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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, ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ 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 ▪ ▪ ▪ ▪ First priority: PERSONAL SAFETY! Second priority: crew Third priority: public Fourth priority: patient st 1 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 nd 2 CREW SAFETY 2. Second priority: crew safety It is the responsibility of every team member to ensure the safety of the other team members rd 3 PUBLIC SAFETY 3. Third Priority: public safety Crowd control ▪ Often unaware of hazards ▪ May be violent ▪ Utilize law enforcement when possible th 4 PATIENT SAFETY 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 ▪ ▪ ▪ ▪ ▪ 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 ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ 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