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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 1

EMS Systems

Why this chapter matters

Patients move through a regulated system; your authority and responsibilities come from law, medical oversight, and agency policy.

Learning objectives (14)

  1. Characterize the EMT’s role in disease and injury prevention and public education in the community — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  2. Define emergency medical services (EMS) systems — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  3. Define mobile integrated health care and community paramedicine — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  4. Describe EMT licensure criteria; include how the Americans With Disabilities Act (ADA) applies to employment as an EMT — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  5. Describe how medical direction in an EMS system works and the EMT’s role in the process — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  6. Describe the attributes an EMT is expected to possess — Knowledge/skills objective (printed page 3); confirm wording in your course copy.
  7. Describe the levels of EMT training in terms of sets of knowledge, skills, and attitudes needed for each of the following: EMR, EMT, AEMT, and paramedic — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  8. Describe the roles and responsibilities of the EMT — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  9. Discuss the historical background of the development of the EMS system — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  10. Explain the guiding principles of EMS Agenda 2050 — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  11. Explain the impact of the Health Insurance Portability and Accountability Act (HIPAA) on patient privacy — Knowledge/skills objective (printed page 3); confirm wording in your course copy.
  12. Explain the purpose of the EMS continuous quality improvement (CQI) process — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  13. Name the four levels of EMT training and licensure — Knowledge/skills objective (printed page 2); confirm wording in your course copy.
  14. Recognize the presence of other first responders at a scene with EMS training, some knowledge of first aid, or merely good intentions, and their need for direction — Knowledge/skills objective (printed page 2); confirm wording in your course copy.

Chapter outline

  1. Historical development of EMS in the U.S.; roles of fire service, third service, private, and volunteer models
  2. National EMS Research Agenda / evidence-informed practice (high level)
  3. Agenda 2050 (national EMS modernization themes at overview level)
  4. Components of an EMS system: community (public), agency (EMS organization), communications, transportation and destination networks, assessment and care, continuity of care, information systems, evaluation (system performance)
  5. Human resources: EMR, EMT, AEMT, paramedic; training, credentialing, certification vs licensure
  6. Medical oversight: offline (protocols, standing orders, training) vs online (direct voice contact); role of physician medical director
  7. Regulation and standards: state EMS office; National EMS Scope of Practice Model (conceptual fit of your level)
  8. Quality improvement: CQI/QA mindset; documentation supporting system learning
  9. Research literacy: why protocols change; how to read summaries cautiously as an EMT
  10. Professionalism: reliability, accountability, boundary with media/public safety messaging

Vocabulary (11)

AEMT
Advanced EMT; intermediate scope bridging EMT and paramedic. Utilization: May include limited ALS skills per state and protocol.
Continuity of care
Unbroken transition of assessment, treatment, and information across EMS and hospital teams. Utilization: Give concise handoffs and complete documentation so the next caregiver can continue the plan.
Medical director
Physician who provides oversight, protocols, and quality direction for an EMS agency. Utilization: Protocols and standing orders derive authority from this leadership role.
Offline medical direction
Prospective direction through protocols, policies, and training approved in advance. Utilization: Guides default care paths before you speak with a physician.
Online medical direction
Real-time physician guidance by radio or phone during a call. Utilization: Use for unusual presentations, protocol deviations, or medications requiring voice contact.
Paramedic
Highest common prehospital clinician in many systems; broad ALS scope. Utilization: Leads complex airway, pharmacology, and critical care transitions.
Protocol
Written standing guidance approved by medical direction. Utilization: Defines assessments and interventions within scope.
PSAP
Public safety answering point where emergency calls are received. Utilization: Starting node for 911 processing and resource assignment.
Quality improvement (QI)
Systematic review to improve care delivery. Utilization: Uses charts, audits, and feedback without blaming individuals.
Scope of practice
Range of duties and skills an EMS clinician may perform by regulation and medical oversight. Utilization: Stay inside training and local protocol; ask for online orders when care exceeds standing orders.
Standing orders
Written treatment authorizations within protocols that crews may initiate without a call. Utilization: Allows immediate lifesaving steps when criteria in protocol are met.

Sequence practice (2 puzzles on Quiz Me)

Levels of EMS training

Order EMS provider levels from the least to the most advanced scope of practice.

  1. EMR — Emergency Medical Responder
  2. EMT — Emergency Medical Technician
  3. AEMT — Advanced EMT
  4. Paramedic
EMS call lifecycle

Order the phases of a typical EMS response from start to end.

  1. Citizen recognizes emergency and calls 9-1-1
  2. PSAP dispatches the appropriate units
  3. Crew arrives and performs scene size-up
  4. Primary assessment and patient care begin
  5. Patient is transported to the receiving facility
  6. Crew completes documentation and QI review

Quick fire sample (11 of 11 on Quiz Me)

Public safety answering point where emergency calls are received.
  1. Standing orders
  2. Protocol
  3. Online medical direction
  4. PSAP
Advanced EMT; intermediate scope bridging EMT and paramedic.
  1. AEMT
  2. Continuity of care
  3. Scope of practice
  4. Standing orders
Unbroken transition of assessment, treatment, and information across EMS and hospital teams.
  1. Continuity of care
  2. Scope of practice
  3. Standing orders
  4. requirements
Range of duties and skills an EMS clinician may perform by regulation and medical oversight.
  1. Scope of practice
  2. PSAP
  3. requirements
  4. Medical director
Written standing guidance approved by medical direction.
  1. Medical director
  2. Protocol
  3. Scene size
  4. PSAP
Written treatment authorizations within protocols that crews may initiate without a call.
  1. Offline medical direction
  2. Standing orders
  3. Medical director
  4. Data
Systematic review to improve care delivery.
  1. PSAP
  2. AEMT
  3. Quality improvement (QI)
  4. Standing orders
Prospective direction through protocols, policies, and training approved in advance.
  1. Paramedic
  2. Offline medical direction
  3. Online medical direction
  4. Continuity of care
Real-time physician guidance by radio or phone during a call.
  1. Online medical direction
  2. Quality improvement (QI)
  3. requirements
  4. Protocol
Physician who provides oversight, protocols, and quality direction for an EMS agency.
  1. Continuity of care
  2. Online medical direction
  3. requirements
  4. Medical director
Highest common prehospital clinician in many systems; broad ALS scope.
  1. Continuity of care
  2. Scope of practice
  3. Paramedic
  4. Quality improvement (QI)

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/01/print/. Answers are not marked on this sheet.