01 introduction to ems system

7/28/2019 01 Introduction to EMS System

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Introduction to

the EMS System

Lesson 1


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Introduction

First Responders are essential part of EMSsystem

First trainedpersons to reach ill/injured patient

Individual summoned to provide care in anemergency

Professional duty to respond/provide emergencycare

Usually have access to supplies/equipment forproviding initial care


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Examples of Occupations of

First Responders Law enforcement

personnel

Firefighters

Industrial safetyofficers

Prison guards

Lifeguards

Daycare attendants

Athletic trainers

Ski patrol members

Civil defense

personnel

Disaster team

members


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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


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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


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Injuries Causing Deaths

Motor vehicle crashes, injuries at home, public

places, and work

Injuries may strike at any time

First Responders provide care until patientreceives advanced help


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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

patientAccessing 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


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911 Systems

Callers identify name,location, and phonenumber

Enhanced 911 systems

automatically providedispatcher with callersphone number/locationfor land lines

Caller may need to

specify exact location

With cellular calls, callerslocation is unknown


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Steps of EMS Response to

Emergencies1. Medical emergency occurs

2. Emergency recognized/EMS is activated

3. Citizen responder may give first aid/CPR on the scene iftrained

4. First Responders arrive

5. EMTs/Paramedics arrive and assume care

6. EMTs continue care measures begun by FirstResponders

7. Following stabilization and care, patient transported tohospital

8. Patient transferred to in-hospital care system


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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


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Types of Facilities Receiving

Patients

Hospital emergency departments

Specialty facilities:

Trauma centers

Burn centers

Pediatric centers

Perinatal centers


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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 areused


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Preplanning

Preparing a plan in anticipation of differentemergencies

Many industrial plants have plans for responsethat identify:

key personnel, locations of supplies

mechanism for notifying EMS

evacuation routes

Fire departments/EMS systems preplanresponses to areas of potential hazards


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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


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Notification of Medical

Emergencies

Police department, fire department, andEMS receive the call

Lifeguards, ski patrol members, and

athletic trainers are already at scene


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Responding to the Call

Gather medicalequipment and go toscene

Respond in the

appropriate vehicle Fire, police, and rescue

personnel have vehiclesequipped with thenecessary warning

equipment If private vehicle, obey all

traffic laws/signs


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Ten Components of EMS

Systems

Regulation and policy

Resource management

Human resources and training

Transportation

Facilities


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Communications

Public information and education

Medical oversight

Trauma systems

Evaluation

Ten Components of EMS

Systems Continued


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Dispatcher

First Responder

Emergency Medical

Technician (EMT)

Medical Director

EMS

Professionals


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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 whatpersonnel/equipment are

needed

Sends appropriate EMS

unit(s) to the scene


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First Responder

Sometimes called an

emergency medical responder

Usually first person to arrive at

emergency

Takes over care of victim fromthose giving first aid

Gathers information

concerning the victim

Controls scene

Prepares for arrival of anambulance

Provides care until more

advanced professionals arrive


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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)


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Medical Director

Physician within EMS system who oversees

First Responders/EMTs

Establishes protocols for medical care

Available for consultation by radio or telephone


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Categories of First Responders

Responsibilities

General responsibilities

Patient care responsibilities

Responsibilities at the scene

Personal responsibilities and characteristics


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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 localrecordkeeping requirements


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Patient Care Responsibilities

1. Give care needed for life-threatening problems

2. Activate EMS system

3. Further assess patient to detect medical

problems/life threats4. Provide care/remain with patient

5. Assist other EMS personnel as needed

6. Maintain the patients privacy and confidentiality


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Responsibilities at the Scene

1. Identify safety issues,determine number ofpatients, determineresources needed

2. It may be necessary toaccess the patient

3. Maintain safety of self,patient and others atscene

4. Assist personnel asrequired /requested


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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


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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


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Personal Responsibilities and

Characteristics

Maintain a caring and professional attitude

Respect all patients, family

Maintain composure

Maintain a professional appearance

Maintain personal fitness and health


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Medical Oversight

Responsibility of physician overseeing out-of-

hospital emergency care

Medical director leads response team and

decides how care is delivered

Includes direct/indirect medical control


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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


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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


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Legal Responsibility of Medical

Director

First Responders function under

guidance/control of medical director

First Responders generally considered agents of

the medical director

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