HISTORY OF EMS PRE-20TH CENTURY
- 1700 BC: CODE OF HAMMURABI
- 1790: AMBULANCES VOLANTES
- 1869: FIRST AMBULANCE SERVICE
20TH CENTURY EMS
- WW1 &WW2: SOLDIERS TRANSPORTED TO HOSPITALS
- KOREAN WAR: HELICOPTER EVAC, MASH UNITS
WHAT IS THE WHITE PAPER
- 1966: ACCIDENTAL DEATH AND DISABILITY: THE NEGLECTED DISEASE OF MODERN SOCIETY
- THE US DEPARTMENT OF TRANSPORTATION WAS CREATED
WHAT ARE THE 14 REQUIREMENTS OF THE EMS SYSTEM ACT OF 1973
- INTEGRATION OF HEALTH SERVICES
- EMS RESEARCH
- LEGISLATION AND REGULATION
- SYSTEM FINANCE
- HUMAN RESOURCES
- MEDICAL DIRECTION
- EDUCATION SYSTEMS
- PUBLIC EDUCATION
- PUBLIC ACCESS
- COMMUNICATION SYSTEMS
- CLINICAL CARE
- INFORMATION SYSTEMS
WHAT ARE THE 5 LEVELS OF PROVIDERS IN THE EMS SYSTEM?
- FIRST RESPONDER
- EMT BASIC
- EMT INTERMEDIATE
- EMT PARAMEDIC
WHAT ARE THE PRIMARY RESPONSES OF A PARAMEDIC?
- SCENE MANAGEMENT
- PT ASSESMENT AND CARE
- MANAGEMENT AND DISPOSITION
- PT TRANSFER
- RETURN TO SERVICE
WHAT ARE THE DUTIES OF A MEDICAL DIRECTOR?
- DEUCATING AND TRAINING PERSONEL
- PARTICIPATING IN PERSONNEL SELECTION
- EQUIPMENT SELECTION
- DEVELOPING CLINICAL PROTOCOLS
- ASSISTING IN QI
- DIRECT INPUT INTO PATIENT CARE
- INTERFACING BETWEEN EMS AND OTHER AGENCIES
- SERVING AS EMS ADVOCATE
- SERVING AS MEDICAL CONCIENCE
WHAT ARE THE 5 TYPES OF RESEARCH?
WHAT ARE THE 4 COMPONETS OF WELL-BEING
WHAT IS STRESS
A NONSPECIFIC RESPONSE OF THE BODY TO A DEMAND MADE UPON IT
WHAT ARE THE 2 TYPES OF STRESS
- EUSTRESS: POSITIVE STRESS
- DISTRESS: NEGATIVE STRESS
WHAT IS AN ALARM REACTION
- THE FIRST STAGE
- BEGINS WITH A QUICK ALERT RESPONSE
- SUDDEN STIMULATION OF THE SYMPATHETIC NERVOUS SYSTEM
HOW CAN YOU COPE WITH STRESS?
- CONTROLL BREATHING
- PROGRESSIVE RELAXATION
RESPONSES OF PATIENTS TO STRESS
PATIENT DEFENSE MECHANISMS
RESPONSE OF FAMILY FRIENDS AND BYSTANDERS TO STRESS
RESPONSE IN MULTI CASUALTY INCIDENTS TO STRESS
- BLIND PANIC
- CONVERSION HYSTARIA
SYMPTOMS OF IMPENDING BURNOUT
- CHRONIC FATIGUE AND IRRITABILITY
- CYNICAL, NEGATIVE ATTITUDE
- LACK OF DESIRE TO REPORT TO WORK
- EMOTIONAL INSTABILITY
- CHANGING IN SLEEP PATTERNS
- FEELING OVERWHELMED OR HELPLESS
- LOSS OF INTREST IN HOBBIES
- DECREASE ABILITY TO CONCENTRATE
- DECLINING HEALTH
- TIGHTNESS IN MUSCLES
- OVEREATING OR SMOKING
- ABUSING DRUGS OR ALCOHOL
5 STEPS OF GRIEVING
The 4 Es of injury prevention
- –Economic incentives
WHAT ARE THE 2 INJURY TYPES
- –Refer to injuries resulting from purposeful human action, whether directed at oneself or othersAssault and suicide are included in intentional injuries.
- –Refers to injuries that were unplanned
- •Injury occurs in a short period of time—seconds to minutes.
- •Harmful outcome was not sought.
- •The outcome was the result of one of the forms of physical energy in the environment or normal body functions being blocked by external means.
The five steps to developing a prevention program:
- –Conduct a community assessment.
- –Define the injury problem.
- –Set goals and objectives.
- –Plan and test interventions.
- –Implement and evaluate interventions.
- •Intentionally making a false statement through written or verbal communication that injures a person’s good name or reputation
- –Libel is making a false statement in writing.
- –Slander is verbally making a false statement.
- •Provides stringent privacy requirements for patient information
- –Medical information can be disclosed only if it is necessary for a patient’s treatment or for payment or medical/billing operations.
- •Privacy officer
- –Responsible for ensuring all protected health information (PHI)
GOOD SAMARITAN LAW
- •Provides immunity from liability to any member of the community who stops and helps at the scene of an emergency
- –Initially passed to encourage the public to help at emergency scenes
- •Provides some protection for EMS personnel who are off duty and assist at an emergency
- •Emergency care must be given free of charge.
- •Requires that persons responding to an emergency do all they can, within their knowledge, to support and sustain life and to prevent further injury
WHAT ARE ETHICS
: the philosophy of right and wrong
what is morality?
- •code of conduct defined by
what is medical ethics
- •Also called bioethics
- •Discusses and debates the health care of human beings, your patients
CODE OF ETHICS
- •Oath of Geneva
- –Issued in 1948
- –World Medical Association
- •Code of Ethics for EMTs
- –Issued in 1978National Association of EMTs
- •Patients have the right to direct their own care.
- •Patients have the right to decide how their end of life care should be provided.
- •Patients have the right to decide what and when care should be stopped.
the human body
- –Made up of cells, tissues, and organs
- –Function in a constantly changing microenvironment
what is a cell
- •Basic self-sustaining unit of the human body
- •Three main components
- –Cell membrane
- –Consists of fat and protein
- –Surrounds the cell and protects the internal components within the cytoplasm
- –Found in the cytoplasm
- –Operate in a cooperative and organized fashion to maintain the life of the cell
- –Endoplasmic reticulum
- –Golgi complex
- –Peroxisomes Mitochondria
- –Contains genetic material and the nucleoli
- –Ribonucleic acid (RNA)
- –Nuclear envelope
- –Embedded in the cytoplasm
4 types of tissue
- –Absorption of nutrients in the intestines
- –Secretion of various body substances
- –Endothelial cells
- –Binds the other types of tissue together
- –Extracellular matrix
- –Bone and cartilage
- –Adipose tissue
- –Characterized by its ability to contract
- –Enclosed by fascia
- –Overlies the framework of the skeleton
- –Classified in terms of structure and function
- –Three types
- •Skeletal muscle
- •Cardiac muscle
- •Smooth muscle
- –Characterized by its ability to transmit nerve impulses
- –Peripheral nerves
- •Molecules either produced by the body or given as a drug –Bind any receptor leading to any reaction
- –Endocrine hormones
- –Exocrine hormones
- –Paracrine hormones
- –Autocrine hormone
•Adaptations in Cells and Tissues
- •Exposed to adverse conditions
- –Process of adaptation in an attempt to protect themselves from injury
•Distribution of Body Fluids
- •Environmental changes
- –Due to aging, exercise, pregnancy, medications, disease, and injury
- –Body fluids contain
•Distribution of Body Fluids
•Total body weight
- –Approximately 50% to 70% is fluid.
- –Average male is 60% fluid.
- –Average female is 50% fluid.
- –Intracellular fluid
- –Extracellular fluid
- –Interstitial fluid
- –Intravascular fluid