|Date published:||19 Sep 2018|
Perception or Standardization
One of the most crucial mission of the emergency medical services (EMS) staff is to transfer patients in medical emergency situations. For this mission to be accomplished Ambulance services must be put in the forefront of healthcare services. Over the past decade the need for ambulances and emergency transportation of patients has increased significantly, though some of the transportations have not been so urgent (Gurchiek, 2014). Safety is a very crucial theme underlying the EMS service delivery. This is because delivery of medical emergency services involves hazardous activities which needs care and safety. The purpose of this paper is to explain the theme safety by showing clearly how it has been used in the context of EMS. This paper will explore some of the safety issues addressed in EMS and the factors to be considered by the EMS staff on the safety of the patients.
In order to progress from a classroom medic to a “street” medic, a very necessary process is required to transform controlled classroom learning into applicable knowledge in the hectic, pre-hospital patient care reality. On-the-job training or field internship (preceptorship) is used for Nursing Programs and other allied health professions to include Emergency Medical Services (EMS). Though there are national standards in place for Emergency Medical Services (EMS) certifications, without standardization of EMS preceptor programs, EMS agencies will have inconsistencies with patient care, provider competency, knowledge, skills and abilities.
Every work environment is different; EMS agencies provide an undeniably unique environment. Newly certified medics, without prior EMS experience and even those with experience, are faced with accomplishing a variety of tasks, knowledge, skills, and abilities. The environment for the medic, the internee, should be conducive for learning, providing a place where the internee can gain confidence in their skills and find their way as a provider (Gurchiek, 2014).
The transition from classroom medic to “street” medic is facilitated by a preceptor who are responsible for ensure proper patient care while balancing educating and evaluating the internee (Gurchiek, 2014). In essence, the internee is placing their future in the hands of their preceptor. The preceptor immensely impacts the internee’s experience, as would any teacher to a student. Preceptor evaluation errors, preceptor lack of experience, knowledge of educating (Gurchiek, 2014) a major asset to student learning is the preceptor’s knowledge and experience along with the preceptor’s attitude and approach (Gurchiek, 2014).
There are standards in other avenues of EMS. There are national certification requirements for EMS providers through the National Registry of Emergency Medical Technicians. A platform named Platinum Planner was created By Platinum Education Group to aid in scheduling, reporting, and skill tracking. This platform provides a tracking system of hands-on experience that is utilized by students, instructors, preceptors, administrative staff, and clinical sites. (Platinum Educational Group Launches Skills Tracking App., 2016). Tidewater Community College uses Platinum Planner which replaced the main use of paper tracking which is no longer the sole primary form of skills tracking.
The theme of Safety is clearly shown in the emergence medical services. First, due to safety measures in every EMS there must be an Ambulance. Ambulance is a life-saving vehicle hence an issues of safety comes out clearly. In addition, inside the Ambulance, there is another issue of safety. For example, in the cab. Mostly, EMS vehicles have cab which has two seats for two peoples. Some of the safety principles followed in the cab are; to always wear the lap and the shoulder belts in order to improve the chance of survival in a crash. This is because it will provide safety restraints which will help a person to stay in position when there is a displacement in the force of momentum.
Another safety rule in the cab is that, no leaving a loose items on the dash. Most of EMS personnel’s without home base may spend their time in the EMS units. During lulls they may decide to listen to, music, read books or even watch some movies on a small portable television, therefore it’s advisable that they keep loose items such as books, electronics or electronic appliances on the dash (The Preceptor-Student Relationship, 2004). This is because in the dash, the objects remains harmless unless displaced by unexpected change in momentum. Both occupants should make sure that they watch the road so as to increase precaution even when one of them is in a call. The driver should avoid sleepiness in addition to safety. During the night shift the driver may feel sleepy while driving. It’s therefore advisable not to rely on caffeine or sugar for energy on such cases, shake off the drowsiness by opening the EMS unit’s window or by getting out a few minutes to stretch.
In the patient compartment there needs safety also. Though in the patient compartment it’s not risky but the EMS staff also need to follow some strategies to promote its safety. First, never let tunnel vision remove the need for your personal safety. Secure the seat belts, also secure the patient by doing whatever it regard despite the ride. The Ems stuff in the patient compartment should also develop the hanging habit. One of the inherent risk of EMS is moving around the patient compartment for example, during CPR in a moving ambulance, the person doing chest compression must bend over the patient, with arms straight with appropriate position to push down (The Preceptor-Student Relationship, 2004).
Another key aspect of safety in EMS is safe driving (Gurchiek, 2014). Sometimes EMS personnel are asked to drive big vehicles which are big than their personal cars, though some of them have never gone for training in any of the emergency medical vehicle driving school. Some of the basic safe driving principles related to driving an EMS unit are: no driving while lights and sirens are on. This is because people react different when they hear about sirens. Some obey the rules by pulling off their vehicles or stop. If the vehicle was being driven in non- emergence mode then this may cause harm to the members of the public by sending wrong information. Another principle is that, obey the local standards operating procedures.
There are some jurisdictions rules provided to guide on the use of emergence mode ((Gurchiek, 2014)). Most require sirens and lights to be used only during the emergence mode only, while others allow some direction to minimize the use of sirens to avoid destruction of the interest of the community. For example it’s advisable that you turn off all emergency flashes and sirens early in situations of potential interpersonal violence, turn off one or two blocks away and drive to the scene obeying all the traffic rules as a none emergency vehicle. Also for safe driving if using warning equipment, use of all of it.
Another aspect is seen in the decisions of the EMS staffs on whether to transport patients. For patient transportation a lot of safety considerations are done. Patients’ physical status is one of the major contributing factor influencing the EMS staffs decision about transportation. In general the patients’ vital status are the main criteria for assessing the patients’ safety. According to (Gurchiek, 2014), heart rate, blood pressure, body temperature, level of consciousness and oxygen saturation are some of the physiological parameters which are used in determining the patients physical health status. Rees and Mann, in his study included two physiological parameters, which are central nervous system response and respiratory rate.
It is also argued that, beside the abnormal physiological conditions, the presence of pathologic conditions also plays an important role in making a decision on transportation. For example, if an EMS staff notices a life- threatening condition like an acute myocardial infarction, they can decide to transport the patient immediately despite of the other parameters and conditions. The main idea here is that the signs and the symptoms of pathologic condition can not only used for making decisions, but also the EMS staffs require a great amount of knowledge and expertise for diagnosing the patient.
[bookmark: _GoBack] In conclusion, Safety has been given the main concern in the SMS. This is because, by following the safety rules in real live situation a lot of lives can be saved. There are also other themes expressed in emergency medical services like healthy. The strength of socioeconomically and organizational support perception also affects the transportation decision made by the EMS staff. Perception of stronger support implies that, they could make decision that they are more sensible. According to Platinum Educational Group Launches Skills Tracking App.