Ems

IC D E M

EMERGENCY MEDICAL G R E SERVICES M

Y C N E

E

April B. Llaneta, MD, DPBECP

U H G P P-

9 1

Layman

Police Fire Brigade Security Guard Civil Defense Scouts Red Cross

Emergency Ambulance Service

E.D.

I.C.U

Ward

Rehabilitation DISASTER

Access Emergency Telephone Number

Pre-Hospital Phase

Public Health Center

Hospital Phase

HISTORICAL DEVELOPMENT

HISTORICAL DEVELOPMENT LARREY (1766-1842) ■ Napoleon’s surgeon-in-chief ■ Noted that wounded soldiers were left unattended until after the battle was over ■ Developed the 1st organized EMS system

HISTORICAL DEVELOPMENT JONATHAN LETTERMAN (1824-1872) ■ Improved military ambulance services during the American civil War ■ Organized methods for rapid transport of wounded soldiers

HISTORICAL DEVELOPMENT COMMERCIAL HOSPITAL IN CINCINNATI (University of Cincinnati Medical Center)

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Established the 1st hospital-based ambulance service in 1865

HISTORICAL DEVELOPMENT BELLEVUE HOSPITAL, NEW YORK ■

Began the 1st city ambulance service in 1869

HISTORICAL DEVELOPMENT 911 ■ Universal emergency access number ■ Connects a caller to a central communications center ■ Provides emergency medical services

HISTORICAL DEVELOPMENT Makati Rescue Pasay City rescue Chinese Fire Brigade UP-PGH EMS Quezon City Rescue Marikina Rescue 116 Cavite Rescue 161 117 Private EMS

UP-PGH ■ Training of 1st batch of EMTs in 1996 ■ Acquisition of 2 modern and equipped ambulances ■ Residency training in EM began in 1997

TERMINOLOGY Basic Life Support (BLS) ■ Provision of emergency first aid without the use of advanced therapeutic interventions ■ CPR, hemorrhage control, fracture and spine immobilization, assisting with childbirth, transportation

TERMINOLOGY Advanced Life Support (ALS) Provision of advanced emergency care ■ Advanced airway interventions, IV therapies, cardiac monitoring, certain invasive procedures ■

EMS Personnel FIRST RESPONDER ■ Personnel trained to respond to select calls to provide initial care until definitive treatment and transport services arrive ■ Usually a police officer or firefighter

EMS Personnel Emergency Medical TechnicianBasic ■ Minimum level required to staff an ambulance ■ FR skills, triage, more detailed patient assessment, transportation

EMS Personnel Emergency Medical TechnicianIntermediate ■ Allowed to establish an IV and to defibrillate ■ Limited medications and adjunctive airway devices

EMS Personnel Emergency Medical Technician-Paramedic ■ Most advanced prehospital care provider ■ Capability to address all prehospital emergencies ■ Defibrillation, endotracheal intubation, needle decompression of a tension pneumothorax, needle or surgical cricothyrotomy

EMS Personnel Emergency Medical Dispatcher ■

Responsible for recognizing a stated complaint or interrogating the caller to ascertain the primary medical condition and for providing prearrival instructions

EMS Personnel EMS Medical Director ■ A physician with specialized interest and knowledge of patient care activities in the prehospital setting ■ Implement patient care protocols, interact with all components of the system, remove a provider from practice

MEDICAL DIRECTION OF EMS SYSTEMS Indirect Medical Control ■ Medical accountability for patient care activities ■ Develop patient care guidelines and protocols for EMDs and EMTs ■ Provide CME ■ Quality assessment and improvement

MEDICAL DIRECTION OF EMS SYSTEMS Direct Medical Control ■ Real-time direction of the personnel providing prehospital patient care ■ Radio or telephone communications or direct scene observation ■ Knowledgeable about entire EMS sytem, receiving facilities, protocols, equipment, medicolegal implications

OTHER COMPONENTS Medications ■ Equipment ■ Vehicles ■ Communications ■ Access ■

SALAMAT PO!