Introduction to the EMS System

Lesson 1

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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

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Examples of Occupations of First Responders

Law enforcement personnel Firefighters Industrial safety officers 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 patient receives 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 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
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911 Systems
Callers identify name, location, and phone number Enhanced 911 systems automatically provide dispatcher with callers phone number/location for land lines Caller may need to specify exact location With cellular calls, callers location is unknown
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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
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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 are used

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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

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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, 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
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Ten Components of EMS Systems

Regulation and policy Resource management Human resources and training Transportation Facilities

Ten Components of EMS Systems Continued

Communications Public information and education Medical oversight Trauma systems Evaluation

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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
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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

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 local recordkeeping 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 threats 4. 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 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

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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-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

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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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