the location where a crime has been committed or any place that evidence relating to a crime may be found.
a legal document, usually signed by the patient and his physician, which states that the patient has a terminal illness and does not wish to prolong life through resuscitative efforts.
an obligation to provide care to a patient. ethical regarding a social system or social or professional expectations for applying principles of right and wrong.
consent given by adults who are of legal age and mentally competent to make a rational decision in regard to their medical well-being
• Safety of the crew, patient, and bystanders. The same dangers you face will also be faced by others at the scene. As a professional, you must be concerned with their safety as well as your own. • Patient assessment. As an EMT, one of your most important functions will be assessment of your patient, or finding out enough about what is wrong with your patient to be able to provide the appropriate emergency care. Assessment always precedes emergency care.
• Patient care. The actual care required for an individual patient may range from simple emotional support to lifesaving CPR and defibrillation. Based on your assessment findings, patient care is an action or series of actions that your training will prepare you to take to help the patient deal with and survive his illness or injury.
• Lifting and moving. Since EMTs are usually involved in transporting patients to the hospital, lifting and moving patients are important tasks. You must perform them without injury to yourself and without aggravating or adding to the patient’s existing injuries.
• Transport. It is a serious responsibility to operate an ambulance at any time, but even more so when there is a patient on board. Safe operation of the ambulance, as well as securing and caring for the patient in the ambulance, will be important parts of your job as an EMT.
• Transfer of care. Upon arrival at the hospital, you will turn the patient over to hospital personnel. You will provide information on the patient’s condition, your observations of the scene, and other pertinent data so that there will be continuity in the patient’s care. Although this part of patient care comes at the end of the call, it is very important. You must never abandon care of the patient at the hospital until transfer to hospital personnel has been properly completed.
• Patient advocacy. As an EMT, you are there for your patient. You are an advocate, the person who speaks up for your patient and pleads his cause. It is your responsibility to address the patient’s needs and to bring any of his concerns to the attention of the hospital staff. You will have developed a rapport with the patient during your brief but very important time together, a rapport that gives you an understanding of his condition and needs. As an advocate, you will do your best to transmit this knowledge to help the patient continue through the EMS and hospital systems. In your role as an advocate, you may perform a task as important as reporting information that will enable the hospital staff to save the patient’s life or as simple as making sure a relative of the patient is notified. Acts that may seem minor to you may often provide major comfort to your patient.
Limmer, Daniel; O’Keefe, Michael F.; Grant, Harvey; Murray, Bob; Bergeron, J. David; Dickinson, Edward T.. Emergency Care (EMT) (Page 8). Pearson Education. Kindle Edition.
summary of standards
Each state EMS system must have in place enabling legislation (laws that allow the system to exist), a lead EMS agency, a funding mechanism, regulations, policies, and procedures.
• Resource management.
There must be centralized coordination of resources so that all victims of trauma or medical emergencies have equal access to basic emergency care and transport by certified personnel, in a licensed and equipped ambulance, to an appropriate facility.
• Human resources and training.
At a minimum, all those transporting prehospital personnel (those who ride the ambulances) should be trained to the EMT level using National EMS Education Standards that are taught by qualified instructors.
Safe, reliable ambulance transportation is a critical component. Most patients can be effectively transported by ground ambulances. Other patients require rapid transportation, or transportation from remote areas, by helicopter or airplane.
• Facilities. The seriously ill or injured patient must be delivered in a timely manner to the closest appropriate facility.
• Communications. There must be an effective communications system, beginning with the universal system access number (911), dispatch-to-ambulance, ambulance-to ambulance, ambulance-to-hospital, and hospital-to-hospital communications.
• Public information and education. EMS personnel may participate in efforts to educate the public about their role in the system, their ability to access the system, and prevention of injuries.
• Medical direction.
Each EMS system must have a physician as a Medical Director accountable for the activities of EMS personnel within that system. The Medical Director delegates medical practice to nonphysician providers (such as EMTs) and must be involved in all aspects of the patient-care system.
• Trauma systems.
In each state, enabling legislation must exist to develop a trauma system including one or more trauma centers, triage and transfer guidelines for trauma patients, rehabilitation programs, data collection, mandatory autopsies (examination of a body to determine cause of death), and means for managing and ensuring the quality of the system.
• Evaluation. Each state must have a program for evaluating and improving the effectiveness of the EMS system, known as a quality improvement (QI) program, a quality assurance (QA) program, or total quality management (TQM).
2. Emergency Medical Technician (EMT) (previously called EMT-Basic). In most areas, the EMT is considered the minimum level of certification for ambulance personnel. EMTs provide basic-level medical and trauma care and transportation to a medical facility.
3. Advanced Emergency Medical Technician (AEMT) (previously called EMTIntermediate). The AEMT, like the EMT, provides basic-level care and transportation as well as some advanced-level care, including use of advanced airway devices, monitoring of blood glucose levels, and administration of some medications, which may include intravenous and intraosseous administration.
4. Paramedic (previously sometimes called EMT-Paramedic). The Paramedic performs all of the skills of the EMT and AEMT plus advanced-level skills. The Paramedic provides the most advanced level of prehospital care.
a series of laws, varying in each state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care.
The Health Insurance Portability and Accountability Act, a federal law protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed.
the consent it is presumed a patient or patient’s parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed.
in loco parentis
in place of a parent, indicating a person who may give consent for care of a child when the parents are not present or able to give consent.
being held legally responsible
false injurious information in written form.
regarding personal standards or principles of right and wrong.
a finding of failure to act properly in a situation in which there was a duty to act, that needed care as would reasonably be expected of the EMT was not provided, and that harm was caused to the patient as a result.
physician orders that state not only the patient’s wishes regarding resuscitation attempts but also the patient’s wishes of artificial feeding, antibiotics, and other life-sustaining care if the person is unable to state his desires later.
a law that permits a person to drop off an infant or child at a police, fire, or EMS station or to deliver the infant or child to any available public safety personnel. The intent of the law is to protect children who may otherwise be abandoned or harmed.
a set of regulations and ethical considerations that define the scope, or extent and limits, of the EMT’s job.
false injurious information stated verbally.
for an EMT providing care for a specific patient in a specific situation, the care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation.
a civil, not a criminal, offense; an action or injury caused by negligence from which a lawsuit may arise.
aka “Bird Flu”
• Adequate education and training.
• Hepatitis B vaccination.
• Personal protective equipment.
• Methods of control.
• Postexposure evaluation and follow-up.
• Caring for patients suspected of having TB. High-risk areas include correctional institutions, homeless shelters, long-term care facilities for the elderly, and drug treatment centers.
• Transporting an individual from such a setting in a closed vehicle. If possible, keep the windows of the ambulance open and set the heating and air conditioning system on the nonrecirculating cycle.
• Performing high-risk procedures such as endotracheal suctioning and intubation.
Cumulative stress reaction, or burnout, is not triggered by a single critical incident, but instead results from sustained, recurring low-level stressors—possibly in more than one aspect of one’s life—and develops over a period of years.