The Development of Civilian Emergency Medical Services in the United States

During the 1950s, Emergency Management underwent several changes due to relations between the US and the Soviet Union and the Cold War. The fear of a nuclear war and fallout prompted the creation of many civil defense programs and the building of bomb shelters to protect individuals and families. Along with the civil defense program, two major organizations were created due to the Cold War scare, the Federal Civil Defense Administrator (FCDA), and the Office of Defense and Civilian Mobilization (ODCM). Civil defense programs were run by the local government, with state level liaison and functioned under the Federal Civil Defense Administrator. Civil defense directors were typically retired military personnel and they generally received

Could you imagine working as a EMT and not knowing what could happen at anytime that you are on the job. As you can tell this job is in very high demand, people are in need of people to run emergency vehicles. Emergency Medical Technicians have been in need since the 1960s, Emergency Medical Technicians have to go through extensive training and meet education requirements to be able to do this job. There are many different things that Emergency Medical Technicians do while on the job, there are also very many levels to being an Emergency Medical Technicians.

The American Red Cross (ARC) is an organization that was founded in 1881 by Clara Barton and established itself as the most well-known emergency relief organization devoted to the care of war victims, disaster victims, and the suffering worldwide. Unfortunately, the ARC has been plagued with a high executive turnover, slow response to disastrous events, and mismanagement of donation funds. These problems now have the ARC facing another problem, fixing their credibility for the future.

When focusing on the Centers for Medicare and Medicaid Systems strategies for improvement with unnecessary emergency room visits, a major key area is accessibility to health care at the appropriate health care setting. For many years, there has been the perception that the emergency department is the only place for someone who is uninsured or underinsured can go to receive the needed and appropriate health care, and in some situations that may be the case. (Rhodes et al, 2013, p.394) Due to the decreases in reimbursements for the publicly funded, more and more physicians are opting out to treating these patients, thus leading to an increase in emergency department utilization. According to a study conducted by Rhodes, Bisgaier, Lawson, Soglen, Krug, and Haitsma, this is becoming a greater concern for the

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results.

The electronic medical record system (EMR) serves many purposes in an emergency for the patient, physicians, and hospitals involved in the diagnosis and care during an emergency.

Each year in the United States approximately 114 million people visit their local Emergency Department (ED), and 16 million of these patients arrive by Emergency Medical Services (EMS). (Board et al.) Health care in America has moved from an individual, fee-for-service health care system, towards a more integrated healthcare system i.e., The Affordable Care Act (ACA), which is a government controlled healthcare system, and is set up to be a value-based payment system. The ACA will expand and transform the roles of EMS within the healthcare system. EMS’s ability to survive and thrive in this new era of healthcare, will revolve, in part, on its ability to articulate its value to healthcare providers, healthcare organizations, hospital systems, and payers, as well as patients and family members. (Smith) EMS can thrive in the future, if it embraces change. John F. Kennedy had this to say about change, “Change is the law of life. And those who look only to the past or present are certain to miss the future.” (BrainyQuote) In order for EMS to thrive in the changes that the future is bringing, it must: focus on mobile integrated healthcare, be data driven in their clinical practices. There are three other areas that will be discussed at length, EMS agencies should be actively pursuing a community paramedicine program, EMS using remote telemedicine and EMS moving towards a value-based payment system.

The Ambulance services have less complications than the Fire services does implementing the above concepts. The Fire service provides a larger spectrum of services and has many different apparatus for different uses. In the ambulance service they only have ALS and BLS ambulances which can sometimes work for eachother. For instance, a ALS ambulance can run a BLS call easily. However in the Fire service, a ALS ambulance cannot have the firefighting capabilities of a Truck or Engine crew. In addition, Ambulance companies have a plethora of resources that they can call on, to get another ambulance on the street is easy as calling a few people in since they have many spare ambulance that can be deployed if needed. The largest problem with the

This invention is the ambulance. The invention of the ambulance began in 1859 when prototypes emerged in mass numbers. With ambulances, patients were now able to be transferred to other medical facilities more rapidly and efficiently. A man named Jonathan Letterman was appointed medical director of the Army of Potomac in 1862 and he immediately began to rework the structuring of the Ambulance Corps. He was able to combine the use of ambulances and he began to train enlisted men to be the Ambulance Core.

You are a bystander to an accident on the road. You notice a person pleading for help as they are screaming in pain, what do you do? Well, it honestly depends on which profession you have chosen: Medic or EMT? When I compare being a Medic in the United States Military to being a civilian EMT; I think that being a Medic is better. Upon comparing the credentials and future availability to attain additional credentials, individual capabilities, and impact on health of those treated, I believe that you too will agree with the idea that being a Medic is more beneficial.

Comparing Maryland EMS to the White Paper, the White Paper’s several recommendations to improve systems as a whole was built into the framework of Maryland EMS, and aided in the growth of our system. Since the White Paper, many improvements have been made. First, there is now a standard curriculum for EMT-Basics, EMT-Intermediate, and EMT-Paramedics through National Registry, with program accreditation guidelines developed by CoAEMSP. Specifically in Maryland, there is now a defined scope of practice written by physicians, implemented through standing-orders in a statewide protocols.

Tactical medicine is an important part of the EMS system because of the many violent scenes ems personnel respond on. Tactical EMS members would be used in more of and active shooter situation where there is still a definite hot zone and a threat to first responders and civilians. There is a statistic from the FBI that states that 1 out of 10 officers are assaulted in their career.

There are different skilled are required for working in EMS like EMS worker must have the ability to tackle high stress, anxiety, because it is the job that can be fast paced as well as emotional and physically demands. EMS needs to be strong because they have to lift patients and lift heavy equipment from one place to another. On the other side, EMS worker must have better ability of communication, so that they can teach patients about their disease situation and teach them how to take medicine on required time.

by grenades, gaseous agents, bombs, or bullets. At the beginning of the nurses did not

Thus, emergency physicians cannot rely on earned trust or on prior knowledge of the patient's condition, values, or wishes regarding medical treatment. The patient's willingness to seek emergency care and to trust the physician is based on institutional and professional assurances rather than on an established personal relationship. Fourth, emergency physicians practice in an institutional setting, the hospital emergency department, and in close working relationships with other physicians, nurses, emergency medical technicians, and other health care professionals. Thus, emergency physicians must understand and respect institutional regulations and inter-professional norms of conduct. Fifth, in the United States, emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other feasible access to care. Sixth, emergency physicians have a societal duty to render emergency aid outside their normal health care setting when such intervention may save life or limb. Finally, by virtue of their broad expertise and training, emergency physicians are expected to be a resource for the community in pre-hospital care, disaster management, toxicology, cardiopulmonary resuscitation, public health, injury control, and related areas. All of these special circumstances shape the