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EMERGENCY C
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MEDICAL G

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SERVICES ME
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April B. Llaneta, MD, DPBECP
U
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9
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G
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 Police
Fire Brigade
Emergency E.D. I.C.U Ward
Security Guard
Layman Civil Defense Ambulance
Scouts Service
Red Cross

Rehabilitation

DISASTER
Access Public
Emergency Health
Telephone Number Center

Pre-Hospital Phase 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)

■ 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 Technician-
Basic
■ Minimum level required to staff an
ambulance
■ FR skills, triage, more detailed
patient assessment, transportation
 EMS Personnel
Emergency Medical Technician-
Intermediate
■ 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!