1

Emergency Medical
Service System
and the EMR
 2
Objectives
Upon completion of this lesson, you will be
able to:
1. define Emergency Medical Service (EMS)
System

2. explain the historical background of EMS in

sequence

3. identify the components of the EMS system

correctly;

Emergency Medical Responder Course

 Objectives 3

4. explain the meaning of the logo, ‘Star of Life”

based on the explanation of the American
Academy of Orthopaedic Surgeons 10th Edition;
5.
. identify the different levels of training in proper
order;
6. appreciate and practice the roles and
responsibilities of an EMR appropriately;
7. explain the regulation and policies of the BFP in
the EMS system based on BFP MC 2008-011; and,

Emergency Medical Responder Course SL 2-2

Rev. March 2014
 Objectives 4

8. understand and apply the ethical principles

applicable in the EMS system.

Emergency Medical Responder Course

 5

Emergency Medical Services

(EMS) System
The chain of human resources and services
linked together to provide continuous
emergency care from the onset of care at the
pre-hospital scene, during transport, and on
arrival at the medical facility.

Emergency Medical Responder Course

 6

A network of resources
linked together for the
purpose of providing
emergency care and
transport to victims of
sudden illness or injury.
 History of Emergency Medical
Services (1 of 3)
 Emergency care developed during
warfare at the beginning of the 20th
century.
 By the 1960s, domestic emergency
care lagged behind.
 Staffed emergency departments were
often limited to large urban areas.
 History of Emergency Medical
Services (2 of 3)
Accidental Death and Disability:
The Neglected Disease of Modern
Society (1966)
Recommended:
Development of training
Development of federal guidelines and
policies
Provide emergency care and transport
Establish staffed emergency departments
 History of Emergency Medical
Services (3 of 3)
Highway Safety Act and
the Emergency Medical Act
created funding
DOT developed the first
National Standard
Curriculum for training
EMTs in the early 1970s
EMS established in most of
the United States by 1980
1
0
EMS in the Philippines 1
1

 1970 – ambulance services serves as extension

of hospital services. NGOs and LGUs saw the
need to purchase transport vehicles for
emergency care.
1986 – Emergency Rescue Unit Foundation (ERUF)expanded in
CEBU City.

1990s – MMDA, BFP, Subic EMS, PGH upgraded

Ambulance services.
Lifeline Arrow, Makati Rescue, QC EMS, Davao 911
 1
2
Components
1
3
1
4
 1
5

Communication
1
6
Components of EMS System1
7

Regulation and Policy

Resource Management
Human Resources and Training
Transportation
Facilities
Components of EMS 18

System
Communications
Public Information and Education
Medical Direction
Trauma System
Evaluation
 1
9

Star of Life
 2
0

Emergency Medical Responder Course

 2
1
• The symbol applies to all emergency medical goods
and services which are funded under the DOT/EMS
programs.

• Designed by Leo R. Schwartz, chief of the EMS

Branch, National Highway Traffic Safety
Administration(NHTSA)
 22

•The first Symbol was an Omaha Orange Cross on a

square background of reflectorized white.

• The “Star of Life” was created after the American

Red Cross complained in 1973.
 2
3

Levels of EMS Training

Emergency Medical Responder Course

Levels of EMS Training 2
4
(Philippines)
 Lay Rescuer
 First Aider
 Medical/First Responder
 Ambulance Care Assistant
 EMT-B
 EMT-D
 EMT-Advance
 EMT-Paramedic
 2
5

Emergency Medical Responder Course

Levels of EMS Training 26

 Emergency Medical Responder

(EMR)
 Emergency Medical Technician –
Basic
(EMT – B)
 EMT Advance
 Paramedic
 2
7
Emergency Medical Responder

They are usually the first medically trained

personnel to reach the patient.

Emergency Medical Responder Course

Duties of EMR
 Protect your safety and safety of
your crew, the patient, and
bystanders.
 Gain access to the patient.
 Assess the patient to identify life
threatening problems.
 Alert additional EMS resources.
 Provide care based on
assessment findings.
Duties of EMR

 Assist other EMS personnel.

 Participate in record keeping &
data collection as received.
 Act as liaison with other public
safety workers.
 Perform patient packaging &
preparation for movement &
transport.
3
0
MEMORANDUM CIRCULAR 3
1
NUMBER 2008-011
SUBJECT: AMENDED POLICIES, GUIDELINES
AND PROTOCOLS ON BFP EMS
OPERATIONS
3
2
 3
3
EMS Models

1. Fire-based
2. Third-service
3. Hospital-based

Emergency Medical Responder Course

 3
Activating EMS 4

Emergency Medical Responder Course

EMS in the Bureau 3
5
of Fire Protection
1992 – Emergency Medical responses started
through the leadership of Ret. Gen.
Mario Tanchangco
- Using L300 vans as response vehicle.

- Oplan Sagip Buhay (DILG)

1998 – thru Project EARnet 117, BFP-EMS

was activated
- through the leadership of Ret. Gen.
Francisco Senot
EMS in the Bureau 3
6
of Fire Protection
In line with its objective to serve
the people better, the command
activated the Emergency Medical
Rescue Service (EMRS) which
delivers free rescue and
ambulance services to the people
from all walks of life in all kinds of
emergency.
 3
7

 Each central fire stations and

District Fire Stations has its own
Medical Service Unit manned
by highly trained
Paramedics and Nurses
and state-of-the-art
ambulances and rescue vans
similar to those being used by
Rescue 911 in the United
States.
 3
 The command has a total of 25 8
ambulances and rescue vans in its line
force ready to be dispatched during fire
alarms and other emergency calls with
its staff of expert paramedics prepared
to conduct first aid and rescue
operations.

 To
easily avail the immediate service of
BFP-NCR EMS, as well as fire protection
and suppression service, the public is
advised to call the hotline number 117
 3
Basic Equipment of the MFR 9

Basic personal protective equipment (PPE)

 Latex gloves
 Personal Mask
 Eye Protection
 Gown
 CPR mask
 4
Basic Equipment of the MFR 0

Basic equipment for pre-hospital care

 Backboard
 Dressings
 Cervical collars
 Bandages
 Sheets
 4
Legal and Ethical Principles of1
Emergency Care
Good Samaritan Law
- A series of state laws designed to protect
certain care providers if they deliver the
standard of care in good faith, to the level of
training, and the best of their abilities.

Emergency Medical Responder Course SL 4-4

Rev. March 2014
42
 Philippine EMS Law 4
3
 1990 – Proposed by Senator Webb
 SB 2091 – EMS and Trauma Care Act of 2008
 SB 3458 – EMS System of 2009
 HB 7086 – EMS Standard Act of 2010
 SB3579 – Pre Hospital Amergency Care act of
2010
 HB 1675 – EMS and Trauma Care Act of 2010
 SB2410 – Pre-Hopital Emergency Care Act of
2010
 HB1714 - Pre-Hopital Emergency Care Act of
2010
Philippine EMS Law 44

 HB5928 - Pre-Hopital Emergency Care Act of

2012
 HB1489 - Pre-Hopital Emergency Care Act of
2013
 HB 4577 - Pre-Hopital Emergency Care Act
 4
5

Do you have a duty?

 4
6

RA 9514
BFP Mission: 4
7

We commit to prevent and

suppress destructive fire,
investigate its causes
enforce fire code and
other related laws,
respond to man-made
and natural disaster and
other emergencies
 4
8
Duty

Legal obligation to provide care

Emergency Medical Responder Course

 4
9

Legal Responsibi1ity
1. Standard of care
2. Scope of Practice

Emergency Medical Responder Course

 5
Legal Responsibi1ity 0

Standard of care
- the care that should be provided for any
level of training based on local laws,
administrative orders, and the guidelines and
order established by the local EMS system.

Emergency Medical Responder Course SL 4-8

Rev. March 2014
 5
Legal Responsibi1ity 1

Scope of Practice
refers to what is legally permitted to be done
by some or all individuals trained or licensed
at particular level.

Emergency Medical Responder Course SL 4-6

Rev. March 2014
 5
Ethical Responsibility 2

Ethics – study of principle that define

behavior as right, good and proper
Values – core of beliefs how a person
actually behaves

Emergency Medical Responder Course SL 4-9

Rev. March 2014
 5
3
Consent

legal term that means to give formal

permission for something to happen

Emergency Medical Responder Course SL 4-10

Rev. March 2014
 5
Consent 4

Competence – the quality of being

adequately or well qualified to make
decisions both physically and intellectually.
Competent – properly or sufficiently
qualified or capable of making decisions
about one’s own condition

Emergency Medical Responder Course SL 4-11

Rev. March 2014
 5
Types of Consent 5

1. Expressed
2. Implied

Emergency Medical Responder Course SL 4-12

Rev. March 2014
 5
6
Emancipated Minor

A minor whose parents have entirely

surrendered the right to the care, custody,
and earnings and no longer are under any
duty to support the minor.

Emergency Medical Responder Course SL 4-12

Rev. March 2014
 5
Refusal of care 7

- stay calm and professional

-Inform them the potential dangers and
refusal
-Use the aid of someone the patient trust to
try to convince
-Document

Emergency Medical Responder Course SL 4-13

Rev. March 2014
 5
Advance Directives 8

-document that allow the patient to define in

advance what his wishes are should become
should he become incapacitated due to
medical illness or severe injury.

Emergency Medical Responder Course SL 4-14

Rev. March 2014
 Advance Directives 5
9
- Designation of agent to make decision on
your behalf
- Do nor resuscitate order (DNR)
- Choice to prolong or not prolong life
- Pain relief
- Donation of organs
. Emergency Medical Responder Course SL 4-15
Rev. March 2014
 6
0
Negligence
Failure to provide the expected standard
of care.

Emergency Medical Responder Course

 Elements of Negligence 6
1
1. Duty to act - legal duty to provide care
2. Breech of duty – care of patient was not
provided to acceptable standard of care.
3. Damages – patient was injured
4. Causation – a direct link can be
established between damages of patient
and breech of duty
Emergency Medical Responder Course
 6
Abandonment 2

To leave a sick or injured patient before

equal or more highly trained personnel can
assume responsibility of care.

Emergency Medical Responder Course

 6
Confidentiality 3

Refers to the treatment of information that an

individual has disclosed in relationship of
trust and with the expectation that it will not
be divulged to others.

Emergency Medical Responder Course SL 4-19

Rev. March 2014
 6
4

~~ The End ~~

Emergency Medical Responder Course