This chapter will describe several factors that make up a prehospital response system for trauma. It includes the discussion of acts allowed by various levels of providers and the care they can provide for both the United States and Canada systems. It is important to note that the variation is significant at the local level, in addition to the equipment limitations present within each system. Therefore, it is imperative to have a complete knowledge basis of your first responders’ capabilities as a medical director. The core concept is to educate, train, and mentor the level below you. The invaluable face time from a system trauma surgeon to a paramedic or EMT will greatly enhance your system’s effectiveness by establishing a conduit of progressive evidence-based research to field providers and the establishment of a contiguous set of expectations throughout the entire trauma system. A key component of system responsiveness is to have ongoing training that is non-siloed established by one mutually agreed-upon response plan to include hospitals, prehospital, and law enforcement. At any opportunity, having regionalized responses has a greater chance of success over individualized agency responses. The key is planning and establishing roles, definitions, and differences in terminology and known expectations. Being a first responder carries inherent risk. Calculated risk, effective decision-making models, and leadership create healthy systems and great patient care. There will be instrumental people in your systems that are like-minded, solving the problem on the table of each trauma patient. This section is dedicated to people like Chief Troy Jackson, Operations Chief, South Metro Fire Rescue that saw a vision that required uncomfortable change within the organization, brutal honesty of self-evaluation, benchmark metrics, and the wisdom to seek out opportunities to improve individual competency and system effectiveness no matter how uncomfortable or temporarily upsetting the journey was in order to better serve the citizens we are sworn to protect. Preventable mortality within the controllable limitations we have as responders and as trauma systems is the key to effective deployment, balanced risk mitigations for responders, and aggressive interventions addressing critical factors with limited resources that change the outcomes of our patients. This work is the compilation of lessons learned from decades of data analysis, thousands of hours of training paramedics, and the opportunity of experience. In the end, a team of training officers that were few, transformed a response for an entire large urban system with key partners in law enforcement and hospitals.

Out-of-Hospital Care from Paramedical to Non-medical Personnel

章节
发表日期：

2025年

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Ryan Shelton,
Matthew Brock

摘要

This chapter will describe several factors that make up a prehospital response system for trauma. It includes the discussion of acts allowed by various levels of providers and the care they can provide for both the United States and Canada systems. It is important to note that the variation is significant at the local level, in addition to the equipment limitations present within each system. Therefore, it is imperative to have a complete knowledge basis of your first responders’ capabilities as a medical director. The core concept is to educate, train, and mentor the level below you. The invaluable face time from a system trauma surgeon to a paramedic or EMT will greatly enhance your system’s effectiveness by establishing a conduit of progressive evidence-based research to field providers and the establishment of a contiguous set of expectations throughout the entire trauma system. A key component of system responsiveness is to have ongoing training that is non-siloed established by one mutually agreed-upon response plan to include hospitals, prehospital, and law enforcement. At any opportunity, having regionalized responses has a greater chance of success over individualized agency responses. The key is planning and establishing roles, definitions, and differences in terminology and known expectations. Being a first responder carries inherent risk. Calculated risk, effective decision-making models, and leadership create healthy systems and great patient care. There will be instrumental people in your systems that are like-minded, solving the problem on the table of each trauma patient. This section is dedicated to people like Chief Troy Jackson, Operations Chief, South Metro Fire Rescue that saw a vision that required uncomfortable change within the organization, brutal honesty of self-evaluation, benchmark metrics, and the wisdom to seek out opportunities to improve individual competency and system effectiveness no matter how uncomfortable or temporarily upsetting the journey was in order to better serve the citizens we are sworn to protect. Preventable mortality within the controllable limitations we have as responders and as trauma systems is the key to effective deployment, balanced risk mitigations for responders, and aggressive interventions addressing critical factors with limited resources that change the outcomes of our patients. This work is the compilation of lessons learned from decades of data analysis, thousands of hours of training paramedics, and the opportunity of experience. In the end, a team of training officers that were few, transformed a response for an entire large urban system with key partners in law enforcement and hospitals.