INTRODUCTION TO
EMERGENCY MEDICAL
CARE
Temple College
EMS Professions
ECA
Updated Spring 2011
Origins of EMS
• Trauma
– Accidental Death
& Disability: The
Neglected Disease
of Modern Society
• Sudden Death
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
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
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
EMS System
• Differ by City, County, and State
• Transporting
– Ground
– Air
• Non-Transporting
– First Responders
• All contain similar components
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
Communication Systems
• System Communication
– Radio
– Cellular
– Data
• System Access
– 911
– Other easily remembered numbers
Dispatch Center
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Design
Equipment
Staffing & Training
Policies & Procedures
Link between public and System Components
Ambulance Service
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System Design
Equipment
Maintenance
Education
– Initial
– Continuing Education
Related Agencies
• First Responders
• Law Enforcement
– Police
– Sheriff's Department
– Department of
Public Safety
– Federal
• Public Health
Other Agencies
• Regional Organizations
• Federal Agencies
• Texas Department of
State Health Services
Administration
• Advisory Council/Governing Board
• Management
– Well Educated
• Initial
• Continuing Education
– Well Supported
• Budget
• by Upper Level Management
Public
• Public Information & Education
Health Care
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Categorized Hospital Emergency Capabilities
Rapport with Other Healthcare Professionals
Funding
Reports & Records
Continuum of Care
• 1st Phase - Out of Hospital Care
• 2nd Phase - Emergency Department Care
• 3rd Phase - Definitive Care
Disaster Plans
• Major Incident Response
– Designed by EMS
– Designed to Integrate with Other Agencies
Quality Improvement
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Protocol Review/Update
Remedial or Continuing Education
Risk Management/Loss Control
Outcome Studies
System Status Management
Roles and Responsibilities
• Safety
• Levels of Training
Levels of Training
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ECA (EMR)
EMT-Basic (EMT)
EMT-Intermediate (AEMT)
E MT-Paramedic (Paramedic)
Safety
• Priorities
– Yourself
– Partner
– By-standers
– Patient
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
ECA Patient Care
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Patient Assessment
Basic Life Support
Mechanical Aids to Breathing
Pulse-Oximetry
Semi-Automatic External Defibrillator
Bandaging & Splinting
Emergency Childbirth
Spinal Immobilization
EMT Care
• Pneumatic Anti-Shock Garment (PASG or
MAST)
• Traction Splinting
• Advanced Airway (Optional)
EMT Medications
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Oxygen
Hand-held Metered Dose Nebulizers
Epinephrine Auto-injectors (Epi pens)
Nitroglycerin
Aspirin
Charcoal
Oral Glucose
Additional
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
EMT-Intermediate (AEMT) Care
• All EMT Skills/Knowledge
• Advanced Airway
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Esophageal Airways
Endotracheal Intubation (Oral & Nasal)
Cricothyrotomy (Needle & Surgical)
Vascular Access
• Intravenous
• Intraosseus
EMT-Intermediate (AEMT)
– Drug Therapy
• D50W
• Narcan
– Gastric Tube Placement (Oral & Nasal)
– Pleural Decompression
EMT-Paramedic
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All EMT-I Skills/Knowledge
Additional Assessment Skills
EKG Interpretation
Defibrillation/Cardioversion/Pacemaker
IV Infusion Pumps
Mechanical Ventilators
Urinary catherization
Professionalism
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
Think of a “Profession”
What characteristics of this group
demonstrates professionalism?
Professionalism
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Appearance
Attitude
Interaction with others
Manner
Speech
Writing
Knowledge & Skills
– Participation in CE
– Participation in QI
How do others
perceive your
actions?
Personal Attitude & Conduct
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Confidence
Compassion
Empathy
Leadership
Sound Judgment
Good Moral Character
Stability
Adaptability
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
Texas ECA Certification
• Requirements
– Successfully complete a Texas DSHS approved
ECA course
– Schedule exam with NREMT
– Submit to Texas DHSH:
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Results from Nation Registry ECA Exam
Fingerprint
Completed DSHS EMS Personnel Application
Application fees (if not exempt)
ECA Application
• Access via DSHS Website
• Finger Print processing takes time
• Encouraged to begin now!