NREMT Basic Final Exam Study Guide

EMS Systems Most states have four training and licensure levels: -EMR (Emergency Medical Responders) -EMT (Emergency Medical Technicians) -AEMT (Advanced EMT) -has training in ALS (advanced life support) including: -IV therapy (Intravenous) -administration of certain emergency medications -Paramedic History of EMS: -Origins include: volunteer ambulances in WW1, field care in WW2, field medic and rapid helicopter evacuation in Korean conflict -EMS as we know it originated in 1966 with the publication of Accidental Death and Disability: The Neglected Disease of Modern Society -DOT (Department of Transportation) published first EMT training curriculum in early 1970s -EMS care is governed and part of the Department of Transportation -National Highway Traffic Safety Administration (NHTSA) ) EMS Types: -Anglo-American model (ours) -brings patient to the hospital -Franco-German model (Europe) -brings the hospital to the patient Levels of training: -Federal level: National EMS Scope of Practice Model provides guidelines for EMS skills -State level: Laws regulate EMS provider operations -Local level: Medical director decides day-to-day limits of EMS personnel -every 3 years resubmit for recertification (40 hours of continuing educ. required) Public BLS (basic life support): -millions of laypeople are trained in BLS/CPR -teachers, coaches. child care providers Emergency Medical Responders (EMR): -law enforcement, firefighters, park rangers, ski patrol, etc. -initiate immediate care and assist EMT’s on their arrival -good samaritans trained in first aid and CPR Emergency Medical Technicians (EMT): -has knowledge and skills to provide basic emergency care -responsibility for assessment -emergency care -package and transport of patient Advanced Emergency Medical Technicians (AEMT): -adds knowledge and skills in specific aspects of ALS -IV therapy -advanced airway adjuncts -medication administration Paramedics: -extensive course training -wide range of ALS skills -endotracheal intubation -emergency pharmacology -cardiac monitoring; use of electrocardiogram (EKG) ) Medical Direction: -physician medical director authorizes EMTs to provide medical care in field -appropriate care is described in standing orders and protocols -medical control can be off-line or online -Online (direct) -directions given over phone or radio -Offline (indirect) -standing orders or protocols Evaluation: -medical director maintains quality control -continuous quality improvement (CQI) -reviews and audits EMS system -refresher training or continuing education -minimizing errors is the goal