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The Well-Being of the EMT-B. Origins of EMS. Accidental Death & Disability: The Neglected Disease of Modern Society Department of Transportation (DOT) Highway Safety Act of 1966 Department of Health and Human Services (DHHS) Emergency Medical Act of 1973. National Standard Curriculum.

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Origins of ems
Origins of EMS

  • Accidental Death & Disability: The Neglected Disease of Modern Society

  • Department of Transportation (DOT)

    • Highway Safety Act of 1966

  • Department of Health and Human Services (DHHS)

    • Emergency Medical Act of 1973

National standard curriculum
National Standard Curriculum

  • Developed by DOT

    • First developed in early 1970’s

    • Current - 1994

  • Purpose

    • Standardization of Training Programs

    • Standardization of Levels of Certification

    • Standardization of Patient Care

Ems system
EMS System

The complete human and physical resources that provides patient care in cases of sudden illness or injury

Levels of ems training
Levels of EMS Training

  • First Responder

  • EMT – Basic

  • EMT – Intermediate

  • EMT – Critical Care

  • EMT – Paramedic

Components of an ems system
Components of an EMS System

  • Advisory Council

  • Medical Direction (Scope of Practice)

    • The process used by the Medical community to assure quality and accountability in the delivery of pre-hospital care

    • On-line

    • Off-line

      • Protocols

      • Quality Improvement

Components of an ems system1
Components of an EMS System

Specialty Facilities

  • Trauma Center

  • Burn Center

  • Pediatric Center

  • Stroke Centers

  • Other specialty centers

Components of an ems system2
Components of an EMS System

  • EMT Training

    • Initial – 180 hours

    • Continuing Education

  • Instructor Training

Components of an ems system3
Components of an EMS System

  • Communications Systems

    • System Communication

      • Radio

      • Cellular

    • System Access

      • 911

      • Other easily remembered numbers

Components of an ems system4
Components of an EMS System

  • Dispatch Center

    • Well Designed

    • Well Equipped

    • Well Staffed & Trained

    • Policies & Procedures

Components of an ems system5
Components of an EMS System

  • Ambulance Service

    • Well Designed

    • Well Equipped

    • Well Maintained

    • Well Trained Staff

Components of an ems system6
Components of an EMS System

  • Rapport with other healthcare professionals

  • Reports & Records

  • System Evaluation

    • Quality Improvement – CQI

      • Protocol Review/Update

      • Run Review

      • Remedial or Continuing Education

Components of an ems system7
Components of an EMS System

  • Disaster Plans

    • Major Incident Response

      • Designed by EMS

      • Designed to Integrate with Other Agencies

The well being of the emt b

A professional provider of emergency care

Scope of practice
Scope of Practice

  • Defined by NYS Public Health Law

  • Established by Medical Director

    • Medical Practice Act

      • Allows Physicians to delegate procedures to EMS personnel

    • Off-Line Medical Direction (Protocols)

      • Standing orders issued by the Medical Director that allow EMT’s to give certain medications and perform certain procedures without speaking to a physician

    • On-Line Medical Direction

      • Orders from an on-duty physician given directly to the EMT in the field by radio or telephone

Roles responsibilities
Roles & Responsibilities

  • Safety

    • Priorities

      • Yourself

      • Partner

      • By-standers

      • Patient

      • Survey Scene

        • Look for Hazards

        • Listen to Others

The well being of the emt b


  • Stay aware of danger

  • PLAN

    • Support personnel

    • Proper clothing

    • Radio


    • Violence

    • Pets

    • Crime Scene

    • Weapons


    • Retreat B. Radio C. Reevaluate

  • E. Hazards-power lines

  • F. Alcohol/Drugs

  • G. Bystanders

Scene safety
Scene Safety

  • Body Substance Isolation

    • Hand washing

    • Eye protection

      • Prescription eye glasses with side shields OR goggles

    • Gloves

      • Needed for contact with bodily fluids

      • Change between contact with different patients

    • Gowns

      • Needed for large splash situations

    • Masks

      • Surgical for blood splatter

      • High Efficency Particulate Air (HEPA) respirator with suspected tuberculosis (TB)

Scene safety1
Scene Safety

  • Hazardous Materials

    • Identify possible hazards

    • Protective clothing

    • Haz-Mat scenes are controlled by Haz-Mat teams

    • EMT patient care starts when the scene is safe and the patient has been decontaminated

Scene safety2
Scene Safety

  • Rescue

    • Identify and reduce potential life threats

      • Electricity

      • Fire

      • Explosion

      • Hazardous materials

    • Protective clothing

      • Turnout gear

      • Puncture-proof gloves

      • Helmet

      • Eyewear

Scene safety3
Scene Safety

  • Violence

    • Scene should always be controlled by law enforcement before providing care

Roles responsibilities1
Roles & Responsibilities

  • Patient Care

    • Patient Assessment

    • Basic Life Support

    • Mechanical Aids to Breathing

    • Pulse-Oximetry

    • Semi-Automatic External Defibrillator

    • Pneumatic Anti-Shock Garment (PASG or MAST)

Roles responsibilities2
Roles & Responsibilities

  • Patient Care (cont.)

    • Hand-held Metered Dose Nebulizers

    • Epinephrine Auto-injectors (Epi pens)

    • Nitroglycerin

    • Aspirin

    • Charcoal

Roles responsibilities3
Roles & Responsibilities

  • Patient Care (cont.)

    • Oral Glucose

    • Bandaging & Splinting / Traction Splinting

    • Emergency Childbirth

    • Spinal Immobilization

Roles responsibilities4
Roles & Responsibilities

  • Extrication & Rescue

  • Transport

  • Transfer of Care

  • Communications

  • Records & Reports

Roles responsibilities5
Roles & Responsibilities

  • Patient Advocacy

  • Maintenance

    • Vehicle Maintenance

    • Equipment Maintenance

    • Self

Emt traits
EMT Traits

  • Physical Traits

    • Hygiene

    • Good physical health

    • Eyesight

  • Attitude

  • Resourceful

  • Sincerity/Compassion/Empathy

Temple College EMS Professions

Emt traits1
EMT Traits

  • A leader/self-starter

  • Emotional stability

  • Good moral character

  • Adaptability

  • Effective communicator

    • Verbal

    • Written

  • Ongoing Education

Temple College EMS Professions

The well being of the emt
The Well-Being of the EMT

  • Personal health, safety, and well-being are vital to an EMS operation.

  • You must learn to recognize and protect yourself from hazards.

  • You must cope with mental and physical stress.

Medical examiner cases
Medical Examiner Cases

  • DOA – no Primary MD

  • Unknown cause of death

  • Suicide

  • Violent death

  • Poisoning

  • Accidents

  • Criminal act

Keep notes of any care provided.

Death and dying
Death and Dying

  • Death is something you will have to face.

  • Coming to grips with death is part of delivering care.

Stages of grieving
Stages of Grieving

  • Denial – refusal to accept

  • Anger – blaming others

    • Be tolerant

    • Do not become defensive

  • Bargaining – promise to change

    • “Ok, but first let me”

  • Depression – open expression of grief, sadness/despair

  • Acceptance

    • “Ok, I’m not afraid”

What you are

feeling is


Dealing with the dying patient and family members
Dealing with the dying patient and family members

  • Patient needs include dignity, respect and communication

  • Act in a calm manner

  • Listen empathetically

  • Family members may express rage, anger and despair

  • Show concern about privacy

  • Do not create false hope or falsely reassure

Definition of stress
Definition of Stress

Any response, physical, emotional or behavioral, we have to the things that happen in our lives, on and off the job






Home life

Social life

Examples of stressful situations
Examples of Stressful Situations

Mass casualty situations

Infant and child trauma


Infant/child/elder/spouse abuse

Death/injury of a family member, co-worker or other public safety personnel

What can you do to help deal with stress
What can you do to help deal with stress?

Change your diet

Reduce sugar, caffeine, and alcohol intake

Avoid fatty foods

Increase carbohydrates


Practice relaxation techniques

Deep breathing – inhale through your nose deeply, hold breath for 3 seconds and then forcefully exhale through your mouth

Talk about your worries, fears, concerns

Components of cism system

CISD – Critical Incident Stress Debriefing

A team of peer counselors and mental health professionals who help emergency care workers deal with critical incident stress

Meeting is held 24 to 72 hours after a major incident

Open discussion of feelings, fears and reactions

Not an investigation or interrogation

All information is confidential

Components of CISM System


What can you do to help deal with stress1
What can you do to help deal with stress?