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EMT Basic · Chapter 1 · Review · Chapter track

EMS Systems

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

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

Chapter web resources

Optional reading from authoritative sites. Your textbook remains the primary source for this course.

When sources disagree (5 topics to verify before you teach from this chapter alone)

Printable study sheetPrintable flashcards (PDF, 10-up)Read first, then practise the track.

Showing Chapter track material. Switch tracks on the chapter page.

Vocabulary · 11

  • AEMT

    Advanced EMT; intermediate scope bridging EMT and paramedic. Utilization: May include limited ALS skills per state and protocol.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • 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.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • 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.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • Offline medical direction

    Prospective direction through protocols, policies, and training approved in advance. Utilization: Guides default care paths before you speak with a physician.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • 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.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • Paramedic

    Highest common prehospital clinician in many systems; broad ALS scope. Utilization: Leads complex airway, pharmacology, and critical care transitions.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

    Learn more on the web

  • Protocol

    Written standing guidance approved by medical direction. Utilization: Defines assessments and interventions within scope.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

  • PSAP

    Public safety answering point where emergency calls are received. Utilization: Starting node for 911 processing and resource assignment.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

  • Quality improvement (QI)

    Systematic review to improve care delivery. Utilization: Uses charts, audits, and feedback without blaming individuals.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

  • 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.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

  • 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.

    SourcePrinted pages 2–29. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)

Sequences · 2

  • Levels of EMS training — Order EMS provider levels from the least to the most advanced scope of practice.
  • EMS call lifecycle — Order the phases of a typical EMS response from start to end.