Emergency Medical Services (EMS)

• Emergency Medical Technicians (EMTs) and paramedics are prehospital medical professionals
• These professionals administer immediate care to critically ill or injured patients.
• Scope of practice varies by state and locality.
• The National Registry of Emergency Medical Technicians (NREMT) offers national certification, used by many states, but state regulations can still vary

Levels of EMS Training

• Emergency Medical Responder (EMR) provides immediate basic life support and often assists higher-level personnel.
• Emergency Medical Technician (EMT) provides basic life support, including CPR, oxygen administration, splinting, and spinal immobilization.
• Advanced EMT (AEMT) provides advanced life support, including IV therapy, advanced airway management, and administration of some medications.
• Paramedics provide the highest level of prehospital care, including advanced assessment, diagnosis, and treatment.

Core Responsibilities

• Responding to emergency calls is a core responsibility.
• Assessing the patient's condition is critical.
• Providing basic and advanced medical care is essential.
• Transporting patients to medical facilities is a key duty.
• Documenting patient information accurately is necessary.

Patient Assessment

• Scene safety involves ensuring the safety of the environment before approaching the patient.
• Primary assessment involves identifying and treating immediate life threats like airway obstruction, breathing difficulty, or severe bleeding.
• Secondary assessments involve a thorough head-to-toe examination to identify other injuries or medical conditions.
• Vital signs monitored include heart rate, blood pressure, respiratory rate, and oxygen saturation.

Airway Management

• Ensure a patent airway by using techniques such as head-tilt/chin-lift, jaw-thrust, or suctioning.
• Insert oropharyngeal (OPA) or nasopharyngeal (NPA) airways to maintain an open airway.
• Provide supplemental oxygen via nasal cannula, mask, or bag-valve-mask (BVM).

Breathing Support

• Assist ventilation with a BVM if the patient is not breathing adequately.
• Administer medications, such as bronchodilators, via nebulizer or inhaler for respiratory distress.
• Monitor the patient's respiratory status and adjust interventions as needed.

Circulation Support

• Controlling bleeding is done by applying direct pressure, using tourniquets, or applying hemostatic agents.
• Initiate CPR for patients in cardiac arrest, following established guidelines.
• Administer medications, such as epinephrine, for anaphylaxis or cardiac arrest.
• Start intravenous (IV) lines to administer fluids and medications.

Splinting and Immobilization

• Splint fractures and dislocations to prevent further injury and reduce pain.
• Immobilize the spine of patients with suspected spinal injuries using a cervical collar and backboard.

Medical Emergencies

• Cardiac emergencies include chest pain, heart attack, and cardiac arrest.
• Respiratory emergencies include asthma, COPD, and pneumonia.
• Neurological emergencies include stroke, seizure, and altered mental status.
• Diabetic emergencies include hypoglycemia and hyperglycemia.
• Allergic reactions include anaphylaxis.

Trauma Management

• Head injuries include concussion and traumatic brain injury.
• Spinal injuries include fractures and dislocations.
• Chest injuries include pneumothorax, hemothorax, and flail chest.
• Abdominal injuries include blunt or penetrating trauma.
• Musculoskeletal injuries include fractures, dislocations, sprains, and strains.
• Burns can be thermal, chemical, or electrical.

Pharmacology

• Common medications administered include Oxygen, Aspirin, Epinephrine, Naloxone, Glucose, and Bronchodilators.
• Routes of administration include oral, sublingual, intramuscular (IM), subcutaneous, intravenous (IV), and intranasal (IN).

Special Populations

• Pediatric patients require specialized knowledge of anatomy, physiology, and medication dosages.
• Geriatric patients may present with atypical symptoms and multiple medical conditions.
• Pregnant patients require consideration of both the mother's and fetus's well-being.
• Patients with disabilities require sensitivity and adaptation to individual needs.

Communication and Documentation

• Communicate effectively with patients, family members, and other healthcare professionals.
• Use clear and concise language.
• Document patient information accurately and completely.
• Maintain patient confidentiality.

Legal and Ethical Considerations

• Scope of practice involves understanding the legal limits of your role and responsibilities.
• Consent requires obtaining informed consent from patients before providing treatment.
• Confidentiality involves protecting patient privacy and confidentiality.
• Duty to act means providing care to patients in need when you are on duty.
• Negligence involves avoiding actions that could harm patients.
• Abandonment means not discontinuing care until relieved by someone of equal or higher training.
• Ethics involves adhering to ethical principles such as beneficence, non-maleficence, and justice.

Medical Equipment

• Stretcher: Used to transport patients
• Oxygen tank: Provides supplemental oxygen
• Suction unit: Removes fluids from the airway
• Glucometer: Measures blood glucose levels
• Blood pressure cuff: Measures blood pressure
• Pulse oximeter: Measures oxygen saturation
• Defibrillator: Delivers electrical shocks to restore normal heart rhythm

Ambulance Operations

• Vehicle safety includes inspecting the ambulance regularly and operating it safely.
• Route planning involves choosing the safest and most efficient route to the hospital.
• Radio communication involves communicating with dispatch and other responders.
• Infection control involves following procedures to prevent the spread of infection.

Stress Management

• Dealing with death and dying: Providing support to grieving family members
• Critical incident stress: Managing stress after responding to traumatic events
• Self-care: Taking care of your physical and mental health

Continuing Education

• Staying up-to-date on the latest medical knowledge and skills.
• Attending continuing education courses.
• It is important to maintain certifications and licenses.

Professionalism

• Maintain a professional appearance and demeanor
• Treat all patients with respect and compassion
• Work effectively as part of a team
• Uphold the standards of the EMS profession