First Responder EMS Curriculum for Training Centers in Eurasia

6. The In-Hospital Care SystemThe goal of all pre-hospital EMS personnel is to identify patients with illness or injury andtransport them as quickly and safely as possible to facilities where more definitive medicalcare can begin. Hospitals constitute the final destination for all patients. Hospitals mayvary in their capabilities to care for patients with certain medical and traumatic illnesses orinjuries. Emergency departments represent the front line of emergency care in the hospitalsystem. Doctors and nurses trained in the emergency care of patients with a vast array ofmedical and traumatic emergencies continue the care begun by pre-hospital personnel inthe field. Transfer of patients to more specialized facilities should be considered as soon aslife-threatening problems have been managed and the patient is stabilized. These facilitiesmay include trauma centers, burn centers, pediatric centers, perinatal centers, and poisoncenters.7. Overview of the Local EMS SystemIt is important for local EMS systems to continually evaluate and update their currentsystems. This effort involves retraining and recredentialing of EMS pre-hospital and inhospitalpersonnel on a routine basis.8. Roles of the First ResponderThe First Responder is usually the first care provider at the scene of a medical or traumaticemergency. The First Responder plays several important roles at the scene. The firstpriority is always personal safety, as well as patient and other bystander safety. It isnecessary to gain access to the patient without risking personal injury or further injury tothe patient. After gaining access to the patient, the First Responder assesses the patient toidentify life-threatening conditions. The next step is contacting additional EMS personnelfor help and continuation of care. Based on the initial patient assessment, the FirstResponder then initiates emergency care until further EMS personnel arrive to help. Oncemore advanced help arrives, the First Responder functions to inform other EMS personnelof the events prior to their arrival and the emergency care already performed. The FirstResponder acts as liaison with other public safety workers, including local lawenforcement, fire departments, and other EMS providers.9. Responsibilities of the First ResponderTo maintain optimum performance, a First Responder must fulfill several responsibilities.Always maintain personal health and safety. You cannot help a patient if you become ill orinjured yourself. Always maintain a caring attitude. Reassure and comfort the patient,family, and bystanders while awaiting other EMS personnel. Maintain composure,confidence in your training, and a clean and professional appearance. Make the patient’sneeds a priority without endangering yourself or others at the scene. The First Respondershould provide continuity of care by communicating patient information to the EMSpersonnel taking over the care of the patient. It is also the responsibility of the FirstResponder to maintain up-to-date knowledge and skills, including continuing education,refresher courses, and recertification. Maintain current knowledge of local, industrial, andnational issues affecting EMS systems.10. Medical Oversight of the EMS SystemEvery EMS system consists of a formal relationship between the EMS providers at alllevels of training and the physician responsible for providing pre-hospital emergency carein the community. This physician is often referred to as the system medical director. TheFirst Responder EMS Curriculum/AIHA, July 2002 3