Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Phil ems system

2,250 views

Published on

Published in: Healthcare
  • Get the best essay, research papers or dissertations. from ⇒ www.HelpWriting.net ⇐ A team of professional authors with huge experience will give u a result that will overcome your expectations.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • ⇒ www.WritePaper.info ⇐ This service will write as best as they can. So you do not need to waste the time on rewritings.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Want to preview some of our plans? You can get 50 Woodworking Plans and a 440-Page "The Art of Woodworking" Book... Absolutely FREE ●●● https://url.cn/xFeBN0O4
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Phil ems system

  1. 1. THE PHILIPPINE EMS SYSTEM Teodoro Javier Herbosa MD FACS FPCS FPSECP Professor Department of Emergency Medicine Universiti Kebangsaan Malaysia Medical Center, KL College of Medicine University of the Philippines, Manila
  2. 2. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Objectives Present EMS its evolution Define selected terms used in Emergency Medical Systems. State the principles of the organization and management of an Emergency Medical Systems Present Philippines EMS System
  3. 3. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Definitions Emergency any situation that requires immediate action. WHO Situation wherein – Proposed intervention is deemed necessary – Delay in treatment may jeopardize life or result in disfigurement or impaired faculties
  4. 4. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Emergency Medicine International Federation for Emergency Medicine, 1991 knowledge & skills required for the prevention, diagnosis and management of acute & urgent aspects of illness & injury all age groups spectrum of episodic undifferentiated physical & behavioral disorders encompasses pre-hospital & in-hospital emergency medical systems
  5. 5. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Tel Aviv, Israel 1991
  6. 6. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine 911 Cook County EMS
  7. 7. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Stuuggard DRF
  8. 8. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Formula 1 EMS 2008, 2009, 2010Formula 1 EMS 2008, 2009, 2010
  9. 9. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Emergency Medicine in the Philippines 70’s-80’s ERC – Under DFM 1991 –Departmentalization of Emergency Services, UP-PGH 1992 – Trauma Surgery Fellowship Program April 1994 – Chairman of DEMS 1996 – Setting up of PGH Emergency Medical Services System 1997 – Establishment of Residency Program at DEMS, PGH 2001 – Department of EM established as Academic unit of UP College of Medicine EE M E R G E N C Y C Y 1997 U P -P G H M E D IC IN E
  10. 10. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System The total system intended to care for a casualty from the site of incident to definitive care.
  11. 11. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System includes Triage On-site care Initial resuscitation and treatment Medical transport Definitive care or Trauma Center
  12. 12. ““Scoop and run”Scoop and run”
  13. 13. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System Components Transport Personnel Communications System Medical Control Equipment and Supplies Legislation and advocacy
  14. 14. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System COMPONENTS Transport - system of ambulances which may vary from (BLS) to (MICU) or (ALS) vehicles. Also connotes air transport either through fixed wing aircraft or rotary wing type air transports. Personnel - Medical First Responders (MFR), Emergency Medical Technicians (EMT's), Paramedics, Ambulance Nurses, & Flight Paramedics.
  15. 15. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS Transport
  16. 16. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System COMPONENTS Communications System connotes the ability to relay information about an emergency response and to receive information or instruction as to what further actions should be taken.
  17. 17. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine The BystanderThe Bystander The DispatcherThe Dispatcher The EMS RespondersThe EMS Responders By calling first, youBy calling first, you join a team ofjoin a team of Emergency ServiceEmergency Service dispatchers anddispatchers and responders.responders. Each member hasEach member has a vital role.a vital role. Early Access
  18. 18. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System COMPONENTS Medical Control - use of on-line communications with a specialized physician or through off-line protocols of care for emergency situations. Off- line (indirect) medical control is the responsibility of the service medical director. Three components of off-line medical director are: (1) development of protocols, (2) development of medical accountability (QA) (3) development of ongoing education.
  19. 19. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EMS System COMPONENTS Equipment and Supplies - all the necessary tools which EMT's need Legislation and Advocacy - stipulates the regulation of the practice of pre-hospital and emergency medicine in a locality. Secures the high standards of care needed. The financial aspects of the EMS System may also be included.
  20. 20. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine
  21. 21. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Regional Trauma Care System An organized approach in the management of acute injury utilizing the components of an EMSS and trauma centers or definitive care centers, trauma specialists and other aspects of trauma care in a locality, province, region or country.
  22. 22. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine
  23. 23. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine COMPARATIVE DESIGNS OF EMERGENCY RESPONSE SERVICES USA Philippines Funding Well Funded Scarce Funding Infrastructure Uniform federal Not Uniform Support National Safety stats. Vehicles, Exists Does not Exist equipment's Minimum standard Recognition Requires care provided present recognition Minimum guidelines Existing Not existing for education & training
  24. 24. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine COMPARATIVE DESIGNS OF EMERGENCY RESPONSE SERVICES USA Philippines Support Professional Minimal Voluntary Improvements in Organizations Organizations System Design Cost of Med. & Heightened Lack of Trauma Care awareness awareness Public Health Continued Non existent Prevention Prog. Awareness Network for Disaster Structured Partially Response structured System Flexibility Existent No System
  25. 25. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Human Resources in the Emergency Medical Services System Medical First Responder Emergency Medical Technicians EMT - Basic EMT - Intermediate EMT – Paramedic EMS Physician/Medical Director Emergency Nurses Emergency Physician General Surgeon/Trauma Surgeon/Orthopedic Surgeon/Physicians Emergency Manager/Emergency Department Coordinator
  26. 26. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine EP's and EMSS Emergency Physicians (EP's) great help in improving the health care during MCI’s. help triage and institute initial management of injured patients while the surgeons deliver definitive care. this specialist may be those certified in other fields of specialization like general surgery, orthopedics, internal medicine, or family medicine.
  27. 27. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Airway Devices oxygen tanks non-rebreather masks nasal cannula oropharyngeal airway devices of different sizes nasopharyngeal airway devices Intubation equipment like laryngoscopes endotracheal tubes LMA's (laryngeal mask airway) tracheostomy instruments tracheostomy tubes and suction machines Cervical immobilization devices
  28. 28. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Management of Hypovolemic Shock Devices for hemorrhage control Surgical gauze packs Elastic and rolled bandages IV access, IV cannulas of different sizes, central lines, cutdown sets, intra-osseous infusion needles Crystalloids & colloids for fluid replacement Access to blood bank facilities or blood retrieval Traction splints for long bone fractures
  29. 29. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Defibrillation Automated external defibrillators (AED's) – Manual defibrillators Personnel trained in ACLS Biphasic defibrillators Cardiac monitors w/ AED's incorporated into one machine
  30. 30. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Critical Care Monitoring Critical monitoring devices should include pulse oximetry non-invasive blood pressure readings, heart rate and cardiac rhythm Point of care testing devices like arterial blood gas determinations (ABG) and electrolytes are useful. End Tidal carbon dioxide tension (ETCO2)
  31. 31. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine
  32. 32. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Characteristics of the EMSS Triage, Stabilize, Prioritize, Refer, Observe ABCs Limited resources – Time – Information – Space Technology dependent Cutting-edge medicine
  33. 33. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Unique Characteristics of Prehospital Care Not necessary to arrive at diagnosis Does not follow sequence of SOAP – Assess  Action  Reassess  Action Always thinks of worst-case scenario – Chest pain is MI! SAMPLE history Don’t believe everything you hear!
  34. 34. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Patient Transport Star of Life Type I – cab & chassis Type II – van-type, modified height Type III – larger with walk-through passage BLS or ALS/ICU
  35. 35. 1902 American Era Used blueprint of Johns Hopkins University (JHU)—the best US medical school Philippine Medical School 1905 Philippine General Hospital 1907 University of the Philippines College of Medicine 1908 Sept 1, 1910, state-of-the-art public teaching hospital, the Philippine General Hospital
  36. 36. Philippine General Hospital 1910
  37. 37. PGH Horse drawn ambulance
  38. 38. CIRCA 1992
  39. 39. Capiz 2009
  40. 40. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Philippine EMS System Components Transport (family van conversions) Personnel (EMT-B) Communications System (117) Medical Control (EP's) Equipment and Supplies Legislation and advocacy (EMT law SB3458)
  41. 41. Modern EMS units in the Philippines PNRC Subic Naval Base ERUF AAP PCSO DOH STOPDEATH UPPGH Makati Rescue Lifeline Arrows BFP FC Fire brigade PAGCOR EMS Bacolod Amity EMS Davao 911 Marikina Rescue Many others
  42. 42. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine SAREX NAIA
  43. 43. Philippine Society of EMT's PSEMT Affiliate of the Philippine Society of Emergency Care Physicians PSECP Australasian Registry of EMT's AREMT
  44. 44. Life Support Training International is a Philippine Training Industry leader in all levels of instructions in pre-hospital emergency care. It carries the standard of the Philippines Society of Emergency Medical Technicians, member expanded council of resuscitation of the Philippine Heart Association, the International Liaison committee on resuscitation and the country regional affiliate of Australasia Registry of Emergency Medical Technicians. http://apcaregivers.com/trainings.htm
  45. 45. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Directions in EMS EMT Law Research & Documentation SimulationTraining – BLS, ACLS, ATLS/BEST – Emergency Nursing – Emergency Medical Technicians
  46. 46. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Directions in EMSS Pre-Hospital & ED reimbursement Emergency Public Health Information Dissemination EMS Systems Design Patient Safety Quality Assurance Decreasing Errors in EM Technology
  47. 47. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine The Future is Uncertain “Everything that can be invented have been invented.” Charles Duell Commissioner US Office of Patents 1899 “Who the hell wants to hear actors talk?” Harry M. Warner Warner Brothers 1921 “There is no reason for any individual to have a computer in their home.” Kieth Olsen, President, Chairman and Founder Digital Equipment Corp. 1977 (filed for bankcruptcy 1991)
  48. 48. UPCMUPCM Department of Emergency MedicineDepartment of Emergency Medicine Questions ?Questions ?

×