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INTRODUCTION TO
EMERGENCY MEDICAL
CARE

EMERGENCY MEDICAL TECHNICIAN - BASIC

 History of “Paramedics”
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 First seen during the Roman times, where

centurions during battle, removed wounded and
offered some care
 First “ambulance” during Napoleonic times
 Intermittently organized groups such as during the
plagues in 1598 and 1665
 Consistently since the American Civil War
 History of “Paramedics”
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 Jonathan Letterman, major during Civil War

(1861), created “triage”, field hospitals, and
ambulance corps
 Motorized amulances folowed World War I
 Training of “paramedics” started possibly
around 1928
 Origins of EMS
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 Accidental Death & Disability: The Neglected

Disease of Modern Society (published in 1966)
 A large number of preventable deaths
 Department of Transportation (DOT) and the
Department of Health and Human Services (DHHS)
 Through the Highway Safety Act of 1966 and the
Emergency Medical Act of 1973, created the US EMT
system
 Creating a Standard Curriculum
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 Siloam EMT will be based on the current US EMT

system with modifications as needed
 Purpose of creating a standard Siloam curriculum
 Standardization of Training
 Standardization of Competence
 Standardization of Patient Care
 Components of the
Siloam EMT System
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 Siloam EMT Advisory Council located in

corporate management
 Medical Direction: EMT Medical Advisor
 Will oversee and advise regarding EMT procedures,
protocols and training
 Off-line manuals
 Protocols
 Quality Improvement procedures
 Components of the
EMT Training
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 EMT Training
 Initial slide presentations and book reading are self-directed
learning
 Continuing Education is ongoing after certification
 Hands-on training for procedures
 BLS (and ACLS in the near future )training required
 Instructor Training
 EMT may go on to become instructors in future plans
 Components of an EMS System
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 Communications Systems
 System Communication
 Radio possibly
 Cellular Phone
 System Access
 Patients or others in need will call the EMS Siloam
telephone number (to be determined)
 The call will then be addressed and appropriate response
sent
 Components of an EMS System
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 Central Dispatch Center

 Needs to be well designed, well equipped, well staffed
& trained, with good policies & procedures
 Needs efficient and accurate response
 Needs good communication with the rest of the EMS
systems
 Components of an EMS System
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 Ambulance Service
 Well Designed
 Well Equipped
 Well Maintained
 Well Trained Staff
 Initial
 Continuing Education
 Components of an EMS System
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 Rapport with Other Healthcare Professionals

 Reports & Records
 System Evaluation
 Quality Improvement
 Protocol Review/Update
 Run Review
 Remedial or Continuing Education
 Components of an EMS System
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 Key part of disaster plans

 Major Incident Response
 Designed by EMS
 Designed to Integrate with Other Agencies

 Involved in public education and information

 Continuum of Care of Patient
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 1st Phase - Out of Hospital Care

 2nd Phase - Emergency Department Care
 3rd Phase - Definitive Care
 EMS RELATED AGENCIES
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 First Responders
 People at the scene of an accident
 Law Enforcement
 Police
 Department of Public Safety
 Federal agencies
 Fire Department
 Roles & Responsibilities
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 Safety (“do no harm”)

 Priorities
 Yourself
 Partner
 By-standers
 Patient
 Roles & Responsibilities
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 Safety (cont.)
 Safe Behaviors
 Health
 No Destructive Activities
 Rest
 Conditioning
 Do not push body past limitations (Mentally and Physically)
 Wear Personal Protective Equipment
 Survey Scene
 Look for Hazards
 Listen to Others
 Roles & Responsibilities
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 Patient Care
 Patient Assessment
 Basic Life Support
 Mechanical Aids to Breathing
 Pulse-Oximetry
 Semi-Automatic External Defibrillator
 Roles & Responsibilities
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 Patient Care (cont.)

 Hand-held Metered Dose Nebulizers
 Epinephrine Auto-injectors (Epi pens)
 Nitroglycerin
 Aspirin
 Charcoal
 Roles & Responsibilities
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 Patient Care (cont.)

 Oral Glucose
 Bandaging & Splinting / Traction Splinting
 Emergency Childbirth
 Spinal Immobilization
 Advanced Airway (Optional)
 Record-keeping
 Radio/phone communication
 EMT-Intermediate
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Roles & Responsibilities
 Patient Care - Intermediate (depending on training
of EMT and situation)
 Intermediate Patient Assessment
 Advanced Airway
 Esophageal Airways
 Endotracheal Intubation (Oral & Nasal)
 Cricothyrotomy (Needle & Surgical)
 End-tidal CO2 Monitoring
 EMT-Intermediate
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Roles & Responsibilities
 Patient Care - Intermediate (Cont.)
 Vascular Access
 Intravenous
 Intraosseus
 Gastric Tube Placement (Oral & Nasal)
 Pleural Decompression
 EKG Interpretation
 Defibrillation/Cardioversion
 EMT-Intermediate
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Roles & Responsibilities
 Patient Care - Intermediate
 Drug Therapy
 D50W
 Narcan
 Intermediate Recordkeeping
 Intermediate Radio Communication
 Roles & Responsibilities
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 Extrication & Rescue (with help of other services

such as police)
 Transport
 Transfer of Care
 Roles & Responsibilities
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 Patient Advocacy
 Maintenance
 Vehicle Maintenance
 Equipment Maintenance
 Self Maintenance
 Personal Attitude & Conduct
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 Professionalism
 Appearance
 Attitude
 Manner
 Speech
 Writing
 Knowledge & Skills
 Participation in CE (continuing education)
 Participation in QA (quality assessment) as needed
 Personal Attitude & Conduct
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 Confidence
 Compassion
 Empathy
 Leadership
 Personal Attitude & Conduct
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 Sound Judgement
 Good Moral Character
 Stability
 Adaptability
 Siloam EMT Certification
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 Requirements
 Successfully complete a Siloam approved EMT- Basic
course
 Successful completion of Siloam BLS and ACLS
course
 Successful participation and completion of the
procedures hands-on course
 Pass the Siloam certification written and hands-on
examination