Chapter 1:
Bolded Terms:
- EMS:
- emergency services system
- EMR:
- provides immediate lifesaving care to patients
- EMT:
- provides basic emergency medical care and transportation to patients
- AEMT:
- provides both basic and limited advanced emergency medical care and
transportation to patients
- Paramedic:
- includes the skills performed by the EMT and AEMT with the addition of more
advanced assessment and patient management skills and provision
- Prehospital care:
- emergency medical treatment given to patients before they are transported to a
hospital or other facility
- Americans with Disabilities Act (ADA):
- protects individuals who have a documented disability from being denied initial or
continued employment based on their disability
- Medical oversight:
- responsibilities of the EMS system’s medical director
- Indirect medical oversight:
- routine duties and responsibilities of the EMS medical director, including the
creation of protocols and standing orders
- Direct medical oversight:
- real-time oversight or medical direction provided by a physician to an EMS
provider seeking immediate feedback or direction; can be online or on-scene
- On-line medical direction:
- direct orders from a physician to a prehospital care provider given by radio or
telephone
- On-scene:
- medical direction provided by an EMS medical director physician who is on scene
with the EMS crew
- Medical director:
- physician who is legally responsible for the clinical and patient care aspects of an
EMS system
- Medical direction:
- medical policies, procedures, and practices that are available to EMS providers
either off-line or on-line
- Protocols:
- policies and procedures for all components of an EMS system
, - Off-line medical direction:
- medical policies, procedures, and practices that medical direction has
established in written guidelines
- Standing orders:
- preauthorized treatment procedures; a type of treatment protocol
- Quality improvement (QI):
- system of internal and external reviews and audits of an EMS system to ensure a
high quality of care
- Evidence-based medicine:
- medical practice based on scientific evidence that certain procedures,
medications, and equipment improve patient outcome
- Evidence-based guidelines:
- development of medical guidelines based on scientific evidence and research
studies
- Mobile integrated healthcare (MIH):
- provision by a variety of health care entities and practitioners of patient-centered
health care in the out-of-hospital environment using mobile technology and
resources and integrated administratively or clinically with the EMS system
- Community paramedicine (CP):
- services provided by the EMS agency and personnel that are administratively
and clinically integrated with other health care entities
Extra Information:
- Department of Transportation: through it's National Highway Traffic Safety
Administration (NHTSA), took a leadership role in the development of EMS systems
- “White paper:” 1966, Accidental Death and Disability: The Neglected Disease of Modern
Society
- Detailed the number of deaths and injuries related to traffic crashes in the United
States
- Each state has control of its EMS system but the NHTSA provide standards called
“Technical Assistance Program Assessment Standards”
- Regulation & policy: must have laws, regulations, policies, and procedures that
govern its EMS
- Resource management: must have central control of EMS resources so that
each locality and all patients have equal access to acceptable emergency care
- Human resources & training: all personnel who staff ambulances and transport
patients must be trained to at least the EMT level
- Transportation: patients must be provided with safe, reliable transportation by
ground or air
- Facilities: seriously ill or injured patients must be delivered in a timely manner to
an appropriate medical facility
- Communications: system of communications must be in place
, - Public information and education: E MS should participate in programs to educate
the public in the prevention of injuries and how to access the EMS system
- Medical direction: EMS system must have a physician as a medical director to
provide medical oversight
- Trauma systems: must develop a system of specialized care for trauma patients
- Evaluation: must have a quality improvement system for the continual evaluation
of and upgrades to the system
- More recently EMS systems need:
- Clinical quality
- Service quality
- Economic efficiency
- Accountability
- Improvement
- Resilience
- Universal number: 911 (fire, police, and EMS)
- Enhanced 911: provides automatic number & location identification
- Basic 911: wireless service provider to transmit all calls to a PSAP regardless of
whether the caller subscribes to the provider’s service
- Phase 1 Enhanced 911: provides the telephone number & the location of the cell
site transmitting the call
- Phase 2 Enhanced 911: provides the latitude and longitude of the caller
- Public Service Answering Point (PSAP):
- Receives the calls, collects, verifies, and records the information about the
emergency, decides which service must respond, and then facilitates alerting the
necessary service
- Ran by Emergency Medical Dispatchers (EMD) can also provide instructions for
things such as bleeding control or CPR
- Cell phones only provide the location of the closest cell tower, not as accurate
- Types of EMS:
- Fire dept. EMS
- Municipal EMS (third service)
- Private EMS
- Hospital-based EMS
- Law Enforcement EMS
- Public Safety Officer
- According to the National EMS Scope of Practice Model:
- Emergency medical responder (EMR):
- uses basic airway, ventilation, and oxygen therapy devices; takes patient
vital signs; and provides stabilization of the spine and suspected extremity
injuries, eye irrigation, bleeding control, emergency moves, CPR,
automated external defibrillation, and emergency childbirth care
- Emergency medical technician (EMT):
, - EMR level w addition of advanced oxygen therapy and ventilation
equipment, pulse oximetry, use of automatic blood pressure monitoring
equipment, and limited medication administration
- Advanced emergency medical technician (AEMT):
- EMT level w addition of the use of advanced airway devices, monitoring
of blood glucose levels, initiation of intravenous and intraosseous (in the
bone marrow) infusions, and administration of a select number of
medications
- Paramedic:
- AEMT level w addition of advanced assessments, form a field impression
and provide invasive and drug interventions as well as transport
- Facilities: trauma, burn, obstetrical, peds, poison control, stroke, cardiac, hyperbaric,
spinal, psychiatric
- EMT Roles/Responsibility:
- Protect your own safety- use seatbelts, proper equipment, and check scene
safety
- Move patients the way you were trained for both the patients and your safety
- Determine the transport location before leaving the scene
- Keep an up-to-date log of calls, complete the prehospital care report
- Protect patients rights
- Know your knowledge and skills
- Must be able to lift and carry up to 125lbs
- Federal agencies involved in EMS:
- NHTSA
- CDC
- HRSA
- National fire academy
- Department of defense
- NIH
- Quality improvement as an EMT:
- Document carefully
- Perform reviews
- Obtain feedback
- Maintain equipment
- Participate in continuing education
- Maintain skills
- Prehospital environment:
- Based on current research and techniques and treatments change all the time
- Public health:
- Health prevention and promotion- vaccines and education
- Disease surveillance- reporting diseases
- Injury prevention- use of safety equipment
Bolded Terms:
- EMS:
- emergency services system
- EMR:
- provides immediate lifesaving care to patients
- EMT:
- provides basic emergency medical care and transportation to patients
- AEMT:
- provides both basic and limited advanced emergency medical care and
transportation to patients
- Paramedic:
- includes the skills performed by the EMT and AEMT with the addition of more
advanced assessment and patient management skills and provision
- Prehospital care:
- emergency medical treatment given to patients before they are transported to a
hospital or other facility
- Americans with Disabilities Act (ADA):
- protects individuals who have a documented disability from being denied initial or
continued employment based on their disability
- Medical oversight:
- responsibilities of the EMS system’s medical director
- Indirect medical oversight:
- routine duties and responsibilities of the EMS medical director, including the
creation of protocols and standing orders
- Direct medical oversight:
- real-time oversight or medical direction provided by a physician to an EMS
provider seeking immediate feedback or direction; can be online or on-scene
- On-line medical direction:
- direct orders from a physician to a prehospital care provider given by radio or
telephone
- On-scene:
- medical direction provided by an EMS medical director physician who is on scene
with the EMS crew
- Medical director:
- physician who is legally responsible for the clinical and patient care aspects of an
EMS system
- Medical direction:
- medical policies, procedures, and practices that are available to EMS providers
either off-line or on-line
- Protocols:
- policies and procedures for all components of an EMS system
, - Off-line medical direction:
- medical policies, procedures, and practices that medical direction has
established in written guidelines
- Standing orders:
- preauthorized treatment procedures; a type of treatment protocol
- Quality improvement (QI):
- system of internal and external reviews and audits of an EMS system to ensure a
high quality of care
- Evidence-based medicine:
- medical practice based on scientific evidence that certain procedures,
medications, and equipment improve patient outcome
- Evidence-based guidelines:
- development of medical guidelines based on scientific evidence and research
studies
- Mobile integrated healthcare (MIH):
- provision by a variety of health care entities and practitioners of patient-centered
health care in the out-of-hospital environment using mobile technology and
resources and integrated administratively or clinically with the EMS system
- Community paramedicine (CP):
- services provided by the EMS agency and personnel that are administratively
and clinically integrated with other health care entities
Extra Information:
- Department of Transportation: through it's National Highway Traffic Safety
Administration (NHTSA), took a leadership role in the development of EMS systems
- “White paper:” 1966, Accidental Death and Disability: The Neglected Disease of Modern
Society
- Detailed the number of deaths and injuries related to traffic crashes in the United
States
- Each state has control of its EMS system but the NHTSA provide standards called
“Technical Assistance Program Assessment Standards”
- Regulation & policy: must have laws, regulations, policies, and procedures that
govern its EMS
- Resource management: must have central control of EMS resources so that
each locality and all patients have equal access to acceptable emergency care
- Human resources & training: all personnel who staff ambulances and transport
patients must be trained to at least the EMT level
- Transportation: patients must be provided with safe, reliable transportation by
ground or air
- Facilities: seriously ill or injured patients must be delivered in a timely manner to
an appropriate medical facility
- Communications: system of communications must be in place
, - Public information and education: E MS should participate in programs to educate
the public in the prevention of injuries and how to access the EMS system
- Medical direction: EMS system must have a physician as a medical director to
provide medical oversight
- Trauma systems: must develop a system of specialized care for trauma patients
- Evaluation: must have a quality improvement system for the continual evaluation
of and upgrades to the system
- More recently EMS systems need:
- Clinical quality
- Service quality
- Economic efficiency
- Accountability
- Improvement
- Resilience
- Universal number: 911 (fire, police, and EMS)
- Enhanced 911: provides automatic number & location identification
- Basic 911: wireless service provider to transmit all calls to a PSAP regardless of
whether the caller subscribes to the provider’s service
- Phase 1 Enhanced 911: provides the telephone number & the location of the cell
site transmitting the call
- Phase 2 Enhanced 911: provides the latitude and longitude of the caller
- Public Service Answering Point (PSAP):
- Receives the calls, collects, verifies, and records the information about the
emergency, decides which service must respond, and then facilitates alerting the
necessary service
- Ran by Emergency Medical Dispatchers (EMD) can also provide instructions for
things such as bleeding control or CPR
- Cell phones only provide the location of the closest cell tower, not as accurate
- Types of EMS:
- Fire dept. EMS
- Municipal EMS (third service)
- Private EMS
- Hospital-based EMS
- Law Enforcement EMS
- Public Safety Officer
- According to the National EMS Scope of Practice Model:
- Emergency medical responder (EMR):
- uses basic airway, ventilation, and oxygen therapy devices; takes patient
vital signs; and provides stabilization of the spine and suspected extremity
injuries, eye irrigation, bleeding control, emergency moves, CPR,
automated external defibrillation, and emergency childbirth care
- Emergency medical technician (EMT):
, - EMR level w addition of advanced oxygen therapy and ventilation
equipment, pulse oximetry, use of automatic blood pressure monitoring
equipment, and limited medication administration
- Advanced emergency medical technician (AEMT):
- EMT level w addition of the use of advanced airway devices, monitoring
of blood glucose levels, initiation of intravenous and intraosseous (in the
bone marrow) infusions, and administration of a select number of
medications
- Paramedic:
- AEMT level w addition of advanced assessments, form a field impression
and provide invasive and drug interventions as well as transport
- Facilities: trauma, burn, obstetrical, peds, poison control, stroke, cardiac, hyperbaric,
spinal, psychiatric
- EMT Roles/Responsibility:
- Protect your own safety- use seatbelts, proper equipment, and check scene
safety
- Move patients the way you were trained for both the patients and your safety
- Determine the transport location before leaving the scene
- Keep an up-to-date log of calls, complete the prehospital care report
- Protect patients rights
- Know your knowledge and skills
- Must be able to lift and carry up to 125lbs
- Federal agencies involved in EMS:
- NHTSA
- CDC
- HRSA
- National fire academy
- Department of defense
- NIH
- Quality improvement as an EMT:
- Document carefully
- Perform reviews
- Obtain feedback
- Maintain equipment
- Participate in continuing education
- Maintain skills
- Prehospital environment:
- Based on current research and techniques and treatments change all the time
- Public health:
- Health prevention and promotion- vaccines and education
- Disease surveillance- reporting diseases
- Injury prevention- use of safety equipment
