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CPR, BLS, ILS, ALS and Paramedic. What does
it all mean? |
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Each successive level in the Emergency
Medical System builds on the previous level as well as
offering additional techniques and training. Each
level is also exponentially more complicated and demanding
than the previous level. CPR Training can be taught in less
than 14 hours, with minimal retraining once every 3 years,
while paramedic training is traditionally at least a two
year program, with constant recertification and annual
requirements.
CPR is Cardiopulmonary Resuscitation,
basic and essential life support.
BLS is Basic Life Support, managing Airway,
Breathing, and Circulation.
ILS is Intermediate Life Support, using drugs to
treat problems ranging from anaphylactic shock to angina, as
well as more advanced techniques to control the airway.
ALS is Advanced Life Support, able to trace ECG
rhythms, as well as offer a wider array of drugs and life
saving procedures.
Paramedic level training is the gold standard for
emergency medical services. Able to offer a wide array of
drugs and perform a multitude of procedures to safeguard
human life.
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Whatcom County Fire District #5 Emergency Medical Services (EMS) |

The six bars of the Star of Life represent six distinct phases of
an EMS system – detection, reporting, response,
on scene care, care
in transit, and transfer to definitive care. The phases are
described below:
Detection: Citizens must first recognize that an emergency exists
and must know how to contact the EMS system in their community.
There is no better way to contact the EMS system than by dialing 9-1-1.
Reporting: Callers are asked specific information so that the proper
resources can respond. In an ideal system, certified Emergency
Medical Dispatchers (EMDs) ask a pre-defined set of questions. If
someone were having a heart attack, then they would look under the
heart attack protocol for appropriate questions to ask and also give
appropriate pre-arrival instructions (such as CPR). In this phase,
dispatchers also become a link between the scene and the responding
units and can provide additional information as it becomes
available.
Response: This is the response of the EMS resources to the scene.
This may be a tiered response with First Responders and EMT's
responding initially and backed up by paramedics shortly thereafter.
It may mean that a fire engine and crew are also dispatched to help
with lifting and moving the patients or getting them out of a
smashed automobile.
On Scene Care: A lot of types of care can be provided on the scene,
versus waiting until the patient arrives at the hospital. Standing
orders and radio or cellular contact with the emergency physician
has broadened the range of on-scene care that can be provided. A
long protocol of procedures and drugs may be used before the patient
is removed from the scene. When the EMS system was just getting
started, all patients were transported to a hospital. Today, in
certain instances such as minor trauma, or when a patient is not
seriously ill or injured, not all patients are transported from the
scene to a hospital.
Care in Transit: Initially, patients were transported in hearses or
station wagons, with nobody taking care of them in the back. With
the advent of federal regulations and the maturing of EMS, specially
designed ambulances now carry mobile oxygen, suction, patient
monitoring and communications equipment, as well as special drugs
for emergency care of patients.
Transfer to Definitive Care: Up until the passage of the Trauma Care
Systems Planning and Development Act of 1990, a patient might be
seen in the emergency room (ER) by a physicians trained in specific
specialties, such as a cardiology or a surgery. They usually did not
have the training necessary to address the many types of injuries
and illnesses that present themselves in an ER. Today, there are
board certified emergency physicians. Nurses now receive
certification in emergency care and specialized training in trauma.
Hospitals may hold special levels of designation in trauma care.
This means they have additional specific equipment, rooms and
physicians available for the most traumatically injured patients.
There are specialized burn centers to handle burn patients and
special children’s hospitals that handle only pediatric patients.
Definitive care has come a long way, as has EMS, in a relatively
short time.
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04/11/04: FAA rules US jets must have defibrillators. |
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So
what's a defibrillator? First, some background. Sudden Cardiac Arrest (SCA) kills more than 450,000 Americans
every year, making it the leading cause of death.
The most common cause of SCA is ventricular fibrillation, a
lethal arrhythmia characterized by rapid, chaotic contractions of
the heart. While in ventricular fibrillation, the heart is
unable to pump blood to vital parts of the body, particularly the
brain. Factors contributing to SCA include Coronary Heart
Disease, electrocution, drowning, choking, trauma, and illegal drug
use.
Death of SCA is sudden and unexpected, occurring instantly, or
shortly after the onset of symptoms. According to the American
Heart Association, as many as 50% of SCA victims have no prior
indication of heart disease - their first symptom is cardiac arrest.
For those with a known history, chances increase 4-6 times that of
the general population.
In many cases, SCA can be reversed with early defibrillation, the
use of an AED (Automated External Defibrillator) to shock the heart
back into a normal rhythm by means of electric current. According to
the AHA, each minute of delay in delivering a defibrillation shock
to a cardiac arrest victim reduces their chances of survival by 10
percent. Studies have shown that early defibrillation within the
first few minutes of SCA can save up to 74% of victims. AHA
has stated that the definitive survival treatment for an SCA victim
is a defibrillation shock.
The Point Roberts Fire Department trains and maintains several
AED's, one placed in Car 510, our rapid response vehicle. |

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