Emergency Medical Services

G. Patrick Lilja

Robert A. Swor

Local.Role.in Emergency., Medical Services Personnel

Training

Communications

Transportation

Facilities

Critical., Care, .units Public. Safety. Agencies Consumer .Participation

Ac£e,ss|o.care Tra.ns.fer.of.Care

Standardization. . .of. .Patients' ..Records

Public Information and Education

Independent . . Review . and . . Evaluation Disaster .Linkage Mutual..Aid..Agre,ements MedicalControl

Medical.. Basis for ..E.mergen.c.ynMedical ..Services Emergency. .Cardiac ..Care

Trauma..Care

Adult ..Medical..Care

Pediatric..Care

Rura.!.„Emergen.cY ..Medical.Services Emergency ..Medical..Se^rvices.nAg.endan for ..the Future Chapter References

Emergency medical services (EMS) constitute the extension of emergency medical care into the community. Strong emergency department leadership is absolutely essential to a safe and effective EMS system.

The 1966 National Highway Safety Act authorized the US Department of Transportation (DOT) to fund ambulances, communications, and training programs for prehospital medical services.1 Coincidentally, in 1967 J. Frank Pantridge began using a mobile coronary care unit in Belfast, Northern Ireland, to extend coronary care into the prehospital setting.

In 1973, public law 93-154 defined a goal of improving emergency medical care and EMS on a national scale. Although much has changed in EMS since passage of that initial act, the original definition of EMS systems is useful for understanding their functions. This law identified 15 elements of an EMS system: (1) personnel, (2) training, (3) communications, (4) transportation, (5) facilities, (6) critical care units, (7) public safety agencies, (8) consumer participation, (9) access to care, (10) transfer of care, (11) standardization of patients' records, (12) public information and education, (13) independent review and evaluation, (14) disaster linkage, and (15) mutual aid agreements. Thus, an EMS system is the entire system in place to provide care to emergency patients, from the initial 911 call until definitive care is rendered.

State laws broadly outline what is safe and prudent for the public good. State EMS laws and regulations typically define levels of ambulance service capability, training requirements, equipment requirements, and requirements for physician leadership and accountability. In addition, the state health department may be the lead agency in promoting and funding EMS activity.

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