Scene Safety Considerations

Scene Safety Considerations

Information Covered:

  1. EMS Systems
    1. Components of the EMS System
      1. Manpower --levels of EMS licensure
      2. Education/training
        1. National EMS Education Agenda for the Future: A Systems Approach
          1. National EMS Scope of Practice Model
          2. National EMS Education Standards
          3. National EMS Education Program Accreditation
          4. National EMS Certification
      3. Communications
      4. Transportation
      5. Facilities
      6. Critical care units
      7. Use of public safety agencies
      8. Consumer participation
      9. Accessibility of Care
      10. Transfer of patients
        1. Integration with other professionals and continuity of care
          1. Medical personnel
          2. Law enforcement
          3. Emergency management
          4. Home healthcare providers
          5. Other responders
      11. Standardized medical record-keeping
      12. Patients information and education
        1. Patient education
          1. Pre-incident
          2. Post-incident
        2. Public education
          1. Role modeling
          2. Community involvement
          3. Leader activities
          4. Community activities
          5. Prevention activities
      13. Independent review and evaluation
      14. Disaster linkage
      15. Mutual aid agreements
    2. Chain of survival
      1. Bystander care
      2. Dispatch
      3. Response
      4. Prehospital care
      5. Transportation
      6. Emergency department care
      7. Definitive care
      8. Rehabilitation
    3. Service Types
      1. Fire-based
      2. Third service
      3. Private (for profit and nonprofit)
      4. Hospital-based
      5. Hybrid/other
    4. Trauma Systems
    5. Medical Direction
      1. Role of the EMS physician in providing medical direction
        1. Education and training of personnel
        2. Participation in personnel selection process
        3. Participation in equipment selection
        4. Development of clinical protocols
        5. Participate in quality improvement and problem resolution
        6. Provides direct input into patient care
        7. Interface between EMS providers and other health care agencies
        8. Advocacy within the medical community
        9. Serve as the “medical conscience” of the EMS system (Advocate for quality patient care)
      2. Types of medical direction
        1. On-line/direct
        2. Off-line/indirect
      3. Benefits of medical direction
        1. On-line
        2. Off-line
          1. Prospective
          2. Retrospective
  2. Roles/Responsibilities/Professionalism of EMS Personnel
    1. Roles and Responsibilities
    2. Leadership/Affective Characteristics
      1. Attributes of professional
        1. Integrity
        2. Empathy
        3. Self–motivation
        4. Appearance and personal hygiene
      2. Confidence in skills and ability
      3. Communication
        1. Verbal
        2. Written
      4. Time management
      5. Teamwork and diplomacy
      6. Respect for patients, coworkers and other health care professionals
      7. Patient advocacy
      8. Careful delivery of service
    3. Administration
      1. Record keeping and reporting
      2. Special project coordination and implementation
      3. Station duties
      4. Interagency relationships/partnerships
    4. Credentialing
      1. Licensure
      2. Certification
      3. National registration
      4. Reciprocity
        1. Maintenance of certification and licensure
          1. Personal responsibility
          2. Continuing education
          3. Skill competency verification
          4. Criminal implications
          5. Fees
    5. Less Traditional Roles
      1. Expanded scope of practice
      2. Paramedics in Other Settings
    6. Operational Responsibilities
      1. Preparation
      2. Response
      3. Scene assessment
      4. Patient assessment
      5. Management
        1. Following protocols
        2. Interacting with medical direction physician, as needed
      6. Appropriate disposition
        1. Disposition issues
          1. ED transport
          2. Alternative destinations
          3. Ground
          4. Air
          5. Selection of the proper receiving facility
          6. Requires knowledge of the receiving facilities
          7. Hospital designation/categorization
          8. Based on hospital resource capabilities
          9. Clinical capabilities and specialty availability
          10. Transfer agreements
          11. Payers and insurance systems
        2. Non-Transport
          1. Against medical advice
          2. No assistance needed
          3. Transfer to other EMS
          4. Medical examiner investigations
      7. Transfer of care
      8. Documentation
      9. Returning to service
    7. Education
      1. Education principles & practices
        1. National EMS Scope of Practice Model
        2. National EMS Education Standards
      2. Paramedic education/accreditation
        1. National EMS Program Accreditation
        2. State accreditation
      3. Patient education
        1. Pre-incident
        2. Post-incident
      4. Public education
        1. Role modeling
        2. Community involvement
        3. Leader activities
        4. Community activities
        5. Prevention activities
      5. Episodic/non-acute care activities
        1. Patient home assistance
        2. Social assistance
        3. Home health care assistance
    8. Professionalism
      1. Profession
      2. Specialized body of knowledge or expertise
        1. Self-regulating
        2. Maintains standards
      3. Professionals
        1. Education
        2. Follow standards of conduct and performance
        3. Adhere to code of ethics
      4. Health care professional
        1. Conforms to the standards of health care professions
        2. Provides quality patient care
        3. Instills pride in the profession
        4. Strives for high standards
        5. Earns respect of others
        6. High societal expectations while on and off duty
        7. EMS personnel occupy positions of public trust
        8. Unprofessional conduct
        9. Commitment to excellence
        10. Image and behavior
  1. Paramedics represent a variety of people
    1. Self
    2. EMS agency
    3. State/county/ district EMS offices
    4. Peers
    5. Affective characteristics
      1. Integrity
      2. Empathy
      3. Self-motivation
      4. Appearance and hygiene
      5. Self-confidence
      6. Time management
      7. Communication
        1. Verbal
        2. Written
      8. Teamwork and diplomacy
      9. Respect for patients, coworkers and other healthcare professionals
      10. Patient advocacy
      11. Careful delivery of service
  1. Quality Improvement
    1. System for continually evaluating and improving care
    2. Continuous quality improvement (CQI)
    3. Dynamic process
  2. Patient Safety
    1. Significant-one of the most urgent health care challenges
    2. Incidence-IoM report “To Err is Human” up to 98,000 patients die due to medical errors
    3. High risk activities
      1. Hand off
      2. Communication issues
      3. medication issues
      4. airway issues
      5. dropping patients
      6. ambulance crashes
      7. spinal immobilization
    4. How errors happen
      1. skills-based failure
      2. rules-based failure
      3. knowledge-based failure
    5. Preventing Errors
      1. Environmental
        1. Clear protocols
        2. Light
        3. Minimal interruptions
        4. Organization and packaging of drugs
      2. Individual
        1. Reflection in action
        2. Constantly question assumptions
        3. Reflection bias
        4. Use decision aids
        5. Ask for help

 

Content Creator: Chris Hunt

CAPCE Course Number: 16-EMTP-F3-4303

Total CE Hours: 1.75

Level: Basic

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.