Emergency care system.ppt
- 1. Introduction to Emergency Medical Services (EMS)
- 2. Emergency medical assistance (EMS) is a type of medical care provided to citizens in the event of illness, accidents, injuries, poisoning and other conditions requiring urgent medical intervention. Emergency calls are available in every country.
- 3. History of EMS The beginnings, rudiments and attempts at first aid date back to the early Middle Ages. The most ancient institution that provided first aid can be attributed to the xendochium, a shelter for travellers, the poor and the sick. In contrast to pandogeions and mitates, which provided their services for a fee and were exclusively secular in nature, xenodohia were philanthropic institutions based on the principles of Christian hospitality. Already at this stage, "the sick were brought to the doctor" and not, as later, "doctor to patient". The prototype of the ambulance is also seen in the activities of the Hospitallers. The first equipped ambulance stations were set up in 1417 in the Netherlands due to the presence of many canals and the large number of drowning persons. The main task of the stations was to rescue and assist those who were drowning.Translated with www.DeepL.com/Translator (free version)
- 4. In the CIS, ambulance services are provided by ambulance stations or departments attached to hospitals in towns and rural areas. Emergency stations are organized in cities and regional centres with population over 50 thousand people and are separate preventive treatment institutions or are included in the structure of city emergency hospitals as structural subdivisions. In towns with smaller populations, there are emergency units at city, district and other hospitals. In remote and inaccessible areas, emergency medical care is also provided in some cases by the emergency and routine consultative medical care units of regional (provincial))
- 5. According to regulations adopted back in the Soviet era, all emergency stations are divided into categories. Stations carrying 75 thousand and more calls per year are considered first category, from 50 thousand to 75 thousand are second category, from 25 thousand to 50 thousand are third category, and finally from 10 thousand to 25 thousand are fourth category. The first and second category stations are independent institutions and in their work report directly to the municipal (city) health care authority. The stations of the third and the fourth category are organized at the large municipal and central regional hospitals and work on the rights of the departments of these medical preventive institutions.
- 6. General characteristics Characteristic features that fundamentally distinguish emergency medical aid from other types of medical aid are as follows: -Immediate nature of its provision in cases of emergency medical care and delayed nature in cases of urgent conditions (emergency medical care) -Non-refusal nature of care -Free-of-charge procedure for the provision of SOC -Diagnostic uncertainty under time pressure -Strong social relevance
- 7. Conditions of emergency medical care: • Outside the medical organization (at the place of call of the team, as well as in the vehicle during medical evacuation) • Outpatient (in conditions not providing round- the-clock medical supervision and treatment) • Inpatient (in an environment with round-the- clock medical supervision and treatment)
- 8. Basic functions Emergency medical assistance is provided to citizens in cases of conditions requiring urgent medical attention (accidents, injuries, poisonings and other conditions and illnesses). In particular, ambulance stations (departments) provide
- 9. • Round-the-clock rendering of timely and qualitative medical aid in accordance with the standards of medical aid to the sick and injured outside medical and preventive institutions, including in case of catastrophes and natural disasters. • Timely transport (and also transport at the request of medical personnel) of sick persons, including infectious diseases, victims and maternity patients in need of emergency inpatient assistance. • Provision of medical assistance to patients and casualties who have sought assistance directly to the emergency station, in an office for the reception of ambulatory patients.
- 10. Notify the municipal health authorities of all emergencies and accidents in the service area of the ambulance station. Ensuring uniform staffing of the mobile ambulance teams by medical personnel for all shifts and providing them with full equipment according to the approximate list of equipment for the mobile ambulance team.
- 11. Forms of territorial organization • Central municipal (district or united regional (krai/oblast) - in some regions of Russia) station with regional (inter-municipal) substations of emergency medical care in its composition. • Ambulance department, including as a structural subdivision of the central municipal ambulance station and/or regional (republic within the Russian Federation, krai or oblast) or central municipal (district) hospital. • Emergency medical care hospital - both an independent structure and a structural subdivision of the central city (regional) emergency medical care station. • Emergency department - on the basis of regional, district and city hospitals.
- 12. Departments of ambulance • Operations department • The acute and somatic hospital unit • The maternity and gynaecology hospital unit • The maternity and gynaecology hospital unit • Infections department • Medical statistics department
- 13. In the state of Massachusetts there are four levels of emergency care providers: • First Responder • Emergency Medical Technician (EMT) – Basic • EMT – Intermediate • EMT - Paramedic
- 14. • All of the skills of the first responder plus: – Trained in the use and operation of the ambulance – Certified to administer oxygen, glucose, epinephrine and some other medications at the on-line or off-line direction of the closest emergency department’s lead physician • Called the “medical control” physician EMT - Basic
- 15. EMT - Intermediate • All of the skills of the EMT-Basic plus: – Capable of starting an intravenous line and infusing volume-replacing normal saline – Trained to place an endotracheal tube in a patient’s windpipe to create a secure means of ventilating the lungs
- 16. • All of the skills of the EMT-Intermediate plus: – Administration of intravenous medications for cardiac, diabetic and other medical conditions under either off-line or on-line direction – Many other optional and advanced skills such as chest decompression and needle crichothyrotomy, etc. EMT - Paramedic
- 17. Basic or Advanced? • Basic life support called BLS describes the care given by First Responders and EMT- Basics • Advanced life support, called ALS, is the higher level of care performed by EMT- Intermediates and Paramedics – Permitted to perform invasive procedures • Procedures that introduce foreign substances or equipment into the patient’s body
- 18. Training • The EMS provider is legally prohibited from performing skills that are beyond his or her level of training • Each group of skills requires the proper certification • The length of time required for learning the advanced skills is considerable
- 19. First Responder Training • Prerequisite: Health Care Professional level CPR – 8 hours • 24-hour class • Three-year certification period – Certification is maintained with a refresher course • 12 hours
- 20. EMT Basic Training • Prerequisite: Health Care Professional level CPR – 8 hours • 110-hour class plus – Five patient contacts • State certification application and fee • Two-year certification period – 24-hour refresher course – 28 hours of continuing education
- 21. EMT Intermediate Training • Prerequisite: Health Care Professional level CPR – 8 hours • 180-hour class plus – 100 hours of clinical observations and skills • 30 i.v. starts • 10 intubations – 100 hours of field observations and skills • 10 i.v. starts • 1 intubation
- 22. EMT Paramedic Training • Prerequisite: Health Care Professional level CPR & EMT-B certification • X contact hours as an EMT-B • 400-hour class plus – 200 hours of clinical observations and skills • 60 i.v. starts • 10 intubations – 200 hours of field observations and skills • 30 i.v. starts • 1 intubation
- 23. How Far Do You Want to Go? • HCP CPR – Written and practical tests • Minimum passing grade 84% • Unlimited repeat attempts are allowed • First Responder – Written and practical tests • Minimum passing grade 80% • Unlimited repeat attempts are allowed
- 24. How Far Do You Want to Go? • EMT Basic – EMT-B is no longer part of the regular curriculum – Apply to take the summer course • Classes held at Mohawk • Evenings and alternate Saturdays from June – Aug. • Free to qualified Mohawk students
- 25. Mohawk Evening Class • Do you want to become an EMT?
- 26. What is Involved? • Lectures & written tests – Called the didactic portion – Subjects are similar to the first responder curriculum but everything is covered in more depth
- 28. What is Involved? • Practical skills demonstrations
- 32. What do the participants say?