chapter 1 introduction to emergency medical services
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Chapter 1Introduction to Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Overview
The History of Emergency Medical Services Components of an EMS System Voices for EMS Providers Modern EMS Acute Medical Care The Future of EMS
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The History of Emergency Medical Services
The military truly gave emergency medical services the field to be tested.
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The History of Emergency Medical Services
The Napoleonic Wars– Brought about the first use of ambulances– Use of ambulances could greatly reduce casualty
rates by allowing one to get to the patient and treat en route
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The Civil War– Makeshift field hospitals were effective in the
treatment of the wounded– Covered wagon ambulances still in use – “Treat them where they lie”
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The World Wars– Soldiers trained in front line medical care– The first field medics to arrive in specialized
ambulance designated with the red cross
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The Korean War– Ambulances took to
the air– Specialized helicopters
took patients to M.A.S.H. units in the field.
Courtesy of Bell Helicopter Textron Inc., Fort Worth, TX.
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The Vietnam War– The helicopter changed into a
mobile treatment center– Care was rendered en route by medics– Lowest en route casualty rate in a war
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The Civilian World– It was quickly realized that an
EMS system needed to be in place
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The American Red Cross– The first agency to take aid to the public– Taught CPR and first aid to lay persons in
the late 1950s and 60s
The History of Emergency Medical Services
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The Father of EMS– Dr. Joseph D. (“Deke”) Farrington – Realized training was needed in the streets – Began training the Chicago Fire Department
in street medicine
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
The White Paper– An article written by experts for
President Kennedy– Laid groundwork for inclusion
of EMS legislation
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
National Highway Safety Act (1966)– Encouraged states to begin
organized EMS programs– Organization of the National Highway
Safety Administration
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Emergency Medical Services Act (1973)– Identified the components of an EMS system
The History of Emergency Medical Services
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Components of an EMS System
Personnel Training Communications Transportation Emergency facilities Critical care units Public safety agencies Consumer participation
Access to care Patient transfer Standardization of record
keeping Public information and
education System review and
evaluation Disaster management Mutual aid agreements
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Voices for EMS Providers
National Association of Emergency Medical Technicians (NAEMT)– Supports EMS activities in both the private
and public sectors
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Voices for EMS Providers
American Ambulance Association (AAA)– Represents ambulance services
in the EMS industry
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Voices for EMS Providers
The International Association of Fire Fighters (IAFF)– 80% of EMS is provided
in the fire service
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Voices for EMS Providers
The National Registry of EMTs– An advocate for standardization
in EMS education
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Stop and Review
Name historical events that shaped the field of EMS.
Name a key position paper and its impact on the field of EMS.
Name the professional groups that represent the interests of EMS.
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Modern EMS
Universal Access Integrated 911
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Modern EMS
Emergency Medical Dispatch– EMD course– Provide instruction on care
until EMS arrives
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Modern EMS
First Responders– Basic assessment– Simple airway management– Oxygen administration– Bleeding control – Rescuer CPR– Defibrillation
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Modern EMS
Emergency Medical Technician–Basic– Airway maintenance– Oxygen administration– Bleeding control– CPR– Defibrillation– Patient assessment– Limited medication administration
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Modern EMS
Emergency Medical Technician–Intermediate– Advanced airway management, intubation– Cardiac arrest management, ECG interpretation– Intravenous therapy– Higher level patient assessment– Drug administration– Advanced trauma care
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Modern EMS
Emergency Medical Technician–Paramedic– Comprehensive patient assessment – Advanced airway management– Intravenous access– Expanded medication administration– Cardiac arrest management
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Acute Medical Care
Emergency Medicine– American College of Emergency
Physicians organized in 1968
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Acute Medical Care
Trauma Centers– Specialized care with the
Golden Hour of EMS response
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Acute Medical Care
Aeromedical Transport– Rapid transportation to hospitals
with specialized services
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Stop and Review
What is the relationship of EMS to the modern health care system?
How is the EMT of today different from the EMT of the 1960s? How are they the same?
What are the EMT’s role and responsibilities within the health care system?
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The Future of EMS
Where do we go from here?
You can make the difference!
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Future of EMS
Aging Americans– Increasing health problems– Increasing use of EMS
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Future of EMS
Homelessness– Deinstitutionalization – Poor economic means
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Future of EMS
Human Resources– Declining volunteers – Financial restrictions
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Future of EMS
Accountability– Continuous quality improvement
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© 2005 by Thomson Delmar Learning,a part of The Thomson Corporation. All Rights Reserved
Future of EMS
EMS Research– Proof that something works
scientifically to gain validity
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Stop and Review
What are the challenges that EMTs will face in the future?
How do changes in emergency health care affect the field of EMS?
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