EMT/EMR INTRODUCTION TO EMS & RESEARCH POWERPOINT TRAINING MODULE
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This document provides an introduction and overview of emergency medical services (EMS) for EMT-1 students. It defines key concepts like the EMS system, roles of EMTs, and quality improvement. It discusses the history and development of EMS in the US. Regulations and standards for EMS are set by the National Highway Traffic Safety Administration and include education levels, authorization to practice, and the 10 key components of EMS systems. EMTs must demonstrate professionalism, maintain certification, and participate in quality improvement efforts like identifying errors to enhance patient safety.
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EMT/EMR INTRODUCTION TO EMS & RESEARCH POWERPOINT TRAINING MODULE
- 1. Brave Training Solutions Copyright 2017 www.bravetraining.com EMT-1 V2 INTRODUCTION TO EMERGENCY MEDICAL CARE & RESERACH IN EMS
- 2. OBJECTIVES Define the EMS system Differentiate the roles & responsibilities of the EMT vs. other EMS providers Discuss the roles & responsibilities of the EMT towards the safety of the crew, patient & bystanders Define quality improvement & discuss the EMT’s role in the process
- 3. OBJECTIVES State the specific statues & regulations in your state EMS system Assess areas of personal attitude & conduct the EMT Characterize various methods used to access the EMS system
- 4. VISION OF EMS As written in the EMS AGENDA OF THE FUTURE Emergency Medical Services (EMS) of the future will be community-based health management that is fully integrated with the overall healthcare system. It will have the ability to identify & modify illness & injury risks, provide acute illness & injury care follow-up, & contribute to treatment of chronic conditions & community health monitoring. This new entity will be developed from the redistribution of existing health care resources & will be integrated with other healthcare providers, public health, & public safety agencies. I will improve community health & result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net.
- 5. EMS AGENDA OF THE FUTURE 14 Components Integration of health services EMS research Legislation & regulation System finance Human resources Clinical care Education systems Public education Prevention Public access Medical direction Evaluation Information systems Communication systems
- 6. THREE EMS SYSTEMS Hospital Based Fire Based Third Party Service Commercial Non-Profit Service may be different but based upon community needs & resources Goals are the same
- 7. NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION (NHTSA) Lead coordinating agency for EMS Sets national standards for training
- 8. ACCESS TO EMS Calls normally come from Public Safety Access Point (PSAP, 911) 911 Service is universally available in over 95% of United States (Some other countries have similar services) All 911 phone calls to local PSAP’s are toll free (including Cell Phones)
- 9. EDUCATIONAL STANDARDS NHTSA has developed a “National Scope of Practice” Includes Description of the profession 5 Pre-hospital personal levels National EMS Educational Standards
- 10. AUTHORTIY TO PRACTICE State EMS office Determines scope of practice Licenses personal & EMS services
- 11. MEDICAL OVERSIGHT Protocols- to allow EMT’s to practice Quality improvement- Future scope of practice standards Administration- Maintaining the EMS System
- 12. LOCAL CREDENTIALING Many areas require proof of proficiency Usually administered by “Medical Control Authorities” (MCA) Has a Physician Medical Director (PMD) May have an administrator
- 13. EMPLOYER POLICIES & PROCEDURES Requirements for Uniforms Staffing levels Grooming Equipment repair Mandated operational standards
- 14. ROLES, RESPONSIBILITIES, & PROFESSIONALISM Inspecting & maintaining equipment to operational standards Safety Personal Patient Others on Scene
- 15. ROLES, RESPONSIBILITIES, & PROFESSIONALISM Provide scene evaluation & summon additional resources as needed Gain access to patient Perform patient assessment Administer EMS care while awaiting arrival of additional resources (Ambulance, Fire, Law)
- 16. ROLES, RESPONSIBILITIES, & PROFESSIONALISM Provide emotional support Patient Family Other responders
- 17. ROLES, RESPONSIBILITIES, & PROFESSIONALISM Maintain “Continuity of Care” The EMT is a step in the ladder Maintain medical & legal standards & assure patient privacy Maintain community relations
- 18. PROFESSIONALISM Characteristics of professional behavior Maintenance of certification & licensure
- 19. PROFESSIONALISM Characteristics of professional behavior Integrity Empathy Self-motivation Appearance & hygiene Self-confidence Knowledge of limitations
- 20. PROFESSIONALISM Characteristics of professional behavior Time management Communications Teamwork Respect Tact Patient advocacy Careful delivery of care
- 21. MAINTAIN CERTIFICATION (Licensure) Personal responsibility Continuing education Skill competency Criminal implications Fees
- 22. QUALITY IMPROVEMENT Dynamic system for continually evaluating & improving care Patient safety Significant – one of the most urgent health care challenges How errors happen Skills-based failure Rules-based failure Knowledge-based failure
- 23. HOW TO REDUCE ERRORS Debrief calls Constantly question assumptions Use decision aids Ask for help
- 24. HISTORY OF EMS EMS was developed during the war times in the 19th & 20th centuries In the early 1960’s technology & training EMS lagged behind developments in other areas of medicine Emergency department staffing was often limited & only in large urban areas
- 25. KOREAN WAR Medical helicopters were introduced causing a decreased rates in battlefield injuries
- 26. 1950’s -1960’s Ambulance service emerged from primarily run by funeral homes to fire departments & ambulance services
- 27. HISTORY OF EMS 1966 National Highway Safety Act Charged the US DOT to create training standards to assist states in upgrading EMS systems 1970 National Registry of EMT’s (NREMT) was created to establish professional standards
- 28. HISTORY OF EMS Research paper “Accidental Death & Disability: The Neglected Disease of Modern Society” was released in 1966 It called for Development of training Development of federal guidelines & policies Providing for emergency care & transport Establish staffed emergency departments
- 29. HISTORY OF EMS 1960 CPR developed 1960’s Portable defibrillators introduced 1966 Landmark paper “Accidental Death & Disability: The Neglected Disease of Modern Society” published
- 30. HISTORY OF EMS 1972 Television show “Emergency” 1973 Congress passed the “National Emergency Medical Services Act” to lead the improvement of EMS Systems in the US
- 31. NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION (NHTSA) Administers the EMS technical assessment programs based upon 10 components of EMS with standards for EMS
- 32. NHTSA 10 KEY COMPONENTS Regulation & policy Facilities Resource management Communications Human resources & training Transportation Medical direction Trauma systems Evaluation Public information & education
- 33. EVOLUTION OF CURRENT EMS SYSTEMS From this the current EMS systems were created using Emergency Medical Technician’s & other parts of the system
- 34. NHTSA TECHNICAL ASSISTANCE PROGRAMS Regulation & policy Resource management Human resources & training Transportation Facilities
- 35. ACCESS TO EMS Improvements to 911 (PSAP) dispatch
- 36. COMMUNICATIONS SYSTEM Central 911 dispatch system Enhanced 911 Dispatchers trained in Emergency Medical Dispatch (EMD) Ambulance to hospital communications Radio Cell phone Landline
- 37. EDUCATION Created 6 levels of EMS care Lay rescuer EMR-Emergency Medical Responder EMT-Emergency Medical Technician AEMT- Advanced Emergency Medical Technician Paramedic Paramedic Practitioner
- 38. LAY RESCUER Carries little or no equipment Able to recognize life-threatening injuries Provides care till EMS arrives CPR-AED Relief of airway obstruction Bleeding control
- 39. EMERGENCY MEDICAL RESPONDER Equipped with Oxygen Epi-Pen AED Naloxone Airway equipment Provides care till ambulance arrives Primarily seen in Fire Departments but can be seen in business, industry, & schools
- 40. EMT-BASIC Provides basic, non-invasive skills Patient assessment Airway adjuncts AED Childbirth Spinal immobilization Assists with patient’s medication administration Can transport patient
- 41. EMT-BASIC Record keeping Patient advocacy Communications Extrication Vehicle & equipment maintenance
- 42. EMT-INTERMEDIATE Can provide all functions of EMT Provides more advanced skills Advanced airway ECG ‘s IV Fluids Administration of many medications
- 43. PARAMEDIC Provides all functions of EMT & EMT-I Provides advanced techniques including ECG interpretation Drug therapy Invasive airways Manual defibrillation
- 44. PARAMEDIC PR ACTIONER Works with patients in the home setting to reduce ER admissions Can redirect patient to another facility Assists paramedics on scene with difficult cases
- 45. AUTHORIZATION TO PRACTICE Legislative decisions on scope of practice State EMS office oversight Medical oversight Clinical protocols Offline Online Standing orders Quality improvement Administrative
- 46. AUTHORIZATION TO PRACTICE Local credentialing Administrative Employer policies & procedures
- 47. ROLES, RESPONSIBILITIES, & PROFESSIONALISM OF EMS PERSONAL We will review Roles & responsibilities Professionalism
- 48. ROLES & RESPONSIBILITIES Maintain vehicle & equipment readiness Safety Personal Patient Others on the scene Operate emergency vehicles Provide scene leadership Perform patient assessment
- 49. ROLES & RESPONSIBILITIES Administer emergency medical care to a variety of patients with varied medical conditions Provide emotional support Patient Patient’s family Other responders
- 50. ROLES & RESPONSIBILITIES Integration with other professionals & continuity of care Medical personnel Law enforcement Emergency management Home healthcare providers Other responders
- 51. ROLES & RESPONSIBILITIES Resolve emergency incident Maintain medical & legal standards Provide administrative support Enhance professional development Develop & maintain community relations
- 52. CHARACTERISTICS OF PROFESSIONAL BEHAVIOR Integrity Empathy Self-motivation Appearance & hygiene Self-confidence Time management
- 53. CHARACTERISTICS OF PROFESSIONAL BEHAVIOR Communication Verbal Written Teamwork & diplomacy Respect for patients, co-workers & other healthcare professionals Patient advocacy Careful delivery of service
- 54. LIAISON WITH OTHER PROFESSIONALS Conflicts may occur when responsibilities overlap with other professionals Police take charge at crime scenes Fire takes charge fire & HAZMAT Scenes EMS provides for patient care & transport Other medical professionals care for patient at a fixed facility (hospital, nursing home, clinic, patient’s home) Cooperation is essential Incident Command System needs to be practiced
- 55. MAINTENANCE OF CERTIFICATION & LICENSURE Personal responsibility Continuing education Skill competency verification Criminal implications Fees
- 56. QUALITY IMPROVEMENT System for continually evaluating & improving care Continuous Quality Improvement (CQI) Dynamic process
- 57. EMT’s ROLE Documentation Run review & audits Feedback from patients & hospital staff Maintaining equipment Continuing education Skills maintenance
- 58. PATIENT SAFETY Significant – One of the most urgent health care challenges High-risk activities Hand-off Communication issues Dropping patients Ambulance crashes Spinal immobilization
- 59. PATIENT SAFETY How Errors Happen Skills-based failure Rules-based failure Knowledge-based failure
- 60. PREVENTING ERRORS Environmental Clear protocols Light Minimal interruptions Organization & packaging of drugs
- 61. PREVENTING ERRORS Individual Reflection in action Constantly question assumptions Reflection bias Use decision aids Ask for help
- 62. REASERCH IN EMS Impact of research on EMS Care Research findings are important to identify what should be changed in EMS Assessment & management and to improve patient care & outcome (i.e. CPR guidelines change based on current research ) Quality assurance research for an EMS system can improve service delivery Data collection
- 63. EVIDENCE BASED DECISION MAKING Traditional medical practice Is based on Medical knowledge Intuition Judgment High-quality patient care should focus on procedures proven useful in improving patient outcomes The challenge for EMS is the relative lack of pre- hospital research
- 64. EVIDENCE BASED DECISION MAKING Evidence-based decision-making technique Formulate a question about appropriate treatments Search medical literature for related research Appraise evidence for validity & reliability If evidence supports a change in practice, adopt the new therapy allowing for unique patient needs
- 65. PAPERWORK Local School Municipal State Varies from state to state Federal Can be sent via commercial software
- 66. COURSE DESCRIPTION This course meets the requirements of NHTSA EMS Training NREMT State Local facility
- 67. COURSE EXPECTATIONS Upon successful completion of this training program the student may be take the NREMT exams A practical & computer based exam will need to be passed to state certification (licensure) Student will be required to complete all sections of this training program & pass all exams to be recommended to take the NREMT exam
- 68. PHYSICAL EXAM EXAM Student must pass physical exam as specified by this institution IMMUNIZATIONS Influenza (Flu) Hep B MMR TDaP
- 69. CRIMINAL BACKGROUND CHECK Most states require medical personnel to have a criminal background check prior to certification (licensure) Requirements vary by state Some clinical sites require students to have a clear record
- 70. CRITERIA FOR CERTIFICATION Successful course completion Be physically & mentally able to met the safe & effective practices of the EMT-B Written & practical exams State & local requirements
- 71. AMERICANS WITH DISABILITIES ACT Federal, state, & local requirements will be meet
- 72. HARASSMENT Class policy on harassment
- 73. PROGRAM POLICIES Uniforms (grooming) Confidentiality Drugs (alcohol) Weapons Attendance Smoking Safety Grades Dismissal from the program
- 74. INCIDENT MANAGEMENT SYSTEM HOME WORK Complete FEMA independent Study Courses ICS-100-b Introduction to Incident Command System ICS-700.a National Incident Management System (NIMS) An Introduction Turn copies of Online Certificates of Completion to instructor http://www.training.fema.gov/is/crslist.aspx
- 75. ?? QUESTIONS ?? NEXT ASSIGNMENT THE END