Alternative Names EMS, pre-hospital care, out-of-hospital care
Definition Emergency Medical Services (EMS) extends emergency medical care from the emergency room of a hospital into the community. The EMS system was developed to provide care to ill and injured people as quickly as possible.
What is the information for this topic? When a person calls for help with an injury or illness, Emergency Medical Services often responds. Many towns have a 911 system to report emergencies. A dispatcher answers the call. He or she takes information and alerts EMS. The caller's address may be automatically identified. The dispatcher may be trained to give medical instructions for handling the emergency before an ambulance arrives.
Some communities do not have a 911 system. In these areas, emergency calls must be routed differently.
EMS service is provided by many people. In urban areas, police officers, firefighters, and ambulance staff are most likely to provide this type of care. In rural or wilderness areas, volunteers, park rangers, or ski patrol staff may provide it. EMS courses on topics such as basic first-aid and cardiopulmonary resuscitation (CPR), are also offered to the public in many places.
EMS training and certification can be broken down into four general skill levels:
First responder training is for a person who is often the first on the scene, such as:
A person at this level may have taken a Red Cross advanced first-aid course or the Department of Transportation's First Responder Course. First responders provide quick care for life-threatening injuries. They know how to alert the EMS system. Their job is to control the scene and prepare for an ambulance to take the person to the emergency department.
EMT-Basic training is required for ambulance staff. A person at this level:
has first aid skills, including CPR
can take care of basic and life-threatening conditions
can safely remove a person from a dangerous area, such as a crash site
EMT-Intermediate training builds on EMT-Basic courses. A person at this level can give some types of advanced life-support. He or she:
can place an intravenous (IV) line into a vein
knows what to do if a person stops breathing
can give certain medications
EMT-Paramedic training teaches a much higher level of skill. A paramedic gives care according to a set of steps called protocols that respond to certain medical situations. He or she can often perform lifesaving procedures before a person reaches the emergency department, such as:
A paramedic can do electrocardiograms, or ECG. This is a test that records heart activity.
Each EMS system has a medical director. This person is a doctor who is responsible for EMS patient care. The doctor also oversees training and develops protocols. Procedures not covered by protocols require the EMS caregiver to speak with a doctor. That doctor will then instruct him or her on how to proceed.
Ground ambulances used by EMS staff are well outfitted for taking care of the sick or injured. Lifesaving techniques can now be done before a person is brought to the emergency department. If time is critical, air transport may be considered. While this usually speeds care, not all areas have air ambulances.
Author: Gail Hendrickson, RN, BS Reviewer: Vincent J. Toups, MD Last Updated: 01/31/01 Contributors Potential conflict of interest information for reviewers available on request
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