Download Chapter 2: Medical Responsibilities

Unit 1

Discuss in detail
 Roles & Responsibilities
 Professionalism
 Training Format
 Continuing education
 Appropriate medical direction

The EMT is an important member of prehospital care team (NOT just one
person…it’s a NETWORK!)
 Shares a common goal with other team
members deliver professional care to patients
in a timely manner

Pre-hospital health care team: multidisciplinary
team of medical personnel, firefighters & law
enforcement officers
 Care for patients before their admittance to the
hospital

Responsibilities
 Expected to bring expert
basic medical care to
patients wherever they
may be found
▪ Life-saving procedures….to
comforting the patient
▪ Provide high quality of basic
medical care to the patient
in a professional manner
 Do what is best for the
patient

Job Description
 Procedural duties (Table 2-1)
▪ Stock emergency response vehicle
▪ Maintain equipment
▪ Respond to emergencies
▪ Render patient care
▪ Transport patient
▪ Report to receiving facility
 Job Description
▪ Management of
 Patient care duties (Table 2-2) respiratory, cardiac,
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diabetic, allergic,
Airway maintenance
behavioral, suspected
Ventilation of patients
poisonings, and
CPR
environmental
Use of AED
emergencies
Hemorrhage (bleeding) control ▪ Assisting patients with
Treat hypoperfusion (shock)
prescribed medications
Bandaging wounds
▪ Administration of
Immobilization of extremities ▪ oxygen, oral glucose,
and activated charcoal
Assisting in child birth

Safety
 Personal Safety: assurance that
no hazards are present that might
endanger the EMT
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First priority: PERSONAL SAFETY!
Second priority: crew
Third priority: public
Fourth priority: patient
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PERSONAL SAFETY
 1. First priority: personal safety
 An injured rescuer is helpful to no one
 Safety precautions
▪ May be simple (pre-physical examination)
▪ May be complicated (delayed entry to a hazardous scene
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CREW SAFETY
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2. Second priority: crew safety
 It is the responsibility of every team member to ensure
the safety of the other team members
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PUBLIC SAFETY
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3. Third Priority: public safety
 Crowd control
▪ Often unaware of hazards
▪ May be violent
▪ Utilize law enforcement when possible
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PATIENT SAFETY
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4. Fourth priority: patient safety
 Hazardous scenes
 Self-harm

Professional conduct: a caring,
confident, and courteous
demeanor expected of all health
care providers

Appearance
 First impressions  IMPORTANT!
▪ Would you want an EMT who takes poor
care of themselves take good care of
you?
 Clean
 Neat
 Positive image

Skill maintenance
 Skills degenerate if not
routinely used/practices
 Practice makes perfect
 Continuing education
required

Physical preparedness
 Many duties are physically active
▪ Lift & carry up to
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125 lbs
Good eyesight
Good color vision
Good hearing
Effective oral and written communications
Puts patient’s needs as a priority without
endangering self

Personal Traits
 Certain personality traits are better suited to the role of EMT
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Compassion
Kindness
Self-sacrifice
Calm & reassuring
Leadership ability
Good judgment
Good moral character
Stability & adaptability
Ability to listen
Resourcefulness & improvisation
Cooperativeness

Training
 State & federal agencies regulate training
 Educational standards outlined by U.S. DOT (United
States Department of Transportation) EMT—Basic
curriculum
 Each state enriches the minimum curriculum to meet
specific needs
HOW DO EMT’S LEARN & TRAIN?
3 primary areas
 Classroom & didactic portions
 Prepares students for cognitive or
knowledge-based objectives

Practical hands-on instruction
 Students learn critical psychomotor
skills in a controlled environment

Clinical observation
 In the hospital
 Pre-hospital

Certification & Licensure
 ALL EMTs must successfully complete the standardized
examination of skills & knowledge
 Certification: proof of satisfactory completion of the
minimum requirements in a curriculum
▪ Implies minimal standards are met

Certification & Licensure
 Licensure: permission to engage in a certain activity
(EMS) granted by the appropriate authority (state
department of health)
▪ CANNOT PRACTICE AS AN EMT WITHOUT A LICENSE IN
MOST STATES
▪ Implies minimal standards met

Continuing education: training beyond initial
certification requirements
 Professional development
▪ Lifelong learning: education that a person continues
throughout life by keeping current on new information &
maintaining competence in skills
▪ Changes in medicine
▪ Improvement in methods
▪ Continuously increases base of knowledge

Refresher training
 Assures competency
▪ Over time skills may “rust” over time and material may
be forgotten  needs reviewing!
▪ Most states establish time lines for required refresher training
(about every 2-3 years)
▪ Ensures EMT reviews core training components
 How?  refresher classes & continuing
education
▪ May require test
▪ Would you want procedures used back in the 1800’s used on you
today if there were BETTER and SAFER methods available?

National Association of Emergency
Medical Technicians (NAEMT)
represents EMS professionals across
the US
 Promotes advancement of EMS as an
allied health profession

Common in medical professions
 “ethical principals” by which a group
operates
 Descendant of the “Hippocratic Oath”
 Oath of professional conduct
 List of moral rules

Medical direction: advice provided by a higher
medical authority  physician
 EMTs act as allied health care providers
▪ Extension of physician into pre-hospital environment
▪ EMS physician ultimately responsible for all care provided by
EMT under his/her direction
▪ Physician cannot/need not be present on every call
▪ Moral & legal obligation to provide direction to EMTs

Medical director: a
physician who acts as a
medical expert,
consultant, and
educator
 Every ambulance
service/rescue squad
must have physician
medical direction

Medical direction and control accomplished in
several ways
 Off-line medical control: involvement of a physician in
a protocol and procedure preparation
▪ Protocols: medical practice guidelines approved in advance by
medical director  needs continuing education & skill
maintenance
 Online-medical control: direct communication between
EMT & physician while care is being provided in the field
▪ Patient situations don’t fit protocols
▪ Requires telecommunications

Quality improvement (CQI): actions taken to
improve the quality of care given
 Information from assessments integrated & analyzed 
determine if plan was met or if problem exists
 Dynamic process
▪ Re-examine if goal was met  could it be better?
▪ Re-examine if goal wasn’t met
▪ Unrealistic goal
▪ System needs changed

EMTs are professional, specially trained
health care providers

Integral part of pre-hospital health care team

Fulfilling responsibilities is what makes an
EMS system successful