Topik 1_Emergency Medical Team

Emergency Medical Service
and Team

Learning Teaching

At the end of the session, student shall be able to:
1. State the definition emergency medical service

(EMS).
2. State the services provided by an Emergency

Department.
3. Explain the component of emergency setting and

the organization.
4. Identify the important equipment and medication

used in emergency setting.
5. Explain the role and responsibilities of nurses in

emergency depatment.

What is Emergency Medical
Services (EMS) ?

• It is a system.
• Activated by an incident that causes serious

illness or injury.
• Easily recognized when emergency vehicles

are seen responding to emergency incidents.

• It is a system of coordinated response and
emergency medical care, involving multiple
people and agencies.

EMS

• Ambulance @ Paramedic services.
• Provide treatment on the scene to those in

need of urgent medical care.
• To fulfil the basic principles of first aid.

Who provide EMS?

1. Government ambulance services (JPAM,
Bomba)

2. Charity ambulance services (Malaysian Red
Crescent)

3. Private ambulance services (Mahamas
Ambulance)

4. Hospital based service
5. Internal ambulance (large factory, industrial

centre)

Personnel

1. Physician
2. Paramedic
3. Emergency medical technician
4. Registered nurses
5. Driver
6. Attendant

Strategies for delivering care

Anglo-American Model Franco-German Model

• Known as "load and go“. • Known as "stay and play“.
• Ambulances are staffed • Doctors respond directly

by paramedics to all major emergencies
and/or emergency medical requiring more than
technicians. simple first aid.
• Staff have specialized • Physicians and
medical training, but not to nurses provide all medical
the same level as a interventions for the
physician. patient.
• Other ambulance
personnel are not non-
medically trained and only

Component of Emergency
Department Services

1. Pre hospital care:

• Primary responder service to emergency
location. (EMS).

• Emergency & inter-facility service through main
road, air dan water.

• Medical Emergency Coordinating system
(MECC) dan 999 Emergency call management
system (Call centre).

• Pengurusan kecemasan dan insiden perubatan
yang major.

•

Component of Emergency
Department Services _ cont.

2. Hospital based care:

• Triage system service
• Emergency clinical care
• Observational medicine
• One stop crisis centre (OSCC)
• Emergency medicine and trauma

Component of Emergency Nursing
Management

1. Emergency nursing practice setting.
2. Standard of emergency nursing practice.
3. Emergency nursing environment

Component of Emergency Nursing

Management _ cont.

Emergency Nursing Bergantung kepada
Practice Setting organisasi

Jabatan kecemasan hospital

Pre hospital arena

Keadaan luar Kawasan rawatan kecemasan
kawalan yg Klinik rawatan
memerlukan Perkhidmatan ambulan

intervensi

Emergency Nursing Standard Nursing
Practice
Environment

Kedudukan sumber hospital.( x- Polisi dan prosedur.
ray, makmal, E-troli) Standardised care plan
Jumlah pesakit. Orientation and education
Severity, urgency dan diagnosis. program.
Berbagai budaya dan bahasa. Performance improvement
program.

Contoh:



Emergency equipment

Emergency equipment

Emergency equipment

Emergency equipment

Emergency equipment

Emergency equipment

Emergency equipment

Emergency equipment

Emergency Drugs

1. Adrenaline 11. Lidocaine
2. Atropine 12. Magnesium Sulphate
3. Adenosine 13. Frusemide
4. Calcium chloride 14. Midazolam
5. Sodium bicarbonate 15. Nalaxone
6. Dextrose 50% 16. Flumazenil
7. Chlorpenamine 17. Dll mengikut polisi
8. Amiodarone
9. Hydrocortisone hospital.
10. Potassium Chloride

Peranan dan Tanggungjawab
Jururawat

1. Memastikan keselamatan:

a. diri sendiri.
b. Ahli pasukan
c. Pesakit
d. Orang am sekeliling (bystander)

2. Memberi penjagaan kepada pesakit:

a. Melakukan asesmen
b. Memberi jagaan yang simple sehingga menyelamatkan

nyawa

Peranan dan Tanggungjawab
Jururawat (samb.)

3. Transport

a. Kenderaan ambulan yang selamat digunakan.
b. Keselamatan pesakit dalam ambulan.
c. Memindah dan mengalihkan pesakit secara selamat.

4. Transfer care

a. Memindahkan ke pesakit ke hospital yang menerima.
b. Memberi maklumat tentang keadaan pesakit.
c. Memastikan setiap maklumat penjagaan pesakit

diserahkan kepada pegawai yang berkaitan.

Peranan dan Tanggungjawab
Jururawat (samb.)

5. Patient advocacy (penjaga)
a. Membina hubungan baik sepanjang tempoh
memberi penjagaan.
b. Menjaga hak dan keperluan pesakit.
c. Memberi pendidikan kepada pesakit.

Peranan dan Tanggungjawab
Jururawat (samb.)

5. Patient advocacy (penjaga)
a. Membina hubungan baik sepanjang tempoh
memberi penjagaan.
b. Menjaga hak dan keperluan pesakit.
c. Memberi pendidikan kepada pesakit.

Ciri-ciri Jururawat

1. Fizikal:

 Sihat tubuh badan bagi menjalankan
tanggungjawab.

 Berupaya mengangkat dan memindahkan
pesakit dengan selamat.

 Tajam penglihatan, pendengaran yang baik
 Berupaya untuk berkomunikasi dengan

bystander.

Ciri-ciri Jururawat (samb.)

2. Ciri-ciri peribadi:

 Berkeyakinan bagi menenangkan pesakit.
 Berkebolehan memahami situasi dan perasaan pesakit.
 Boleh bekerjasama dengan anggota pasukan bagi

memastikan koordinasi dan penjagaan yang baik serta
tindakan yang pantas.
 Bertindak pantas mengikut bidang tugas.
 Emosi yang stabli bagi menenangkan keadaan.
 Berupaya memimpin bagi mengawal keadaan.
 Neat and clean: mendapat keyakinan dan
mengurangkan kontaminasi.
 Able to listen

Ciri-ciri Jururawat (samb.)

3. Education:

 Pengetahuan dan skil yang up-to-date.
 Pendidikan yang berterusan.
 Kursus setiap 2 – 4 tahun.