ems fire chiefs handbook Flashcards
Even in the smallest departments, a chief will likely require support from a ___________to effectively administer an EMS program
qualified fire-based EMS officer
Although the duties of admin istering an EMS program can and often are delegated, the responsibility for EMS rests with who?
The fire chief
Most fire departments began providing EMS as a reaction to a ________the service from hospitals experiencing medical personnel shortages during World War II, following major disasters where EMS was not available in sufficient quantity, or when the quality or timeliness of EMS was in question.
crisis-absorbing
Fire departments protect _____ EMS protects ____.
property, people
Traditionally, property is owned by who?
wealthy members of society, or at least those with jobs, savings, and resources
The typical EMS patient is often what?
not wealthy, but more likely a member of the lower socioeconomic sector of society
America’s first ambulance service was reportedly started by who and what year?
the U.S. Army in 1865
During World War II, the loss of hospital personnel to the war effort caused many hospitals to turn their ambulance services over to volunteer groups and organizations capable of operating a motor vehicle for this type of service. Typically, who was these groups?
these were fire departments, police departments, or funeral homes.
During the 1960s, the medical community began to focus on what type of care?
cardiac care
The long-range effects of quality emergency medical care on mortality were discussed in a 1966 report by the National Research Council’s National Science Foundation, entitled ___________
“Accidental Death and Disability, the Neglected Disease of Modern Society.”
a 1966 report by the National Research Council’s National Science Foundation, entitled “Accidental Death and Disability, the Neglected Disease of Modern Society.” The report, more commonly referred to by the EMS community as ___________
“The White Paper,”
The White Paper,” concluded that, of the mobile emergency teams studied, most had an average response time of more than ____ minutes, and had inadequately equipped and trained crews.
40
________addressed EMS issues by developing specifications covering ambulance attendant training, equipment requirements, and the design of the emergency vehicle itself.
the Highway Safety Act of 1966 (Standard 11)
The ________ designated federal funding to improve EMS across the nation through the development of regional EMS systems.
The Emergency Medical Services Systems Act of 1973
The Emergency Medical Services Systems Act of 1973 designated federal funding to improve EMS across the nation through the development of regional EMS systems. Specific requirements outlined by this act included?
training and certification, interagency cooperation, equipment development, communications, and public education-are still recognized today as key elements of effective EMS systems.
In the ____, much of the federal funding for EMS programs was reduced or eliminated
mid-1980s
At the federal level, who serves to coordinate government involvement in EMS.?
the National Highway Traffic Safety Administration (NHTSA) under the Department of Transportation (DOT)
______operates a Web portal (www.ems.gov) facilitating access to the broad range of federal agencies who work collaboratively to coordinate and develop EMS systems in the United States
NHTSA
_______develops the national standard educational curricula for various levels of EMS providers, supports research and planning for EMS, operates a central data collection and reporting system for emergency medical services (the National EMS Information System, or NEMSIS), and develops federal purchasing standards for ambulances, among other activities.
NHTSA
Most state EMS agencies are housed within the
state health department
State EMS directors, medical directors, state training coordinators, data coordinators and trauma coordinators often participate in the _______ , a non-profit organization (www.nasemso.org).
National Association of State EMS Officials (NASEMSO)
credentialing, or granting authority to practice, continuing education, medical treatment protocols, and public information, education, and relations (PIER) programs are often handled what level.
at the local or regional
Two physician groups influential in providing guidance and direction on emergency medical care are the
American College of Emergency Physicians (ACEP, www.acep.org) and the National Association of EMS Physicians (NAEMSP, www. naemsp.org).
A relatively new organization, works to educate legislators on fire-based EMS and assure fire service participation in national policy discussions on EMS.
Fire Service-Based EMS Advocates (www.fireserviceems.com),
Some communities rely solely on a _____ whether private, hospital-based, or a separate governmental entity
third service,
The particular emergency medical services offered are predicated on what three things?
Each of these factors influences fire-based EMS program start-up as well as continuation over time.
community need, willing ness of the fire department to deliver, and cost.
____firefighters is the most common approach to the delivery of fire-based emergency medical services.
Cross training
A cost containment solution has been to train ______and as fire department EMS providers
employ civilian personnel
The practice of medicine is restricted by law to physicians and other licensed providers such as
podiatrists, dentists, and nurse practitioners
When advanced life support was first extended into the community in the ___, paramedics were empowered to deliver care under the license of a supervising physician. This concept of EMS providers acting as physician extenders is known as
1970s
delegated practice .
who provides care to patients under the supervision and license of a specific physician medical director.
every EMS provider from the emergency medical dispatcher (EMD) emergency medical responder (EMR) to the emergency medical technician (EMT) to the paramedic
The ________provides medical oversight of the EMS program and is (or should be) a crucial link between regulatory authorities (such as state or regional medical boards) and the fire department.
fire department EMS medical director
The job description for a medical director varies considerably. Recommended roles and duties have been outlined by both the
American College of Emergency Physicians (ACEP) and the National Association of EMS Physicians (NAEMSP).
______are designed to monitor and continually improve care provided;
Quality improvement (QI) programs
Supervision of EMS providers is also a medical director duty, whether performed directly through ride-alongs or field responses, or indirectly through _____ or EMS officer-delegated observation.
chart review
The medical director is responsible for clinical care provided by EMS members of the department. As such, he or she should possess strong EMS
qualifications, including:
Board certification in emergency medicine
Prehospital care experience
Competence in all the skills expected of fire department EMS providers
Approval by state and regional EMS authorities
Operational decisions are not ordinarily within the scope of the _____although the fire chief and EMS officer(s) may benefit from consultation with the medical director.
medical director,
medical directors are often afforded the ability to limit the practice of an EMS provider by progressive disciplinary actions, the circumstances of these actions must ______, when they affect employment, must allow an employee due process
be spelled out in a contract and
who is in the best position to resolve hospital concerns .
The fire department EMS medical director
The duties of administering a fire-based EMS program are often delegated to
a qualified EMS officer
so-called alphabet courses
ACLS (Advanced Cardiac Life Support), PHTLS (Prehospital Trauma Life Support), PALS (Pediatric Advanced Life Support), and so on.
