Chapter 1Chapter 1

What is your What is your role in the EMS role in the EMS

System?System?

Have you or Have you or anyone you anyone you know been know been

involved in a involved in a serious serious

accident?accident?http://www.instructorscorner.org/media/videos/a2.html

Chapter 1Chapter 1ObjectivesObjectives

1.1. Name the six parts of the EMS system.Name the six parts of the EMS system.2.2. Describe the function of each part of Describe the function of each part of

the EMS system.the EMS system.3.3. Evaluate your role in the EMS system.Evaluate your role in the EMS system.4.4. Identify the most important action you Identify the most important action you

could take in an emergency situation.could take in an emergency situation.5.5. List 5 common barriers to action that List 5 common barriers to action that

may prevent people from responding may prevent people from responding to emergencies.to emergencies.

6.6. Explain ways bystanders can help at Explain ways bystanders can help at the scene of an emergency.the scene of an emergency.

What is an emergency?What is an emergency?

An emergency is a situation An emergency is a situation demanding immediate action.demanding immediate action.

An emergency can happen at any time An emergency can happen at any time or at any place, it is not a clear-cut or at any place, it is not a clear-cut situation.situation.

Your response may be the difference Your response may be the difference between:between:

– life or deathlife or death– temporary or permanent disabilitytemporary or permanent disability– short or long term recoveryshort or long term recovery

Types of EmergenciesTypes of Emergencies

There are two types of emergencies that There are two types of emergencies that require first aid: require first aid:

Sudden illnessSudden illness is a physical condition that is a physical condition that requires immediate medical attention. requires immediate medical attention. Examples of sudden illness include a Examples of sudden illness include a heart attack and a severe allergic heart attack and a severe allergic reaction.reaction.

InjuryInjury is damage to the body from an is damage to the body from an external force, such as a broken bone external force, such as a broken bone from a fall.from a fall.

Types of EmergenciesTypes of Emergencies(Continued)(Continued)

Emergencies can also be categorized as life-Emergencies can also be categorized as life-threatening and non-life-threatening. threatening and non-life-threatening.

1.1. A A life-threatening emergencylife-threatening emergency is an illness is an illness or injury that impairs a victim’s ability to or injury that impairs a victim’s ability to circulate oxygenated blood to all parts of circulate oxygenated blood to all parts of his or her body.his or her body.

2.2. A A non-life-threatening emergencynon-life-threatening emergency is a is a situation that does not have immediate situation that does not have immediate impact on a victim’s ability to circulate impact on a victim’s ability to circulate oxygenated blood , but still requires oxygenated blood , but still requires medical attention. medical attention.

What is First Aid?What is First Aid?

First Aid is the Immediate care First Aid is the Immediate care given to a victim of injury or given to a victim of injury or sudden illness until more sudden illness until more advanced care can be obtained.advanced care can be obtained.

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The EMS System The EMS System

The emergency medical services (EMS) system is a The emergency medical services (EMS) system is a network of community-based personnel often network of community-based personnel often dispatched through a local emergency number who dispatched through a local emergency number who provide emergency care for ill or injured victims.provide emergency care for ill or injured victims.

Think of the EMS system as a chain made up of several Think of the EMS system as a chain made up of several links. Each link depends on the others for success.links. Each link depends on the others for success.

When the EMS system works correctly, a victim moves When the EMS system works correctly, a victim moves through each link in the chain, beginning with the through each link in the chain, beginning with the actions of a responsible citizen and ending with care actions of a responsible citizen and ending with care being provided to attempt to restore the victim to being provided to attempt to restore the victim to health.health.

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The EMS System The EMS System (Continued)(Continued)

There are six parts of the There are six parts of the EMS system:EMS system:

1.1. The Citizen ResponderThe Citizen Responder

2.2. The EMS DispatcherThe EMS Dispatcher

3.3. The First ResponderThe First Responder

4.4. The Emergency Medical Technician The Emergency Medical Technician (EMT)(EMT)

5.5. Hospital Care ProvidersHospital Care Providers

6.6. RehabilitationRehabilitation

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The Citizen ResponderThe Citizen Responder

As a citizen responder, you are the first and As a citizen responder, you are the first and most crucial link in the EMS system.most crucial link in the EMS system.

A citizen responder is a lay person (someone A citizen responder is a lay person (someone who does not have special or advanced medical who does not have special or advanced medical training/skills) who recognizes an emergency training/skills) who recognizes an emergency and decides to help.and decides to help.

The CR must first recognize that the illness or The CR must first recognize that the illness or injury that has occurred is an emergency.injury that has occurred is an emergency.

He/she must then activate EMS with a 911 call.He/she must then activate EMS with a 911 call.

The EMS DispatcherThe EMS Dispatcher

The 2The 2ndnd link in system. link in system. The dispatcher receives the The dispatcher receives the

call and quickly determines call and quickly determines what help is needed.what help is needed.

Some dispatchers are trained Some dispatchers are trained EMT's.EMT's.

The First ResponderThe First Responder

The 3The 3rdrd link in the EMS system. link in the EMS system.

A first responder is a person trained in A first responder is a person trained in emergency care who may be called upon.emergency care who may be called upon.

Usually the first person to arrive on scene who Usually the first person to arrive on scene who is trained to provide a higher level of care. is trained to provide a higher level of care.

The FR provides a critical transition between The FR provides a critical transition between the CR’s basic level of care and the care the CR’s basic level of care and the care provided by more advanced EMS professionals.provided by more advanced EMS professionals.

A FR can be a law enforcement officer, fire A FR can be a law enforcement officer, fire fighter, or a lifeguard. fighter, or a lifeguard.

The Emergency The Emergency Medical Technician Medical Technician

(EMT)(EMT) The 4The 4thth link in the EMS system. link in the EMS system.

An EMT is a person who has successfully An EMT is a person who has successfully completed a state-approved emergency medical completed a state-approved emergency medical technician training program.technician training program.

They are capable of providing more advanced They are capable of providing more advanced care.care.

At the scene, they serve as "eyes & ears" of At the scene, they serve as "eyes & ears" of hospital.hospital.

The first four links of the EMS system give The first four links of the EMS system give victims of injury or sudden illness the best victims of injury or sudden illness the best possible out-of-hospital medical care.possible out-of-hospital medical care.

Hospital Care Hospital Care Providers Providers

The 5The 5thth link of the EMS system. link of the EMS system.

It begins once the victim It begins once the victim arrives at hospital.arrives at hospital.

They provide the most They provide the most advanced care.advanced care.– ER doctors/nurses, X-ray techs, ER doctors/nurses, X-ray techs,

specialists, etc.specialists, etc.

RehabilitationRehabilitation

The sixth and final link to the EMS The sixth and final link to the EMS system.system.

The goal of rehabilitation is to The goal of rehabilitation is to return the victim to his or her return the victim to his or her previous state of health.previous state of health.

These professionals include These professionals include family physicians, consulting family physicians, consulting specialists, social workers, and specialists, social workers, and physical/occupational therapists. physical/occupational therapists.

Your role in the EMS Your role in the EMS systemsystem

1.1. Recognize that an Recognize that an emergency exists. emergency exists.

2.2. Decide to act.Decide to act.

3.3. Call EMS professional (9-1-Call EMS professional (9-1-1).1).

4.4. Provide first aid until help Provide first aid until help arrives.arrives.

Recognizing Recognizing Emergencies Emergencies

Recognizing an emergency is the first step in Recognizing an emergency is the first step in responding.responding.

A medical emergency is a sudden illness that A medical emergency is a sudden illness that requires immediate medical attention, such as a requires immediate medical attention, such as a heart attack.heart attack.

An injury is damage to the body from an external An injury is damage to the body from an external force, for example, such as occurs with a fall or force, for example, such as occurs with a fall or extremes of temperature. extremes of temperature.

Some emergencies are more obvious than othersSome emergencies are more obvious than others

Common indicators include unusual noises, Common indicators include unusual noises, sights, odors, and appearance or behavior. sights, odors, and appearance or behavior.

Unusual NoisesUnusual Noises

Screams, moans, yells, calls for Screams, moans, yells, calls for helphelp

Breaking glass, crashing sounds, Breaking glass, crashing sounds, screeching tiresscreeching tires

Abrupt/loud unidentifiable sounds Abrupt/loud unidentifiable sounds

SilenceSilence

Unusual SightsUnusual Sights

Things that look out of the Things that look out of the ordinary:ordinary: A stalled vehicleA stalled vehicle An overturned pot An overturned pot Spilled medicine containerSpilled medicine container Broken glassBroken glass Downed electrical wires. Downed electrical wires.

Unusual odorsUnusual odors

Smells that are stronger than Smells that are stronger than normal:normal: Gasoline at a gas stationGasoline at a gas station Chlorine at swimming poolsChlorine at swimming pools SmokeSmoke

Unrecognizable odorsUnrecognizable odors

Unusual Appearance or Unusual Appearance or Behavior Behavior

UnconsciousUnconscious Difficult breathing Difficult breathing Clutching chest/throatClutching chest/throat Slurred, confused, or hesitant Slurred, confused, or hesitant

speechspeech Unexplainable Unexplainable

confusion/drowsinessconfusion/drowsiness Sweating for no apparent reasonSweating for no apparent reason Skin color is unusualSkin color is unusual

Deciding to Act Deciding to Act

How do you feel about what you just How do you feel about what you just saw?saw?

How many of you feel you would How many of you feel you would respond to this emergency?respond to this emergency?

Those of you who would not respond, Those of you who would not respond, why not?why not?

Can anyone think of any reasons that Can anyone think of any reasons that might discourage a person from might discourage a person from responding?responding?

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Barriers to actionBarriers to action

Sometimes people fail to recognize an emergency. At Sometimes people fail to recognize an emergency. At other times, people recognize an emergency but are other times, people recognize an emergency but are reluctant to act. reluctant to act.

Reasons people give for not helping are called barriers Reasons people give for not helping are called barriers to action. to action.

Common barriers include: Common barriers include: The presence of bystanders. The presence of bystanders. Uncertainty about the victim. Uncertainty about the victim. The nature of the injury or illness.The nature of the injury or illness. Fear of disease transmission. Fear of disease transmission. Fear of not knowing what to do or of doing Fear of not knowing what to do or of doing

something wrong. something wrong.

Presence of Presence of Bystanders Bystanders

Bystanders can cause confusion at an Bystanders can cause confusion at an emergency scene. emergency scene.

Never assume that just because a crowd Never assume that just because a crowd has gathered that someone is caring for has gathered that someone is caring for the victim. the victim.

You may feel embarrassed about coming You may feel embarrassed about coming forward in front of strangers. Do not let forward in front of strangers. Do not let this feeling deter you from helping. You this feeling deter you from helping. You may be the only one who knows first aid. may be the only one who knows first aid.

Presence of Presence of BystandersBystanders

(Continued)(Continued) If someone else is already giving care, offer to help. If someone else is already giving care, offer to help. Untrained bystanders may be a great help in an Untrained bystanders may be a great help in an

emergency. They can:emergency. They can: Call for an ambulance. Call for an ambulance. Meet the ambulance and direct EMS personnel to Meet the ambulance and direct EMS personnel to

the victim.the victim. Direct traffic away from the accident scene.Direct traffic away from the accident scene. Help provide care. Help provide care. Retrieve necessary equipment and supplies. Retrieve necessary equipment and supplies. Provide information about the victim regarding his Provide information about the victim regarding his

or her medical condition or the cause of injury. or her medical condition or the cause of injury. Comfort and reassure victims. Comfort and reassure victims.

Uncertainty About the Uncertainty About the VictimVictim

Since most emergencies happen in or near Since most emergencies happen in or near the home, you are more likely to give care to the home, you are more likely to give care to a friend or family member than to a stranger. a friend or family member than to a stranger.

If you do not know the victim, you may feel If you do not know the victim, you may feel uncomfortable touching a stranger. How the uncomfortable touching a stranger. How the victim may look or act may also make you victim may look or act may also make you feel uncomfortable. feel uncomfortable.

Sometimes victims of injury or illness may Sometimes victims of injury or illness may act strangely or be uncooperative. If at any act strangely or be uncooperative. If at any time you feel threatened, retreat to safety time you feel threatened, retreat to safety and call 9-1-1 or the local emergency and call 9-1-1 or the local emergency number. number.

Nature of the Illness or Nature of the Illness or InjuryInjury

An injury or illness may sometimes be An injury or illness may sometimes be very unpleasant to handle.very unpleasant to handle.

You cannot always predict how you will You cannot always predict how you will respond to disturbing factors, such as respond to disturbing factors, such as blood, vomit, unpleasant odors, or torn blood, vomit, unpleasant odors, or torn or burned skin. or burned skin.

Sometimes you may need to compose Sometimes you may need to compose yourself before acting. Take a few yourself before acting. Take a few deep breaths and then provide care. deep breaths and then provide care.

Fear of Disease Fear of Disease TransmissionTransmission

Although there is general concern for disease transmission Although there is general concern for disease transmission in a first aid situation, the actual risk is much smaller than in a first aid situation, the actual risk is much smaller than you may think. you may think.

Giving first aid in and of itself will not cause you to become Giving first aid in and of itself will not cause you to become infected with a disease. infected with a disease.

Four conditions must be present for a disease to be Four conditions must be present for a disease to be transmitted. If any of these conditions is absent, disease transmitted. If any of these conditions is absent, disease transmission is not possible. The conditions are:transmission is not possible. The conditions are:– The injured or ill person must be infected with a The injured or ill person must be infected with a

disease. disease. – The rescuer providing first aid must be exposed to an The rescuer providing first aid must be exposed to an

infected person's body substances. infected person's body substances. – The rescuer must come in contact with infected The rescuer must come in contact with infected

substances through breaks or cuts in his or her skin or substances through breaks or cuts in his or her skin or through the mucous membranes of the mouth or eyes. through the mucous membranes of the mouth or eyes.

– There must be sufficient amounts of body substances There must be sufficient amounts of body substances that contain enough pathogens to cause infection. that contain enough pathogens to cause infection.

Fear of Disease Fear of Disease TransmissionTransmission

(Continued)(Continued)

Diseases that can pass from one Diseases that can pass from one person to another are called infectious person to another are called infectious diseases and can develop when diseases and can develop when pathogens enter the body. pathogens enter the body.

In situations that require first aid, In situations that require first aid, diseases can be transmitted by diseases can be transmitted by touching, breathing, and biting. touching, breathing, and biting.

Fear of not knowing what to Fear of not knowing what to do or of doing something do or of doing something wrongwrong Doing the wrong thing and possibly making Doing the wrong thing and possibly making

the situation worse is a common fear. the situation worse is a common fear. Always remember that the worst thing to do Always remember that the worst thing to do

is nothing.is nothing. Sometimes people worry about being sued. Sometimes people worry about being sued.

Do not let this overly concern you. Lawsuits Do not let this overly concern you. Lawsuits against those who give emergency care are against those who give emergency care are highly unusual and rarely successful. highly unusual and rarely successful.

Most states have enacted Good Samaritan Most states have enacted Good Samaritan Laws that protect citizen responders who Laws that protect citizen responders who voluntarily give first aid in good faith. voluntarily give first aid in good faith.

GOOD SAMARITAN GOOD SAMARITAN LAWSLAWS Gives legal protection to people Gives legal protection to people

who willingly provide medical care who willingly provide medical care to ill or injured people with out to ill or injured people with out accepting anything in return.accepting anything in return.

This law does not apply to people This law does not apply to people when responses are grossly or when responses are grossly or willfully negligent or reckless or willfully negligent or reckless or when the rescuer abandoned the when the rescuer abandoned the victim after initiating care.victim after initiating care.

Help may be givenHelp may be given

When:When: The victim is or says the following:The victim is or says the following:

"you can help me""you can help me" Victim is unconsciousVictim is unconscious Victim becomes unconscious after Victim becomes unconscious after

refusing carerefusing care Victim's state of mind is such that Victim's state of mind is such that

they may not know/understand the they may not know/understand the seriousness of injuriesseriousness of injuries

Victim is a small unattended childVictim is a small unattended child

Help cannot be givenHelp cannot be given

When:When: The victim is conscious, alert, The victim is conscious, alert,

understands what is going on, and understands what is going on, and refuses your help.refuses your help.

Call 911 if injuries warrant it.Call 911 if injuries warrant it. LAWS MAY VARY FROM STATE TO LAWS MAY VARY FROM STATE TO

STATESTATE

Helping at an Helping at an emergency scene emergency scene

Providing help at an emergency Providing help at an emergency scene does not always mean scene does not always mean providing direct care for the providing direct care for the victims. victims.

In what other ways can you give In what other ways can you give help?help?

Other ways to give Other ways to give helphelp Keeping the scene safeKeeping the scene safe Finding out what is wrongFinding out what is wrong Getting professional helpGetting professional help Giving careGiving care

Important noteImportant note

Different situations may change the order in which Different situations may change the order in which things are done. For instance, if the scene is un- things are done. For instance, if the scene is un- safe, you should call the emergency number first. safe, you should call the emergency number first. In a situation where the scene is safe, you might In a situation where the scene is safe, you might not call 9-1-1 until you check the victims. not call 9-1-1 until you check the victims. Sometimes these actions can happen Sometimes these actions can happen simultaneously. For instance, you might send simultaneously. For instance, you might send someone else to call the emergency number someone else to call the emergency number while you check the injured or ill person(s).while you check the injured or ill person(s).

As a rule, the safety of the rescuers, victims, and As a rule, the safety of the rescuers, victims, and bystanders should always be foremost, and life-bystanders should always be foremost, and life-threatening conditions should be cared for before threatening conditions should be cared for before conditions of lesser urgency. conditions of lesser urgency.

ClosingClosing

Emergency scenes can be overwhelming and Emergency scenes can be overwhelming and confusing.confusing.

Deciding to act is not always an easy decision to Deciding to act is not always an easy decision to make. make. The presence of a crowd does not mean that The presence of a crowd does not mean that

someone is helping. someone is helping. It is not always easy to determine how to help in an It is not always easy to determine how to help in an

emergency. emergency. There are many ways to help besides providing first There are many ways to help besides providing first

aid care. aid care.

The decision to act is yours and yours alone. The decision to act is yours and yours alone.

Your decision to respond should be guided by your Your decision to respond should be guided by your own values, as well as the knowledge of the risks that own values, as well as the knowledge of the risks that may be present. may be present.

ClosingClosing

Regardless of your decision, calling EMS Regardless of your decision, calling EMS personnel is the most important action personnel is the most important action you can take when you recognize that you can take when you recognize that an emergency has occurred.an emergency has occurred.

In the next lesson, you will learn the In the next lesson, you will learn the Emergency Action Steps, which will Emergency Action Steps, which will provide a basic plan of action for any provide a basic plan of action for any emergency situation. emergency situation.