EMS Systems Lecture Notes

Introduction

• Lecture starts early to allow students to prepare.
• Ensure you have access to the textbook via a laptop or desktop for better functionality.
• The class is informative; not intended to replace professional training for EMTs or paramedics.
• Emphasizes the importance of being informed about body functions and illnesses.

History and Evolution of EMS

Early Developments

• 1487: First use of ambulance during the Siege of Malaga.
• 1800s: Baron Dominique John Lafrie established the first pre-hospital triage and transport system.
• 1869: First ambulance service at Bellevue Hospital, NYC.
• 1899: First automobile-type ambulance at Michael Reese Hospital, Chicago.

Mid-20th Century

• 1950s-1960s: Significant advancements during and post-WWII.
  • Introduction of helicopters for medical transport (1951, Korean War).
  • Mouth-to-mouth resuscitation (1956).
  • Portable defibrillator (1959).

Establishment and Reformation

• 1965: NAS and NRC released the white paper highlighting EMS flaws.
• 1968: Establishment of 911 system.
• 1969: First paramedic program by Dr. Eugene Nagel, introduction of telemetry.
• 1973: EMS Systems Act promoting regional development in trauma care.

Current EMS System

Roles and Responsibilities

• EMS is a community service activated via 911.
• Importance of public education on recognizing emergencies.
• Trained dispatchers provide pre-arrival instructions.

EMS Providers in the System

• Variety of EMS employment:
  • Fire-based EMS: Integrated into fire departments.
  • Third-service EMS: Independent municipal services.
  • Private EMS: For-profit/non-profit, contracted to municipalities.
  • Hospital-based: Offers inter-facility and aeromedical transports.
  • Hybrid EMS: Private companies providing in-house medical services.

Medical Direction

• Protocols and Guidelines: Paramedics work under medical director protocols.
• Medical Control:
  • Online (real-time communication)
  • Offline (protocols/standing orders)

Quality Improvement (CQI)

• Evaluation of care through CQI processes to improve patient care.
• Identifying and addressing system-wide issues and human errors.

Human Error Reduction

• Adequate lighting, limiting interruptions, clear protocols.
• Awareness of environment to limit errors during patient care.

Conclusion

• Emphasized the importance of knowing hospital capabilities and response times.
• The lecture will be available on YouTube for review.
• Encouragement to participate in discussions and test preparation.