Research, Profession and Practice EMS SYSTEMS Components of an EMS System
Research, Profession and Practice
EMS SYSTEMS
Components of an EMS System
Research, Profession and Practice
Today’s EMS System
• Every EMS system must develop an EMS system that best meets its needs.
• Provincial and regional-level EMS systems are often responsible for planning, developing protocols, and establishing standards.
Research, Profession and Practice
What Constitutes an EMS System
• By accepted definition, an EMS System is:– A comprehensive network of personnel,
equipment, and resources established to deliver aid and emergency medical care to the community.
Research, Profession and Practice
OUT-OF-HOSPITAL COMPONENTS OUT-OF-HOSPITAL COMPONENTS OF AN EMS SYSTEMOF AN EMS SYSTEM
MEMBERS OF THE
COMMUNITY
COMMUNICATIONS SYSTEM
EMS PROVIDERS
PUBLIC UTILITIES
POISON CONTROL CENTERS
FIRERESCUEHAZMAT
Research, Profession and Practice
IN-HOSPITAL COMPONENTS OF IN-HOSPITAL COMPONENTS OF AN EMS SYSTEMAN EMS SYSTEM
EMERGENCYNURSES
EMERGENCY AND SPECIALTYPHYSICIANS
ANCILLARY SERVICES
REHABILITATION SERVICES
Research, Profession and Practice
Some Systems are tiered in which BLS arrives first and then, if required, ALS arrives later.
Research, Profession and Practice
Medical Direction
• A medical director is a physician who is legally
responsible for all clinical aspects of the system.
• Ontario Base Hospital Group.
Research, Profession and Practice
Medical Direction• The medical director’s role in a
system is to:– educate and train personnel– participate in equipment and personnel selection– develop clinical protocols– participate in problem resolution and QA/QI– provide direct input into patient care– interface with the EMS system– advocate within the medical community– serve as the “medical conscience” of the EMS system– Certify and License personnel to practice
Research, Profession and Practice
The Medical Director can
provide on-line guidance to
EMS personnel in the field.
This is known as
on-line medical direction.
Research, Profession and Practice
Off-line medical direction refers to medical policies, procedures, and
practices that medical direction has set up in
advance of a call, such as standard
protocols or standing orders.
Research, Profession and Practice
Protocols are the policies and
procedures for all elements of an EMS
system.
Research, Profession and Practice
Protocols are designed around the four “T’s” of emergency care.
• Triage
• Treatment
• Transport
• Transfer
Research, Profession and Practice
Patient Transportation
• Patients should be taken to the nearest facility whenever possible.
• Medical direction should designate the facility.
• Patients may be transported by ground or air.
Research, Profession and Practice
The helicopter has become an integral part of prehospital
care.
Research, Profession and Practice
Military helicopters frequently assist civilian
EMS systems.
Research, Profession and Practice
A Type-I Ambulance
Research, Profession and PracticeA Type II
Ambulance
Research, Profession and Practice
A Type III Ambulance
Research, Profession and Practice
An Emergency Response Unit
Research, Profession and Practice
Air Ambulance
Research, Profession and Practice
Not all receiving facilities are equal in emergency and support service
capabilities.
Local systems and regions categorize hospitals based on capabilities.
Research, Profession and PracticeAmerican Trauma Center
Levels• Level I – provides the highest level of
trauma care
• Level II – may not have specialty paediatrics or a neurosurgeon on site
• Level III – generally does not have immediate surgical facilities available
Research, Profession and Practice
Canadian Trauma Centre Levels
• Tertiary Trauma Centre (TTC)
• District Trauma Centre (DTC)
• Primary Trauma Centre (PTC)
Research, Profession and Practice
Mutual Aid and Mass-Casualty Preparation
• A formalized mutual aid agreementensures that help is available when needed.
• Agreements should be betweenneighbouring departments, municipalities, systems, or provinces.
• Each system should also put a disaster plan in place for catastrophes that can overwhelm available resources.
Research, Profession and Practice
KEY POINT
An EMS system should have a
disaster plan in place that is practiced
frequently.
Research, Profession and Practice
Quality Assurance and Improvement
• Quality Assurance is designed tomaintain continuous monitoring andmeasurement of the quality ofclinical care.
• Continuous Quality Improvement (CQI) is designed to refine and improve an EMS system, emphasizing customer satisfaction.
Research, Profession and Practice
An EMS system must be designed to meet the needs of the patient. Therefore,
the only acceptable quality of an EMS system is
EXCELLENCE!
Research, Profession and Practice
Customer satisfaction can be created or
destroyed with a simple word or deed.
Service Quality
Research, Profession and Practice
Public Education
• An essential and often overlooked component of EMS is the public.
• EMS systems should develop plans to educate the public on recognizing an emergency. … accessing the system. … initiating BLS procedures.
Research, Profession and Practice
CommunicationsA coordinated, flexible communications plan should include:• Citizen Access• Single Control Centre• Operation Communication Capabilities• Medical Communication Capabilities• Communications Hardware• Communications Software
Research, Profession and Practice
Education and Certification
• Two kinds of EMS education are initial and continuing education. Initial education is the original training
course for pre-hospital providers. Continuing medical education programs
include refresher courses for recertification and periodic in-service training sessions.
Research, Profession and Practice
Initial Education
• Ideally based on the PAC NOCP’s establishes the minimum competencies for
the course CMA accredits education courses http://www.paramedic.ca under ‘initiatives’ Not all programs follow NOCP guidelines
tightly
Research, Profession and Practice
Once the initial education is
completed, the paramedic will become either
certified or licensed.
Research, Profession and Practice
Certification vs. Licensure
• Certification is the process by which an agency grants recognition to an individual who has met its qualifications.
• Licensure is the process of occupational regulation.
Research, Profession and Practice
4 Certification Levels
• Emergency Medical Responder• Primary Care Paramedic• Advanced Care Paramedic• Critical Care Paramedic
Make sure you know the scope of practice and CME requirements for these
Research, Profession and Practice
The First Responder is usually the first EMS-trained provider to
arrive on the scene.
Research, Profession and Practice
The PCP is trained to do all that a first responder can do, plus
other complex skills.
Research, Profession and Practice
The ACP Should Possess All the Skills of a PCP and Be
Competent in Advanced Airway, IV Therapy, and Other Skills.
Research, Profession and Practice
The CCP is the most advanced EMS provider.
Research, Profession and Practice
Paramedic Association of
Canada• Canada’s only national organization
• ‘May’ Regulate Practice
• ‘May’ Approve Training Programs
Research, Profession and Practice
For next WeekFor next Week
National Groups and Associations