First Responder EMS Curriculum for Training Centers in Eurasia

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of day when the number of calls to the emergency medical services system peak. Someconsiderations may be particular to your system.After determining the needs of patients, you can set about developing features in yoursystem to serve these needs. To produce these particular features in your system a processmust be developed that takes into consideration your available resources. Once the processis developed, your personnel must be trained in the process to achieve success.Scene response time is one of the most common targets for improvement. Scene responsetimes can be reduced in a variety of ways. The easiest way is to place more units in areas ofhigh population density, which will reduce average scene response time but will do so atthe expense of those patients who live away from high-density areas. These latter peoplewill then experience scene response times much higher than the average. Another way toimpact scene response time is to set a limit for response times and set up the system toensure that most scene times fall below this limit. This method is known as fractileresponse time. The benefit of this second approach is that most patients will benefit from aresponse time below the set limit and, when compared with the system driven by averageresponse times, the maximum response time will be shorter. This example shows how asystem process must be developed that takes into account patient needs within theframework of the system resources.4. Examination of the ProcessOnce the process has been implemented, you must find out if it is achieving what youwanted to achieve. The process deals with the activities between practitioners and patients.The presence of a process allows uniformity of practice, which is a necessary first step ifchanges are to be made for improvement.The process can be examined by direct observation and by utilizing the documentationassociated with patient care. First, you must examine if the process is operating in the wayit was designed or if there are barriers that prevent this. Only after consistency of theprocess is achieved can you examine if the process is providing the desired outcomes. Ifthe process is not consistent, break it down to see if you can identify the source ofvariability. Some sources of variability will be outside your control but you must firstknow the sources of variability to see how to improve consistency.Once you judge your process to be as consistent as possible you can determine if it isachieving its goals. The difference between the performance of your process and yourperformance goal is the area for improvement. How to go about improvement can varydepending on the actual process and goals.5. Quality ImprovementActing on the difference between actual performance and performance goals is what isknown as quality improvement. Once you identify the difference between your actualprocess achievements and your process goals, you can begin to act on this difference. It isbest to achieve improvement by incremental change. Instead of trying to achieve a quickfix by radically changing one element of your process, it is normally more effective tomake many small improvements in different areas of the process. When you add up allthese small improvements the result is a significant gain.236 First Responder EMS Curriculum/AIHA, July 2002
Identify concrete, specific projects that target a measurable outcome. Once you havedesigned a plan for improvement, re-training of the First Responders to apprise them ofchanges should follow. After a period of time to allow the new process to stabilize, performa new measurement of the performance to see if an improvement was achieved. If so,methods to reinforce the new process are put into place. This will continue reinforcing thenew process to maintain the new gains.6. InformationTo be able to make improvements you must start with reliable information. Informationcan be obtained through direct observation or through patient care documentation. Patientcare documentations generate the bulk of the data for performance analysis. Improper orpoor documentation makes this tool much less useful. Consistent and completedocumentation is part of the job of the First Responder.Familiarize yourself with your particular system’s form of documentation. At a minimum,the call report sheets should contain certain information fields:a. Call DataInformation regarding the particular call is recorded under this heading. Thisinformation includes the recording of various times such as time call received fromdispatch, time unit under way, and time of arrival at scene. The location of the call andthe First Responders involved also should be listed under this heading.b. SituationInformation about the scene should be under this heading. This information shouldinclude where and how the patient is found and other factors relevant to initialtreatment. In case of a motor vehicle accident, this section should contain informationabout the condition of the vehicle and the location of the patient within the vehicle.c. Patient InformationHere you record information pertaining to the patient, including the patient’s name andage, past medical history, allergies, and any other information your system deemsimportant. You can also include history of present illness under this heading.d. Patient ExamThe results of your physical exam are listed under this heading. If the elements of thephysical are clearly separated in your system’s run report, it will aid the First Responderin being thorough in his/her exam and collection of information.e. TreatmentInformation regarding your interventions belongs in this section.f. Transport DataThis section should contain information about patient transport. This information isneeded whether the patient remained at the scene, was transported by ambulance, or wastransported by the First Responder to a hospital.7. Application of Content Materiala. Procedural (How)Demonstrate familiarity with the call sheet.First Responder EMS Curriculum/AIHA, July 2002 237
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PrefaceIn the region of Central and
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Practical Lab MaterialsAirway .....
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Guidelines for Conducting the First
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sheets supplied in this guide will
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should have attended a workshop tha
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Job Description: First ResponderThe
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c. Additional Skills1. Use of the t
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as possible. After students have pr
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Guidelines for Case-Based Practical
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General Lecturing GuidelinesChapter
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discussing the different methods of
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survival. First Responders include
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medical director functions to ensur
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First Responder EMS Curriculum/AIHA
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Well-Being of the First ResponderCo
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and family. Do not become defensive
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1. Eye protection. Safety glasses m
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Legal and Ethical IssuesContents1.
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a. Expressed ConsentExpressed conse
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14. DocumentationProviding written
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The Human Body: A Systems ApproachC
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that the pharynx performs the dual
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c. Kinesthetic (Doing)1. Students w
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38 First Responder EMS Curriculum/A
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Lifting and Moving PatientsContents
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If the patient is on the floor or g
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7. Application of Content Materiala
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14. Describe how to clear a foreign
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Precautions1. Finger must not press
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. Finger SweepsThis method involves
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4. Place your other fingers along t
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. Management of the Obstructed Airw
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5. Students will practice ventilati
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19. Explain what additional questio
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can be determined by questioning th
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Determine estimated time of arrival
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E - Events Leading to the Injury or
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c. Kinesthetic (Doing)1. Students w
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100 First Responder EMS Curriculum/
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CirculationContents1. Objectivesa.
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Veins are the vessels that carry bl
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Step 5:Step 6:Step 7:Step 8:Step 9:
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Steps of Infant CPRStep 1: Assess r
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a. Use of the Semiautomatic Externa
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PracticalEvaluate the actions of th
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Medical EmergenciesContents1. Objec
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5. Demonstrate the steps in providi
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additional emergency medical person
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this internal temperature, adverse
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Signs and SymptomsSigns and symptom
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3. Ask questions in a calm, reassur
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EvaluationWrittenDevelop evaluation
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2. Attend to the feelings of the pa
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transmission of disease to yourself
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Sharp, pointed objects cause penetr
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c. Chemical BurnsChemical burns fro
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6. Partial-thickness burns7. Full-t
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2. Demonstrate opening the airway i
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3. Try to pad the extremity to prev
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soft tissue injuries. Remember, the
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Page 222 and 223: 2. IntroductionChildbirth can occur
Page 224 and 225: a. Delivery ProceduresWhen assistin
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Page 235 and 236: Infants and ChildrenContents1. Obje
Page 237 and 238: Suctioning the airway also is an im
Page 239 and 240: 6. Common Problems in Infants and C
Page 241 and 242: Remember that parents will be in ag
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Page 256 and 257: 3. DispatchDispatch is the communic
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Page 265: Documentation and Quality Managemen
Page 273 and 274: Practical Lab: AirwayObjectives1. C
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Page 295: EvaluationPracticalEvaluate the act
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12. As the feet are delivered, gras
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2. The rescuer at the head places o
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Skill Algorithms: AirwayForeign Bod
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Trauma PatientSkill Algorithms: Pat
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Skill Algorithms: Patient Assessmen
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Two-Person CPRSkill Algorithms: Cir
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External BleedingSkill Algorithms:
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Skill Algorithms: Illness and Injur
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Skill Algorithms: Childbirth and Ch
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Skill Algorithms: Lifting and Movin
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Skill Algorithms: Lifting and Movin
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Sample Case Scenario - Patient Asse
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Sample Case Scenario - Illness and
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Sample Case Scenario - Childbirth a
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• Demonstrate the extremity lift.
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Figure 6. Check for unresponsivenes
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Head Tilt-Chin Lift ManeuverTo acco
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help. Monitor the victim, particula
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necessary to open the victim's mout
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In the second technique (lateral te
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is important to note that this smal
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CirculationAssessment: No Pulse Che
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these arteries even when hypotensio
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the nipples. This method has been u
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Current evidence indicates that the
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assess the victim's responsiveness
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arrhythmias should be instructed to
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jaw lift, for use in unresponsive v
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Figure 29. Mouth-to-mouth breathing
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Types of Ventilation Bags (Manual R
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Gastric Inflation. Increasing inspi
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. Specificity (ability to correctly
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After provision of approximately 20
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Chest Compression in the Infant (<
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ventilation after every fifth compr
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Coordination of Compressions and Re
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necessary to maintain optimal venti
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5. Keep foreign objects (i.e., marb
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Figure 38. Subdiaphragmaticabdomina
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tongue. Then use a hooking action t
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APPENDIX DRelief of Foreign-Body Ai
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Figure 41. Infant back blows to rel
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4. Repeat steps 1 through 3 until t
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6. It may be necessary for the Firs
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18. The correct rate to deliver che
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30. What is the greatest danger to
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First Responder Post-Course Test1.
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12. Which of the following statemen
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24. Components of an ongoing assess
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36. An adult patient sustains burns
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48. Which of the following is true?
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First Responder Extra Test Question
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11. Negligence is the deviation fro
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Answer KeyFirst Responder Extra Tes
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First Responder EMS Curriculum for Training Centers in Eurasia

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