Chapter 1

Introduction to Emergency
Medical Care

Slide 1

Overview
 The Emergency Medical Services System
 National Highway Traffic Safety Administration
Technical Assistance Program
 Access to the Emergency Medical Services System
 Levels of Education
 The Health Care System
 Liaison with Other Public Safety Workers

Slide 2

Overview
 The Emergency Medical Technician-Basic
 Roles and Responsibilities
 Professional Attributes

 Quality Care
 Quality Improvement
 Medical Direction

Slide 3

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 The Emergency Medical Services
System

Slide 4

The Emergency Medical Services

System
A system of:
 Agencies
 Personnel
 Institutions
Involved in
 Planning
 Providing
 Monitoring

Emergency care

Slide 5

The National Highway Traffic

Safety Administration
 Division of the Department of Transportation
 Mission
 To reduce death and disability caused by motor
vehicle collisions on the nation’s highways
 Developed a number of programs and
initiatives to achieve this mission including
the USDOT National Standard Curricula

Slide 6

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 The National Highway Traffic
Safety Administration

Slide 7

The National Highway Traffic

Safety Administration
 Technical assistance program
 10 standards to benchmark EMS systems
• Regulation and policy
• Resource management
• Human resources and training
• Transportation
• Facilities
• Communications
• Public information and education
• Medical direction
• Trauma systems
• Evaluation
Slide 8

NHTSA Technical
Assistance Program
 Regulation and policy
 Recommends all states have:
• A lead EMS agency
• Funding
• Regulations and operational policies and procedures

Slide 9

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 NHTSA Technical
Assistance Program
 Resource management
 Allow everyone access to basic emergency medical care
• Treatment by personnel trained at the EMT-Basic level
• Patients to be transported in a well-equipped vehicle
• Transported to a staffed, equipped, and prepared receiving
facility
• Initial educational programs
 EMT-Basics
 Advanced providers
 Continuing education

Slide 10

NHTSA Technical
Assistance Program
 Transportation
 Safe and effective
transportation for all patients
 Ambulances and air medical
units must meet minimum
criteria and be inspected
periodically
 All aspects of the state EMS
system must be in a constant
mode of readiness

Slide 11

NHTSA Technical
Assistance Program
 Facilities
 Patients are transported to the
closest appropriate facility
 Prehospital care providers
understand the hospitals'
capabilities
 This includes specialty facilities
• Trauma centers
• Burn centers
• Children’s hospitals

Slide 12

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 NHTSA Technical
Assistance Program

 Communications
 Patients can call for emergency
care
 Emergency personnel can
communicate effectively with the
receiving hospital and other EMS
personnel

Slide 13

NHTSA Technical
Assistance Program

 Public information and education

 Promote the public’s involvement in the EMS
system
 Injury prevention programs

Slide 14

NHTSA Technical
Assistance Program
 Medical direction
 Medical direction standards
help ensure that physicians
stay involved in the patient
care system
• Developing protocols or
patient care guidelines
• Providing medical direction
and consultation
• Evaluating patient care
activities and quality
improvement

Slide 15

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 NHTSA Technical
Assistance Program
 Statewide trauma care systems
 Designated trauma centers
 Trauma triage guidelines
 Data collection
 Trauma registry definitions
 System management
 Quality assurance

Slide 16

NHTSA Technical
Assistance Program

 Evaluation
 Evaluates the effectiveness of patient care
 The EMS system can continue to improve the
quality of patient care delivered

Slide 17

Access to the EMS System

 9-1-1

 Non–9-1-1

Slide 18

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 Access to the EMS System
 EMS providers
should teach the
public how to
access the EMS
system

Slide 19

Levels of Education
 NHTSA has developed standardized curricula
recognizing four levels of EMS provider
 First Responder
 EMT-Basic
 EMT-Intermediate
 EMT-Paramedic

 Not every level is recognized in every state

Slide 20

First Responder
 Designed for:
 Law enforcement
 Firefighters
 Persons likely to encounter an ill or injured person

 Not trained for ambulance service

 Provide initial stabilization until additional
EMS resources arrive

Slide 21

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 EMT-Basic
 Prepares personnel to provide primary
medical care before the patient reaches the
hospital

 Most states require the EMT-Basic as the

minimum accepted education level for
ambulance staff

Slide 22

EMT-Intermediate
 The EMT-Intermediate level is an advanced
EMT level
 Includes
 All skills of an EMT-Basic
 Advanced skills
• Manual defibrillation
• Administration of intravenous fluids and some
medications

Slide 23

Paramedic
 Currently the highest skill level
 Includes
 All of the skills of an EMT-Basic
 All of the skills of an EMT-Intermediate
 Advanced techniques
• Tracheal intubation
• Administration of additional medications
• Additional knowledge of the human body

Slide 24

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 The Health Care System

 EMS is an essential part of the healthcare

system in the United States

Slide 25

The Health Care System

 Hospitals and specialty facilities
 Trauma centers
 Burn centers
 Poison centers
 Children’s hospitals

Slide 26

The Health Care System

 Health care professionals

 Physicians
 Nurses
 Allied health providers
 EMS providers
 Support personnel

Slide 27

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 Liaison with
Other Public Safety Personnel

Slide 28

Roles and Responsibilities

 Personal safety

 Safety of the crew,

patient, and bystanders

 Patient assessment

 Patient care based on

assessment

Slide 29

Roles and Responsibilities

 Lifting and moving
patients safely

 Transport and transfer

of care

 Record-keeping and
data collection

 Patient advocacy
(patient rights)

Slide 30

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 Professional Attributes
 Appearance

 Attitude

 Knowledge and skills

 Makes patient’s needs a priority

 Knowledge of issues

 Continuing education
Slide 31

EMTs have an
obligation to be
knowledgeable and
provide technically
proficient care

Slide 32

Continuing Education

Slide 33

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 Quality Improvement

 Quality improvement (QI)

 A system for continually evaluating and improving
the care provided within an EMS system
• Quality assurance
• Quality management

Slide 34

Quality Improvement
 Provides the EMT with:
 Resources
 Motivation
 Education

 Purpose:
 Detect problems
 Create solutions
 Maintain quality care

Slide 35

Medical Direction
 Medical direction
 Sometimes called medical control
 The process by which physicians monitor the care
given by EMT-Basics to ill or injured patients

Slide 36

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 Medical Direction

 Online
 Direct medical direction
• Also referred to as online
medical control
• Direct communication
between the physician
and the provider in the
field

Slide 37

Medical Direction
 Offline
 Indirect medical
direction, or off-line
medical control
 Consists of other
ways physicians
influence care
• EMS system design
• Developing protocols
and standing orders
• Providing initial and
continuing education
• Participating in quality
improvement
Slide 38

Summary
 The Emergency Medical Services System
 National Highway Traffic Safety Administration
Technical Assistance Program
 Access to the Emergency Medical Services System
 Levels of Education
 The Health Care System
 Liaison with Other Public Safety Workers

Slide 39

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 Summary
 The Emergency Medical Technician-Basic
 Roles and Responsibilities
 Professional Attributes

 Quality Care
 Quality Improvement
 Medical Direction

Slide 40

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