Chap 1 Intro To Advanced EMT Practice

Advanced EMT
A Clinical-Reasoning Approach
CHAPTER 1
Introduction to Advanced
Emergency Medical
Technician Practice
Advanced EMT
Education Standard
• Applies fundamental knowledge of the
EMS system, safety/well-being of the
AEMT, and medical/legal and ethical
issues to the provision of emergency
care.
Advanced EMT: A Clinical-Based Approach

Melissa Alexander • Richard Belle • Medical Editor: Steven Weiss
Objectives
1. Define key terms introduced in this

chapter.
2. Describe the competencies, roles,
responsibilities, and professional
characteristics of the Advanced
Emergency Medical Technician (AEMT).
16-17, 31-37
3. Describe the scope of practice of the
AEMT. 5-9

Objectives
4. Place the roles and responsibilities of the

AEMT in the larger contexts of emergency
medical services (EMS), health care, and
public health. 21-29
5. Discuss key issues in the contemporary
practice of the AEMT, including
professionalism, the focus on patient
safety, research, and evidence-based
practice. 10, 20, 30, 38

Introduction
• AEMTs are a critical part of the

emergency medical services (EMS).
• They provide comfort, emergency
medical care, and transportation.
• AEMTs provide a link between patients
and the health care and public health
systems.

EMS and EMS Providers
• EMS systems developed to provide life-

saving care and emergency
transportation to critically ill and
injured patients.
• EMS providers engage in community
health education and promotion efforts
and work in a variety of settings.

The Contemporary
EMS Profession
• EMS knowledge defined in documents
published by NHTSA.
– National EMS Core Content
– National EMS Scope of Practice
– National EMS Education Standards

EMS and EMS Providers
Figure 1–1 AEMTs work in a variety of settings.

(© Craig Jackson/In the Dark Photography)

The Contemporary EMS Profession
• EMT Oath and EMT Code of Ethics

describe the professional conduct
expected of EMS personnel.
• EMS providers must be aware of
activities and agendas of major EMS
state and national professional agencies
and organizations.

Think About It
• While on a call you see a coworker

photograph a patient. Later, when you
ask them about it, they tell you they
are going to post the photo online
because it was unusual.
• What role do rules of professional
conduct play in this situation?

EMS Provider Levels
• Four nationally recognized levels of

EMS providers
– Emergency medical responder (EMR)
– Emergency medical technician (EMT)
– Advanced emergency medical technician
(AEMT)
– Paramedic

EMS Provider Levels
• Emergency Medical Responders (EMRs)

– Trained in very basic skills.
– Use minimal equipment.
– Provide basic first-aid measures to less
critically ill and injured patients.
– Can perform simple assessments to
identify and manage life threats.

EMS Provider Levels
• Emergency Medical Responders (EMRs)

– Use basic airway management and
ventilation skills, CPR, AED, simple
methods to control bleeding.
– Trained to recognize injuries that
require immobilization.
– Training completed in 48 to 60 hours.

EMS Provider Levels
• Emergency Medical Technicians (EMTs)

– Provide emergency medical care and
transportation.
– Use basic equipment supplied on an
ambulance.
– Play a variety of roles in EMS systems.
– Act in a first-response capacity.
– Provide immediately life-saving care.

EMS Provider Levels
• Emergency Medical Technicians (EMTs)

– May provide primary transporting EMS
service in a community or work for
ambulance services.
– May work with partner at same level or
may work with an AEMT or paramedic
partner.
– Trained to assess patients.
– Training completed in 150 to 190 hours.

EMS Provider Levels
• Advanced EMT
– Training includes all knowledge and
skills of EMRs and EMTs.
– Able to provide limited number of
advanced life support (ALS)
interventions.
– Must practice within the Scope of
Practice approved by state and EMS
service physician medical director.

EMS Provider Levels
• Advanced EMT
– Must either have completed EMT
training or it must be incorporated into
program.
– Training requires 150 to 250 hours
beyond time required to complete EMT
training.

EMS Provider Levels
• Paramedics
– Allied health care professionals who
provide complex assessments and
interventions for critical and emergent
patients.
– Complex understanding of anatomy,
physiology, pathophysiology, and
treatment modalities.

EMS Provider Levels
• Paramedics
– Education programs are often based in
institutions of higher education.
– The Commission on Accreditation of
EMS programs (CoAEMSP) accredits
paramedic education programs.
– Programs range from 1000 to 1500
hours beyond—EMT level.

Think About It
• A tour bus MVC has occurred in your

jurisdiction, resulting in multiple
injuries and possible fatalities.
• What levels of EMS responders are
likely to be on-scene?
• Responders must work together.

Advanced EMT Roles and
Responsibilities
Figure 1–5 AEMT responsibilities include making sure equipment and the emergency
vehicle are prepared to respond to emergency calls.

Responsibilities
• Each state has legislation that defines
the Scope of Practice of licensed EMS
personnel.
• Emergency vehicle readiness and
operations
– Emergency vehicle must be in good
mechanical repair and driven safely.
– Vehicle must have adequate amount of
required equipment and supplies.

Responsibilities
• Safety
– Responsibility for own safety, and safety
of coworkers, patients, and others.
– Important to adhere to the AEMT’s safe
medication administration practices.
– Awareness of safety of public while
operating emergency vehicle and safety
of others at scene of emergency.

Responsibilities
Figure 1–6 Teamwork is required to integrate the tasks of patient care and patient
transportation.

Responsibilities
• Scene leadership, management,
teamwork
– Be confident and in control.
– Be empathetic to medical and emotional
needs of patients and family members.
– Patient assessment, care, and
transportation must be integrated into a
smooth process.

Responsibilities
• Patient assessment and management
– Ability to assess and manage patients
who have variety of illnesses and
injuries from minor to critical.
– Be aware of the most current trends
and practices in EMS.
– Be willing to discard outdated
knowledge and practice to add new
ones.

Responsibilities
• Maintaining certification or licensure
– An individual professional obligation of
each health care provider, not a
responsibility of employers or
educational institutions.
– Requirements include documentation of
mandatory continuing education
activities, medical director verification of
skills, submission of CPR card, payment
of a fee.
Responsibilities
Figure 1–7 AEMTs work closely with other health care and public safety providers.

Responsibilities
• Working with other public safety and
health-care personnel
– Emergency medical services are cross-
disciplinary; both public safety and
health care personnel.
– Strive to maintain cooperative
relationships with other professionals.

Think About It
• You arrive at the emergency

department with a 9-year-old drowning
victim.
• What is the most important information
to share in the handoff?
• What could result from an incomplete
handoff?

Advanced EMT Professional
Characteristics
• Professional characteristics defined by
– Expectations of public
– Professional group itself
– Other related professional groups
– Most visible way patients and families
can judge—professionalism is through
interactions with them

Characteristics
• Define each term listed below
– Integrity
– Empathy
– Self-motivation

Characteristics
Figure 1–8 Appearance and demeanor are critical elements of professionalism.

Characteristics
• Why do EMS personnel wear uniforms?
• Define the each term listed below
– Self-confident
– Self-confidence

Characteristics
• Who do AEMTs communicate with?
• Why is good communication required?
• What does good time management
mean?

Characteristics
• Define each of the following terms
– Teamwork
– Diplomacy (tact)
– Respect

Characteristics
• Define each of the following terms
– Patient advocacy
– Careful delivery of service

Think About It
• You and your partner respond to a

domestic violence call at a familiar
address. You arrive shortly after law
enforcement.
• How do you proceed?

Chapter Summary
• AEMTs are an essential part of EMS and

of the health care and public health
systems.
• AEMTs are health care professionals of
whom the public has high expectations.


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Advanced EMT

Advanced EMT: A Clinical-Based Approach

1. Define key terms introduced in this

Advanced EMT: A Clinical-Based Approach

4. Place the roles and responsibilities of the

Advanced EMT: A Clinical-Based Approach

• AEMTs are a critical part of the

Advanced EMT: A Clinical-Based Approach

• EMS systems developed to provide life-

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Figure 1–1 AEMTs work in a variety of settings.

Advanced EMT: A Clinical-Based Approach

• EMT Oath and EMT Code of Ethics

Advanced EMT: A Clinical-Based Approach

• While on a call you see a coworker

Advanced EMT: A Clinical-Based Approach

• Four nationally recognized levels of

Advanced EMT: A Clinical-Based Approach

• Emergency Medical Responders (EMRs)

Advanced EMT: A Clinical-Based Approach

• Emergency Medical Responders (EMRs)

Advanced EMT: A Clinical-Based Approach

• Emergency Medical Technicians (EMTs)

Advanced EMT: A Clinical-Based Approach

• Emergency Medical Technicians (EMTs)

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

• A tour bus MVC has occurred in your

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

• You arrive at the emergency

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Figure 1–8 Appearance and demeanor are critical elements of professionalism.

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

Advanced EMT: A Clinical-Based Approach

• You and your partner respond to a

Advanced EMT: A Clinical-Based Approach

• AEMTs are an essential part of EMS and

Advanced EMT: A Clinical-Based Approach

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