Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition1.1

Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition
CHAPTER 1 Introduction to Emergency Medical Care KEY TERMS Direct medical direction:
Medical direction in which physician speaks directly with EMTs in the field; also referred to as online medical direction.
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Emergency medical dispatcher:

An EMS dispatcher who has received special education for giving medical care instructions to patients and others over the phone before EMTs arrive.
Emergency Medical Services (EMS) System:

A system of many agencies, personnel, and institutions involved in planning, providing, and monitoring emergency care.
Emergency Medical Technician (EMT):

The generic term for a prehospital emergency care provider educated at least to the EMT-Basic level.
EMT-Basic:
A basic prehospital life support provider trained to the NHTSA guidelines for EMT-Basic.
EMT-Intermediate:
An EMT with additional education in one or more advanced techniques such as vascular access and intubation.
EMT-Paramedic:
An EMT with additional education to the level of full advanced life support.
First Responder:
An individual employed in a position that includes providing initial medical assistance in an emergency.
CHAPTER 1 Introduction to Emergency Medical Care
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition Indirect medical direction:
Any direction provided by physicians that is not direct, including system design, protocol development, education, and quality improvement; also referred to as offline medical direction.
Medical direction:
The process (usually by a physician) of ensuring that the care EMTs provide is medically appropriate; also called medical oversight.
National EMS Education and Practice Blueprint:

A consensus document that establishes a core content for the scope of practice for the four levels of prehospital care providers.
Quality improvement:
A system for continually evaluating and improving the care provided within an EMS system.
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IN THE FIELD
Marco and Brittany had just completed the morning truck check. As they were sitting down to a glass of orange juice and the review of the outgoing shifts calls, the EMS supervisor, Walt, arrived at their station. Along with him was Juan, a local high-school student. Juan was interested in taking an EMT-Basic course and working as an EMS provider. Marco explained the training requirements. He told Juan that it was challenging, but rewarding. He told him without the knowledge and skills he learned in the EMT course, he could not function as well as he did in this environment. Brittany talked about the personal satisfaction she gained from helping others. She described the camaraderie of her co-workers and displayed her pride in the profession. She encouraged Juan to enroll in the course and offered him the opportunity to complete ride-along shifts with her and Marco while he attended class. As Walt and Juan left the station, Marco and Brittany returned to their chart review, confident that they had helped guide Juan's career and proud of their service and the EMS system. Welcome to the rewarding and exciting field of Emergency Medical Services! This chapter marks the beginning of your educational process for becoming an Emergency Medical Technician (EMT). EMTBasics who care for ill or injured patients before they reach the hospital require a solid foundationa road map for
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learning. This chapter outlines the job roles and responsibilities to help you learn what you need to know to become an EMTBasic. This chapter also describes the Emergency Medical Services (EMS) system and the role of EMTBasics within this system. This is a system of professionals who provide emergency medical care, beginning when someone initially realizes an injured or ill person requires emergency care, through the patient's admission to the hospital (Fig. 1-1).
THE EMERGENCY MEDICAL SERVICES SYSTEM

You are about to embark on a great journey that will affect not only your life but also the lives of many others. You will learn to help patients who are strangers, neighbors, friends, and even loved ones. The average person requires the assistance of emergency personnel every 7 years. Clearly, this is an important job. Working or volunteering as an EMTBasic is both a demanding and rewarding career. Few other professions have such an impact on people's daily lives. Everyone has a different reason for becoming involved in the EMS system. Some students have experienced the loss of a friend or family member following illness or after a medical emergency and want to prevent others from experiencing the same loss. Others become involved because of television dramas that depict EMS as an exciting, challenging, and fulfilling profession. Some people take the EMTBasic program without planning to work as an EMTBasic but instead use the education to move toward another health care position such as a nurse, physician's assistant, or physician. Whatever your reason is, welcome to the ranks of one of the most rewarding professions in the world. Every day, people's lives are touched by EMTs. From an elderly patient who must reach the doctor's office for an appointment, to a child with a life-threatening airway emergency, all of the patients you will encounter have one thing in commonthey need help. They require the assistance of a competent, qualified, and caring individual. They need you, the EMTBasic. The following sections will help you better understand the role of the EMT-Basic in the EMS system, beginning with the national agency that sets standards for EMS and the education of EMS providers.
THE NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION TECHNICAL ASSISTANCE PROGRAM

The goal of the Department of Transportation (DOT) and the National Highway Traffic Safety Administration (NHTSA) is to reduce the death and disability caused by motor vehicle collisions on the nation's highways. NHTSA has therefore developed a number of programs and initiatives including the National Standard Curricula and Technical Assistance Programs to guide EMS systems everywhere in the provision of quality care.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition Fig. 1-1 The EMS system encompasses emergency recognition, system access, EMS personnel dispatch and response, care provided to the patient as the scene, medical direction when necessary, and patient stabilization, transportation, and delivery to the hospital.
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NHTSA has developed standards in 10 areas to assess and benchmark EMS systems (Fig. 1-2). Regulation and policy Resource management Human resources and training Transportation Facilities Communications Public information and education Medical direction Trauma systems Evaluation
These aspects of the system are described below to help you better understand the overall system in which you will be working as an EMTBasic. Regulation and policy standards ensure that all states have a lead EMS agency, funding, regulations, and operational policies and procedures. State legislatures must pass laws that promote quality EMS care and provide adequate funding. States finance their EMS systems in various ways, but all need to have funds to provide high-quality, effective EMS care. As you train for your profession and begin working as an EMT Basic, you will become familiar with state and local rules and regulations, policies, and procedures.
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Fig. 1-2 The National Highway Traffic Safety Administration's 10 standards for EMS systems.
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Resource management standards coordinate resources throughout the state. These standards allow everyone access to basic emergency medical care, including treatment by personnel trained primarily at the EMT Basic level, and allow all patients to be transported in a well-equipped vehicle to a staffed, equipped, and prepared receiving facility. Human resources and training standards require all states to have initial educational programs for EMTBasics and other higher levels of EMS personnel, as well as continuing education. Transportation standards describe safe and effective transportation for all patients. Ambulances and air medical units must meet minimum criteria and be inspected periodically. All aspects of the state EMS system must be in a constant mode of readiness. The facilities standard ensures that patients are transported to the closest appropriate facility. Prehospital care providers such as EMTs must understand the different hospitals' capabilities and local policies for specific emergency situations. This includes specialty facilities, such as trauma and burn centers, or children's hospitals. Communications standards ensure that patients can call for emergency care and that emergency personnel communicate effectively with the receiving hospital and other EMS personnel. Public information and education guidelines promote the public's involvement in the EMS system and injury prevention programs. EMTs often provide the public with information about system procedures and injury prevention. This education improves the system and helps patients receive quality care. In the EMS system, direct patient care is delegated to four levels of providers: First Responders and three levels of EMTsEMTBasics, EMTIntermediates, and EMTParamedics. Medical direction standards help ensure that physicians stay involved in the patient care system by developing protocols or patient care guidelines, by providing medical direction and consultation, and by evaluating patient care activities and quality improvement. Across the United States, there are many state-wide trauma care systems, including designated trauma centers, trauma triage guidelines, data collection, trauma registry definitions, system management, and quality assurance. Trauma is a severe wound or injury. Trauma patients require specialized care, provided through the state's trauma system. The final standard involves evaluation of the effectiveness of patient care, including the care provided by EMTBasics. In this way, the EMS system can continue to improve the quality of patient care delivered.
ACCESS TO THE EMERGENCY MEDICAL SERVICES SYSTEM

The manner in which the public contacts the EMS system is extremely important. In most areas of the United States, 911 is the universal access number to police, fire, and EMS (Fig. 1-3). However, some areas of the country do not have this capability and must dial a seven- or ten-digit number to access the EMS system.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition Fig. 1-3 In many areas of the United States, 911 is the universal number for access to police, fire, and EMS.
Regardless of the phone number used, EMTs should educate the public on proper access to the system. Public information campaigns, such as Make the Right Call, teach the public the proper local access number and when to call for an ambulance. EMTs at all levels should be active in these and other public service campaigns.
LEVELS OF EDUCATION
The National EMS Education and Practice Blueprint sets the standards for the education of prehospital emergency care providers. As mentioned earlier, the four established levels are: First Responder EMTBasic EMTIntermediate
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EMTParamedic The EMS system currently lists these four levels for certification or licensure, although not all states use every level. States can also augment the levels with additional care levels. Each recognized level has its own scope of practice. The First Responder course is for individuals who are likely to encounter an ill or injured person but are not trained for ambulance service. The focus at this level is to provide initial stabilization until additional EMS resources arrive. Many police officers and firefighters are trained at this level. The EMTBasic course prepares personnel to provide primary medical care before the patient reaches the hospital. Most states require the EMT-Basic as the minimum accepted education level for ambulance staff. The EMTIntermediate level is an advanced EMT level that includes all skills of an EMT-Basic. In addition, the EMT-Intermediate is taught advanced skills such as manual defibrillation and administration of intravenous fluids and some medications. The EMTParamedic, currently the highest skill level, includes all of the skills of an EMT-Basic and EMT-Intermediate. The training and education also includes more advanced techniques such as tracheal intubation and administration of additional medications, along with additional knowledge of the human body. While requirements and skill levels vary from state to state, a national agency, the National Registry of EMTs, prepares and conducts examinations designed to test the competency at the First Responder and all three EMT levels. State regulations and local medical directors determine the specific procedures at all levels. Check with your instructor regarding the certification process in your state.
THE HEALTHCARE SYSTEM

The EMS system is a part of the overall healthcare system in the United States. This healthcare system has many components. Most important to EMTBasics are the prehospital setting and the hospital, although many other aspects are involved. First Responders, EMTBasics, EMTIntermediates, and EMTParamedics are the primary emergency medical care providers outside of the hospital. The process begins when someone recognizes the patient's illness or injury and calls the EMS system through the local access number. First Responders such as firefighters or lifeguards may already be at the scene and provide initial care until more qualified EMTs arrive. Also involved are professional dispatchers who not only forward the emergency call to the EMS unit, but who may also give care instructions before the EMS unit arrives. In many systems, emergency medical dispatchers have received education for providing medical care instructions over the phone before the EMTs arrive. The next step in the healthcare system is the hospital. This typically begins with the arrival to the emergency department, although some states permit EMTs to transport a patient directly to a physician's office or clinic. Healthcare workers in the emergency department include physicians, nurses, nursing
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assistants, nurse practitioners, and physician assistants. Many people perform support services, lab work, electrocardiograms, x-rays, and other services including clerical, communications, and housekeeping support. Like you, the EMT-Basic, each person has an important role in providing patient care or supporting that effort. Without this team of providers and support staff, the system would be ineffective.
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Some patients require the attention of a specialty care center. EMTs transport these patients to centers such as trauma facilities, burn centers, pediatric or children's hospitals. Additionally, with the advances in healthcare, many areas now have access to chest pain and stroke centers. These specialty centers vary in different regions. Knowledge of the specialty centers in your area is important, including the local protocol for transporting patients to one of these facilities. Your service area may have additional specialty centers.
LIAISON WITH OTHER PUBLIC SAFETY WORKERS

Most of the EMTBasic's responsibilities involve patient care. EMTs also interact with other public safety workers including local, state, and possibly federal law enforcement. A strong working relationship with law enforcement personnel ensures the safety of EMTs, patients, and bystanders (Fig. 1-4). Depending on the system and local policies, some EMTs may interact with law enforcement on every prehospital call, whereas others work with law enforcement only at automobile crashes, crime scenes, and hazardous materials scenes. In some systems, law enforcement officers are trained to the First Responder skill level or higher and routinely arrive on the scene to provide care until other emergency personnel arrive. EMTBasics may also work with the local fire department. Many communities organize EMS activities as a branch of the fire department, using firefighters or EMTBasics to work on both fire apparatuses and ambulances. In some areas, EMTBasics may also interact with the fire department by using their resources for first response to medical emergencies and traumatic injuries, vehicle rescue, special rescue situations, and hazardous materials situations. A strong professional relationship between EMTs and other public safety agencies is important, because this guarantees smooth operation and successful delivery of quality public safety. As an EMT-Basic, you may interact with other agencies regularly.
Fig. 1-4 EMTs often interact with other public safety workers, including law enforcement officials.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition REVIEW QUESTIONS THE EMERGENCY MEDICAL SERVICES SYSTEM
1. What federal agency has developed standards for training and development of the EMS system? a. The National Highway Traffic Safety Administration b. The Department of Homeland Security c. The Department of Public Health d. The National Institutes of Health 2. Currently, the National EMS Education and Practice Blueprint and the National Registry of EMTs recognize how many levels of EMS providers? 3. List the levels of recognition/certification.
THE EMERGENCY MEDICAL TECHNICIANBASIC ROLES AND RESPONSIBILITIES

The roles and responsibilities of EMTBasics are continually evolving. Job descriptions established by each service define specific requirements. EMTBasics must understand these roles and responsibilities to be competent, professional members of the healthcare team (Box 1-1).
Personal Safety BOX 1-1 Roles and Responsibilities of the EMTBasic

Personal safety Safety of the crew, patient, and bystanders Patient assessment Patient care based on assessment findings Lifting and moving patients safely Transport and transfer of care Record keeping and data collection Patient advocacy (patient rights)
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As an EMTBasic, you have a primary responsibility for your own safety. This role is discussed in depth in Chapter 2. Ensuring personal safety includes maintaining a healthy body, remaining physically fit, and using body substance isolation precautions appropriately. Personal safety also includes surveying the emergency scene for hazards or potential hazards before entering. Chapter 9 describes the appropriate measures to be taken in this important procedure.
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Safety of the Crew, Patient, and Bystanders

EMTs are also responsible for the safety of fellow crew members, patients, and bystanders. Looking out for the well-being of your partners is extremely important. This includes maintaining scene safety and coping with stress, as you will learn in the next chapter. You also must ensure the safety of patients. You are responsible for providing the best possible care for patients, while carrying out safety precautions that will prevent further injury to them from hazards at the scene. You must also consider the safety of bystanders. By securing a safe scene and communicating effectively with bystanders, you protect everyone's safety.
Patient Assessment and Care

Patient assessment is a primary responsibility (Fig. 1-5). EMTs assess the patient's needs and provide basic medical care established by that assessment. Chapter 10 Chapter 11 Chapter 12 Chapter 13 through Chapter 14 describe how to assess a patient. As an EMT, you should practice and master these skills. Without an accurate assessment, you may provide inadequate or inappropriate care to your patient. The emergency care you provide is based on assessment findings. This approach allows for rapid management of life-threatening injuries and illnesses and relieves the patient's discomfort quickly.
Lifting and Moving Patients

When the patient has been evaluated and treatment initiated, EMTs then prepare the patient for transport. Therefore, you must be able to lift and move patients safely. You must be sure the environment is safe for lifting, for example, by moving debris off of a sidewalk before moving a patient over it. You also must use safe lifting and moving techniques as described in Chapter 6.
Fig. 1-5 EMTs assess patients to determine the need for care.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition Transport and Transfer of Care
When en route to the receiving facility, or when awaiting a transport unit, EMTs continue to provide care based on ongoing patient assessment. An orderly transfer of patient care should be maintained, whether transporting to the receiving facility or another unit. This involves medical/legal issues such as preserving patient confidentiality and preventing abandonment (see Chapter 3). Chapter 15 and Chapter 16 describe important issues involved in the transfer of care and information such as record keeping and data collection. Both are important roles of EMTBasics (Fig. 1-6).
Patient Advocacy
Another role of EMTs is that of the patient advocate. You must support the patient's legal rights, privacy, and human dignity as an individual. Chapter 3 describes the patient's legal rights. All patients should be treated with respect and dignity, regardless of their social and economic backgrounds. Always treat patients as you wish to be treated yourself.
PROFESSIONAL ATTRIBUTES Fig. 1-6 One of the many responsibilities of EMTs is record keeping and data collection.
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In addition to these roles and responsibilities, EMTs must behave professionally. Professional attributes include physical appearance; a positive attitude; up-to-date knowledge and skills; making the patient's needs a top priority without endangering yourself or others; and expanding current knowledge of local, state, and national issues affecting EMS and healthcare. EMTs are healthcare professionals and are an important part of the healthcare team. Therefore, you should strive to project a professional appearance. Overall grooming, hair, and clothing should be neat and clean at all times. Shoes or boots should be clean and polished. Many services have a uniform policy for appropriate attire. Some services may have duty uniforms and dress uniforms to be worn at the appropriate times. The patient's and family's first impression of healthcare personnel can come from their initial contact with you. An unkempt EMT may imply sloppy patient care. Dressing in a crisp, clean uniform may reduce the patient's and family's anxiety. As you enter this facet of the world of healthcare, you are choosing a profession that demands lifelong continuing education and skills. Medical care will continue to evolve, and technology will provide EMS with new options for patient care. Federal, state, and regional laws and regulations will also change the way in which care is provided. EMTs have an obligation to be knowledgeable and provide technically proficient care. As a professional, you must keep abreast of changes and advances in medical care. Continuing education is therefore an important aspect of your career. EMTBasics should attend continuing education courses whenever possible and practice skills that are not often used (Fig. 1-7). Continuing education should not be postponed until you conclude your initial education program. To begin enhancing your knowledge and reinforcing concepts learned in class, you should begin to attend these programs immediately. Ask your instructor which programs can be taken before completing your initial education, and which can be taken afterward. Consider attending courses providing vehicle operation and rescue education programs. Many states require continuing education as a part of the recertification process or license renewal.
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Fig. 1-7 Continuing education provides opportunities for EMTs to expand their knowledge and practice skills that are not often used.
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EMSrelated journals can keep EMTs informed about trends in prehospital care. Several journals offer excellent information, such as JEMS (Journal of EMS), Rescue, Prehospital Emergency Care, and Emergency Medical Services. Check with your instructor or service to see which journal is best suited to your needs. Another way to stay informed is to join a professional organization. Several are of benefit to EMTs, including the National Association of EMTs (NAEMT), the National Assocition of EMS Educators (NAEMSE), and the National Association of EMS Physicians (NAEMSP). Both organizations keep their members abreast of changes in EMS through newsletters, journals, and conferences. In addition to these national organizations, many states and local areas have professional associations for EMS providers. This is an ideal opportunity to learn more about issues that affect EMS and to participate in decisions affecting EMTBasics.
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REVIEW QUESTIONS THE EMERGENCY MEDICAL TECHNICIANBASIC

1. Which of the following is a role or responsibility of the EMTBasic? a. Vehicle extrication b. Fire suppression c. Patient assessment d. Crime prevention 2. An EMT's appropriate professional appearance and confidence help to reduce a patient's: a. Blood pressure b. Length of stay c. Level of consciousness d. Anxiety 3. In order to maintain up-to-date knowledge and skills, the EMT-Basic should: a. Attend conferences b. Read professional journals c. Attend continuing education sessions d. All of the above 4. Maintaining the patient's dignity, right to privacy, and respecting their wishes is an example of which role of the EMT-Basic?
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a. Patient confidentiality b. Patient recognition c. Patient advocacy d. Patient assessment
QUALITY CARE QUALITY IMPROVEMENT

Quality improvement (QI) is a system for continually evaluating and improving the care provided within an EMS system. You may also hear terms such as quality assurance and quality management, which have similar goals of evaluating patient care to make improvements to the system. Most EMS systems have a quality improvement system that identifies a program's strengths and weaknesses and ensures that the public receives the highest caliber of prehospital care. The current trend in quality improvement is an approach that gives field providers such as EMT-Basics the resources, motivation, and education to detect problems, create solutions, and develop methods for maintaining quality care. The goal is to evaluate the system to determine which methods are successful and which must be further developed to improve the overall delivery of care. As healthcare professionals, EMTs must ensure that patients receive the best possible care. This requires an active role in quality managementparticipating in patient care reviews and giving constructive criticism to both co-workers and management for methods of system improvement. Without your input and attention to quality the system cannot improve.
MEDICAL DIRECTION
Medical direction, sometimes called medical control, is the process by which physicians monitor the care given by EMTBasics to ill or injured patients. In the past, some states required medical direction only at an advanced level and not for EMTBasics. The nationwide curriculum change in 1994 recommended that physicians be involved in all levels of prehospital care. Additionally, several skills performed by the EMT-Basic require medical direction authorization. These skills can be monitored through the two components of medical direction called direct medical direction and indirect medical direction. Direct medical direction, also referred to as online medical control, means direct communication between the physician and the provider in the field (Fig. 1-8). This communication may occur via a cellular telephone, radio, or telephone (land-line). In some cases, the physician may be present at the scene of the illness or injury, allowing prehospital providers to speak directly with the physician. The role of a physician at the emergency scene may vary. Local protocol dictates the proper procedure for following the orders and advice of a physician at the emergency scene. Indirect medical direction, or offline medical control, consists of other ways physicians influence care, such as EMS system design, developing protocols and standing orders, providing initial and continuing
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education, and participating in quality improvement. Indirect medical direction encompasses all components of physician involvement beyond direct medical direction (Fig. 1-9).
Fig. 1-8 A, Direct medical direction allows the EMT on the scene to consult with physicians or other medical staff at the medical treatment facility (B) by radio or telephone to determine proper care for the patient.
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The relationship of EMTBasics and the medical director depends on the specific system. Rural and frontier providers tend to use the indirect approach because of distance factors. Urban and suburban providers often interact with medical directors more frequently. Ideally, the relationship begins when the medical director becomes involved in the education of EMTBasics. This relationship continues as students complete their coursework and begin to provide patient care. The medical director participates in quality improvement of the service and aids in the development of protocols.
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Fig. 1-9 Indirect medical direction, such as routine physician review of prehospital care reports, contributes to quality improvement and influences care to all patients.
EMTBasics have a responsibility to interact with the medical director in a professional manner and to abide by his or her decisions. The medical director is a resource for problem solving before, during, and after patient interactions. Try to become acquainted with your EMS system of medical direction. A strong working relationship with the medical director will enhance the quality and appropriateness of the medical care you provide.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition REVIEW QUESTIONS QUALITY CARE
1. Indicate whether the following activities are direct or indirect medical direction. a. The medical director meets with a crew to perform case reviews. b. The medical director rewrites the Chest Pain Protocol. c. The medical director advises the EMTBasic over the radio to administer sublingual nitroglycerin. d. The medical director advises the EMTBasic to complete a trauma education program. e. The medical director orders the patient to be transported to a burn center. 2. Quality improvement is best described as? a. Sorting out the bad apples b. System audits c. A continuous cycle of evaluation d. Improving the patient care delivery system
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CHAPTER SUMMARY THE EMERGENCY MEDICAL SERVICES SYSTEM

The EMS system is one of many agencies, personnel, and institutions involved in planning, providing, and monitoring emergency medical care. The National Highway Traffic Safety Administration helps states to develop EMS systems through established technical standards and assessments of EMS delivery in each state. These standards include regulation and policy, resource management, human resources and training, transportation, facilities, communications, public information and education, medical direction, trauma systems, and evaluation. Each area addresses specific concerns for the quality delivery of EMS. The four recognized levels of prehospital care providers as defined by the National EMS Education and Practice Blueprint are First Responder, EMTBasic, EMTIntermediate, and EMTParamedic. All EMS personnel interact with other healthcare system professionals. EMTBasics also interact with law enforcement officials and firefighters. EMTBasics should establish a strong working relationship with these personnel.
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition THE EMERGENCY MEDICAL TECHNICIANBASIC
The EMTBasic has many roles and responsibilities, including personal safety; the safety of crew, patient, and bystanders; patient assessment; patient care based on assessment findings; lifting and moving patients safely; transportation of patients and transfer of care; record keeping and data collection; and patient advocacy. The individual ambulance service provides the EMTBasic with a job description outlining specific roles and responsibilities. The EMTBasic is a healthcare professional with certain professional attributes: attending continuing education programs; projecting a professional appearance; maintaining knowledge and skills at a competent level; participating in issues that affect EMS on a local, state, and national level; and serving as a patient advocate.
QUALITY CARE
Quality improvement and medical direction go hand in hand. They are important aspects of quality prehospital care. Quality improvement includes comprehensive planning, reviews of patient care delivery, and development of methods to improve the delivery system. Medical direction establishes that all care given to a patient is medically appropriate. Direct medical direction involves direct contact between the physician and providers in the field. Indirect medical direction includes other activities such as system planning, protocol development, education, and quality management.
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United Statis Department of Transportation National Highway Traffic Safety Administration EMT-Basic Objectives
Check your knowledge. The National Registry of EMTs and many state EMS agencies use the objectives below to develop EMT-Basic certification examinations. Can you meet them?
Cognitive
1. Define Emergency Medical Services (EMS) systems. 2. Differentiate the roles and responsibilities of the EMT-Basic from other prehospital care providers. 3. Describe the roles and responsibilities related to personal safety. 4. Discuss the roles and responsibilities of the EMT-Basic for the safety of the crew, the patient, and bystanders. 5. Define quality improvement and discuss the EMT-Basic's role in the process. 6. Define medical direction and discuss the EMT-Basic's role in the process.
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7. State the specific statutes and regulations in your state regarding the EMS system.
Affective
1. Assess areas of personal attitude and conduct of the EMT-Basic. 2. Characterize the various methods used to access the EMS system in your community.
Psychomotor
No psychomotor objectives identified.
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Review Questions Answer Key THE EMERGENCY MEDICAL SERVICES SYSTEM

1. a 2. 4 3. First Responder, EMT-Basic, EMT-Intermediate, EMT-Paramedic
THE EMERGENCY MEDICAL TECHNICIANBASIC

1. c 2. d 3. d 4. c
QUALITY CARE
1. a. indirect b. indirect c. direct d. indirect e. direct 2. c
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Mosby's EMT-Basic Textbook - Revised Reprint, 2nd Edition

Emergency medical dispatcher:

Emergency Medical Services (EMS) System:

Emergency Medical Technician (EMT):

CHAPTER 1 Introduction to Emergency Medical Care

National EMS Education and Practice Blueprint:

CHAPTER 1 Introduction to Emergency Medical Care