Introduction to
the EMS System
Lesson 1
1-1
Introduction
• First Responders are essential part of EMS
system
• First trained persons to reach ill/injured patient
• Individual summoned to provide care in an
emergency
• Professional duty to respond/provide emergency
care
• Usually have access to supplies/equipment for
providing initial care
1-2
Examples of Occupations of
First Responders
• Law enforcement
personnel
• Firefighters
• Industrial safety
officers
• Prison guards
• Lifeguards
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Daycare attendants
Athletic trainers
Ski patrol members
Civil defense
personnel
• Disaster team
members
1-3
Medical Emergencies
• Situation where person suddenly needs medical care
• Often person is injured or experiences sudden illness
• May be life-threatening
U.S. Medical Emergency Statistics
• 40 million visits made to emergency departments
• 2 million people are hospitalized
• 140,000 die from injuries
• 180,000 die from heart attacks
• 162,000 die from strokes
1-4
Sudden Illness
• Medical conditions that occur suddenly
• Person with non-emergency chronic illness
Common Causes of Injuries Treated in Emergency
Departments
• Examples of annual cases in U.S.:
– Falls - 7,989,000
– Motor vehicle crashes - 4,582,000
– Struck by or against object - 4,209,000
– Cut or pierced by object - 2,544,000
– Poisoning - 750,000
– Burns - 516,000
1-5
Injuries Causing Deaths
• Motor vehicle crashes, injuries at home, public
places, and work
• Injuries may strike at any time
• First Responders provide care until patient
receives advanced help
1-6
Emergency Medical Services
System (EMS)
• EMS Act of 1973 established nationwide system
• Sophisticated network of services
• Single call for help initiates responses to rush care to
patient
Accessing EMS
• Activated when someone calls 911 or another local
number
• Most communities have a centralized 911 system
• 911 calls reach dispatcher who then sends resources to
scene
1-7
911 Systems
• Callers identify name,
location, and phone
number
• Enhanced 911 systems
automatically provide
dispatcher with caller’s
phone number/location
for land lines
• Caller may need to
specify exact location
• With cellular calls, caller’s
location is unknown
1-8
Steps of EMS Response to
Emergencies
1. Medical emergency occurs
2. Emergency recognized/EMS is activated
3. Citizen responder may give first aid/CPR on the scene if
trained
4. First Responders arrive
5. EMTs/Paramedics arrive and assume care
6. EMTs continue care measures begun by First
Responders
7. Following stabilization and care, patient transported to
hospital
8. Patient transferred to in-hospital care system
1-9
Response of First Responders
• Sent to scene by
dispatcher after a citizen
has activated EMS
• If on-scene, initiates call
to dispatcher to activate
EMS.
• “Ensure that EMS has
been activated” to cover
all situations
1-10
Types of Facilities Receiving
Patients
• Hospital emergency departments
• Specialty facilities:
– Trauma centers
– Burn centers
– Pediatric centers
– Perinatal centers
1-11
Preparation of First Responders
• Equipment used must be clean, complete, and readily
available for use
• Frequent checks of equipment /supplies:
– All equipment safe and in good working order
– Dated supplies checked and replaced before
expiration
– Oxygen cylinders kept full
– Dressings/bandages replaced as soon as they are
used
1-12
Preplanning
• Preparing a plan in anticipation of different
emergencies
• Many industrial plants have plans for response
that identify:
– key personnel,
– locations of supplies
– mechanism for notifying EMS
– evacuation routes
• Fire departments/EMS systems preplan
responses to areas of potential hazards
1-13
First Responder Preparation
• Preparation begins with training
• First Responders should strive to keep
skills/knowledge up to date
• Infrequently used skills should be practiced
• Continuing education also essential
1-14
Notification of Medical
Emergencies
• Police department, fire department, and
EMS receive the call
• Lifeguards, ski patrol members, and
athletic trainers are already at scene
Responding to the Call
• Gather medical
equipment and go to
scene
• Respond in the
appropriate vehicle
• Fire, police, and rescue
personnel have vehicles
equipped with the
necessary warning
equipment
• If private vehicle, obey all
traffic laws/signs
1-16
Ten Components of EMS
Systems
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•
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Regulation and policy
Resource management
Human resources and training
Transportation
Facilities
Ten Components of EMS
Systems Continued
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Communications
Public information and education
Medical oversight
Trauma systems
Evaluation
1-18
EMS
Professionals
• Dispatcher
• First Responder
• Emergency Medical
Technician (EMT)
• Medical Director
Dispatcher
• Called an emergency medical
dispatcher (EMD) or dispatch
• Receives most 911 calls
• Located in law enforcement
agency, fire station, or other
site
• Trained to obtain
information/determine what
personnel/equipment are
needed
• Sends appropriate EMS
unit(s) to the scene
First Responder
• Sometimes called an
emergency medical responder
• Usually first person to arrive at
emergency
• Takes over care of victim from
those giving first aid
• Gathers information
concerning the victim
• Controls scene
• Prepares for arrival of an
ambulance
• Provides care until more
advanced professionals arrive
1-21
Emergency Medical Technician
(EMT)
• Arrive in ambulance equipped
for Basic or Advanced Life
Support
• Take over care/transport
patient for definitive medical
care
• EMTs with different levels of
training perform different
medical treatments
– EMT-Basic (EMT-B)
– EMT-Intermediate (EMT-I)
– EMT-Paramedic (EMT-P)
1-22
Medical Director
• Physician within EMS system who oversees
First Responders/EMTs
• Establishes protocols for medical care
• Available for consultation by radio or telephone
Categories of First Responders’
Responsibilities
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General responsibilities
Patient care responsibilities
Responsibilities at the scene
Personal responsibilities and characteristics
1-24
General Responsibilities
1. Respond in safe/rapid manner
2. Maintain personal safety
3. If emergency requires special
personnel/equipment, contact EMS
4. Gain access to patient
5. Give care to the patient
6. Document emergency/actions to meet local
recordkeeping requirements
1-25
Patient Care Responsibilities
1. Give care needed for life-threatening problems
2. Activate EMS system
3. Further assess patient to detect medical
problems/life threats
4. Provide care/remain with patient
5. Assist other EMS personnel as needed
6. Maintain the patient’s privacy and confidentiality
1-26
Responsibilities at the Scene
1. Identify safety issues,
determine number of
patients, determine
resources needed
2. It may be necessary to
access the patient
3. Maintain safety of self,
patient and others at
scene
4. Assist personnel as
required /requested
1-27
Responsibilities at the Scene
Continued
5. Cooperate with other public safety workers
6. Other responsibilities may include:
– Assist in directing traffic
– Summon other appropriate help
– Control, direct, or ask bystanders for help
– Other responsibilities as dictated by your job
or specific EMS system
1-28
Training Responsibilities
• Keep your skills/ knowledge up to date
• Attend continuing education programs and
refresher training
• Read professional publications
• Maintain current knowledge of issues affecting
EMS
1-29
Personal Responsibilities and
Characteristics
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Maintain a caring and professional attitude
Respect all patients, family
Maintain composure
Maintain a professional appearance
Maintain personal fitness and health
1-30
Medical Oversight
• Responsibility of physician overseeing out-ofhospital emergency care
• Medical director leads response team and
decides how care is delivered
• Includes direct/indirect medical control
Direct Medical Control
• Medical director involved by instructing
prehospital care providers
• Medical director stays in contact with care
providers
• Medical director can authorize specific patient
treatment outside of standard protocols
1-32
Indirect Medical Control
• Refers to offline direction provided by the
medical director
• Medical director responsible for developing
protocols
• Includes EMS system design, standards of
training, quality assurance programs
1-33
Legal Responsibility of Medical
Director
• First Responders function under
guidance/control of medical director
• First Responders generally considered agents of
the medical director
1-34