Bledsoe v1 ch06_lecture

Copyright © 2017, 2013, 2009 Pearson Education, Inc. All Rights Reserved.

Bryan E. BledsoeRichard A. Cherry Robert S. Porter

Paramedic Care: Principles & PracticeVolume 1, 5e

Chapter 6Public Health



Standard

• Public Health



Competency

• Applies fundamental knowledge of principles of

public health and epidemiology, including public

health emergencies, health promotion, and illness

and injury prevention.



Introduction

• EMS providers drawn to EMS to make

contribution to society and those in need.

• Respond to scenes of crisis and tragedy; excited

when critically ill or injured patient improves after

receiving emergency medical care.



Basic Principles of Public Health

• Public health: science and practice of protecting

and improving health of a community.

– Use of preventive medicine

– Health education

– Control of communicable diseases

– Application of sanitary measures

– Monitoring of environmental hazards




• Strong medical oversight of both public health and

EMS.

• Educate emergency care and public health

providers about roles.

• Recognition of role of and commitment to develop

and maintain relationships between leaders of

component groups.




• Bring community stakeholders into planning

process.

• Create disaster plans developed locally; public

health and emergency care; drill repeatedly.

• Pursue and secure funding.



Figure 6-1 An overview of public health.

(Source: Centers for Disease Control and Prevention)



Accomplishments in Public Health

• Vaccination

• Motor vehicle safety

• Safer workplaces

• Control of infectious diseases

• Decline in deaths from coronary artery disease

and stroke



Accomplishments in Public Health

• Safer and healthier foods

• Healthier mothers and babies

• Family planning

• Fluoridation of drinking water

• Recognition of tobacco as health hazard



Public Health Laws

• Illness and prevention

• Police powers for public health agencies

• Epidemiological tools

– 2009: Public Health Law Research Program (PHLRP).

Aids public health entities in promoting effective regulatory and

legal solutions to public health problems.



Epidemiology

• Epidemiology

– Incidence and prevalence of disease in large

populations

– Source and causes of epidemics of infectious disease

– Frequency and pattern of health events that occur in a

population



Epidemiology

• Concepts

– Years of productive life

– Injury (unintentional or intentional)

– Injury risk

– Injury surveillance program

– Primary prevention

– Secondary prevention

– Tertiary prevention



Epidemiology

• Major Roles in Public Health Practice

– Public health surveillance

– Field investigation

– Analytic studies

– Evaluation

– Linkage

– Policy development



Epidemiology

• EMS Public Health Strategies

– Roles for EMS in Public Health

Health promotion

Disease surveillance

Disaster management

Injury prevention



Public Health and EMS

• EMS personnel prime candidates to be advocates

of injury prevention.

• EMS providers perform CPR and other life-saving

procedures.

• EMS providers widely distributed in population;

reflect composition of their communities.




• Organizational Commitment

– Protection of EMS providers

– Education of EMS providers

– Data collection

– Financial support

– Empowerment of EMS providers



Figure 6-4 EMS in the United States needs to be proactive in public education programs.

(Dr. Bryan E. Bledsoe)




• EMS Provider Commitment

– Standard Precautions

– Physical fitness

– Stress management

– Seeking professional care

– Driving safety



Figure 6-5 Disease prevention starts with health care workers.

(Photo: Dr. Bryan E. Bledsoe)





– Scene safety:

Safety is always first priority.

Attention on response and equipment that will be needed

Do not approach dangerous scenes until law enforcement has

arrived and deemed the scene safe.



Figure 6-6 Every paramedic should have the appropriate safety equipment readily available and

in good repair.

(© Ken Kerr)





– Scene safety:

Traffic, road conditions, hazards

Wear reflective clothing.

Precautions in place, approach patients with your own safety in

mind.

All crew members should be restrained while ambulance in

motion.



Prevention in the Community

• Areas Where EMS Can Be Active in Prevention

– Infants and children:

One of every three deaths among children in U.S. results from

injury.

Motor vehicle collisions, pedestrian or bicycle injuries, burns,

falls, firearms





– Motor vehicle collisions:

Responsible for more than half of all deaths from unintentional

injuries

Alcohol use factor in about half of all motor vehicle fatalities.





– Geriatric patients:

Falls responsible for largest number of preventable injuries for

persons over 75.

Some may suffer from some degree of dementia.





– Work and recreation hazards:

22%: back injuries; disabling injuries.

22%: injuries to eyes, hands, fingers.

Sports injuries common.





– Medications:

Taken improperly; taken by others

Following physician's, pharmacist's, label directions imperative.

– Early discharge




• Implementation of Prevention Strategies

– Preserve safety of response team

– Recognize scene hazards

– Document findings

– Engage in on-scene education

– Know your community resources





– Conduct community needs assessment:

Childhood and flu immunizations

Prenatal and well-baby clinics

Elder-care clinics

Defensive driving classes





– Conduct community needs assessment:

Workplace safety courses

Health clinics

Prevention information on your agency's website



Summary

• Each member of EMS shares responsibility of

promoting wellness and preventing illness and

injury among coworkers and community.

• EMS services have gone beyond traditional

treatment-and-transport-only.



Summary

• Commonplace for EMS services to offer programs

to public.

• Partner with members of community to make

everyone more aware of how to prevent avoidable

illness and injury.