| |
| |
| Foreword | |
| |
| |
| Preface | |
| |
| |
| About the Authors | |
| |
| |
| Acknowledgments | |
| |
| |
| Feshe Correlation | |
| |
| |
| Introduction | |
| |
| |
| |
| Introduction to Emergency Medical Systems | |
| |
| |
| The Emergency Medical Services System | |
| |
| |
| Components of an EMS System | |
| |
| |
| Communications | |
| |
| |
| Manpower | |
| |
| |
| Training of Personnel | |
| |
| |
| Use of Public Safety Agencies | |
| |
| |
| Transportation | |
| |
| |
| Mutual Aid Agreements | |
| |
| |
| Facilities | |
| |
| |
| Accessibility of Care | |
| |
| |
| Critical Care Units | |
| |
| |
| Transfer of Patients | |
| |
| |
| Standard Medical Record Keeping | |
| |
| |
| Independent Review and Evaluation | |
| |
| |
| Consumer Information and Education | |
| |
| |
| Consumer Participation | |
| |
| |
| Disaster Linkage | |
| |
| |
| Revision of the 15 Components | |
| |
| |
| Medical Direction | |
| |
| |
| System Finance | |
| |
| |
| Regulation and Policy | |
| |
| |
| Trauma Systems | |
| |
| |
| EMS Agenda for the Future | |
| |
| |
| The 14 Attributes of an EMS System | |
| |
| |
| Integration of Health Services | |
| |
| |
| EMS Research | |
| |
| |
| Legislation and Regulation | |
| |
| |
| System Finance | |
| |
| |
| Human Resources | |
| |
| |
| Medical Direction | |
| |
| |
| Education Systems | |
| |
| |
| Public Education | |
| |
| |
| Prevention | |
| |
| |
| Public Access | |
| |
| |
| Communication Systems | |
| |
| |
| Clinical Care | |
| |
| |
| Information Systems | |
| |
| |
| Evaluation | |
| |
| |
| Critical Patient Areas | |
| |
| |
| |
| History of Emergency Medical Systems | |
| |
| |
| History of Emergency Medical Systems | |
| |
| |
| Preindustrial Era (1600-1850) | |
| |
| |
| Resuscitation | |
| |
| |
| Anesthesia | |
| |
| |
| Transportation | |
| |
| |
| Industrial Era (1850-1970) | |
| |
| |
| Causes of Death | |
| |
| |
| First Aid Training | |
| |
| |
| Resuscitator Calls | |
| |
| |
| Motor Vehicle Injuries | |
| |
| |
| Transportation | |
| |
| |
| Military | |
| |
| |
| Cardiac Care | |
| |
| |
| Government Involvement | |
| |
| |
| EMS Development | |
| |
| |
| Modern Era (1970-2000) | |
| |
| |
| 1970s | |
| |
| |
| 1980s | |
| |
| |
| 1990s | |
| |
| |
| Twenty-first Century | |
| |
| |
| September 11, 2001 | |
| |
| |
| Institute of Medicine Reports | |
| |
| |
| Katrina and Disaster Response | |
| |
| |
| Emergency Medical Direction in the Federal Government | |
| |
| |
| Federal Interagency Committee on EMS/National EMS Advisory Council | |
| |
| |
| Ambulance Fee Schedule | |
| |
| |
| EMS Caucus | |
| |
| |
| Provider Levels and Training | |
| |
| |
| Other Developments | |
| |
| |
| |
| Human Resources | |
| |
| |
| Historical Background | |
| |
| |
| Prehospital Providers | |
| |
| |
| Emergency Medical Responder | |
| |
| |
| Emergency Medical Technician | |
| |
| |
| Advanced Emergency Medical Technician | |
| |
| |
| Paramedic | |
| |
| |
| Specialized Prehospital Providers | |
| |
| |
| Flight Paramedics and Nurses | |
| |
| |
| Critical Care Transport Specialists | |
| |
| |
| Wilderness EMT | |
| |
| |
| Specialized Response Providers | |
| |
| |
| Hospital-Based Providers | |
| |
| |
| Nurses | |
| |
| |
| Physicians | |
| |
| |
| Allied Health Professionals | |
| |
| |
| Other Providers and System Personnel | |
| |
| |
| Telecommunicators | |
| |
| |
| Emergency Medical Dispatcher | |
| |
| |
| Firefighters | |
| |
| |
| Police Officers | |
| |
| |
| EMS Managers | |
| |
| |
| EMS Educators | |
| |
| |
| Sources of Providers | |
| |
| |
| Volunteer Providers | |
| |
| |
| Career Providers | |
| |
| |
| |
| Educational Systems | |
| |
| |
| Introduction | |
| |
| |
| Controversies in EMS Education | |
| |
| |
| National Standard Curriculum | |
| |
| |
| EMS Education Agenda for the Future | |
| |
| |
| National EMS Core Content | |
| |
| |
| National EMS Scope of Practice Model | |
| |
| |
| National EMS Education Standards | |
| |
| |
| National EMS Education Program Accreditation | |
| |
| |
| National EMS Certification | |
| |
| |
| The National Registry of EMTs | |
| |
| |
| CoAEMSP | |
| |
| |
| Settings for EMS Education | |
| |
| |
| Hospitals | |
| |
| |
| Fire Departments | |
| |
| |
| Technical Centers | |
| |
| |
| Community Colleges | |
| |
| |
| Colleges and Universities | |
| |
| |
| Military | |
| |
| |
| Provider Courses | |
| |
| |
| Specialized Courses | |
| |
| |
| Continuing Education and Refresher Training | |
| |
| |
| Technology in Education | |
| |
| |
| Asynchronous Learning | |
| |
| |
| |
| Transportation | |
| |
| |
| The Transportation Attribute | |
| |
| |
| Service Providers | |
| |
| |
| Fire Service | |
| |
| |
| Commercial Service | |
| |
| |
| Third Service | |
| |
| |
| Public Safety Agency | |
| |
| |
| Police or Sheriff-Based Service | |
| |
| |
| Hospital-Based Service | |
| |
| |
| First Responder | |
| |
| |
| Public Utility Model | |
| |
| |
| Integrated System | |
| |
| |
| Delivery Systems | |
| |
| |
| Fixed-Post Staffing | |
| |
| |
| Event-Driven Staffing | |
| |
| |
| ALS Intercept | |
| |
| |
| Interfacility Transport | |
| |
| |
| Staffing Configuration | |
| |
| |
| BLS Staffing | |
| |
| |
| ALS Staffing | |
| |
| |
| Mobile Health Care | |
| |
| |
| EMS Vehicles | |
| |
| |
| Type I | |
| |
| |
| Type II | |
| |
| |
| Type III | |
| |
| |
| Medium Duty | |
| |
| |
| Air Medical Transport | |
| |
| |
| Alternate Transport Modes | |
| |
| |
| Ambulance Equipment | |
| |
| |
| Basic Level Provider Essential Equipment | |
| |
| |
| Advanced Level Provider Essential Equipment | |
| |
| |
| |
| Medical Oversight | |
| |
| |
| Historical Background | |
| |
| |
| Models of Medical Oversight | |
| |
| |
| Indirect Medical Oversight | |
| |
| |
| System Design | |
| |
| |
| Protocols | |
| |
| |
| Education | |
| |
| |
| Quality Systems | |
| |
| |
| Direct Medical Oversight | |
| |
| |
| Regulation and Legislation | |
| |
| |
| |
| Public Access and Communications | |
| |
| |
| Public Access | |
| |
| |
| 9-1-1 | |
| |
| |
| 9-1-1 Operation | |
| |
| |
| Public Safety Answering Point | |
| |
| |
| Call Processing | |
| |
| |
| Call Taking | |
| |
| |
| Dispatch Center | |
| |
| |
| Dispatch Life Support | |
| |
| |
| Emergency Medical Dispatch | |
| |
| |
| Priority Dispatching | |
| |
| |
| Prearrival Instructions | |
| |
| |
| Nonemergency Access Numbers | |
| |
| |
| Pathway Management | |
| |
| |
| Public Education | |
| |
| |
| Communications | |
| |
| |
| Role of Communications | |
| |
| |
| Occurrence | |
| |
| |
| Detection | |
| |
| |
| Notification | |
| |
| |
| Dispatch | |
| |
| |
| Prearrival Instructions | |
| |
| |
| Response | |
| |
| |
| Scene Communications | |
| |
| |
| Medical Communications | |
| |
| |
| Transport | |
| |
| |
| Hospital Arrival | |
| |
| |
| Return to Service | |
| |
| |
| Systems Communications Technology | |
| |
| |
| Systems Communications | |
| |
| |
| Medical Communications | |
| |
| |
| Telemedicine | |
| |
| |
| |
| Clinical Care and Hospital Emergency Medicine | |
| |
| |
| Clinical Care | |
| |
| |
| History of Emergency Medicine | |
| |
| |
| Scope of Emergency Medicine | |
| |
| |
| The Emergency Department | |
| |
| |
| Level I | |
| |
| |
| Level II | |
| |
| |
| Level III | |
| |
| |
| Level IV | |
| |
| |
| Overcrowded Emergency Departments | |
| |
| |
| Approaches to Relieving ED Overcrowding | |
| |
| |
| Freestanding EDs | |
| |
| |
| Categorization and Designation | |
| |
| |
| Trauma Care | |
| |
| |
| Trauma Care System | |
| |
| |
| The Trauma Center | |
| |
| |
| Specialty Referral Centers | |
| |
| |
| Trauma Registry | |
| |
| |
| EMTALA Legislation | |
| |
| |
| Critical Care Transport | |
| |
| |
| Expanded Scope of Practice and Services | |
| |
| |
| |
| System Finances | |
| |
| |
| System Finance | |
| |
| |
| System Organization | |
| |
| |
| Nongovernmental Organizations | |
| |
| |
| Government Services | |
| |
| |
| Volunteer Companies | |
| |
| |
| Sources of Funds | |
| |
| |
| Nongovernmental Organizations | |
| |
| |
| Government Services | |
| |
| |
| Volunteer Organizations | |
| |
| |
| Financing Other EMS Components | |
| |
| |
| Accounting and Budgeting | |
| |
| |
| Nongovernmental For-Profit Company | |
| |
| |
| Government Services | |
| |
| |
| Nonprofit and Volunteer Organizations | |
| |
| |
| Issues for the Future | |
| |
| |
| |
| Legislation and Regulation | |
| |
| |
| Overview of Legislation and Regulation | |
| |
| |
| The Federal Legislative Role | |
| |
| |
| Legislation | |
| |
| |
| Funding | |
| |
| |
| EMTALA | |
| |
| |
| Federal Regulations | |
| |
| |
| Congressional EMS Caucus | |
| |
| |
| Federal Lead Agency | |
| |
| |
| The State Role | |
| |
| |
| Components of a State Lead Agency | |
| |
| |
| State Legislation | |
| |
| |
| Model State EMS Systems | |
| |
| |
| Advocacy | |
| |
| |
| |
| Public Education and Injury Prevention | |
| |
| |
| Introduction | |
| |
| |
| Forms of Public Education | |
| |
| |
| Benefits of Public Education | |
| |
| |
| Public Education Process | |
| |
| |
| Public Service Announcements | |
| |
| |
| Public Education and Technology | |
| |
| |
| Injury Prevention | |
| |
| |
| The Injury Event | |
| |
| |
| Injury Types | |
| |
| |
| Falls | |
| |
| |
| Drownings | |
| |
| |
| Poisonings | |
| |
| |
| Violence | |
| |
| |
| Motor Vehicle Crashes | |
| |
| |
| Bicycle Crashes | |
| |
| |
| Injury Prevention Concepts | |
| |
| |
| Interventions | |
| |
| |
| Surveillance | |
| |
| |
| EMS and Injury Prevention | |
| |
| |
| Developing an Injury Prevention Program | |
| |
| |
| |
| Emergency Medical Services and Disaster Response | |
| |
| |
| Disasters | |
| |
| |
| What Is a Disaster? | |
| |
| |
| Natural Disasters | |
| |
| |
| Technological Disasters | |
| |
| |
| Disaster Management | |
| |
| |
| Mitigation | |
| |
| |
| EMS Role | |
| |
| |
| Hazards | |
| |
| |
| Hazard Analysis | |
| |
| |
| Preparedness | |
| |
| |
| EMS Role | |
| |
| |
| Response | |
| |
| |
| EMS Role | |
| |
| |
| Incident Command System | |
| |
| |
| Recovery | |
| |
| |
| EMS Role | |
| |
| |
| Mass Events | |
| |
| |
| Federal Role in Disasters | |
| |
| |
| Presidential Declaration of a Disaster | |
| |
| |
| Federal Role and EMS | |
| |
| |
| |
| Information Systems and Evaluation | |
| |
| |
| Information Systems | |
| |
| |
| Strategic Information Planning | |
| |
| |
| Information System Integration | |
| |
| |
| Information System Design Considerations | |
| |
| |
| Data Formats | |
| |
| |
| Data Collection Tools | |
| |
| |
| Paper Forms | |
| |
| |
| Stationary Computer Workstations | |
| |
| |
| Field Computers | |
| |
| |
| Mobile Data Terminals | |
| |
| |
| Data Collection | |
| |
| |
| Data Validation | |
| |
| |
| Data Transfer, Secure Storage, and Analysis | |
| |
| |
| Data Usage | |
| |
| |
| Quality and Performance Evaluation | |
| |
| |
| Quality, Cost, and Performance | |
| |
| |
| Measuring Overall Performance | |
| |
| |
| High-Performance EMS Systems | |
| |
| |
| Leadership System | |
| |
| |
| Strategic Quality Planning | |
| |
| |
| Information and Analysis | |
| |
| |
| Process Assurance and Improvement | |
| |
| |
| Scope of Performance Improvement Efforts | |
| |
| |
| |
| Research | |
| |
| |
| What Is Research? | |
| |
| |
| Why Do Research? | |
| |
| |
| Improve Patient Care | |
| |
| |
| Improve the System | |
| |
| |
| Understand the System | |
| |
| |
| Reduce Hazards | |
| |
| |
| Provide Legal Protection | |
| |
| |
| Improve the Profession | |
| |
| |
| Introduction to the Scientific Method | |
| |
| |
| Statistics | |
| |
| |
| Research Design | |
| |
| |
| Quantitative and Qualitative Methods | |
| |
| |
| Observational Studies | |
| |
| |
| Interventional Study | |
| |
| |
| Double-Blind, Randomized Control Study | |
| |
| |
| Quasi-Experiment | |
| |
| |
| The Research Study | |
| |
| |
| Identify the Problem or Question | |
| |
| |
| Review the Literature | |
| |
| |
| Formulate a Hypothesis | |
| |
| |
| Define Your Team | |
| |
| |
| Design the Study | |
| |
| |
| Controlling for Bias | |
| |
| |
| Sample Size | |
| |
| |
| Perform the Study | |
| |
| |
| Analyze the Data | |
| |
| |
| Use the Information | |
| |
| |
| Share the Findings | |
| |
| |
| Future Challenges | |
| |
| |
| Using Research in EMS | |
| |
| |
| Glossary | |
| |
| |
| Index | |