Emergency Medical

Technician (EMT)
INTRODUCTION

1/1/2019 NASC-IILM-EMT 1
Introduction:
This course is designed to work as ambulance service worker.

In this Chapter, a scenario has been discussed describing the

roles and responsibilities of EMT.

1/1/2019 NASC-IILM-EMT 2
The Emergency Operation Centre:
• Mr. James Brown, 59 year old man has chest pain with
his wife, Patrica. Mrs. Brown makes a call to 1122
(Emergency Number in Pakistan), she speaks to the
operator who asks her what she requires?

• CALL: RECEIVE AND RESPOND

She ask for the ambulance service from EMS. The
dispatcher allocates ambulance and categorized Red Call
by medical priority dispatch system, which targets to
respond in 8 minutes.
1/1/2019 NASC-IILM-EMT 3
Patrica complaining about her
husband. Dispatcher allocating EMS.

1/1/2019 NASC-IILM-EMT 4
Arriving on The Scene:
• Conduct a scene assessment
including location, time of day and
type of incident because the scene
may change rapidly.

• In addition, enter the scene with

your paramedic and you will need
personal protective equipments
and immediate aid kit, oxygen,
drugs bag and defibrillator where
Mrs. James Brown is waiting.

1/1/2019 NASC-IILM-EMT 5
Principles of Communication:
• EMT and paramedic introduce yourself to Mr. Brown
who is clutching his chest, looking grey and sweaty.

Adapt your style of communication. It is not always easy

to communicate with patients because some patients
may not communicate with you because of depression,
language, age etc.

1/1/2019 NASC-IILM-EMT 6
Patient Assessment:
• Seek help from your paramedic colleague and complete
an initial assessment of Airway, breathing, circulation,
disability, exposure (ABCDE).
• Airway is patent and the patient is breathing at the rate
of 16bpm.
• Apply pulse oximeter to one of his finger and the
oxygen saturation is 93% excluding the presence of
COPD. Administer low flow oxygen.
• Further measure blood pressure, Blood sugar,
temperature and perform ECG by applying electrodes.
1/1/2019 NASC-IILM-EMT 7
Patient History:
• Mr. Brown shares that he suffered from central chest
pain, radiating to back, jaw and both arms. He felt heavy
pressure, which scores 7 out of 10 associated with
shortness of breath, nausea, sweating. (OPQRSTA)
• His wife states history about his paleness since the
onset of pain. Paramedic further investigated past
history of the presence of high cholestrol and
hypertension. Mr. Brown never had heart attack before
but does admit to suffering from occasional chest pain
over past month.

1/1/2019 NASC-IILM-EMT 8
 The 12-lead ECG:
• Paramedics ask other to record
ECG while he administers
Aspirin and GTN after verifying
no allergies.

After obtaining consent, apply

electrodes to the identified
anatomical landmarks and
connect them to the monitor and
press 12-lead ECG button. After a
short while, ECG is printed.

1/1/2019 NASC-IILM-EMT 9
Manual Handling:
• Fetch a carry chair, Complete TILE Assessment (Task,
Individual, Load and Environment).

Explain Patient how you will carry him. Assist him

to the chair and move to the ambulance stretcher so that
he can transfer onto it, lifting the chair over the lip of any
frame alongside.

1/1/2019 NASC-IILM-EMT 10
 Assist The Paramedic:
• Connect the monitor to the patient to observe changes
en route to hospital. As this was heart attack
emergency, drive blue sirens and head towards some
cardiac setup hospital after pre-alerting the hospital.

• Cannulation:
Gather equipments like dressing pack, alcohol wipe,
syringe, tourniquet and saline to cannulate the patient.
Identify the vein, insert cannula, remove needle safely to
sharps bin.
1/1/2019 NASC-IILM-EMT 11
 Hospital Arrival:
• You head towards driving and after reaching hospital,
paramedic shouts that Mr. Brown has suffered cardiac
arrest and he had already started compressions and
advise you to apply pads removing chest leads and
defibrillate the patient.
• Meanwhile, paramedic was withdrawn from
compressions to analyze heart rhythm and recognizes it
as Ventricular fibrillation. Defibrillator is now ready to
deliver shock after verifying that no one is touching
patient. On delivering shock, patient jolts upward and
you switch over to compressions and interventions.

1/1/2019 NASC-IILM-EMT 12
Other Managements:
• Paramedic inserts OPA.
• Connects BVM to high flow
oxygen. After two minutes of
CPR, pulse returns. His breathing
is not adequate. However, en
route to catheterization,
paramedic assist ventilation with
6 sec interval.

• Handover the patient to waiting

staff explaining all history.

1/1/2019 NASC-IILM-EMT 13
Clean Up and Prepare
for the Next Call:

When patient is in safe hands,

you need to return, restock,
clean up
and prepare for next emergency
call. Later, you find Mr. Brown
had reopened occluded left
anterior descending artery and is
recovering.

1/1/2019 NASC-IILM-EMT 14