Chapter 1-3

Professionalism in Healthcare

• A profession requires specialized knowledge, skills, and expertise.
• Professionalism includes maintaining standards, competencies, continuing education, performance, and ethics.
• Paramedics must instill confidence, maintain credibility, and show concern for patient well-being.
• Appearance matters; paramedics should be clean and professional.
• Unprofessional behavior is unacceptable, regardless of volunteer or part-time status.
• Treat all healthcare professionals with respect, avoiding arguments in front of patients.
• Address concerns professionally through supervisors.

Attributes of Professionalism

• Integrity: Openness, honesty, and truthfulness.
• Empathy: Understanding and identifying with patient and family feelings.
• Self-motivation: Internal drive for excellence.
• Confidence: Assurance in skills and abilities.
• Communication: Effective listening and clear, non-medical language.
• Teamwork and Respect: Guiding and supporting team members.

Patient Advocacy

• Advocates for patients and improvements in the EMS system.
• Act in the patient's best interest; report abuse or neglect as required by law.

Injury Prevention

• Identify and discuss potential hazards with patients or families.
• Participate in training programs on topics like fall prevention.

Careful Delivery of Service

• Pay attention to details and continuously evaluate performance.
• Use other medical professionals as resources.

Time Management

• Prioritize patient needs.
• Keep the emergency vehicle ready.
• Document calls promptly.

Administration

• Taking on special projects or leadership roles in the organization.
• Collaborate with other agencies and public safety resources.

Paramedic Responsibilities

• Paramedics are increasingly utilized in healthcare settings like hospitals and home health agencies.

Preparation

• Requires physical, mental, and emotional readiness.
• Maintaining up-to-date knowledge, skills, abilities, and appropriate equipment.

Response

• Responding safely and promptly.
• Avoiding unnecessary risks with lights and sirens.

Scene Management

• Prioritizing safety for oneself, the team, patients, and bystanders.
• Considering potential hazards from dispatch information.
• Using PPE.

Patient Assessment and Care

• Conducting organized assessments and prioritizing needs.

Management and Disposition

• Following protocols and guidelines.
• Contacting medical control when needed.
• Knowing receiving facility capabilities.

Patient Transport and Report

• Providing concise handoff reports at the receiving facility.
• Protecting patient privacy.

Documentation

• Filing patient care reports promptly as legal records.

Return to Service

• Restocking and preparing the unit quickly.

Community Education

• Teaching injury and illness prevention.
• Promoting CPR and AED training.

Expanded Roles

• Paramedics may work in clinics, emergency facilities, and hospitals.
• Involvement in immunization and medication administration.

EMS Research

• Conducting needs assessment and developing improvement initiatives.
• Educating the media and advocating for EMS.

Medical Direction

• Paramedics operate under the direction of a medical director.
• Advanced skills include cardiologic, pharmacologic, and trauma care.

Medical Director Responsibilities

• Training personnel.
• Recommending equipment.
• Developing protocols and quality improvement programs.
• Providing input on patient care.
• Interfacing with healthcare agencies.
• Advocating for EMS in the community.

Types of Medical Control

• Online (direct): Real-time guidance via communication.
• Offline (indirect): Protocols, policies, and standards approved by the medical director.

Online Medical Control Benefits

• Immediate patient care resources.
• Telemetry transmissions.
• Continuous quality improvement.
• On-scene assistance.

Offline Medical Control Components

• Protocols and guidelines.
• Standing orders and procedures.
• Training.
• Patient care reviews.

Continuous Quality Improvement (CQI)

• CQI: Continuous evaluation of care quality.
• Quality Control: Evaluating problems and finding solutions.

Steps in a CQI Process

• Identifying issues.
• Measuring items.
• Reviewing the issue.
• Developing remedies.
• Creating and enforcing an action plan.
• Re-examining the issue.
• Promoting excellence.
• Modifying protocols.

CQI Program Areas

• Medical direction.
• Education.
• Communications.
• Prehospital treatment and transportation.
• Financial issues.
• Receiving facility and dispatch reviews.
• Public information and education.
• Disaster planning and mutual aid.

Quality Improvement

• All emergency calls should be reviewed.
• The focus of CQI is on improving patient care.

Peer Review

• CQI can be in the form of a peer review
• Peer review is a valuable learning experience with proper guidelines.
• Rotating members on the peer review team

Human Error

• Eliminate human error by ensuring adequate lighting when handling medications and limiting interruptions
• Keeping medications in specific locations or in their original packaging when possible

Handing over Patients

• Handing patients off is a high-risk activity
• Liability can be increased at that time if errorneous processes are followed

Reducing Errors

• There are three primary sources of errors, and knowing these helps

Rules-Based Failure in Healthcare

• A deviation from established protocols or regulations, such as administering medication without proper legal authorization.

Knowledge-Based Failure in Healthcare

• A lapse in understanding or awareness of crucial information, like lacking comprehensive knowledge about a medication's effects and contraindications.

Skills-Based Failure in Healthcare

• An error stemming from inadequate proficiency in practical tasks or procedures, such as improperly using medical equipment during a critical intervention.

Clear Protocols

• Have clear protocols available
• Ensure you are aware of your environment and limit distractions
• Ensure you can find what you need in a timely fashion
• When preforming a patient skill always ask yourself why am i doing this
• What effect will this have on my patient
• Cheat sheets and checklists can hep to reduce error
• Be conscientious of protocols
• Do not allow interruptions when treating your patient