AEMS Levels of EMS Professionals

AEMS Scope of Practice Model defines and describes three (3) levels of EMS professionals. 

• Medical Responder (EMR) (Non - Professional) 

• EMT (

• Advanced EMT (AEMT)

• Paramedic

Each level of EMS professional differs in knowledge, skills, judgment, critical thinking, and decision making. Not every country recognizes all levels of EMS professionals. Although the various levels of EMS professionals may differ from one country to another,  all EMS professionals work to provide the best patient care at their level of training and expertise.

Each level of EMS professional has its own scope of practice. 

The  scope of practice for an EMT is not the same as the scope of practice for an AEMT or

a paramedic. Scope of practice is regulated by the state or country where the individual works and by the medical director.

As new technology or research appears, an EMS professional's scope of practice should change. These changes will reflect the new norms or expectations. An EMS professional can be legally liable if he or she functions outside his or her scope of practice.

Emergency Medical Responder 

                                                                     
A Certified Emergency Medical Responder (EMR) is an EMS professional who provides initial basic life support care to patients who access the EMS system. EMRs were formerly called first responders. An EMR must work with an EMT or higher level personnel during the transport of emergency patients.

Emergency Medical Technician 

A Certified Emergency Medical Technician (EMT) is the minimal level of training required  to transport a patient to an acute care facility. This level of EMS professional can provide non-invasive emergency care, including performing assessments, administering oxygen, and immobilizing a patient.   An EMT can assist patients in taking their own prescribed medications. An EMT can also administer specific over-the-counter medications (such as aspirin and oral glucose) with appropriate medical oversight. 

Advanced Emergency Medical Technician (AEMT) 

A Certified Advanced Emergency Medical Technician (AEMT) is an EMS professional who provides basic and limited advanced skills to patients who access the EMS system. An AEMT was formerly called an EMT-Intermediate. This level of EMS professional varies drastically from country to country .In some country  AEMT skills include giving  dextrose to patients who have a low blood sugar and starting intravenous lines. In other countries, AEMTs can perform advanced airway skills (including endotracheal intubation), apply cardiac monitoring, and give cardiac and respiratory medications. 

Paramedic

A cerified paramedic is the highest level of EMS professional in the pre-hospital setting. This level of EMS professional performs advanced assessments, advanced procedures, and medication administration. A paramedic is competent in all the skills of the EMR, EMT, and AEMT and also can perform a broader range of advanced procedures that the other levels cannot.

Specialized Levels

More specialized levels are specific to individual states like in South Africa, US and UK.  Generally, specialized levels are not replacements for the standard four levels, but rather additional training one can take after receiving the initial EMT or Paramedic credentials. For example :  A  wilderness EMT course is available for EMS personnel who work in remote areas. This course focuses on the long-term stabilization of patients within limited resources.

Paramedics are licensed healthcare professionals who provide the most extensive pre-hospital advanced life support. Paramedics provide care that is on par with that of the emergency room. During a medical emergency Paramedics can provide advanced life support care including: advanced airway management, endotracheal intubation (breathing tube), manual defibrillation, external transcutaneous pacing, EKG monitoring, 12-lead EKG acquisition, IV fluid therapy, intraosseus infusions, hemodynamic monitoring, needle chest decompressions, surgical airways, administration of a wide array of critical care medications and mechanical ventilation.

A certified and licensed critical care paramedic course teaches paramedics additional pharmacology and skills, such as the use of balloon pumps, to help with the care of critically ill patients who depend on equipment. Critical care paramedics commonly work on critical care transport ambulances, which are used to move patients between health care facilities.

Craig Gibson &  Paul Baron ,REMT-P's

Other examples of expanding and emerging roles for paramedics include primary care, industrial medicine, sports medicine, and tactical medicine.

A certified and licensed Intensive Care Paramedic is an advanced clinical practitioner in Paramedicine who provides medical assessment, treatment and care in the out-of-hospital environment for acutely unwell patients with significant illness or injury. ICPs respond to patients experiencing an acute, life threatening emergency. They provide rapid and specialist clinical assessment by implementing a targeted management plan for patients with significant alteration or challenge to normal homeostatic function.  Whilst this role is tasked with providing clinical oversight during the management of these cases all patient care is undertaken in collaborative context with other paramedic staff or health care professionals in attendance.The ICP is required to make rapid, often complex and critical clinical judgment without direct supervision. Individuals are responsible for their own continuing professional development which may be supplemented by employer-provided training.

AEMS Paul Aiden Barson, REMT-P in Sudan

An ICP is usually engaged by a statutory ambulance service, private paramedic service or defense force and may operate in a variety of community, industrial, resource sector, defense or event/public gathering settings including disaster response. professional may be deployed as part of a two-person crew operating in an ambulance equipped with a stretcher and specialist clinical equipment or may practice as a single operator from a purpose-designed response vehicle (typically a marked station wagon).Defence force ICP’s deliver out-of-hospital care as solo practitioners and in team environments alongside other health professionals or a merger of specialties. ICP’s engaged in defence forces provide health care to support and maintain the health and well being of defence force/allied personnel and civilians in times of conflict, disaster or peacetime.  This may include the delivery of health care within austere environments and on/in a variety of platforms such as on land (on foot or in-vehicle), aerospace or on ships. They may attend in situations ranging from a controlled environment through to routine and emergency medical management where a paramedical response is required. ICP may take professional responsibility for the mentoring and support of paramedics, developing ICP’s, paramedics and students.

Craig Gibson demonstrating traction splinting to AEMS students - Davao City.

AEMS Craig Gibson, REMT-P and AEMS EMT's in Kidapawan City's 911.

AEMS's Students on patient care reports - Kidapawan City

AEMS Scholar Alpha in Kidapawan City. 

The AEMS Paramedic Instructors :

Paul A. Barson, REMT-P has NDip in Paramedical Sciences from Churchill Education Australia, is an ALS (Advanced Life Support) Paramedic and an EMT Assessor of AREMT (Australasia Registry of Emergency Medical Technicians), currently registered and licensed with Health Professions Council of South Africa (HPCSA), the government agency handling Paramedic licensing and registration of healthcare professionals and paramedics in South Africa  and has more than 20 years of professional experience in the EMS field as Paramedic/Project Manager with international & national institutions both in the medical and rescue industry, with extensive field work in Sudan, Afghanistan, Somalia and South America. Paul is a Remote / hostile Site Specialist and has an EMS Operations Consultant background inclusive of training and management expertise. Paul is a civilian Paramedic with independent license ( can work without medical supervision of an EMS physician) with Military experience, has spent a large portion of time in hostile and remote locations providing managerial and medical support on the ground as and when it is required. 

Craig A. Gibson,REMT-P is  current and registered as an Independent Intensive Care Paramedic registered with Health Professions Council of South Africa, an EMT Assessor of AREMT (Australasia Registry of Emergency Medical Technicians).  He has more than 20 years of professional experience in the EMS field and remote medicine industry. His previous work experience includes  Hospital Manager for  African Union Darfur Mission in 2005 to 2006. Prior to this position, Craig was project manager for Medical Support Solutions with head office based in the UK.

In 2004, Paul Barson and Craig Gibson worked for  the United Nations Joint Military Commission (JMC) at Nuba Mountains in Sudan for which they were awarded a medal of honor for their  exemplary performance as JMC Paramedic - Head of Medical Services by Brigadier General Jan Erik Wilhelmsenl Chairman of JMC and Head of Joint Monitoring Mission in Nuba Mountains, Sudan.

 https://www.facebook.com/AEMS.Institute/photos/a.311674828957217.1073741924.232956403495727/311677498956950/?type=3&theater

Licensure, Certification, and Registration

To ensure the competence of EMS personnel, all personnel in an EMS system must be certified or licensed by the country  in which they provide patient care. 

Certification and registration is available via TESDA (local) or AREMT (International) through its accredited training centers and  assessors (who are connected directly with a Training Center in the Philippines).  

Although certification and licensure are terms that often are used interchangeably in EMS, their EMS meanings differ from the other.

Local : TESDA 

 Qualified graduates of TESDA’s NC II  can find employment as any of the following :

• First Responder 

• Medical First Responder

• Ambulance Care Assistant

Students enrolled in EMS NC II may be required to undergo a Competency Based assessment before graduation.

Internationally Recognized : AREMT


 For international certification and registration, EMT’s may undergo a written and practical assessment at AREMT through its accredited assessors and training centers in the  Philippines. 

Asia's Emergency Medical Services Institute, Inc. is an accredited/approved training center of the following internation EMS institutions:

The list of AREMT Assessors in the Philippines...

ASHI Certificate for AEMS

www.asiaems.org

EMS INSTITUTIONS AS ONE FOR TESDA NC II ASSESSMENT

Photo : AEMS Head of Training Craig Gibson, EMT-ICP with mock injuries

The TESDA Emergency Medical Services  NC II consists of that a person must achieve to perform basic life support, maintain life support equipment and resources, implement safe access and extrication procedures in an emergency,manage request for service, allocate ambulance services resources, coordinate resources, deliver basic ambulance communication skills , supervise on-road operations, manage the scene of emergency, manage the scene of a special event, manage routine scene, deliver pre-hospital patient care, manage ambulance operations and transport emergency and non-emergency patients. 

Photo : AEMS Paul Aiden Barson with CHEERS Corp. Sandy S. Montano 

Photo : Paul Barson, REMT-P (in blue) as one of the patient during a simulation for participants of TESDA NC II EMS Assessment

Photo : Paul Barson, REMT-P (in blue) as one of the patient during  for participants of the TESDA NC II EMS Assessment.

Photo : Group discussion with AEMS EMS Director Paul Barson (in blue) and AEMS Head of Training on the simulation done by participants for the TESDA NC II EMS Assessment

Photo : The Key Officers of AEMS, CHEERS, NERA and STOUT

Photo : AEMS President and Chairman Imee Callao (in red)  of the Board with EMS colleagues in Quezon City during the TESDA NC II EMS Assessment.
   

KIDAPAWAN 911 and AEMS EMT's FOR THE COMMUNITY

Kidapawan City's Call 911 responding to a maternity emergency with AEMS EMT Students who are now undergoing their mentored practical ambulance exposure under AEMS EMT Program.

Kidapawan City's Call 911 department  was organized and headed by Chief Psalmer Betralte, Director of Red Cross for Kidapawan City Chapter and Cotabato City Chapter  and forms part of  Kidapawan's City Disaster Risk Reduction Management Office (CDRRMO). Call 911 works closely with public safety, healthcare and private sector partners to plan for mass casualty incidents and medical surge, ensuring that the people of Kidpawan City can count on a well planned, coordinated response in the event of a natural or man-made disaster. 

Asia's Emergency Medical Services Institute, Inc.  is a committed partner of the community and is dedicated to protecting people's lives through Quality EMS Education and Training.

AEMS EMT Students Nikolai and Ronn attend to a maternity emergency.

AEMS EMT Students Rodney, Nikolai and Ronn attend to a maternity emergency with Call 911 (CDRRMO) of Kidapawan City. 

www.asiaems.org

AEMS & Lifeline Caring for the Elderly in Davao City

For humans, physiological and psychological changes occur with aging. When we are caring for the elderly patients, we should deal appropriately with these changes - physiological and psychological condition of the elderly,and also the basic principles of caring for the elderly : PATIENCE AND RESPECT.

PHYSIOLOGICAL CHANGES IN ELDERLY

Physiological functions wane when people are getting old. When we take care of the elderly, we should take heed to these changes. Here are some examples:

Vision - In general, old people have a poorer vision. Some even have cataract or glaucoma. Before starting every health care procedure or examination, always tell them beforehand and ensure they are psychologically prepared.

Hearing - The elderly would have a lessened hearing ability. When you need to talk loudly to them, avoid shouting.

Touch - The peripheral sense of some diabetes and malnutrition patients drop much. So when taking care of them, especially if they have pain due to diseases, never overlook their minor response.
Skin - The layer of subcutaneous fat in the elderly is thinner than young people. Their skin also loses elasticity due to dehydration. When moving the body of the elderly, beware of injuring their skin. Keep them warm during the cold season.

Endocrine - Elderly people easily get tired or even sick due to diminished endocrine function and decreased metabolism. Be patient when dealing with these elderly.

Renal - Owing to decreased functioning of the renal system, old people may have problems such as incontinence, frequent urination, etc. Assist them if they need toileting and, be patient with them.

Musculoskeletal - Obvious changes such as general weakness could easily be seen in this kind of patients. Assist them to move about if necessary. Yet, if the condition is safe while the elderly is able to move by himself/herself, simply let them go ahead. Be patient with their slower motion.

In general, people’s bodily functioning decreased when they get older. Nevertheless, old age is not synonymous with diseases. A majority of old people could still lead a healthy life, whilst some may have heart, lung, liver or intestinal diseases. Whatever health condition the elderly may have, we should give appropriate care, attention and assistance to meet their needs.

PSYCHOLOGICAL CHANGES IN ELDERLY

There are also psychological changes when people are getting old. When caring for them, we need to take care of their mind as well.

General psychological condition - Old people get tired easily. They may have lessened ability to express. Be patient when communicating with them. Let them finish what they want to say.

Self-protection - Elderly people tend to resist strangers and do not trust people. Before starting a health care procedure to them, or even before moving their furniture at home, tell them beforehand what you are going to do. This would avoid un-cooperation when they don’t trust you.

Dignity/discrimination - We often use Old Papa or Old Mama to address elderly people. Before providing health care, we should show respect to them by asking them how to address them such as Mr, Mrs. or Madam. What is more, no matter how old and what gender they are, their privacy should be properly protected and respected.

Death - With the advent of death, old people may experience some emotional changes. Some event like the death of spouse or getting a terminal disease may bring them through a grieving process including: Denial, Anger, Bargaining, Depression, and Acceptance. When dealing with these elderly people and their family members, never take death for granted for old people and adopt an indifferent attitude.

Physicians and geriatric social workers warn that there are a number of danger signs that indicate an elderly person needs extra help or a change in living arrangement. Any marked change in personality or behavior should be heeded. However, no change in lifestyle should be made without discussions with the elderly person, other family members, and doctors or other health professionals.

Danger Signals

o Sudden weight loss could be an indication that the elderly person is simply not eating or not preparing foods.

o Failure to take medication or over-dosing may indicate confusion, forgetfulness, or a misunderstanding of the doctor's instructions.

o Burns or injury marks may indicate physical problems involving general weakness, forgetfulness, or a possible misuse of alcohol.

o Deterioration of personal habits such as infrequent bathing and shampooing, not shaving, or not wearing dentures could be the result of either mental or physical problems.

o Increased car accidents can indicate slowed reflexes, poor vision, physical weakness, or general inability to handle a vehicle.

o General forgetfulness such as not paying bills, missing appointments, or consistently forgetting name, address, phone number, and meal times could be a signal.

o Extreme suspiciousness could indicate some thought disorder. Your parents thinking that their neighbors, friends, family, doctor, and lawyer are all conspiring against them would be an example. Intense ungrounded fears about dire consequences may be a danger signal.

o A series of small fires could be caused by dozing off, forgetting to turn off the stove or appliances, or carelessness with matches. They may indicate blackouts or dizzy spells.

o Bizarre behavior of any kind could be a warning sign. This behavior could be dressing in heavy gloves and overcoat in 90 degree weather or going outside without shoes when its raining (or snowing ). Watch for uncharacteristic actions or speech.

o Disorientation of a consistent nature may indicate a need for help. Examples include not knowing who one is, where one is, who the family is, or talking to people who are not there. 

One day, everyone of us will get old. When taking care of the elderly, do pay respect to them as to yourself. Bear in mind : Patience and Respect are the basic principles. 

Care for the Elderly Foundation, Inc, is located in Tugbok, Davao City

Asia's Emergency Medical Services Institute, Inc.  with Ms. Fe Arobo, Founder and Managing Director of Care for the Elderly Foundation, Inc. (Photo - Paul Aiden Barson, Fe Arobo, Craig A. Gibson and AEMS President Imee Callao)

KIDAPAWAN 911 EMT TRAINING ON SEPTEMBER 15, 2014

Asia's Emergency Medical Services Institute, Inc. (AEMS)  will have an EMT Training on September 15, 2014 at 911 Emergency Base Response Center in Kidapawan City. This is in line with Kidapawan city mayor Hon. Joseph Evangelista's thrust of bridging the gap between public health and public safety and plays an important role in the medical aspects of the city's emergency preparedness efforts. 

With Chief Psalmer  and Kidapawan 911 Staff

Kidapawan 911 is headed by Chief Psalmer Betralte, Director of Red Cross for Kidapawan City Chapter and Cotabato City, and works closely with public safety, healthcare and private sector partners to plan for mass casualty incidents and medical surge, ensuring that the people of Kidpawan City can count on a well planned, coordinated response in the event of a natural or man-made disaster. 

In addition to preparing cities for large scale emergencies, Asia's Emergency Medical Services Institute, Inc. (AEMS) also delivers community programming designed to strengthen the health and well being of the city's residents. Through AEMS Community initiatives, AEMS operates to programs designed to educate the community about EMS response and local public health issues. 

AEMS Key Officers 

AEMS President and Chairman of the Board Imee Callao was recently appointed by the Davao City Chamber of Commerce and Industry, Inc. as  Committee Chairman  on Medical and Security for its DATE Event which will be held at SMX Convention Center this November 2014. 

AEMS EMS Director Paul Aiden . Barson and AEMS Head of EMS Training Craig A. Gibson are registered, current and  licensed Independent Paramedics (Intensive Care and Advanced Life Support) with Heath Professions Council of South Africa (HPCSA)  and are the Philippine's assessors of Australasia Registry of Emergency Medical Technicians (AREMT).

AEMS is a committed partner of the community and is dedicated to protecting people's lives through Quality EMS Education and Training. 

www.asiaems.org

AEMS EMT STUDENTS PRACTICAL EXPOSURE

Kidapawan 911 Chief Psalmer (Director of Red Cross for Kidapawan City and Cotabato City) for AEMS EMT Students Practical Exposure. 

The EMT Qualification 

The EMT qualification is based on international curricula and drawn from various sources and encompasses accepted protocols. This qualification will enable the EMT to perform AHA (American Heart Association), ASHI (American Safety and Health Institute) and the Resuscitation Council (UK) standards of CPR and AED use. They will also be competent is basic airway management using various airway adjuncts, be able to maintain an open airway on a compromised patient. They will also apply splinting tactics using various splinting techniques and the use of the Trac III traction splint. During the course and subsequent practical exposure, they will learn how to deliver babies that present normally and will learn to recognize abnormal presentation and how to summon advanced life support for assistance. They will also be exposed to scene management of normal incidents using the mechanism of injury techniques, scene safety approach and carry out effective triage in mass casualty incidents, including incidents that involve bomb blasts, hazardous material and any other disaster that may arise. 

At 911's Emergency Response Center with Chief Psalmer and AEMS Head of Training Craig A. Gibson, REMT-P (HCPSA) and ALS UK Heart Foundation with AEMS Students and Kidapawan 911 Team (Philip and Jeff)

Arriving at Central Mindanao College - AEMS Students led by Davao's Filipino- Chinese Fire Volunteer (AEMS EMT Student) folowed by Angelito Jorolan,RN 
(AEMS EMT Student) and Rymar Pagulong (AEMS EMT Scholar).

At Central Mindanao College in Kidapawan City with Kidapawan's 911 and Bureau of Fire Protection.

                        

www.asiaems.org