EMR ch1

The EMS System
• Timeline of formal system for
responding to emergencies
• American Civil War "corpsmen" trained
to provide care for immediate life
threats (bleeding).

Table 1.1 EMS Time Line
continued on next slide

Table 1.1 (continued) EMS Time Line

Figure 1.1 Examples of early ambulances used to transport ill and injured patients.
(© AP Images)

Table 1.2 Levels of EMS Education

The EMS System
• Emergency Medical Responder (EMR)
 Member of EMS system trained in first
aid care who helps EMTs at emergency
scene

The EMS System
• EMS Models
 Fire-based
• Services and infrastructure operated by
local fire department or consortium
 Third-service
• Operated by non-fire government or
privately owned ambulance services
 Hospital-based
• Operated by large hospital or group of
hospitals

The EMS System
• Scope of Practice
 Identifies duties and skills EMS provider
is legally allowed to perform
 Defined by state and/or regional
statutes and regulations
 Defines related licensing, credentialing,
and certification

The EMS System
• Activating the EMS System
 911 call to emergency dispatcher who
sends responders
 Caller may need to dial seven-digit
number for ambulance, fire, police, or
rescue personnel.
 Enhanced 911

1.1.1 A person becomes injured in a vehicle collision.

1.1.2 A witness to the incident calls 911.

The EMS System
 911 calls automatically directed to public
safety answering point (PSAP)
 Emergency Medical Dispatchers (EMDs)
receive special training and provide
prearrival instructions to callers.

1.1.4 Emergency Medical Responders arrive to assist the patient.

The EMS System
 Resources dispatched
 EMS personnel provide care at scene
and during transport.
 Deliver patient to medical facility

1.1.5 EMTs continue care and transport the patient to the hospital.

1.1.6 Once at the hospital, care is transferred to the emergency department personnel.

The EMS System
• In-Hospital Care System
 Most patients taken to hospital
emergency department
 Patient transferred to appropriate in-
hospital resources
 Specialty hospital

The EMS System
• Medical Direction
 EMS Medical Director
• Assumes responsibility for direction and
oversight of all patient care
 EMRs act as designated agents of
Medical Director.

The EMS System
• Medical Direction
 Off-line medical direction
• Standing orders or protocols
 On-line medical direction
• Direct contact through phone or radio

THE EMERGENCY MEDICAL
RESPONDER

The Emergency Medical Responder
• EMRs are trained to:
 Access and assess the patient
 Provide emergency care
 Move patients without causing further
injury

1.2.1 Emergency Medical Responders working as part of a search-and-rescue team.

1.2.2 Emergency Medical Responders serving as lifeguards at a recreational area.

1.2.3 Many law enforcement personnel receive Emergency Medical Responder training.

1.2.4 Emergency Medical Responders also serve on industrial Medical Emergency Response Teams.

1.2.5 Emergency Medical Responders are often used to support large events such as NASCAR.

1.2.6 Emergency Medical Responders also serve on specialized response teams such as hazmat and rescue
teams.

• Roles and Responsibilities
 Primary concern is personal safety.
 Personal Protective Equipment (PPE)
• Disposable protective gloves
• Barrier devices
• Protective eye wear
• Special face masks
• Gowns or aprons

• Patient-related duties
 Size-up scene
 Determine chief complaint
 Lift, move, or reposition patient
 Transfer patient and patient information
 Protect patient's privacy
 Maintain confidentiality
 Be patient's advocate

1.3.1 One of the duties of an Emergency Medical Responder is to safely gain access to the patient.

1.3.2 The Emergency Medical Responders must act quickly to find out what is wrong with the patient.

1.3.3 Emergency Medical Responders must learn to safely lift and move patients when necessary.

1.3.4 The Emergency Medical Responder will often assist EMTs and other transport personnel at the scene of an
emergency.

• Traits
 Keep emergency care skills sharp and
current.
 Attend continuing education and
regularly practice skills.
 Keep uniform neat and clean.
 Approach patient with respect.
 Be willing to deal with people.

• Traits
 Be respectful and accepting of patient's
rights.
 Be honest and realistic but tactful.
 Be professional and compassionate.
 Maintain focus on patient.
 Resolve stressful calls with
communication.

Figure 1.2 Frequent training promotes a high standard of care for your patients.

• Equipment, Tools, and Supplies
 Blood pressure cuff, stethoscope,
oxygen-delivery systems, suctioning
equipment
 Specialized kits for trauma and medical
emergencies and childbirth

• Continuous Quality Improvement
 Continuous improvement in quality of
product or service being delivered.
 EMS product is patient care.
 Every component within a system can
be improved.
 Submit accurate, complete patient care
reports.

Disaster Assistance
• Disaster Medical Assistance Team
(DMAT)
 Specialized teams designed to provide
medical care following disaster
 Deployed on moment's notice if disaster
strikes in United States

The Role of Research in EMS
• Research is systematic investigation to
establish facts.
• Organizations gather and verify
research that defines how EMS
providers practice emergency care.

Figure 1.3 Staying current with the latest research is an important aspect of being a good Emergency Medical
Responder.

Think About It
• How has research influenced
emergency care?
• Why is it important for treatment
guidelines, based on research, to be
uniform across the nation?
• How can the application of research
and its results be improved?

EMR ch1

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EMR ch1

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