Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewMass casualty incident. Integration with prehospital care.
Mass casualty incident involves the use of limited resources for multiple casualties. The emergency physician must be familiar with both prehospital and hospital plans for mass casualty care in order to facilitate optimal care and to maintain the continuum from field care to definitive treatment. ⋯ Emergency physicians involved in prehospital care should be certain that the local EMS system has adequate training and chances to update their skills and knowledge. Disaster drills of the EMS system are excellent ways to practice, to identify weaknesses, and for preplanning to enhance disaster medical care.
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All patient care aspects of prehospital health care delivery must be physician directed. This process of medical accountability seeks to assure quality EMS patient care. Emphasis in this chapter is on the two main configurations of EMS medical accountability, off-line medical direction and on-line medical control. Topics include EMS physician qualifications, responsibilities, and authority; the role of protocols and standing orders; medical control configurations; and others.
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Emerg. Med. Clin. North Am. · Feb 1990
Emergency medical services legal issues for the emergency physician.
This article discusses the elements of the legal system that impact emergency physicians and their legal responsibilities. It addresses the specific responsibilities of the emergency physician providing on-line direction to EMS units in the field, and the legal principles that control. Special emphasis is placed on compliance with new federal legislation and addressing medical-legal issues presented by field personnel during patient care situations.
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Emerg. Med. Clin. North Am. · Feb 1990
ReviewCommunication with emergency medical services providers.
Communication between the emergency medical services provider and the emergency physician can be either a rewarding or a frustrating experience. As many emergency physicians have found to their chagrin, the EMS provider has a memory for mistakes or bad tidings. This article discusses the relationship between EMS providers and emergency physicians.
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EMS quality assurance programs can help guarantee that the provision of prehospital care is medically accountable. The establishment and management of such a program, although time consuming, are critically important. It is essential that the medical director or a designee responsible for quality assurance activities be allotted the necessary time to carry them out properly. ⋯ The quality assurance program forms a continuous action loop starting and ending with protocols and education. Documentation of variance or compliance with protocols forms the basis for analysis of the quality of care delivered. Any intervention must be based on carefully documented information and should include praise for good work, as well as education when needed, and restriction of function when necessary.