Chapter 1: EMS Systems - Emergency Care and Transportation of the Sick and Injured
Overview
Understanding the origins and structure of emergency medical care delivery
Roles and responsibilities of Emergency Medical Technicians (EMTs)
Quality improvement processes in EMS
Different levels of EMS providers
Foundations of being an ethical and caring EMT
Impact of National Highway Traffic Safety Administration's EMS system components
EMT's role in research, data collection, and evidence-based decision-making
Requirements for EMT certification and licensure
EMS System Structure
Teams of healthcare professionals providing emergency care and transportation
Governed by state laws
Completion of course leads to eligibility for state licensure and certification exams
Four training and licensure levels:
EMR (Emergency Medical Responder): Basic training, assists before ambulance arrives
EMT (Emergency Medical Technician): Basic life support training
AEMT (Advanced EMT): Advanced life support, IV therapy
Paramedic: Extensive advanced life support, cardiac monitoring
EMS System Components
Public Access: 911 system, mobile apps for CPR and AED location
Human Resources: Focus on rewarding EMS careers
Medical Direction: Physician oversight, protocols and standing orders
Legislation and Regulation: State guidelines and senior EMS official responsibilities
Healthcare Integration: Continuity from pre-hospital to emergency department care
Mobile Integrated Healthcare (MIH): Community-based healthcare delivery
Information Systems: Document patient care electronically
Quality Improvement: Continuous quality improvement (CQI) and minimizing errors
System Finance: Varies by organization, involves billing and reimbursement strategies
Education and Training
Licensed EMS instructors
National standards for training programs
Continuous education and skill refreshment
Professional Responsibilities
Vehicle and equipment readiness
Scene safety and evaluation
Patient assessment and emergency care
Professional development and community relations
Adherence to patient confidentiality and HIPAA
Legal and Ethical Considerations
Americans with Disabilities Act (ADA) and protections for EMTs with disabilities
Background and criminal history checks for certification
History of EMS
Origins in military field care and volunteer ambulances
Standardization efforts and national curriculum development
Influential documents like the White Paper and EMS Agenda for the Future
Review Questions and Key Points
Examples of standard order care
Quality control responsibility lies with the medical director
Safety as the highest priority in scene assessment
Levels of EMS required for specific care needs (e.g., cardiac monitoring)
Summary
The chapter provides a foundational understanding of EMS systems, roles, and responsibilities, as well as the educational and legal framework needed for certification and practice as an EMT.