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105 Chapter 1

Intro to Emergency Care

Regulation and Policy Each state EMS system must have enabling legislation, lead ems agency, funding, policies, and procedures
Resource Mgmt. Centralized coordination of resources so that all victims have equal access to care
Human Resources and Training All EMS personnel trained to EMT level using National EMS Standards
Communications There must be effective 911, distpatch-Amb, Amb-Amb,Amb-Hospital, Hos-Hos communication
Medical Direction Must be a physician as a Medical Director accountable for activities of EMS personnel in that system. MD delegates to non-physician workers such as EMTs
Evaluation Each statIe must have program of evaluation + improving EMS system, known as QI, QA, TQM
Trauma Systems Each state needs enabling legislation for one or more trauma centers
EMR Emergency Medical Responder (firefighter, police, industrial health personel) provides care prior to arrival of Ambulance
EMT provides basic level medical and trauma care and transportation to a medical facility
AEMT Everything EMT plus using advanced airway devices, administering some medications, and monitoring blood glucose levels
Paramedic EMT+AEMT+advanced-level skills
EMD Emergency Medical Dispatcher can provide information on CPR, artificial ventilation, bleeding control and more
QI Quality Improvement is consistent self-review with the purpose of identifying aspects of the the system that require improvement
QI 5 things 1) Carefully written documentation 2) Becoming involved in QI process 3) Obtaining feedback from patients and hospital staff 4) Maintaining Equipment 5) Continuing Education
Medical Director Physician who assumes ultimate responsibility of medical direction, and oversees training, develops protocols and huge part of QI
Designated Agent EMT, AEMT who provides medication and emergency care as an extension of the MD's license to practice medicine
Standing Orders Policy or protocol that authorizes EMTs to perform particular skills in certain situation
Offline-Medical Direction Perfoming a standing order without speaking to MD or other physician
Online-Medical Direction Orders given by physician over radio/phone
Protocols List of steps such as assessments and interventions, to be taken in different situations
EMS Role in Public Health 1) Injury prevention for geriatric patients 2) Injury prevention for youth 3) Public Vaccination Programs 4) Disease Serveillance
Impact of Research Patient outcomes and evidence-based techniques
Evidence Based Process Forming Hypothesis, Reviewing Literature, Evaluating Evidence, Adopting the practice if evidence supports it
Methods of Reducing Bias -Prospective vs. Retrospective (new vs old) -Randomization - High quality studies, single- blinded (researcher knows which therapy) Double-blinded (neither) - Control Groups group of patients receiving therapy of the commonly known +used - Study Groups
Types of Medical Research - Case studies/reports always a retrospective report of patient(s) - Cohort/Concurrent Control/Case-Control Studies -RCTs randomized control trials - Systematic Review - Meta-Analysis p19
Created by: jon.kowalski



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