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EMS Systems. Heather Davis, MS, NREMT-P. About the Case Study. Why is the role of ordinary citizens important in this scenario? How many behind the scenes people can be credited with saving Mr... Chlopek’s life? IF E-911 would not have been in place, what delays might have occurred?.

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ems systems

EMS Systems

Heather Davis, MS, NREMT-P

about the case study
About the Case Study
  • Why is the role of ordinary citizens important in this scenario?
  • How many behind the scenes people can be credited with saving Mr... Chlopek’s life?
  • IF E-911 would not have been in place, what delays might have occurred?
ems system components
EMS System Components
  • Prehospital component
  • Hospital Component
  • Support Personnel
the prehospital component
The Prehospital Component
  • Lay persons trained in CPR
  • First Responders
  • EMTs
  • Paramedics
hospital component
Hospital Component
  • Emergency nurses
  • Emergency physicians
  • Specialty physicians
  • Surgery
  • Rehab
support personnel
Support Personnel
  • Emergency Medical Dispatchers
  • Law enforcement
  • Firefighters
  • Public-safety workers
  • Respiratory therapists
  • Other allied health technicians
the systems approach
The Systems Approach
  • System Administration
  • Medical Control
  • Public Information and Education
  • EMS Communications
  • EMD
  • Education and Certification
  • Patient Transportation
the system continued
The System Continued
  • Quality Assurance and Improvement
  • Research
  • Receiving Facilities
  • Mutual Aid/MCI Preparation
  • System Financing
system administration the local ems agency
System Administration:The Local EMS Agency
  • Sets local policies
  • Hires a medical director
  • Manages local resources
  • Assures quality of service
system administration the state ems agency
System Administration:The State EMS Agency
  • Allocates state and federal funding
  • Works for EMS legislation
  • Certifies and licenses personnel
  • Enforces rules and regulations
medical control medical director qualifications
Medical Control:Medical Director Qualifications
  • Experienced in emergency medicine
  • Completed a training program in EMS system
  • Board certified in emergency medicine
  • Frequently rides with field crews
medical control responsibilities
Medical Control:Responsibilities
  • Direct communication with field crews
  • Intervener physician guidelines
  • Protocol development: triage, treatment, transport, transfer, special situations
  • Oversee training and education
  • Ensure quality assurance through chart review, audit, and evaluation
public information education
Public Information/Education
  • Patient denial of symptoms
  • Targeting coronary/stroke patients
  • System access
  • Bystander BLS in CPR, bleeding control, C-spine stabilization
  • Future involvement (bystander defib)
ems communications
EMS Communications
  • Easy citizen access
  • Communications center
  • Operational network
  • Medical communications
  • Communications hardware
  • Communications software
emergency medical dispatch
Emergency Medical Dispatch
  • Interrogation protocols
  • Response configurations
  • System status management
  • Pre-arrival instructions
  • Dispatcher training
  • Desired response times
education certification
Education & Certification
  • Original program requirements: 300 didactic, 100 clinical, 300 field
  • Continuing ed: refresher courses, in-services, seminars
  • Certification levels: EMT-B,I,P
  • Additional certification: ACLS, PALS, PHTLS, BTLS
patient transportation
Patient Transportation
  • Transport to appropriate facility
  • Ground transportation
  • Air transportation
quality assurance
Quality Assurance
  • Monitors quality of clinical care
  • Evaluation of clinical data
  • Documents effectiveness of care provided
  • Identifies weaknesses in system
  • Often viewed negatively
quality improvement
Quality Improvement
  • Focuses on customer perceptions of service
  • Emphasizes customer satisfaction
  • Recognizes, rewards, and reinforces good performance
  • What field tx reduces morbidity and mortality?
  • Are the benefits worth the risks?
  • What is the cost/benefit ratio of prehospital medicine?
  • Is field stabilization possible?
receiving facilities
Receiving Facilities
  • Hospital categorization
  • Specialty centers
  • Requirements: MD on duty, surgical facility, ICU, lab, x-ray, blood bank, participation in EMS system, reception of all patients, QA procedures, MCI plan participation
mci mutual aid requirements
MCI & Mutual Aid Requirements
  • Central coordinating agency
  • Integration of system components
  • Frequent drills
  • Expansion of communications
  • Standardized regional resources
system financing
System Financing
  • System design: hospital based, fire department, municipal third service, private business, volunteer, combo
  • Funding options: tax subsidized, contributions, fundraising, corporate sponsorship, subscriber plans, prepaid HMO, Medicare, Medicaid, private medical or auto insurance, user pay, public utility