Ch. 1 - EMS Systems - Preparatory Flashcards
An individulal who has training in specific aspects of **Advanced life support such as intravenous therapy, Advanced airway adjuncts and the administration of certain emergency medications.**
Remember: Advanced Airway = Advanced EMT (All A’s)
Advanced EMT (AEMT)
Is the person
Advanced life-saving procedures, some of which are now being provided by the EMT.
Advanced life support (ALS)
(First 2 words in the answer - s (support/saving) procedures
Comprehensive legislation that is designed to protect people with disabilities against discrimination.
Americans With Disablilities Act (ADA)
A device that detects treatable life-threatening cardiac dysrhythmias (ventricular fibrillation and ventricular tachycardia) and delivers the appropriate electrical shock to the patient.
Automated external defibrillator (AED)
A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical care.
Certification
(Think you, disney or jeff ellis gets certified each year for lifeguard)
**A health care model in which experienced paramedics recieve advanced training to equip them to provide additional services in the prehospital environment, **such as health evaluations, monitoring of chronic illnesses or conditions, and patient advocacy
Community paramedicine
Hint: This is about the model of training not about the actual paramedi
A system of internal and external reviews and audits of all aspects of an EMS system aiming at improving outcomes.
Continues quality improvement
An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.
Credentialing
Think your school needs credentials to teach this
A system that assists dispatchers in selecting appropriate units to respond to a particular call for assistance and provides callers with vital instructions until the arrival of EMS crews.
Emergency Medical Dispatch (EMD)
Key word: Think Rescue 911 Maddie/Dispatch giving instructions
A first aid trained professional, such as a police officer, firefighter, lifeguard, or other rescuer who may arrive first at the scene of an emergency to provide initial medical assistance.
These Include:
law enforcement officers and firefighters
They can:
Initiate immediate care and assist EMTs on their arrival
Focus on providing BLS and urgent care with limited equipment
Emergency Medical Responder (EMR)
Hint: first aid trained and 1st on scene /you lifeguard til EMS arrives
Emergency Medical Services (EMS)
& Name The Components of the EMS System:
A multi disciplinary system that represents the combined efforts of several professionals and agencies to provide prehospital care to the sick and injured.
Components:
Comprehensive, quality, convenient care
Evidence-based clinical care
Efficient, well-rounded care
Preventive care
Comprehensive and easily accessible patient records
An individual who has training in basic life support, including automated external defibrillation, use definitive airway adjunct, and assisting patients with certain medications.
EMTs are the backbone of EMS system in the United States.
EMTs provide emergency care to the sick and injured.
Emergency Medical Technician (EMT)
An approach to medicine where decisions are based on well-conducted research, classifying recommentations based on the strength of the scientific evidence;
Also called science-based medicine
Evidence-based medicine (EBM)
Health Insurance Portability and Accountability Act (HIPAA)
Federal legislation passed in 1996.
Its main effect in EMS is in limiting availability of patients’ health care information and penalizing violations of patient privacy.
Flip the last 9 to a 6 = (19)96 Hippy Pool based off the 60’s & FLIP
Intravenous (IV) Therapy
The delivery of medication directly into a vein.
Licensure
The process whereby a competent authority, usually the state, allows people to perform a regulated act.
(Think of a driver’s license)
Medical Control
Physician instructions given directly by radio or cell phone (on-line/direct) or indirectly by protocol/guidelines (off-line/indirect), as authorized by the medical director of the service program.
(Think of this as the plan)
Medical Director
The physician who authorizes or delegates to the EMT the authority to provide medical care in the field.
Responsible for maintining quality control
(This of this as the person)
Mobile integrated health care (MIH)
A method of delivering health care that involves providing health care within the community rather than at a physician’s office or hospital.
(think of a mobile pop up blood bus vs going to doctor office)
National EMS Scope of Practice Model
A document created by the National Highway Traffic Safety Administration (NHTSA) that outines the skills performed by various EMS providers.
(Think of the guide book that ALL EMT’s follow)
Paramedic
An individual who has extensive training in advanced life support, including endotracheal intubation, emergency pharmacology, cardiac monitoring, and other advanced assessment and treatment skills.
Extensive training
1,000 to more than 1,300 hours in the classroom and in internships
Training covers a wide range of ALS skills
Think: Higher level (extensive) training
Primary prevention
Efforts to prevent an injury or illness from ever occuring.
Primary service area (PSA)
The designated area in which the EMS agency is responsible for the provision of prehospital emergency care and transportation to the hospital.
Hint: area =the space (you clear a space on the pool deck area)
Public health
The branch of medicine that is focused on examining the health needs of the entire populations with the goal of preventing health problems.
Public safety access point
A call center, staffed by trained personnel who are responsible for managing requests for police, fire, and ambulance services.
9-1-1 system
Access public safety
Dispatchers
Obtain information and dispatch resources
Emergency medical dispatch (EMD) system
Provides medical instruction
Mobile apps assist with layperson CPR and AED location
Hint: PUBLIC can access 911/read how to guide of AED, etc
Quality control
Oversight by the medical director to ensure the appropriate medical care standards are met by EMTs on each call.
Hint: standards of each call across the board for consistancy quality
Secondary prevention
Give an example of Secondary Prevention
Efforts to limit the effects of an injury or illness that your cannot completely prevent.
Educating People on the dangers of running near a pool -Slipping/falling
What year was the white paper: Accidential Death & Disability: The Neglected Disease of Modern Society published?
1966
** dad’s closer to death (the devil 666 =daddy)
What involves FEDERAL LEGISLATION concerning patient confidentialty
HIPPA
What is the goal of CQI?
CQI - Contineous Quality Improvement
- Reviews and performs audits of the EMS system to identify areas of improvement and/or assign remedial training
- Minimizing errors is the goal.
- Uses a plan-do-study-act cycle
vats are “contineously” done to “review” your skills w/minimal misses
What is the purpose of providing MIH care?
MIH- Mobile Inergrated Health Care
- Method of delivering health care
Utilizes the prehospital spectrum - Evolved with the goal to facilitate improved access to health care at an affordable price
- Health care provided within the community by team of professionals
- MIH created additional training levels for EMS providers, including community paramedicine.
- Paramedics receive advanced training to provide services within a community.
- Community paramedics provide additional services.
Hint: Mobile mammograms are cheaper than in hospital
Describe the Public Access Systems
9-1-1 system
* Access public safety
Dispatchers
* Obtain information and dispatch resources
Emergency medical dispatch (EMD) system
* Provides medical instruction
* Mobile apps assist with layperson CPR and AED location
What is E M S
E M S Is a system
* Team of health care professionals
* Provides emergency care and transport
* Is governed by state laws
Hint: What Is E M S vs Who the person E M T
What type of training does an EMR have
An EMR has very basic training.
Provides care before ambulance arrives
May assist in ambulance
EMR= police, lifeguards, etc
What type of training does an EMT Have
An EMT has training in basic life support (BLS), including:
- Automated external defibrillation
- Airway adjuncts
- Assisting patients with certain medications
Explain the History of EMS:
History of EMS
Origins include:
Volunteer ambulances in World War I
Field care in World War II
Field medic and rapid helicopter evacuation in Korean conflict
Not sure you really need to know this!
When did the DOT publish the first EMT training curriculum.
Early 1970s
Hint: Dept of Transportation - publishes a driver’s training guide
What Year was the Emergency Medical Services Act
1973
What year did AAOS publish the first EMT textbook.
Think of the year Disney opened?
1971
Trick: Disney opened in 1971 /this is a book/Disney publishs maps
Tell me what each level is responsible for law wise:
Federal
State
Local
Federal level:
National EMS Scope of Practice Model provides guidelines.
State level:
Laws regulate EMS operations.
Local level:
Medical director provides oversight and support.
BLS/CPR & Immedate Aid
* Basic Life Support
* Cardio Pulmunary Recussitation
Millions of laypeople are trained in BLS/CPR.
Automated external defibrillators (AEDs) are used by laypeople.
What are responsiblities & How Medical Direction Works
Physician medical director
* Authorizes EMTs to provide medical care in field
Medical director
* Acts as liaison
Standing orders and protocols
* Describe appropriate care
* Establish medical direction for providers
* Medical control can be off-line or online.
Off-line (indirect)
* Standing orders, training, supervision
Online (direct)
* Physician directions given over the phone or radio
What level of government does training, protocol & practice follow
State Legistration
Prehospital Care
- Prehospital care is coordinated with hospital care.
- Prehospital care is continued in the emergency department (ED).
- Integration ensures comprehensive continuity of care for the patient.
How are Information Systems used?
- Computer systems are used for documentation of patient care.
- Electronically stored information can be used to improve care.
IS = Computers Go to Dr, they type your history & use it to improve
What is Adopting a Just Culture
Promotes a learning culture that holds employees accountable for behavioral choices by balancing fairness and accountability
Patient Safety
- Minimize medical errors that occur as a result of a rules-based failure, a knowledge-based failure, or a skill-based failure (or a combination).
- Requires the efforts of both the EMS agency and EMS personnel
System Finance
- Finance systems vary depending on the organization involved.
- Personnel may be paid, volunteer, or a mix.
EMTs may be asked to:
* Gather insurance information.
* Secure signatures.
* Obtain permission from patients to bill insurance.
- In 2020, the Centers for Medicare and Medicaid Services (CMS) implemented a pilot program called Emergency Triage, Treat, and Transport (ET3).
- Reimburse EMS systems for providing the right patient care at the right time.
- Set up a payment model for patient transport to alternative destinations.
What is the purpose of EMS Research?
- Helps determine the shape of EMS
- Evidence-based medicine (EBM)
- Focuses on procedures that have proven useful in improving patient outcomes
- Many EMS systems and states consult the National Model EMS Clinical Guidelines from the National Association of State EMS Officials.
- Based on a review of current research and expert consensus
Roles & Responsibilites of EMT
- Keep vehicles and equipment ready.
- Ensure safety.
- Be familiar with emergency vehicle operation.
- Provide on-scene leadership.
- Perform scene evaluation.
- Call for additional resources as needed.
- Gain patient access.
- Perform a patient assessment.
- Give emergency medical care while awaiting additional medical resources.
- Give emotional support.
- Maintain continuity of care.
- Resolve emergency incidents.
- Uphold medical and legal standards.
- Ensure and protect patient privacy.
- Give administrative support.
- Constantly continue professional development.
- Cultivate and sustain community relations.
- Give back to the profession.
Professional Attributes
Integrity
Empathy
Self-motivation
Appearance and hygiene
Self-confidence
Time management
Communications
Teamwork and diplomacy
Respect
Patient advocacy
Careful delivery of care
Every patient is entitled to compassion, respect, and the best care.
EMTs are bound by patient confidentiality.
Be familiar with requirements of the Health Insurance Portability and Accountability Act (HIPAA).
Dates:
I don’t think you need to know!
National standardization efforts
1970s – DOT’s National Standard Curriculum
1980s – Advanced levels of EMTs
1990s – NHTSA’s EMS Agenda for the Future
2019 – NHTSA’s EMS Agenda 2050
