Chapter 1: EMS Systems - Emergency Care and Transportation of the Sick and Injured (12th Edition)

Objectives

Understand the origins and present-day structure of the emergency medical care system.
Comprehend EMT roles, responsibilities, and quality improvement process.
Learn about different levels of EMS providers and the foundations for being a competent EMT.
Discuss EMS systems, history, roles, responsibilities, quality improvement, patient safety, research, and public health.
Overview of licensure requirements and comparison between various EMS training courses.

Teams of healthcare professionals provide emergency care and transportation, governed by state laws.
Completion of the course allows eligibility for national/state certification exams.
Licensure ensures applicant competency in examination settings.
Training and Licensure Levels:
- EMR: Basic training, provides care before ambulance arrives.
- EMT: Basic life support, AEDs, airway adjuncts, assist with medications.
- AEMT: Advanced life support, IV therapy, limited emergency medicines.
- Paramedic: Extensive training, advanced life support skills.

Reading assignments, step-by-step demonstrations, summary skill sheets, case presentations, and scenarios.
Licensure requirements vary by state (e.g., high school diploma, immunizations, background check, driver's license).

Protects individuals with disabilities in accessing state/local programs and employment.
Requires workplace accommodations for candidates with disabilities.

Origins: Volunteer ambulances in WWI, field care in WWII, helicopter evacuation in Korean War.
Notable Developments:
- 1966: "Accidental Death and Disability" report (White Paper).
- 1973: Emergency Services Act, DOT's first EMT training curriculum.
- 1971: First EMT book by American Academy of Orthopaedic Surgeons.
Standardization Efforts: National levels of EMS education and providers.

Federal Level: National EMS scope of practice model.
State Level: Laws regulating EMS operations.
Local Level: Medical director provides oversight.
Public Access: 911 system, emergency medical dispatch (EMD) system.
Human Resources: Encourages working environment for EMS careers.
Medical Direction: Protocols and standing orders for care.
Legislation and Regulation: Training and protocols must follow state legislation.
Integration with Healthcare Services: Continuation of care from pre-hospital to hospital.
Mobile Integrated Healthcare (MIH): Healthcare within community; includes community paramedicine.
Information Systems: Electronic documentation to improve care.
Evaluation: Continuous quality improvement (CQI) for EMS.
Patient Safety: Minimize medical errors through education and procedure.

System Finance: Varies by organization; may include insurance information and billing.
Education Systems: Adherence to national standards, continuing education, and training updates.

Public Health Focus: Primary and secondary prevention strategies, public health accomplishments.
EMS Research: Evidence-based medicine and guidelines to improve patient outcomes.

Key Responsibilities: Safety, emergency vehicle operations, on-scene leadership, patient assessment and care, professional development, and community relations.
Professional Attributes: Integrity, empathy, self-motivation, appearance, hygiene, self-confidence, time management, communication, teamwork.
Patient Care: Compassion, respect, confidentiality (HIPAA), and best care practices.

Discusses examples of care using standard orders, quality control responsibility, priority of EMT safety, and conditions affecting EMS certifications.
Emphasizes EMT roles in emergency scenarios and professional conduct.