Chapter 1. Introduction to Prehospital Care OBJECTIVES Part 1: Introduction to Advanced Prehospital Care (begins on p. 6) After reading Part 1 of this chapter, you should be able to: 1. Describe the relationship between the paramedic and other members of the health professions. (p. 6) 2. Identify the attributes and characteristics of the paramedic. (p. 7) 3. Explain the elements of paramedic education and practice that support its stature as a profession. (p. 7) 4. Define and give examples of the expanded scope of practice for the paramedic. (p. 8) Part 2: EMS Systems (begins on p. 8) After reading Part 2 of this chapter, you should be able to: 1. Describe key historical events that influenced the national development of emergency medical services (EMS) systems. (pp. 10-12) 2. Define the following terms: EMS systems (p. 12), licensure (p. 18), certification (p. 18), profession (p. 18), professionalism (p. 24), ethics (p. 25), peer review (p. 25), medical direction (p. 14), protocols (p. 15). 3. Identify national groups that are important to the development, education, and implementation of EMS, as well as the role of provincial or territorial associations, the Paramedic Association of Canada (PAC), and the roles of various EMS standard-setting agencies. (p. 20) 4. Identify the standards (components) of an EMS system. (p. 12) 5. Differentiate among EMS provider levels: emergency medical responder, primary care paramedic, advanced care paramedic, and critical care paramedic. (p. 18) 6. Describe what is meant by "citizen involvement in the EMS system." (pp. 15-16) 7. Discuss the role of the EMS physician in providing medical direction and prehospital care as an extension of the physician, the benefits of online and offline medical direction, and the process for the development of local policies and protocols. (pp. 14-15) 8. Describe the relationship among the physician on the scene, the paramedic on the scene, and the EMS physician providing online medical direction. (pp. 14-15) 9. Describe the components of continuous quality improvement, and analyze its contribution to system improvement, continuing medical education, and research. (pp. 23-25) 10. Describe the importance, basic principles, process of evaluating and interpreting, and benefits of research. (pp. 25-26) Part 3: Roles and Responsibilities of the Paramedic (begins on p. 26) After reading Part 3 of this chapter, you should be able to: 1. Describe the attributes of a paramedic as a health-care professional. (pp. 30-34) 2. Describe the benefits of continuing education for paramedics and the importance of maintaining the paramedic licence or certification. (p. 35) 3. List the primary and additional responsibilities of paramedics. (pp. 27-30) 4. Define the role of the paramedic relative to the safety of the crew, the patient, and bystanders. (pp. 27-28) 5. Describe the role of the paramedic in health-education activities related to illness and injury prevention. (pp. 29-30) 6. Describe examples of professional behaviours in the following areas: integrity, empathy, selfmotivation, appearance and personal hygiene, self-confidence, communication, time management, teamwork and diplomacy, respect, patient advocacy, and careful delivery of service. (pp. 32-34) 7. Identify the benefits of paramedics teaching in their communities. (pp. 29-30) 8. Analyze how the paramedic can benefit the health-care system by supporting primary care for patients in the prehospital setting. (pp. 28-29) 9. Describe how professionalism applies to the paramedic while on and off duty. (p. 31) Part 4: The Well-Being of the Paramedic (begins on p. 35) After reading Part 4 of this chapter, you should be able to: 1. Discuss the concept of wellness and its benefits, the components of wellness, and the role of the paramedic in promoting wellness. (p. 35) 2. Discuss how cardiovascular endurance, weight control, muscle strength, and flexibility contribute to physical fitness. (pp. 35-40) 3. Describe the impact of shift work on circadian rhythms. (p. 49) 4. Discuss the contributions that periodic risk assessments and warning sign recognition make to cancer and cardiovascular disease prevention. (p. 37) 5. Differentiate proper from improper body mechanics for lifting and moving patients in emergency and nonemergency situations. (pp. 38-40)