Introduction to Ems Systems

by Walz,Bruce J

• ISBN13: 9780766819849
• ISBN10: 0766819841
• Format: Paperback
• Copyright: 2001-08-01
• Publisher: CENGAGE Delmar Learning

Summary

Any student enrolled in a collegiate EMS course will benefit from this broad, contemporary overview of EMS with its real-world focus on the field provider. Readers will appreciate the case studies that introduce chapter topics, as well as the learning objectives, glossary of terms, and study questions that make learning easier. The material offers a national perspective and follows the fourteen attributes of a modern EMS system identified in the EMS Agenda for the Future. Whether you're studying to become an EMS provider or need a general EMS reference tool for your medical library, this book will meet your needs. Key features: *Focuses on pre-hospital delivery of EMS *Presents material in an historical perspective *Offers a national perspective on EMS *Follows the fourteen attributes of an EMS system presented in EMS Agenda for the Future *Provides perspective for the future (EMS, EMS Systems, history, Agenda for the Future, reference)

Table of Contents

Preface	xv
About This Book	xv
How To Use This Book	xvi
About the Author	xvi
Acknowledgements	xvii
Contributors	xviii
Reviewers	xix
Foreword	xxi
Introduction to Emergency Medical Systems	1	(14)
The Emergency Medical Services System	4	(4)
Components of an EMS System	5	(1)
Communications	6	(1)
Manpower	6	(1)
Training of Personnel	6	(1)
Use of Public Safety Agencies	6	(1)
Transportation	6	(1)
Mutual Aid Agreements	6	(1)
Facilities	6	(1)
Accessibility of Care	6	(1)
Critical Care Units	6	(1)
Transfer of Patients	7	(1)
Standard Medical Record Keeping	7	(1)
Independent Review and Evaluation	7	(1)
Consumer Information and Education	7	(1)
Consumer Participation	7	(1)
Disaster Linkage	7	(1)
Revision of the 15 Components	7	(1)
Medical Direction	7	(1)
System Finance	7	(1)
Regulation and Policy	8	(1)
Trauma Systems	8	(1)
EMS Agenda for the Future	8	(3)
The 14 Attributes of an EMS System	8	(1)
Integration of Health Services	9	(1)
EMS Research	9	(1)
Legislation and Regulation	9	(1)
System Finance	9	(1)
Human Resources	9	(1)
Medical Direction	9	(1)
Education Systems	10	(1)
Public Education	10	(1)
Prevention	10	(1)
Public Access	10	(1)
Communication Systems	10	(1)
Clinical Care	10	(1)
Information Systems	10	(1)
Evaluation	11	(1)
Critical Patient Areas	11	(1)
EMS Lead Agency	11	(4)
History of Emergency Medical Systems	15	(26)
History of Emergency Medical Systems	16	(1)
Preindustrial Era 1616 --- 1850	16	(5)
Resuscitation	19	(1)
Anesthesia	20	(1)
Transportation	20	(1)
Industrial Era 1850 --- 1970	21	(7)
Causes of Death	22	(1)
First Aid Training	22	(1)
Resuscitator Calls	23	(1)
Motor Vehicle Injuries	23	(1)
Transportation	24	(1)
Military	25	(1)
Cardiac Care	25	(1)
Government Involvement	26	(1)
EMS Development	27	(1)
Modern Era (1970 --- Present)	28	(13)
1970s	28	(4)
1980s	32	(1)
1990s	33	(1)
Twenty-First Century	34	(1)
Other Developments	35	(6)
Legislation and Regulation	41	(16)
Overview of Legislation and Regulation	42	(2)
The Federal Role	44	(6)
Legislation	45	(1)
Funding	46	(2)
COBRA Statute	48	(1)
Federal Regulations	48	(2)
Federal Lead Agency	50	(1)
The State Role	50	(7)
Components of a State Lead Agency	52	(1)
State Legislation	53	(4)
Human Resources	57	(22)
Historical Background	59	(1)
Prehospital Providers	60	(5)
First Responder	60	(1)
Emergency Medical Technician --- Basic	61	(1)
Emergency Medical Technician --- Intermediate	61	(1)
Emergency Medical Technician --- Paramedic	62	(1)
Specialized Prehospital Providers	62	(1)
Flight Paramedics and Nurses	62	(3)
Critical Care Transport Specialists	65	(1)
Wilderness EMT	65	(1)
Specialized Response Providers	65	(1)
Hospital - Based Providers	65	(3)
Nurses	66	(1)
Physicians	66	(1)
Allied Health Professionals	67	(1)
Other Providers	68	(1)
Telecommunicators	68	(1)
Emergency Medical Dispatcher	68	(1)
Firefighters	68	(1)
Police Officers	69	(1)
Sources of Providers	69	(2)
Volunteer Providers	69	(1)
Career Providers	70	(1)
Organized Labor in EMS	71	(1)
Provider Stress	72	(7)
Critical Incident Stress Management	73	(6)
Transportation	79	(20)
The Transportation Attribute	80	(6)
Service Providers	80	(1)
Fire Service	81	(1)
Commercial Service	81	(2)
Third Service	83	(1)
Public Safety Agency	83	(1)
Hospital Based	84	(1)
First Responder	85	(1)
Ambulance Trust	85	(1)
Public Utility Model	86	(1)
Integrated	86	(1)
Delivery Systems	86	(3)
Fixed - Post Staffing	86	(1)
Event - Driven Staffing	87	(2)
ALS Intercept	89	(1)
Staffing Configuration	89	(2)
BLS Staffing	89	(1)
ALS Staffing	90	(1)
Mobile Health Care	91	(1)
EMS Vehicles	91	(4)
Type I	92	(1)
Type II	92	(1)
Type III	93	(1)
Medium Duty	94	(1)
Air Medical Transport	95	(1)
Ambulance Equipment	95	(4)
Basic Level Provider Essential Equipment	96	(1)
Advanced Level Provider Essential Equipment	96	(3)
Medical Oversight	99	(14)
Historical Background	100	(2)
Models of Medical Oversight	102	(7)
Indirect Medical Oversight	103	(1)
System Design	103	(1)
Protocols	103	(1)
Education	104	(3)
Quality Systems	107	(1)
Direct Medical Oversight	108	(1)
Regulation and Legislation	109	(4)
Educational Systems	113	(24)
Historical Background	114	(1)
Controversies in EMS Education	115	(1)
National Standard Curriculum	116	(1)
The National EMS Education and Practice Blueprint	117	(1)
EMS Education Agenda for the Future	118	(2)
National EMS Core Content	118	(1)
National EMS Scope of Practice Model	119	(1)
National EMS Education Standards	119	(1)
National EMS Education Program Accreditation	119	(1)
National EMS Certification	119	(1)
The National Registry of EMTs	120	(1)
CoAEMSP	120	(1)
Settings for EMS Education	121	(4)
Hospitals	121	(1)
Fire Departments	122	(1)
Technical Centers	123	(1)
Community Colleges	123	(1)
Colleges and Universities	123	(1)
Military	124	(1)
Provider Courses	125	(4)
First Responder	125	(1)
Emergency Medical Technician --- Basic	126	(1)
Emergency Medical Technician --- Intermediate	127	(1)
Emergency Medical Technician --- Paramedic	128	(1)
Specialized Courses	129	(1)
Continuing Education and Refresher Training	129	(3)
Technology in Education	132	(1)
Asynchronous Learning	132	(5)
Public Education	137	(10)
Public Education	138	(1)
Forms of Public Education	138	(1)
Public Information	139	(1)
Public Education	139	(1)
Public Relations	139	(1)
Benefits of Public Education	139	(1)
Public Education Process	139	(8)
Public Service Announcements	141	(3)
Public Education and Technology	144	(3)
Prevention	147	(16)
Injury Process	148	(1)
The Injury Event	148	(2)
Injury Types	150	(3)
Falls	150	(1)
Drowning	151	(1)
Poisonings	151	(1)
Violence	152	(1)
Motor Vehicles	152	(1)
Bicycles	152	(1)
Injury Prevention Concepts	153	(2)
Interventions	154	(1)
Surveillance	155	(1)
EMS and Injury Prevention	155	(8)
Developing an Injury Prevention Program	158	(5)
Public Access	163	(14)
Public Access	164	(4)
911	165	(2)
911 Operation	167	(1)
Public Safety Answering Point (PSAP)	168	(1)
Call Processing	168	(4)
Call Taking	168	(1)
Dispatch Center	169	(1)
Dispatch Life Support	170	(1)
Emergency Medical Dispatch	171	(1)
Priority Dispatching	171	(1)
Prearrival Instructions	171	(1)
Nonemergency Access Numbers	172	(1)
Pathways Management	172	(2)
Public Education	174	(3)
Communications	177	(14)
Communications	179	(3)
Role of Communications	180	(1)
Occurrence	180	(1)
Detection	181	(1)
Notification	181	(1)
Dispatch	181	(1)
Prearrival Instructions	181	(1)
Response	181	(1)
Scene Communications	181	(1)
Medical Communications	181	(1)
Transport	181	(1)
Hospital Arrival	182	(1)
Return to Service	182	(1)
Role of the Dispatcher	182	(1)
Dispatcher Training	183	(1)
Systems Communications Technology	183	(5)
Systems Communications	183	(3)
Medical Communications	186	(1)
Cellular Communications	187	(1)
Telemedicine	188	(3)
Disasters	191	(24)
Disasters	193	(1)
What is a Disaster?	194	(3)
Natural Disasters	195	(1)
Technological Disasters	196	(1)
Disaster Management	197	(7)
Mitigation	198	(1)
EMS Role	198	(1)
Preparedness	199	(1)
EMS Role	199	(2)
Response	201	(1)
EMS Role	201	(1)
Recovery	202	(1)
EMS Role	203	(1)
Hazards	204	(2)
Hazard Analysis	205	(1)
Incident Command System	206	(4)
Federal Role in Disasters	210	(5)
Presidential Declaration of a Disaster	210	(5)
Clinical Care	215	(20)
Clinical Care	217	(7)
History of Emergency Medicine	218	(1)
Scope of Emergency Medicine	219	(1)
The Emergency Department	219	(4)
Freestanding EDs	223	(1)
Categorization and Designation	224	(1)
Trauma Care	225	(4)
Trauma Care System	225	(1)
The Trauma Center	226	(1)
Specialty Referral Centers	227	(1)
Trauma Registry	228	(1)
COBRA Legislation	229	(1)
Critical Care Transport	230	(1)
Expanded Scope of Practice	231	(1)
The Future	232	(3)
Information Systems	235	(14)
Information Systems	236	(1)
Strategic Information Planning	236	(2)
Information System Integration	238	(1)
Information System Design Considerations	239	(2)
Data Formats	241	(1)
Data Collection Tools	241	(2)
Paper Forms	242	(1)
Stationary Computer Workstations	242	(1)
Field Computers	243	(1)
Data Collection	243	(1)
Data Validation	244	(1)
Data Transfer, Storage, and Analysis	244	(1)
Data Usage	245	(4)
System Finances	249	(12)
System Finance	250	(1)
System Organizations	251	(1)
For-Profit Companies	251	(1)
Government Services	251	(1)
Not-for-Profit Companies	252	(1)
Sources of Funds	252	(4)
For-Profit Companies	252	(2)
Government Services	254	(1)
Not-for-Profit Companies	254	(2)
Accounting and Budgeting	256	(2)
For-Profit Company	256	(1)
Government Services	257	(1)
Not-for-Profit Companies	257	(1)
Issues and Tension	258	(3)
Evaluation	261	(14)
Quality and Performance Evaluation	262	(1)
Quality, Cost, and Performance	262	(1)
Measuring Overall Performance	263	(1)
High Performance EMS Systems	264	(5)
Leadership System	265	(1)
Strategic Planning	266	(1)
Information and Analysis	267	(2)
Process Assurance and Improvement	269	(2)
Scope of Performance Improvement Efforts	271	(4)
Research	275	(16)
What is Research?	276	(1)
Why do Research?	276	(2)
Improve Patient Care	277	(1)
Improve the System	277	(1)
Reduce Hazards	277	(1)
Provide Legal Protection	277	(1)
Improve the Profession	278	(1)
Introduction to the Scientific Method	278	(1)
Statistics	278	(1)
Research Design	279	(3)
Observational Studies	280	(1)
Interventional Studies	280	(1)
Double-Blind, Randomized Control Study	280	(1)
Quasi-Experiment	281	(1)
The Research Study	282	(5)
Identify the Problem or Question	282	(1)
Review the Literature	282	(1)
Formulate a Hypothesis	283	(1)
Define Your Team	283	(1)
Design the Study	284	(1)
Controlling for Bias	285	(1)
Sample Size	285	(1)
Perform the Study	286	(1)
Analyze the Data	286	(1)
Use the Information	286	(1)
Share the Findings	286	(1)
Future Challenges	287	(4)
Appendix A: EMS Systems Act of 1973	291	(13)
Appendix B: Resource List	304	(3)
Appendix C: Physician Medical Direction in EMS	307	(18)
Appendix D: Creating an Injury Prevention Program	325	(10)
Glossary	335	(16)
Index	351