Introduction to Emergency Medical Care Flashcards
The first Emergency transport system began in
France in the 1790’s
What happened in 1966
1966 the National Highway Safety Act charged the United States Department of Transportation
(DOT) with developing EMS standards and assisting the states to upgrade the quality of
their prehospital emergency care.
What are the element of NHTSA EMS evaluation
Regulation and policy. Each state EMS system must have in place enabling legislation (laws that allow the system to exist), a lead EMS agency, a funding mechanism, regulations, policies, and procedures.
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Resource management. There must be centralized coordination of resources so that all victims of trauma or medical emergencies have equal access to basic emergency care and transport by certified personnel, in a licensed and equipped ambulance, to an appropriate facility.
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Human resources and training. At a minimum, all those transporting prehospital personnel (those who ride the ambulances) should be trained to the EMT level using a standardized curriculum taught by qualified instructors.
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Transportation. Safe, reliable ambulance transportation is a critical component. Most
patients can be effectively transported by ground ambulances. Other patients require rapid transportation, or transportation from remote areas, by helicopter or airplane.
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Facilities. The seriously ill or injured patient must be delivered in a timely manner to the closest appropriate facility.
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Communications. There must be an effective communications system, beginning
with the universal system access number (911), dispatch-to-ambulance, ambulance-toambulance, ambulance-to-hospital, and hospital-to-hospital communications.
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Public information and education. EMS personnel may participate in efforts to educate the public about their role in the system, their ability to access the system, and prevention of injuries.
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Medical direction. Each EMS system must have a physician as a Medical Director accountable for the activities of EMS personnel within that system. The Medical Director delegates medical practice to nonphysician providers (such as EMTs) and must be involved in all aspects of the patient care system.
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Trauma systems. In each state, enabling legislation must exist to develop a trauma system including one or more trauma centers, triage and transfer guidelines for trauma patients, rehabilitation programs, data collection, mandatory autopsies (examination of bodies to determine cause of death), and means for managing and ensuring the quality of the system.
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Evaluation. Each state must have a program for evaluating and improving the effectiveness of the EMS system, known as a quality improvement (QI) program, a quality assurance (QA) program, or total quality management (TQM).
What are the Roles and Responsibilities on an EMT
The roles and responsibilities of the EMT include safety of the crew, patient, and bystanders; patient assessment; patient care; lifting and moving; transport; transfer of care; patient advocacy; and promotion of public health and safety.
What are the personal traits of an EMT
Some of the desirable personal and physical attributes of the EMT include being in good health and able to lift and carry up to 125 pounds; having good eyesight and hearing; being able to clearly communicate in written and oral form; and being pleasant, sincere, cooperative, resourceful, a self-starter, emotionally stable, able to lead, and neat and clean.
designated agent
an EMT or other person authorized by a Medical Director to give medications and provide emergency care. The transfer of such authorization to a designated agent is an extension of the Medical Director’s license to practice medicine.
evidence-based
description of medical techniques or practices
that are supported by scientific evidence of their safety and efficacy, rather than merely by supposition and tradition.
medical direction
oversight of the patient-care aspects of an EMS
system by the Medical Director.
Off-line medical direction
consists of standing orders issued by the Medical Director that allow EMTs to give certain medications or perform certain procedures without
speaking to the Medical Director or another physician.
On-line medical direction
consists of orders given directly by the on-dutyphysician to an EMT in the field by radio or telephone.
Medical Director
a physician who assumes ultimate responsibility for the patient-care aspects of the EMS system.
911 system
a system for telephone access to report emergencies. A dispatcher takes the information and alerts EMS or the fire or police
departments as needed. Enhanced 911 has the additional capability of automatically identifying the caller’s phone number and location.
patient outcomes
the long-term survival of patients.
protocols
lists of steps, such as assessments and interventions, to be taken in different situations. Protocols are developed by the Medical Director of an EMS system.
quality improvement
a process of continuous self-review with
the purpose of identifying and correcting aspects of the system that require improvement.
