Emergency Medical Services

Mrs. Brodermann – Biomedical 4

Careers in Emergency Medical Services

First Responder Assess illness or injury and provide care May be firefighters, law enforcement officers or

private citizens With limited equipment they provide skilled and

immediate help

Responsibilities of First Responder

Evaluate scene for safety and safely gain access to the patient

Take appropriate body substance isolation precautions Identify the cause of the injury or the nature of the

illness and provide emergency medical care using minimum equipment

Move patient if necessary without causing further injury Transfer information to more highly trained personnel

upon their arrival at the scene Determine the total number of patients Request additional help if necessary

Emergency Medical Technician

Dispatched by 911 Work with fire and police personnel They work in all types of weather and at all hours Seek medical advice from doctors and nurses via

radio or phone Use a variety of equipment found in the ambulance

including back boards, cervical collars and AED’s May be volunteers or full or part-time employees Can work at hospitals, fire departments,

independent ambulance companies, emergency helicopters, industries or correctional facilities

EMT NOT DOING MUCH FOR MY CONFIDENCE ARE YOU?

EMT Responsibilities Assess the situation to determine safety Take appropriate precautions with infection

control Interview and examines patient to determine if

emergency care is necessary Provides appropriate care such as starting an IV,

administering medication, life saving measures, interpreting EKG data and securing airway

Transports patient to a medical facility if necessary

EMT LEVELS BASIC EMT

o Basic national training standard training programo Provide basic life support

• Oral and nasal airways• Cervical collar• Use of AED• Epi-pen• Immobilization of injuries to the arms or legs

Intermediate EMTo Possess additional training and certificationo Can perform advanced procedures such as initiating an IV

line, advanced airway, interpret EKG, administer medicationso Can manage trauma, cardiac, respiratory emergency patients

Paramedic Highest level of training among EMT’s Training programs last 2 years in a college

setting.o Preparation includes: skills practice labs, hospital clinical

rotations and fieldworko They take a board examination to become certified

Additional responsibilities from the EMT-Io Administer all types of medicationso Contacting hospital of patients conditiono Leadership role among other EMT’so Assignment of care, development of plan and

performance of emergency care

Emergency Medical Services Procedures

Client Assessment Process

Scene Evaluationo Safety of all presento Body substance isolationo Assessment of injury or illmesso Number of patientso Need for additional resources

Initial Assessmento Form a general impressiono Determine the level of responsivenesso Assess the airwayo Assess breathingo Assess circulation including presence of pulse and bleedingo Make a decision regarding the priority or urgency of the client

Focused History and Physical Exam

1. Head1. Check for deformities, wounds, bruises and swelling2. Check ears, nose and mouth for blood, injury or foreign bodies

2. Eyes – compare pupils3. Neck

1. Check for deformities, wounds, swelling2. Check for jewelry

4. Chest5. Abdomen6. Pelvis

1. Check for deformities, wounds, swelling and bruises2. Press downward and inward on the pelvis to assess pain

7. Arms and hands8. Legs9. Back10. Vital Signs

SAMPLE History S – Signs and Symptoms

o What is your complaint? A – Allergies

o Are you allergic to any medications? M – Medications

o What prescription or over the counter medications do you take? P – Pertinent Past Medical History

o Have you ever had this problem before? What other medical problems do you have?

L – Last Oral Intakeo When did you last eat or drink anything? What was it?

E – Event Precedingo What were you doing when this happened?

Detailed Assessment is done quickly and an Ongoing assessment is done continuously to reassess patient

Communication with patient, family and medical personnel at hospital or at the scene

Documentation of history and physical and procedures done at the scene and en route.

Airway Management Trauma or disease may limit the ability to freely move air

through the respiratory structures In an unconscious patient, the tongue can fall back into

the mouth and block the airway. Two common airway adjuncts are:

o Oropharyngeal airway• A curved plastic devise with a flange at the mouth opening• Inserted into the mouth and prevents the tongue from falling back

into the pharynx• Most effective on an unconscious patient with no gag reflex

o Nasopharyngeal airway• Used mostly for seizures, strokes, clenched teeth or injury of the

mouth. Made of soft latex tubing• Insterted into one notril, rests in the pharynx and prevents the

tongue from becoming an airway obstruction

Airways

Additional Career Skills

Oxygen Therapy Respiratory or Cardiac Arrest Shock Severe Blood Loss Various lung diseases or Disorders Stroke Drug Overdose Severe Bone Injuries

Oxygen Therapy Equipment

Portable Oxygen Cylinderso No smoking allowed near oxygeno No droppingo No adhesive tape

Oxygen Regulator Oxygen Flow Meter Oxygen Delivery Device

o Mask o Nasal Cannula

AED Used to treat life-threatening cardiac conditions V-fib = Ventricular Fibrillation – most common

cause of cardiac arrest V-tach = Ventricular Tachycardia 49% survival rate if AED used immediately after

collapse

Spinal Immobilization Resulting from

o Automobile collisionso Shallow water diving accidentso Motorcycle collisionso Falls

• In children, falls from heights two to three times the child’s height; falls from a bicycle or tricycle or being struck by a motor vehicle

S/S of Spinal injuryo Paralysis to the arms and /or legso Weakness, tingling or numbness in arms or legso Pain or tenderness along the back of the neck or spineo Pain with or without movemento Loss of bowel of bladder controlo Difficult or labored breathing with little or no movement of the chest

Emergency Childbirth Anatomy & Physiology

o Placenta – organ formed at conception which is an exhange area between mother and fetus. Allows osygen and nutrients to cross from the mother’s circulation to nourish the fetus.• Expelled after birth

o Umbilical Cord – A cordlike structureattached to the fetus’s navel and the placenta.

o Amniotic Sac – a thin membranous sac that contains 1-2L of amniotic fluid and surrounds the fetus.

Stages of Labor First Stage

o Begins with regular contractions of the uterus and thinning and dilation of the cervix

o Contractions range from being 30 minutes apart to being 2-3 minutes apart at an increasing strength

o This stage ends with full dilation and effacing of the cervixo Can last up to 24 hours

Second Stageo Begins when baby enters the birth canal until it is borno Contractions become intense and frequento Delivery is imminent when crowning is observedo Can last up to 2 or more hours

Third Stageo Starts after the delivery of the infant until the delivery of the placentao Can last 10 -30 minutes

Stages of Labor