Chapter 26 EMT_Paramedic .pdf

High Drama in Health Care - Paramedics and emergency medical technicians have a career that is very dramatic because you must take immediate and calm reactions while implying the application of EMT’s skills amid someonetimes dangerous conditions. 9/11 was one of the most dr...

High Drama in Health Care - Paramedics and emergency medical technicians have a career that is very dramatic because you must take immediate and calm reactions while implying the application of EMT’s skills amid someonetimes dangerous conditions. 9/11 was one of the most dramatic and deadly situations that paramedics, along with teams of firefighters and police, had ever faced, and they lived up to their potential and training with great heroism. Not every call received by a paramedic team is a life-or-death situation, the potential for drama always exists. EMT-PARAMEDICS Employment is projected to grow faster than the average for all occupations Emergency medical technicians and paramedics need formal training and certIfication or licensure, but requirements vary by state Emergency services function 24 hour day, so EMTs and paramedics have irregular working hours Opportunities will be best for those who have earned advanced certifications Work description: EMTs and paramedics provide immediate and vital service as they care for and transport the sick or injured to a medical facility. In an emergency: EMTs and paramedics dispatched by a 911 operator to the scene, where they often work with police and firefighters. All together, they are known as first responders. ○ A first responder is a person with specialized training who is among the first to arrive and provide assistance or incident resolution at the scene of an emergency. ○ Refers to the first “certified” person who arrives at the scene of a disaster, accident, or life threatening medical situation. The first responder’s duties include providing medical assistance and calling other emergency caregivers to the scene Once they arrive, EMTS and paramedics assess the nature of the patient’s pre-existing medical conditions. Following medical protocols and guidelines, they provide appropriate emergency care and, when needed, transport the patient.  Some paramedics are trained to treat patients with minor injuries at the scene of an accident, or they may treat them at their home, without transporting to a medical facility. Emergency treatment is carried out under the medical direction of physicians. They may use special equipment, such as backboards. During the transport of a patient, one EMt or paramedic drives while the other monitors the patient's vital signs and gives more care if needed. Some paramedics work as part of the helicopter’s flight crew to transport critically ill or injured patients to hospital trauma centers. ○ Trauma centers are hospital units specializing in the treatment of patients with acute and life-threatening traumatic injuries. At medical facilities: these people help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. They record the care that they provided to the patient. After each run, they replace used supplies and check equipment. If contagious disease: EMTs and paramedics decontaminate and clean the interior of the ambulance and report cases to proper authorities. Also provide transportation from one medical facility to another, particularly if they work for private ambulance services. (patients often need to be moved to a hospital that specializes in their injury/illness/nursing home.) National registry of Emegency Mecia lTechinitioins certifies emergency medical service providers at four levels: ○ Emergency Medical responder: represents the first component of the system. An EMT trained at this level is prepared to care for patients by ambulance to the hospital under medical direction. Has the emergency skills to analyze the patient's condition and manage respiratory, cardiac, and trauma emergencies. ○ Emergency Medical technician: second component, can perform interventions with the basic equipment typically found on an ambulance. Specific tasks that those certified at this level are allowed to perform vary a lot from one state to another. ○ Advanced emergency medical technicians: third component, they have skills of emt plus the knowledge and skills needed to operate both basic and advanced equipment round on a typical ambulance. ○ Paramedics: fourth component, provide most extensive prehospital care. Adding on to carrying out the procedures of the other levels, they may administer drugs  orally and intravenously, interpret eleccardiograms, perform entrance intubations, and use monitors and other complex equipment. Similar to an advanced EMT, what they can do varies from state to state. Work Environment EMTs and paramedics work inside and outside no matter what the weather is. They do a lot of heavy lifting which makes it demanding that you are in good shape They might exposed to disease as well as violence from mentally unstable patients patients Employed by firefighters= 50 hours a week Employed by hospitals=45-60 hours a week Private ambulance services= 45-40 hours Some of these workers, especially those in police and fire departments are on call for extended periods of time Some shifts are 12 hours, others are 24 hours They have irregular working hours Employment Opportunities EMTs and paramedics held about 265,200 jobs in 2019. Volunteer EMTs and paramedics are more common in small cities, towns, and rural areas They volunteer for fire departments, emergency medical services (EMS) or hospitals About 46% worked as employees of private ambulance services 28% word in local governments 19% work in hospitals 1. Private ambulance come from private or public organizations for emergency situation 2. Local governments are usually required to provide ambulance emergency medical services associated with the fire and police departments 3. Hospitals are required to provide the same services for patients in emergency situations Education and legal requirements - A high school diploma and a cardiopulmonary resuscitation (CPR) certificate are required to enter a training program to become an EMT or paramedical.  Workers must complete the formal and certification process. Most of these programs are postsecondary non-degree award programs that can be completed in less than a year, others last about 2 years. Paramedics however need an associate’s degree. Education and training - Trainings is offered at progressive levels ○ Emergency Medical Responder ○ Emergency Medical Technician ○ Advanced Emergency Medical Technician ○ Paramedic At the Emergency medical responder and EMT level they most likely emphasize emergency skills, such as: managing respiratory, trauma, and cardiac emergencies, and patient assessment. Formal courses include time in the emergency room and ambulance. The program includes instruction and practice dealing with: bleeding, features, airway obstruction, cariad arrest, and emergency childbirth. Students learn to use and maintain common emergency equipment which includes: backboards, suction devices, splints, oxygen delivery systems, and stretchers. People who graduate from approved emergency medical responder or EMT training programs must pass a written and practical examination administered by the state certifying agency or the NREMT. At the advanced emergency medical technician level, training requirements vary by state. The nationally defined level typically requires 300 to 350 hours of training based on the scope of practice. Students learn advanced skills such as the use of advanced airway devices, intravenous fluids, and some medications. Advanced EMTs must pass a written and practical examination administered by the state certifying agency or NREMT. The most advanced level of training for this occupation is Paramedic, at this level the caregiver receives training in anatomy and physiology as well as advanced medical skills. The training is mostly conducted in community colleges and technical schools over one to two years and may result in an associate's degree. This kind of education prepares the graduates to take the NREMT examination and become certified as a paramedic. Extensive related coursework and clinical and field experience is required.  Refresher courses and continuing education are available for EMTs and paramedics at all levels. High school students interested in becoming an EMT or paramedic should take courses in health, biology, anatomy, and physiology. Courses that improve problem-solving skills will assist the future EMT or paramedic. Licensure Certifications are required for all 50 states for each the EMT levels In most states and the District of Columbia registration with the NREMT is required at some or all levels of certification Other states make you take the NREMT or state examination They need to recertify every 2 years Other Qualifications EMTs and paramedics need good Emotionally stable Dexterity Agility Physical Coordination Good physique Eyesight Strong listening and speaking skills Advancement Paramedics can become: supervisors, operations managers, administrative directors, or executive directors EMTs & Paramedics: Instructors, dispatchers, or physicians assistants Others move into sales or marketing of emergency medical equipment Employment Trends  Expected to grow faster through 2029 Particularly in cities with private ambulance Employment Change Grow by 6% between 2019-2029 Hard to find and make unpaid volunteers to stay They need full time paid to replace unpaid There are more elders who are living for longer which means we need more EMTs and paramedics to treat them. Job prospects: Many job openings will arise from growth and from the need to replace workers who leave occupation. ○ Might have left because of: limited potential for advancement, modest pay, and benefits in private-sector jobs. Opportunities would be best in private ambulance services. Competitions will be more for jobs in local government, including first police, and independent third rescue squad departments. ○ Tend to have better pay/benefits. Earnings Median wages were $17.62 in May 2020. The middle earned 50% between $14.03-$22.99 The lowest 10% earned less than $11.85 The highest earned 10% earned $29.88 In May 2020 $17.86 Local Government $21.47 Related occupations - Other workers in occupations that require quick level-headed reaction to life-or-death situations are emergency management directors, firefighter, physician assistants, police officers and detectives, and registered nurses.