The EMS Basics
Welcome to the EMS Basics module! Here you can find materials that cover the essential basics of any level EMS provider.
No matter the situation or level of provider you choose to become, it is always important to remember the basics and build your care plan from the bottom up. Is the scene safe? BSI? ABC? and keep going from there.
Professionalism & Patient Respect
(Click the arrow to the right to read the text below!)
As EMS providers, we are seeing people at a low. They have contacted us because they have a problem and need our help. Therefore, we must fulfill our duty while maintaining a degree of professionalism and respect for the patients we are helping. Professionalism is an important part of the job and includes a variety of factors such as how you present yourself, how you speak, the words you use, nonverbal queues, etc. Being professional allows you to build a rapport with the patient and gain their trust. After all, their life is in your hands.
There are many calls in EMS that may not appear to be an emergency, though it may be frustrating at times, you must understand that people are scared and people have different perceptions. Just because it is not an emergency to you, doesn't mean it is not an emergency to someone else. Just like pain, a 7 for you could be a 10 for someone else. It is important that we approach every scene seriously and address the patient's complaint(s). Even if it is 3 a.m. on a busy shift, professionalism must always be maintained. Gaslighting patients is never okay and can lead to peoples' distrust in the healthcare system. When you are called to a scene, it is your job to address the patient's chief complaint and get them taken care of. It is also important to note that dispatch only knows so much. You could get called for toe pain and arrive on-scene to a patient in septic shock! So please, don't get frustrated, and make sure you maintain a professional attitude. If you suspect a patient is abusing the 911 service, take it up with your supervisors and medical control.
Directly related to maintaining a high degree of professionalism, it is also important that you respect your patient. This may seem obvious, but it is vital to quality patient care. You are there to serve the patient and help them with their medical emergency. Thus, all of your personal beliefs and opinions can go out the window. At the end of the day, you are a human helping another human. How might you be professional and respect your patient? I'm glad you asked, here's a list of some examples:
Respect their name - Call them what they request to be called. If your patient wants to be called Mrs. Jones, call them that!
Respect their pronouns - Not everyone uses pronouns that match how they "present". If your patient uses they/them pronouns, use them! Mispronouning people, especially if they have already corrected you, is disrespectful and not an example of quality care (Learn Why).
Respect their property and home - You don't have to take your boots off when entering a patient's house, but be mindful of their property and be careful. Don't run around their house like a bull and repeatedly ram the cot into the walls (because you wouldn't like that either)!
Respect their family - Many times there is family on scene who also need to be respected. Though you might think they are "getting in the way" remember, they are also worried.
Use professional language - Don't spew a bunch of medical jargon at them. Be professional and don't cuss and make bad jokes, etc.
Be empathetic - Show them that you care and are there to help.
Use positive body language - Try and get to the patient's level and not talk down to them. Use affirming gestures like head nods and eye contact, and avoid negative ones like crossed arms.
Be a good human - This may seem obvious, but you are there to help! Go to the scene with a helper's attitude and be kind to the patients. Never enter a scene and say something like "what did you call for this time?" You want your patients to trust you and feel safe, so be nice!
Scene Safety
The intro to this video is a lot cooler than mine... but this is probably one of the most important pieces of the EMS basics! If your scene is not safe, you cannot provide the best care to your patient. You can't help if you're also hurt, so please, for God's sake, make sure that scene is safe!
Taking a History
Getting a good history is vital in your patient assessment. It provides you with a lot of good information that is useful in creating an effective care plan.
Medical Terminology
Before you document your run or read the hospital report, you need to understand all of the medical jargon that is used.
Patient Assessment
Your care is only as good as your assessment. This guy gives a nice explanation of some of the main points in a detailed physical exam. However, remember to ALWAYS start with the big 3, ABC (Airway, Breathing, Circulation), so you address any life threats first before continuing with your assessment.
Vital Signs
What are they?
Obtaining vital signs is a vital part of your patient assessment (pun intended). John's Hopkins SOM has a nice definition as to what exactly they are.
"Vital signs are measurements of the body's most basic functions. The four main vital signs routinely monitored by medical professionals and health care providers include the following: Body temperature, Pulse rate, Respiration rate, (rate of breathing), and Blood pressure. Vital signs are useful in detecting or monitoring medical problems. Vital signs can be measured in a medical setting, at home, at the site of a medical emergency, or elsewhere" (references 17).
As mentioned, when vital signs are measured, they can be some of the first indicators of pathology in your assessment. For example, if you arrive on scene to someone who has felt poor for a week, and they have a temperature of 104F, they may have an infection! It's important to obtain vital signs on EVERY patient, no matter the chief complaint.
How to take a blood pressure.
This is what you should hear with the BP cuff.
These are Korotkoff sounds. This indicates the pulsing artery!
How to take a pulse.
You can assess a pulse at multiple different points in which you can feel the "bumping" of the artery. Pulses are assessed at arteries and can be taken from the radial, ulnar, brachial, carotid, femoral, popliteal, posterior tibial, and dorsalis pedis arteries. The most common places to take a pulse are the radial and carotid arteries. However, it is good to note that on an infant, you should assess the brachial pulse.
How to count respirations.
Respiratory rate can be a good indicator of respiratory dysfunction. Remember, try not to tell the patient you are counting respirations because they will breathe funny knowing that you are watching, making your assessment not as good!
How to take a temperature.
Temperature is a good vital sign to take as it can indicate illness. Also, please NEVER mix up the oral and rectal probes.
How to take a pulse oximetry reading.
Pulse oximetry measures the saturation of oxygen in peripheral blood, typically in the fingertips or ears. Normal ranges are typically between 93-99%. Always remember the scene and chief complaint, because a pulse ox of 100% is not always good (hint: CO poisoning can give that reading).