambulance Service
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Well Designed
Well Equipped
Well Maintained
Well Trained Staff
• Initial
• Continuing Education
Components of an EMS System
• Rapport with Other Healthcare
Professionals
• Reports & Records
• System Evaluation
– Quality Improvement
• Protocol Review/Update
• Run Review
• Remedial or Continuing Education
Components of an EMS System
• System Evaluation (Cont.)
– Risk Management/Loss Control
– Outcome Studies
– System Status Management
• Disaster Plans
– Major Incident Response
• Designed by EMS
• Designed to Integrate with Other Agencies
Components of an EMS System
• Public Information & Education
• Categorized Hospital Emergency
Capabilities
• Funding
Components of an EMS System
• Management
– Well Educated
• Initial
• Continuing Education
– Well Supported
•$
• by Upper Level Management
Continuum of Care
• 1st Phase - Out of Hospital Care
• 2nd Phase - Emergency Department Care
• 3rd Phase - Definitive Care
EMS RELATED AGENCIES
• First Responders
• Law Enforcement
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Police
Sheriff's Department
Department of Public Safety
Federal
EMS RELATED AGENCIES
• Fire Department
• Regional Organizations
• Texas Department of Health
Roles & Responsibilities
• Safety
– Priorities
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Yourself
Partner
By-standers
Patient
Roles & Responsibilities
• Safety (cont.)
– Safe Behaviors
• Health
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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
Roles & Responsibilities
• Patient Care
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Patient Assessment
Basic Life Support
Mechanical Aids to Breathing
Pulse-Oximetry
Semi-Automatic External Defibrillator
Pneumatic Anti-Shock Garment (PASG or
MAST)
Roles & Responsibilities
• Patient Care (cont.)
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Hand-held Metered Dose Nebulizers
Epinephrine Auto-injectors (Epi pens)
Nitroglycerin
Aspirin
Charcoal
Roles & Responsibilities
• Patient Care (cont.)
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Oral Glucose
Bandaging & Splinting / Traction Splinting
Emergency Childbirth
Spinal Immobilization
Advanced Airway (Optional)
EMT-Intermediate
Roles & Responsibilities
• Patient Care - Intermediate
– Intermediate Patient Assessment
– Advanced Airway
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Esophageal Airways
Endotracheal Intubation (Oral & Nasal)
Cricothyrotomy (Needle & Surgical)
End-tidal CO2 Monitoring
EMT-Intermediate
Roles & Responsibilities
• Patient Care - Intermediate (Cont.)
– Vascular Access
• Intravenous
• Intraosseus
– Gastric Tube Placement (Oral & Nasal)
– Pleural Decompression
EMT-Intermediate
Roles & Responsibilities
• Patient Care - Intermediate
– Drug Therapy
• D50W
• Narcan
– Intermediate Recordkeeping
– Intermediate Radio Communication
EMT-Paramedic
Roles & Responsibilities
• Patient Care - Paramedic
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Advanced Patient Assessment
Drug Administration Techniques
EKG Interpretation
Defibrillation/Cardioversion
EMT-Paramedic
Roles & Responsibilities
• Patient Care - Paramedic (Cont.)
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External Pacemakers
IV Infusion Pumps
Mechanical Ventilators
Urinary catherization
Roles & Responsibilities
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Extrication & Rescue
Transport
Transfer of Care
Communications
Records & Reports
Roles & Responsibilities
• Patient Advocacy
• Maintenance
– Vehicle Maintenance
– Equipment Maintenance
– Self
Personal Attitude & Conduct
• Professionalism
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Appearance
Attitude
Manner
Speech
Writing
Knowledge & Skills
• Participation in CE
• Participation in QI
Personal Attitude & Conduct
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Confidence
Compassion
Empathy
Leadership
Personal Attitude & Conduct
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Sound Judgement
Good Moral Character
Stability
Adaptability
Texas EMT Certification
• Requirements
– Successfully complete a TDH approved EMTBasic course
– Submit to TDH:
• Course Completion Certificate
• Completed TDH EMS Personnel Application
• TDH application fees (if not exempt)
– Schedule state exam appointment with TDH
regional office