Essentials of Paramedic Care Volume 1
Chapter 1. Introduction to Prehospital Care
OBJECTIVES
Part 1: Introduction to Advanced Prehospital Care (begins on p. 6)
After reading Part 1 of this chapter, you should be able to:
1. Describe the relationship between the paramedic and other members of the health professions.
(p. 6)
2. Identify the attributes and characteristics of the paramedic. (p. 7)
3. Explain the elements of paramedic education and practice that support its stature as a
profession. (p. 7)
4. Define and give examples of the expanded scope of practice for the paramedic. (p. 8)
Part 2: EMS Systems (begins on p. 8)
After reading Part 2 of this chapter, you should be able to:
1. Describe key historical events that influenced the national development of emergency medical
services (EMS) systems. (pp. 10-12)
2. Define the following terms: EMS systems (p. 12), licensure (p. 18), certification (p. 18),
profession (p. 18), professionalism (p. 24), ethics (p. 25), peer review (p. 25), medical direction
(p. 14), protocols (p. 15).
3. Identify national groups that are important to the development, education, and implementation
of EMS, as well as the role of provincial or territorial associations, the Paramedic Association of
Canada (PAC), and the roles of various EMS standard-setting agencies. (p. 20)
4. Identify the standards (components) of an EMS system. (p. 12)
5. Differentiate among EMS provider levels: emergency medical responder, primary care
paramedic, advanced care paramedic, and critical care paramedic. (p. 18)
6. Describe what is meant by "citizen involvement in the EMS system." (pp. 15-16)
7. Discuss the role of the EMS physician in providing medical direction and prehospital care as
an extension of the physician, the benefits of online and offline medical direction, and the
process for the development of local policies and protocols. (pp. 14-15)
8. Describe the relationship among the physician on the scene, the paramedic on the scene, and
the EMS physician providing online medical direction. (pp. 14-15)
9. Describe the components of continuous quality improvement, and analyze its contribution to
system improvement, continuing medical education, and research. (pp. 23-25)
,Essentials of Paramedic Care Volume 1
10. Describe the importance, basic principles, process of evaluating and interpreting, and benefits
of research. (pp. 25-26)
Part 3: Roles and Responsibilities of the Paramedic (begins on p. 26)
After reading Part 3 of this chapter, you should be able to:
1. Describe the attributes of a paramedic as a health-care professional. (pp. 30-34)
2. Describe the benefits of continuing education for paramedics and the importance of
maintaining the paramedic licence or certification. (p. 35)
3. List the primary and additional responsibilities of paramedics. (pp. 27-30)
4. Define the role of the paramedic relative to the safety of the crew, the patient, and bystanders.
(pp. 27-28)
5. Describe the role of the paramedic in health-education activities related to illness and injury
prevention. (pp. 29-30)
6. Describe examples of professional behaviours in the following areas: integrity, empathy, self-
motivation, appearance and personal hygiene, self-confidence, communication, time
management, teamwork and diplomacy, respect, patient advocacy, and careful delivery of
service. (pp. 32-34)
7. Identify the benefits of paramedics teaching in their communities. (pp. 29-30)
8. Analyze how the paramedic can benefit the health-care system by supporting primary care for
patients in the prehospital setting. (pp. 28-29)
9. Describe how professionalism applies to the paramedic while on and off duty. (p. 31)
Part 4: The Well-Being of the Paramedic (begins on p. 35)
After reading Part 4 of this chapter, you should be able to:
1. Discuss the concept of wellness and its benefits, the components of wellness, and the role of
the paramedic in promoting wellness. (p. 35)
2. Discuss how cardiovascular endurance, weight control, muscle strength, and flexibility
contribute to physical fitness. (pp. 35-40)
3. Describe the impact of shift work on circadian rhythms. (p. 49)
4. Discuss the contributions that periodic risk assessments and warning sign recognition make to
cancer and cardiovascular disease prevention. (p. 37)
5. Differentiate proper from improper body mechanics for lifting and moving patients in
emergency and nonemergency situations. (pp. 38-40)
,Essentials of Paramedic Care Volume 1
6. Describe the problems that a paramedic might encounter in a hostile situation and the
techniques used to manage the situation. (p. 53)
7. Describe the considerations that should be given to using escorts, dealing with adverse
environmental conditions, using lights and siren, proceeding through intersections, and parking
at an emergency scene. (pp. 53-54)
8. Discuss the concept of "due regard for the safety of all others" while operating an emergency
vehicle. (p. 54)
9. Describe the equipment available for self-protection in a variety of adverse situations,
including body substance isolation steps for protection from airborne and bloodborne pathogens.
(pp. 40-42, 53, 54-56)
10. Given a scenario in which equipment and supplies have been exposed to body substances,
plan for the proper cleaning, disinfection, or disposal of the items. (pp. 42-43)
11. Describe the benefits and methods of smoking cessation. (p. 38)
12. Identify and describe the three phases of the stress response, factors that trigger the stress
response, and causes of stress in EMS. (pp. 47-50)
13. Differentiate between normal or healthy and detrimental physiological and psychological
reactions to anxiety and stress. (pp. 50-
51)
14. Describe behaviour that is a manifestation of stress in patients and those close to them and
describe how that behaviour relates to paramedic stress. (pp. 50-51)
15. Identify and describe the defence mechanisms and management techniques commonly used
to deal with stress, and the components of critical incident stress management (CISM) and
provide examples of situations in which CISM would be beneficial to paramedics. (pp. 50, 51-
52)
16. Given a scenario involving a stressful situation, formulate a strategy to help adapt to the
stress. (pp. 47-52)
17. Describe the stages of the grieving process (Kubler-Ross) and the unique challenges for
paramedics in dealing with themselves, adults, children, and special populations concerning their
understanding or experience of death and dying. (pp. 44-47)
18. Given photos of various motor-vehicle collisions, assess scene safety and propose ways to
make the scene safer. (pp. 53-54)
Part 5: Illness and Injury Prevention (begins on p. 54)
After reading Part 5 of this chapter, you should be able to:
, Essentials of Paramedic Care Volume 1
1. Describe the incidence, morbidity, and mortality, and the human, environmental, and
socioeconomic impact of unintentional and alleged unintentional injuries. (pp. 54-56)
2. Identify health hazards and potential crime areas within the community. (pp. 59-60)
3. Identify local, municipal, and community resources available for physical and socioeconomic
crises. (pp. 56-57, 61)
4. List the general and specific environmental parameters that should be inspected to assess a
patient's need for preventive information and direction. (pp. 59-60)
5. Identify the role of EMS in local, municipal, and community prevention programs. (pp. 55,
56-61)
6. Identify the injury and illness prevention programs that promote safety for all age populations.
(pp. 59-62)
7. Identify patient situations in which the paramedic can intervene in a preventive manner. (pp.
59-62)
8. Document primary and secondary injury prevention data. (pp. 61-62)
Part 6: Ethics in Advanced Prehospital Care (begins on p. 63)
After reading Part 6 of this chapter, you should be able to:
1. Define ethics and morals and distinguish between ethical and moral decisions in emergency
medical service. (pp. 63-66)
2. Identify the premise that should underlie the paramedic's ethical decisions in prehospital care.
(p. 65)
3. Analyze the relationship between the law and ethics in EMS. (p. 63)
4. Compare and contrast the criteria used in allocating scarce EMS resources. (pp. 71-72)
5. Identify issues surrounding advance directives in making a prehospital resuscitation decision
and describe the criteria necessary to honour an advance directive in your province or territory.
(pp. 67-68)
Part 7: Lifting and Moving Patients (begins on p. 74)
After reading Part 7 of this chapter, you should be able to:
1. Define body mechanics. (p. 74)
2. Discuss the guidelines and safety precautions that need to be followed when lifting a patient.
(pp. 74-
75)
Chapter 1. Introduction to Prehospital Care
OBJECTIVES
Part 1: Introduction to Advanced Prehospital Care (begins on p. 6)
After reading Part 1 of this chapter, you should be able to:
1. Describe the relationship between the paramedic and other members of the health professions.
(p. 6)
2. Identify the attributes and characteristics of the paramedic. (p. 7)
3. Explain the elements of paramedic education and practice that support its stature as a
profession. (p. 7)
4. Define and give examples of the expanded scope of practice for the paramedic. (p. 8)
Part 2: EMS Systems (begins on p. 8)
After reading Part 2 of this chapter, you should be able to:
1. Describe key historical events that influenced the national development of emergency medical
services (EMS) systems. (pp. 10-12)
2. Define the following terms: EMS systems (p. 12), licensure (p. 18), certification (p. 18),
profession (p. 18), professionalism (p. 24), ethics (p. 25), peer review (p. 25), medical direction
(p. 14), protocols (p. 15).
3. Identify national groups that are important to the development, education, and implementation
of EMS, as well as the role of provincial or territorial associations, the Paramedic Association of
Canada (PAC), and the roles of various EMS standard-setting agencies. (p. 20)
4. Identify the standards (components) of an EMS system. (p. 12)
5. Differentiate among EMS provider levels: emergency medical responder, primary care
paramedic, advanced care paramedic, and critical care paramedic. (p. 18)
6. Describe what is meant by "citizen involvement in the EMS system." (pp. 15-16)
7. Discuss the role of the EMS physician in providing medical direction and prehospital care as
an extension of the physician, the benefits of online and offline medical direction, and the
process for the development of local policies and protocols. (pp. 14-15)
8. Describe the relationship among the physician on the scene, the paramedic on the scene, and
the EMS physician providing online medical direction. (pp. 14-15)
9. Describe the components of continuous quality improvement, and analyze its contribution to
system improvement, continuing medical education, and research. (pp. 23-25)
,Essentials of Paramedic Care Volume 1
10. Describe the importance, basic principles, process of evaluating and interpreting, and benefits
of research. (pp. 25-26)
Part 3: Roles and Responsibilities of the Paramedic (begins on p. 26)
After reading Part 3 of this chapter, you should be able to:
1. Describe the attributes of a paramedic as a health-care professional. (pp. 30-34)
2. Describe the benefits of continuing education for paramedics and the importance of
maintaining the paramedic licence or certification. (p. 35)
3. List the primary and additional responsibilities of paramedics. (pp. 27-30)
4. Define the role of the paramedic relative to the safety of the crew, the patient, and bystanders.
(pp. 27-28)
5. Describe the role of the paramedic in health-education activities related to illness and injury
prevention. (pp. 29-30)
6. Describe examples of professional behaviours in the following areas: integrity, empathy, self-
motivation, appearance and personal hygiene, self-confidence, communication, time
management, teamwork and diplomacy, respect, patient advocacy, and careful delivery of
service. (pp. 32-34)
7. Identify the benefits of paramedics teaching in their communities. (pp. 29-30)
8. Analyze how the paramedic can benefit the health-care system by supporting primary care for
patients in the prehospital setting. (pp. 28-29)
9. Describe how professionalism applies to the paramedic while on and off duty. (p. 31)
Part 4: The Well-Being of the Paramedic (begins on p. 35)
After reading Part 4 of this chapter, you should be able to:
1. Discuss the concept of wellness and its benefits, the components of wellness, and the role of
the paramedic in promoting wellness. (p. 35)
2. Discuss how cardiovascular endurance, weight control, muscle strength, and flexibility
contribute to physical fitness. (pp. 35-40)
3. Describe the impact of shift work on circadian rhythms. (p. 49)
4. Discuss the contributions that periodic risk assessments and warning sign recognition make to
cancer and cardiovascular disease prevention. (p. 37)
5. Differentiate proper from improper body mechanics for lifting and moving patients in
emergency and nonemergency situations. (pp. 38-40)
,Essentials of Paramedic Care Volume 1
6. Describe the problems that a paramedic might encounter in a hostile situation and the
techniques used to manage the situation. (p. 53)
7. Describe the considerations that should be given to using escorts, dealing with adverse
environmental conditions, using lights and siren, proceeding through intersections, and parking
at an emergency scene. (pp. 53-54)
8. Discuss the concept of "due regard for the safety of all others" while operating an emergency
vehicle. (p. 54)
9. Describe the equipment available for self-protection in a variety of adverse situations,
including body substance isolation steps for protection from airborne and bloodborne pathogens.
(pp. 40-42, 53, 54-56)
10. Given a scenario in which equipment and supplies have been exposed to body substances,
plan for the proper cleaning, disinfection, or disposal of the items. (pp. 42-43)
11. Describe the benefits and methods of smoking cessation. (p. 38)
12. Identify and describe the three phases of the stress response, factors that trigger the stress
response, and causes of stress in EMS. (pp. 47-50)
13. Differentiate between normal or healthy and detrimental physiological and psychological
reactions to anxiety and stress. (pp. 50-
51)
14. Describe behaviour that is a manifestation of stress in patients and those close to them and
describe how that behaviour relates to paramedic stress. (pp. 50-51)
15. Identify and describe the defence mechanisms and management techniques commonly used
to deal with stress, and the components of critical incident stress management (CISM) and
provide examples of situations in which CISM would be beneficial to paramedics. (pp. 50, 51-
52)
16. Given a scenario involving a stressful situation, formulate a strategy to help adapt to the
stress. (pp. 47-52)
17. Describe the stages of the grieving process (Kubler-Ross) and the unique challenges for
paramedics in dealing with themselves, adults, children, and special populations concerning their
understanding or experience of death and dying. (pp. 44-47)
18. Given photos of various motor-vehicle collisions, assess scene safety and propose ways to
make the scene safer. (pp. 53-54)
Part 5: Illness and Injury Prevention (begins on p. 54)
After reading Part 5 of this chapter, you should be able to:
, Essentials of Paramedic Care Volume 1
1. Describe the incidence, morbidity, and mortality, and the human, environmental, and
socioeconomic impact of unintentional and alleged unintentional injuries. (pp. 54-56)
2. Identify health hazards and potential crime areas within the community. (pp. 59-60)
3. Identify local, municipal, and community resources available for physical and socioeconomic
crises. (pp. 56-57, 61)
4. List the general and specific environmental parameters that should be inspected to assess a
patient's need for preventive information and direction. (pp. 59-60)
5. Identify the role of EMS in local, municipal, and community prevention programs. (pp. 55,
56-61)
6. Identify the injury and illness prevention programs that promote safety for all age populations.
(pp. 59-62)
7. Identify patient situations in which the paramedic can intervene in a preventive manner. (pp.
59-62)
8. Document primary and secondary injury prevention data. (pp. 61-62)
Part 6: Ethics in Advanced Prehospital Care (begins on p. 63)
After reading Part 6 of this chapter, you should be able to:
1. Define ethics and morals and distinguish between ethical and moral decisions in emergency
medical service. (pp. 63-66)
2. Identify the premise that should underlie the paramedic's ethical decisions in prehospital care.
(p. 65)
3. Analyze the relationship between the law and ethics in EMS. (p. 63)
4. Compare and contrast the criteria used in allocating scarce EMS resources. (pp. 71-72)
5. Identify issues surrounding advance directives in making a prehospital resuscitation decision
and describe the criteria necessary to honour an advance directive in your province or territory.
(pp. 67-68)
Part 7: Lifting and Moving Patients (begins on p. 74)
After reading Part 7 of this chapter, you should be able to:
1. Define body mechanics. (p. 74)
2. Discuss the guidelines and safety precautions that need to be followed when lifting a patient.
(pp. 74-
75)
