What Is Emergency Medical Service (EMS)?
EMS is an emergency medical response service that provide on site medical treatment and transportation to the nearest medical facility for patients who cannot transport themselves. This is usually at the site of an emergency, where patients needs immediate medical attention.
EMS can also be known as or referred to by many different names depending on the location and organization in which the EMS belongs to. Some of these names include:
– Paramedic Service
– First Aid Squad
– Rescue Squad
– Ambulance Services, Corps, or Squad
– Life Squad
– Emergency Squad
EMS’s primary goal is provide emergency medical treatment to those in urgent need of medical care. Emergency medical services want to properly treat the patient’s conditions and move them to a proper healthcare or medical facility.
The Star Of Life
EMS and ambulance services exist to provide first aid and emergency are to patients in need. They aim to preserve and prevent further injury. The goal is to get the patient on the fastest road to recovery.
The Star of Life is a common theme that constantly referred to in emergency medicine. It is a star with six arms. Each arm refers to the following:
1). Early Detection – A clinical or medical profession, member of the public, or another medical agency identifies a problem or emergency.
2). Early Reporting – Those who identify the emergency or those first on the scene, make a 911 call to EMS and ask for immediate medical assistance. This enables for an ambulance to pursue
3). Early Response – The EMS professionals or volunteers arrive on the scene. Treatment and transportation can begin.
4). Good On-Scene Care – The appropriate treatments and interventions are given to the patient to treat ailments, prevent further injury, and start the road to recovery. Now EMS prepares for transport.
5). Care In Transit – The patient is loaded on the stretcher and brought aboard the ambulance. This is the vehicle the patient will transported in and treated along the way.
6). Transfer To Definitive Care – The patient is delivered to the emergency care department of the hospital. EMS brief the nurses and physicians at the hospital on patient’s condition. After the patient is handed off, EMS’s job is done.
Different Levels Of Care
In the United States, EMS and ambulances are distinguished by the three levels of care and service. Those levels are Advanced Life Support (ALS) (such as advanced cardiac life support or pediatric advanced life support), Basic Life Support (BLS), and Critical Care Transport (CCT).
Obviously, what sets apart other levels of care from another is the skills of the professional staff aboard the ambulance.
The Roles Of Everyone In Ambulance
Basic Life Support
Ambulance Driver – The driver’s job is transport EMS to the scene and the patient to the nearest medical facility as quickly and safely as possible. They trained in ambulance response driving skills, emergency operations, and radio communications.
Ambulance Care Assist – These assistants are many responsible for preparing and transporting the patients. This means load the patient on the wheelchair or the stretcher. They do not focus as much on medical care as they do on transportation of the patient.
They only perform medical care to the patient if trained to do so. Or when there is a paramedic or nurse that is fully supervising and directing the driver.
Emergency Medical Technician (EMT) – EMTs can usually perform many first aid and emergency care treatments and interventions. There skills vary and can be quite diverse. They are trained to use some medical technology such as automated external defibrillator (AED) and using IVs.
They can administer limited amounts medicine and drugs to the position, open up airways near the lungs and within the body, and cardiac monitoring. There are also different types of EMTs such as Wilderness EMTs.
Emergency Medical Dispatcher (EMD) – These EMS personnel do not actually ride in the ambulance. They are on the phone with the person who called in the emergency. EMDs ask the caller specific questions about the person hurt or sick and gather information for the incoming EMS.
They can also talk the caller the through some preliminary care tactics to help begin treatment on the patient until EMS. This is a highly effective tactic to promoting recovery and healing for the patient.
Advanced Life Support
ALS ambulances contain EMTs, as well as paramedics. Paramedics have a more advanced skill set than EMTs, as we explain below.
Paramedic – They are training at a high level in pre-hospital and emergency care. They learn, know, and perform a greater range of skills than their EMT counterparts. Some of these skills include needle decompression, cardiac monitoring, tracheal intubaton, cannulation (drugs to relieve pain), cricothyrotomy, and pericardiocenetis.
They can identify and treat life threatening issues and look for any other ailments that might prevent recovery or also require treatment. There are several certifications (ex. ACLS and PALS) and types of paramedics exist as well (such as the flight paramedic).
Critical Care Transport
Critical Care Paramedic – These paramedics that have a higher level of certification than regular paramedics. They deal specifically with transferring critically ill and injured patients to medical facilities that are better equipment to treat them.
These paramedics can perform many critical and intensive care treatments and interventions that are beyond the scope of training for regular EMS.
They can administer more complex drugs and medication, perform higher level of life support, work more medical technology, and manage the airways of a patient better than regular EMTs and paramedics.
Other Vital Healthcare Roles
Physician – They perform the surgeries and operations that are vital for repair and recovery in emergency situations. Obviously, these operations and surgeries are far beyond the training that EMTs and paramedics receive. Physicians usually only travel with EMS in the case of a dyer emergency or when they are needed.
Registered Nurse – If you have been around this website long enough then you have an idea what registered nurses do. They assist doctors and provide treatment to the patient after the doctor has diagnosed the patient.
However, they are used in pre-hospital settings depending on the situation or emergency. They can also be used in the case where there is shortage of EMTs or paramedics. Having a nurse on board the ambulance can be very important to patient care.
Registered nurses are mostly used during critical care transport. Those nurses usually come from the intensive care unit to ensure the patient is in proper hands. In some states, there are full time ambulance nurses. These nurses work with the EMS team to treat patients during transport. These are very similar flight nurses.
How EMS Has Evolved?
Years ago, EMS was a term more used to address just the supervision and transportation of patients to the proper healthcare or medical facility in emergency situations. It did not used to include treatment.
Nowadays, EMS refers to pre-hospital treatment that in given on the scene of the emergency and during transport to the proper healthcare or medical facility.
Other Vital Healthcare Functions Of EMS
EMS also have the responsibility of moving patients from medical facility to another. In cases like these, EMS are summoned by medical professionals instead of the public (like during emergencies).
Transfers of patients usually happen for several reasons. But the two most common reasons are:
1). To transfer a patient to more specialized medical facility. Some patients require a specific type of care which they cannot get at medical facilities. Hence, they might need to be transferred somewhere else. This is usually done with patient’s best interest in mind.
2). To transfer patients from specialized medical or healthcare facilities back to a local hospital or nursing. This is usually because these patients no longer require specialized or intensive care on a day to day basis.
In some regions of the country, EMS can also handle technical rescue operations. In many of these cases EMS works with Firemen and Rescue Teams to complete the operation. Either way, they are trained to handle these operations:
– Water rescue
– Search and rescue
– Rope rescue
– Ski Rescue
– Cave Rescue
– Confined Space Rescue
– Trench Rescue
– Building Collapse Rescue
Types Of EMS Providers
1). Private EMS – These are normal private companies. These companies have paid employees. Some of these employees are under contract from the local or federal government. These ambulances usually do ‘second tier response’. This means they only respond to emergencies when all full time ambulances are occupied.
Other full time ambulances that are deployed first ate usually employed by the government. We will talk about them in a minute. Private EMS will usually handle small emergencies as first respondents. Emergencies that include bandaging wounds or cuts. Stuff like that. This allows for EMS to be more available during all emergencies.
2). Volunteer EMS – Non profit and charities can employ and operate ambulances for emergencies and patient transport as well. These non-profits are usually linked to other volunteer services in the same community such as a volunteer fire service.
The Red Cross provides this service around the world for medical care and ambulances. There are many other not for profit organizations that offer ambulance services as well. These ambulances can be first respondents to emergencies.
3). Government EMS – These ambulances are funded by the local, state, and federal government. They operate separately from local fire and police departments. But they still have to take civil service exams like the police and firemen do.
4). Fire and Police EMS – In most developed countries, EMS and ambulances can be operated with local police and fire departments. This usually happens in rural areas where having or maintaining a separate Government EMS is not cost effective or just not affordable.
They can also operate in places where there is no EMS to respond to non-medical emergencies. These EMS can also be deployed to fires and hostile police situations to wait on stand by in the case that emergency develops.
5). Hospital Based EMS – Certain hospitals have their own EMS and ambulance service that they use to operate within the local community. This is usually in places where other ambulance services are unreliable or too expensive to maintain. Their operations are entirely dependent on the hospital.
6). Combined Service EMS – These consist of full service emergency agencies. Those are services that contain not only EMT and ambulance staff but also firemen and police force.
It is typical to find services like this on college campuses, large corporation campuses, airports, train stations, metro service stations, sports and multi purpose arenas and stadiums, and large shopping malls.
Emergency Services Medical Certification Programs And Courses
There are so many certifications that can be acquired and courses that be taken in EMS. We recommend checking with your local community, university, hospital, or library to see what courses might be available. Many of these courses do not last more than a couple days and end with an assessment.
The National Registry of Emergency Medical Technicians and The National Association Of Emergency Medical Technicians (this body also accredits the EMT and paramedic courses) offer some online certification courses that are coupled with in person training. However, some courses are only available at certain times. Check their website for information.