Overview
This lecture covers Chapter 24, focusing on a team approach to health care in the EMS setting, including roles, collaboration, conflict resolution, and assisting ALS providers with advanced skills.
Teamwork in Health Care
- EMTs are critical members of emergency health care teams, improving patient outcomes and safety.
- Community paramedicine and mobile integrated healthcare extend EMS care beyond hospital transfer, supporting patients at home.
- EMS teams include regular teams (same partners), temporary teams (different partners), and special teams (e.g., tactical EMS, bike teams).
- Group structures: dependent (follow supervisor’s instructions), independent (individual responsibilities), and interdependent (shared goals and accountability).
- Effective teams share a common goal, defined roles, skill diversity, strong communication, and supportive leadership.
Communication & Crew Resource Management
- Closed-loop communication: repeat back orders to ensure understanding.
- Crew resource management encourages all members (even with lower rank) to respectfully question, alert, challenge, or declare emergencies.
- Key to safe patient care is clear, common language and priorities, especially during transfer of care.
Transfer of Patient Care
- Errors can occur if information is not communicated clearly during handoff.
- Critical care (e.g., CPR) must continue without interruption during transfer.
- Respectful interaction and use of standard terminology are essential.
BLS & ALS Collaboration
- BLS (Basic Life Support) and ALS (Advanced Life Support) providers must work together; BLS care continues while ALS performs advanced procedures.
- Skills and protocols may vary by region or agency.
Assisting with ALS Skills
- ALS assistance involves four steps: patient preparation, equipment gathering, procedure support, and ongoing care.
- For endotracheal intubation, EMTs can pre-oxygenate, assist with positioning, gather equipment, and monitor airway after procedure.
- For vascular access, EMTs can prep the patient, gather supplies, stabilize limbs, and monitor the IV/IO site for complications.
Conflict Resolution in Teams
- Patient care always takes priority over disagreements.
- Defer conflict discussions until after patient care is completed.
- Separate personal issues from the task at hand and choose battles wisely.
Key Terms & Definitions
- Community Paramedicine — Extending EMS care to follow up with patients outside the hospital.
- Closed-Loop Communication — Repeating back information to confirm understanding.
- Crew Resource Management (CRM) — Using team situational awareness and open communication to improve safety.
- Endotracheal Intubation — Placing a tube into the trachea to keep the airway open.
- IV/IO Access — Gaining entry to the circulatory system via vein (IV) or bone (IO) for fluids/medications.
- Interdependent Group — Team members share responsibility and work toward a common goal.
Action Items / Next Steps
- Watch the assigned CRM video in Google Classroom.
- Practice ALS assistance skills in upcoming lab sessions.
- Review Chapter 24 and class notes for understanding team dynamics and ALS support steps.