College Paper-Emeregncy Medical Technicans and EMS

[n0ssb]

Back in the days of old, there was a TV program, that ran from 1972-1977 that was based in a real Los Angeles County Fire Station, with Squad 51 as the star, along with the people stars of the show, John Gage and Roy Desoto, who with their weekly exploits, showed the U.S. TV audience exactly what a Paramedic was really like. Yep a little over 40 years ago, The US department of Transportation started the Emergency Medical Technician program, which included 2 other levels, EMT-I and Paramedic. (http://.retrojunk.com/details_tvshows/456-emergency/)

Back in the original days of Emergency Medical Services just starting out, Ambulances were of an old Hearse body and very little room for an attendant in the back, we have come a long way from those days into type 1, 2, 3 Ambulances with plenty of room for multiple patients and attendant to work in.

Squad 51 was a Dodge utility style body truck that worked well for the Los Angeles County Fire Department 40 years ago and many other departments as well. But what does a EMT do or a EMT/Paramedic, They handle a variety of emergency situations that range from medical emergencies, hazardous materials exposure, childbirth, child abuse, fires, rescues, trauma and psychiatric crises.(http://.retrojunk.com/details_tvshows/456-emergency/)

What are they trained to do, many things from taking vital statistics to Intubating a patient and they do it many different surroundings and conditions from an accident on a highway to 14,000 foot mountain, top flying in a medavac helicopter to the back of an ambulance.

Back in the Washington D.C. area, someone got the great idea of creating of creating an Emergency Services office and creating Emergency Medical Technicians, who would be better trained than someone with a Red Cross first aid card. So the advent of developing a committee of medical professionals came about and they develop the training for an Emergency Medical Technicians and what they would be allowed to do. They also developed procedures for Ambulances and what should be one and what standards they needed to be built too.

So the Emergency Medical Technician was born and the states adopted the program, due to the possibility of money being attached to the creation of EMS sections within whatever agency would be in charge of training, procedures, protocols and certification of EMT’s.

Emergency Medical Technicians are required to have a High School diploma or GED and Emergency Medical Technician programs are taught under the auspices of a training center authorized by a state to conduct the training. Most Training programs are done through a community college or through a hospital based training/education center.

Training Requirements: Colorado requires 110 Hours of Training and the time is spent studying at length the following areas as well as clinical and ambulance ride-a-longs that add to the total number of hours spent taking EMT training. What is listed below is for an EMT-Basic course that would be taught at a training facility. (Colorado Dept of Health and Environment 2008) (D. Limmer, Brady Publishing 2002)

1. Intro to Emergency Care.

2. Well Being of the EMT-B.

3. Medical/Legal Issues.

4. Human Body.

5. Lifting and Moving.

6. Airway.

7. Scene Size-Up, IA, VS Sample Hx.

8. Assessment of the Trauma Patient & OA.

9. Assessment of the Medical Patient & OA.

10. Assessment Pediatric and Geriatric Patients.

11. Communication & Documentation.

12. General Pharmacology.

13. Respiratory Emergencies.

14. Cardiac Emergencies.

15. Diabetic & AMS.

16. Allergic Reaction.

17. Poisoning & OD.

18. Environmental.

19. Behavioral.

20. OBS & GYN.

21. Bleeding & Shock.

22. Soft Tissue Injuries.

24. Head and Spine.

25. Infants & Children.

26. Ambulance Operations.

27. Gaining Access & Rescue.

28. Special Operations.

29. Advanced Airway Options for EMT-Basic

EMT-I training is actually done in what they call I-85 or I-99 training and there is a difference, under I-85 training. I-85 training teaches IV training and multi-lumen airway devices (even endotracheal intubation in some states). I-99 training teaches more cardiac monitoring and administration of additional Pharmaceutical interventions. The Paramedic Programs teach a lot more Pharmacology and Cardiac Information and some areas are touched on more. More and Basic programs are also teaching IV and EKG recognition courses, allowing the Basic EMT to use three lead scopes and give IV’s and some drugs under medical control. (http://en.wikipedia.org/wiki/Emergency_medical _technician)

In Colorado this normal for a training center to also teach IV and EKG recognition just after a student EMT graduates and is awaiting his National Registry Emergency Medical Technicians Certification. In Colorado you must take the NREMT written exam, now computerized and there practical exam, to be certified as an EMT-Basic by the Colorado Department of Health and Environment.

Colorado Department of Health and Environment is the certifying agency for all the types of Emergency Medical Technician in the state, as with other states, it usually the State Public Health Department that is the certifying or licensing agency.

In Colorado, all EMT’s are under what is called Rule 500, which dictates through the Colorado Board of Medical Examiners which sets the state protocols, with the CDPHE approval and procedures of what each level of EMT can do and cannot do and what drugs can be used or not used by each level.

Each jurisdiction, like Denver, the Medical Directors can add additional things to the rule 500 basic items of procedures and equipment and drugs to be used. In Colorado if you act or serve as an EMT of any level, you must have a Medical Director, under whose license that you work. Hospital based EMT’s serve in many capacities within a hospital and are usually known as tech’s with a Hospital, the Director of Emergency Medicine there also serves as Medical Director for any EMT’s working in that hospital.

Speaking of EMT education let take a look at the US Department of Education’s/National Highway Safety Transportation Agency standard curriculum, this is no small document consisting of681 pages of documents, basically advocating the education material from what would be a basic course at most training facilities, States are allowed to pick and choose, what they want to accept from . (USDOT Emergency Medical Technician National Curriculum, 2007)

DOT in the way of policies and procedures and education requirements. Most states adopt the educational requirements including CPR, while some others may not elect to do advanced airway management for EMT Basic’s deeming that to be a skill for EMT-I or EMT Advanced as now known

This is what career requirements look like for the average Emergency Medical

Technician. responds to emergency calls to provide efficient and immediate care to the critically

Ill and injured, and transports the patient to a medical facility. After receiving the call from the

dispatcher, drives the ambulance to address or location given, using the most expeditious route,

depending on traffic and weather conditions. Observes traffic ordinances and regulations

concerning emergency vehicle operation. Upon arrival at the scene of crash or illness, parks the

ambulance in a safe location to avoid additional injury. (http://www.bls.gov/oco/ocos101.htm)

Prior to initiating patient care, the EMT-Basic will also "size-up" the scene to determine that the scene is safe, the mechanism of injury or nature of illnesses, total number of patients and to request additional helps if necessary. In the absence of law enforcement, creates a safe traffic environment, such as the placement of road flares, removal of debris, and re-direction of traffic for the protection of the injured and those assisting in the care of injured patients.

(http://www.bls.gov/oco/ocos101.htm)

Determines the nature and extent of illness or injury and establishes priority for

required emergency care. Based on assessment findings, renders emergency medical

care to adult, infant and child, medical and trauma patients. Duties include but are not

limited to, opening and maintaining an airway, ventilating patients, and

cardiopulmonary resuscitation, including use of automated external defibrillators.

(http://www.bls.gov/oco/ocos101.htm)

Provide prehospital emergency medical care of simple and multiple system trauma

such as controlling hemorrhage, treatment of shock (hypoperfusion), bandaging wounds, and immobilization of painful, swollen, deformed extremities. Medical patients

include: Assisting in childbirth, management of respiratory, cardiac, diabetic, allergic,

behavioral, and environmental emergencies, and suspected poisonings. Searches for

medical identification emblem as a clue in providing emergency care. Additional care

is provided based upon assessment of the patient and obtaining historical information.

(http://www.bls.gov/oco/ocos101.htm)

These interventions include assisting patients with prescribed medications, including

sublingual nitroglycerin, epinephrine auto-injectors and hand-held aerosol inhalers.The EMT-Basic will also be responsible for administration of oxygen, oral glucose andactivated charcoal. This what the DOT states in their EMT basic Curriculum document stand pretty close to what is needed for the educational requirements. (http://www.bls.gov/oco/ocos101.htm)

There areas additional areas for an EMT to deal with, no matter what level they reassures patients and bystanders by working in a confident, efficient manner. Avoids mishandling and undue haste while working expeditiously to accomplish the task. Where a patient must be extricated from entrapment, assesses the extent of injury and gives all possible emergency care and protection to the entrapped patient and uses the prescribed techniques and appliances for safely removing the patient. If needed, radios the dispatcher for additional help or special rescue and/or utility services. (http://www.bls.gov/oco/ocos101.htm)

Provides simple rescue service if the ambulance has not been accompanied by a specialized unit. after extrication, provides additional care in triaging the injured in accordance with standard emergency procedures. Complies with regulations on the handling of the deceased, notifies authorities, and arranges for protection of property and evidence at scene. Lifts stretcher, placing in ambulance and seeing that the patient and stretcher are secured, continues emergency medical care. (http://www.bls.gov/oco/ocos101.htm)

From the knowledge of the condition of the patient and the extent of injuries and the

relative locations and staffing of emergency hospital facilities, determines the most appropriate facility to which the patient will be transported, unless otherwise directed by medical direction. Reports directly to the emergency department or communications center the nature and extent of injuries, the number being transported, and the destination to assure prompt medical care on arrival. Identifies assessment findings this may require communications with medical direction for advice and for notificationthat special professional services and assistance be immediately available upon arrivalat the medical facility. Constantly assesses patient en route to emergency facility, administers additional care as indicated or directed by medical direction. Assists in lifting and carrying the patient out of the ambulance and into the receiving facility.

(http://www.bls.gov/oco/ocos101.htm)

Reports verbally and in writing their observation and emergency medical care of the

patient at the emergency scene and in transit to the receiving facility staff for purposes

of records and diagnostics. Upon request, provides assistance to the receiving facility

staff. After each call, restocks and replaces used linens, blankets and other supplies, cleans

all equipment following appropriate disinfecting procedures makes careful check of all

equipment so that the ambulance is ready for the next run. Maintains ambulance in

efficient operating condition. Ensures that the ambulance is clean and washed and

kept in a neat orderly condition. In accordance with local, state or federal regulations,

decontaminates the interior of the vehicle after transport of patient with contagious

infection or hazardous materials exposure. (http://www.bls.gov/oco/ocos101.htm)

Determines that vehicle is in proper mechanical condition by checking items required

by service management. Maintains familiarity with specialized equipment used by the

service .Attends continuing education and refresher training programs as required by

employers, medical direction, licensing or certifying agencies. Even with all this knowledge, Pay is still low a making as low as $8.00 per hr. to $15.00 per hr. . . . That’s pretty low money for someone that we trust to save our life in a medical emergency. If it was not for dedication to the purpose of savings lives, whether volunteer or paid, we would not have the caliber of trained professionals out there that we do now.

But what of Emergency Medical System, Well that varies by state also, actually by community within those states, the system can be small or quite huge as cities like Los Angles and New York City would have. These systems are like the EMT’s that man the ambulances within the system, either volley or paid systems, private or City run through the Hospital or Fire Department. Of course Hospitals are a big part of the Emergency Medical system, providing clinical training for EMT’s and of course definitive care.

Bibliography:

. (http://.retrojunk.com/details_tvshows/456-emergency/)

. (Colorado Dept of Health and Environment 2008)

(D. Limmer, Brady Publishing 2002)

((http://www.bls.gov/oco/ocos101.htm)

(http://en.wikipedia.org/wiki/Emergency_medical _technician)

(USDOT Emergency Medical Technician National Curriculum, 2007)

[akflightmedic]

I hope WE get an A.

I mean, I hope YOU get an A, I would never steal this for my own work.

[JPINFV]

Pro Wikipedia tip (from the person who rewrote the EMT article), don't cite it. Everything in the US section should be sourced, thus you should source the primary document (NHTSA National Standard Curriculum). There should even be a link down at the bottom of the reference section on that page.

[n0ssb]

I madea change on mine and got rid of the wikipedia cite. 8) 8) 8) 8)

[akflightmedic]

I madea change on mine and got rid of the wikipedia cite. 8) 8) 8) 8)

I will do the same..thanks for the advice and heads up!!

[Ridryder 911]

Okay, I am missing something? Is this an outline? It is full of inaccuracies, as well as not much detail for a thesis level presentation.

First, attempt not to spout exact facts unless you are assure of them. For example not all ambulances were "hearses" I would present it as they were confining and many were used as hearses as well. Nor the television show "Emergency" had much to do with the initial design of EMS, since the show was created six years after EMS was created. Now, it was instrumental in promoting EMS and without it, one can say it would never had progress as rapidly.

If this is a collegiate level paper, make sure your citations and references are from credible sources. There are plenty of credible literature search engines, as well as many generalized articles on the development of EMS, education and training requirements, etc.. Citations from such as Journal of Trauma, Emergency Medicine, JEMS , Heart & Lung, etc.. are more scientific and credible.

Also, be sure to find out what format they want the paper in APA.. etc?

Good luck!

R/r 911

[akflightmedic]

Crikey!

I will just buy one from those online sites that guarentees an A.

[Chief1C]

For example not all ambulances were "hearses" I would present it as they were confining and many were used as hearses as well.

Commercial Car Chassis. Ambulance & Hearse in one - Combination Car; Ambulance - Commercial Car; Hearse - Funeral Coach.

Also, some early ambulances weren't commercial cars at all; they were panel vans, station wagons, large commercial vans or had a "bread" or "Milk Truck" look. Like New York City, for instance, many were large vans, with more room than a hearse very early on.

Not all commercial cars were small either, some were very roomy. The stories I've heard from old school EMS folks, indicate that some of those cadillac ambulances were very large.

I gained most of this knowledge from James O. Page books, videos; and riding with a F.O.G. on hundreds of calls. An interest in the roots of EMS, per se., and you could present a very in depth look at the beginning.