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Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
An emergency medical technician is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and some part-time departments require their firefighters to be EMT certified.
A paramedic is a healthcare professional trained in the medical model, whose main role has historically been to respond to emergency calls for medical help outside of a hospital. Paramedics work as part of the emergency medical services (EMS), most often in ambulances. They also have roles in emergency medicine, primary care, transfer medicine and remote/offshore medicine. The scope of practice of a paramedic varies between countries, but generally includes autonomous decision making around the emergency care of patients.
The Seattle & King County Emergency Medical Services System is a fire-based two-tier response system providing prehospital basic and advanced life support services.
A medical director is a physician who provides guidance and leadership on the use of medicine in a healthcare organization. These include the emergency medical services, hospital departments, blood banks, clinical teaching services, and others. A medical director devises the protocols and guidelines for the clinical staff and evaluates them while they are in use.
A paramedic is a healthcare professional, providing pre-hospital assessment and medical care to people with acute illnesses or injuries. In Canada, the title paramedic generally refers to those who work on land ambulances or air ambulances providing paramedic services. Paramedics are increasingly being utilized in hospitals, emergency rooms, clinics and community health care services by providing care in collaboration with registered nurses, registered/licensed practical nurses and registered respiratory therapists.
In the United States, the paramedic is a allied health professional whose primary focus is to provide advanced emergency medical care for patients who access Emergency Medical Services (EMS). This individual possesses the complex knowledge and skills necessary to provide patient care and transportation. Paramedics function as part of a comprehensive EMS response under physician medical direction. Paramedics often serve in a prehospital role, responding to Public safety answering point (9-1-1) calls in an ambulance. The paramedic serves as the initial entry point into the health care system. A standard requirement for state licensure involves successful completion of a nationally accredited Paramedic program at the certificate or associate degree level.
The British Columbia Ambulance Service (BCAS) is an ambulance service that provides emergency medical response for the province of British Columbia, Canada. BCAS is one of the largest providers of emergency medical services in North America. The fleet consists of more than 500 ground ambulances operating from 183 stations across the province along with 80 support vehicles. Additionally, BCAS provides inter-facility patient transfer services in circumstances where a patient needs to be moved between health care facilities for treatment. BCAS also operates a medical evacuation program that utilizes both fixed-wing and rotary aircraft.
Advanced Emergency Medical Technician - Critical Care (AEMT-CC) is a former Emergency Medical Services (EMS) certification that was unique to New York. The curriculum for AEMT-CC's in New York was similar to that of the national standard EMT-I/99 but with a broader scope of practice. EMT-CCs are fully classified as Advanced Life Support (ALS) providers within New York and are trained in advanced airway management, including intubation, IV fluid administration, cardiac monitoring, cardiac pacing, and both synchronized and unsynchronized cardioversion, and medication usage/administration in adult and pediatric patients.
A certified flight paramedic (FP-C) is a person who has met the advanced certification requirements for flight paramedics established for this designation by the International Board of Specialty Certification (IBSC), a not-for-profit organization responsible for the administration and development of specialty certification exams for critical care professionals. The FP-C exam was the first specialty paramedic certification offered by the Board for Critical Care Transport Paramedic Certification in 2000. This certification is designed for experienced paramedics who have demonstrated advanced knowledge of critical care medicine.
The Center for Emergency Medicine of Western Pennsylvania is a multi-hospital consortium based in Pittsburgh, Pennsylvania. It is claimed to be one of the world's premiere centers of Emergency Medicine and EMS development. It currently ranks sixth for residencies in emergency medicine by reputation.
An Emergency Care Practitioner (ECP) generally come from a background in paramedicine and most have additional academic qualifications, usually at university, with enhanced skills in medical assessment and extra clinical skills over and above those of a standard paramedic or qualified nurse. It has been recommended by the College of Paramedics that ECPs be trained to PgDip or MSc level, although not all are. Evidence of the best way to target Emergency Care Practitioners is limited with utilisation of traditional Ambulance dispatch codes not always being shown to be most effective and referrals from GPs also potentially failing to deliver management of demand that would be appropriate for this different level of practitioner. Evidence however clearly demonstrates that in discreet groups of patients the use of these extended role staff responding to emergency calls can reduce admissions and thus improve patient outcomes as well as delivering a clear cost saving to the NHS.
A flight nurse is a registered nurse who specialises in the field of providing comprehensive pre-hospital, emergency critical care, and hospital care to a vast scope of patients. The care of these patients is generally during aeromedical evacuation or rescue operations aboard helicopters, propeller aircraft or jet aircraft. On board a rescue aircraft you would find a flight nurse accompanied by flight medics and respiratory practitioners, as well as the option of a flight physician for comprehensive emergency and critical transport teams. The inclusion of a flight physician is more commonly seen in pediatric and neonatal transport teams. A critical care flight nurse must be able to deal with all age groups with broad critical emergencies. With no physicians on site the nurses scope of practice is expanded. The critical care experience is transferred over to a flight nurse with impacting factors such as altitude and changes in pressure, gravitational forces, and weather. Some patients may experience exacerbation because of factors related to the cabin environment including hypoxia, limited mobility, gas expansion, and risk of injury related to turbulence and resources with definitive care are limited. Aeromedical evacuation crews coordinate with other organizations to plan for the safe and timely care and evacuation of patients. Crews must be prepared for patients with trauma and mental health illnesses.
An advanced emergency medical technician is a provider of emergency medical services in the United States. A transition to this level of training from the emergency medical technician-intermediate, which have somewhat less training, began in 2013 and has been implemented by most states. AEMTs are not intended to deliver definitive medical care in most cases, but rather to augment prehospital critical care and provide rapid on-scene treatment. AEMTs are usually employed in ambulance services, working in conjunction with EMTs and paramedics; however they are also commonly found in fire departments and law enforcement agencies as non-transporting first responders. Ambulances operating at the AEMT level of care are commonplace in rural areas, and occasionally found in larger cities as part of a tiered-response system, but are overall much less common than EMT- and paramedic-level ambulances. The AEMT provides a low-cost, high-benefit option to provide advanced-level care when the paramedic level of care is not feasible. The AEMT is authorized to provide limited advanced life support, which is beyond the scope of an EMT.
Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first aid and basic life support. Emergency medical have clinical experience or clinical skills of emergency medical services (EMS) personnel. The EMR program is not intended to replace the roles of emergency medical technicians or paramedics and their wide range of specialties. Emergency medical responders typically assist providing basic life support. "Emergency medical responder" is a broad term, used either to describe a certain EMS certification level, or generally to describe those who respond to medical emergencies. Specifically used, an Emergency Medical Responder is an EMS certification level used to describe a level of EMS provider below that of an emergency medical technician and paramedic. Broadly used, a first responder is the first medically trained personnel who comes in contact with a patient. This could be a passerby, citizen volunteer, or fire department, police, or emergency medical services personnel.
The Queensland Ambulance Service (QAS) is the state emergency ambulance and patient transport provider in Queensland, Australia. QAS is part of the Queensland Government under the Queensland Health portfolio and is one of the largest ambulance services in the world.
CareFlight is an air medical service headquartered in Westmead, New South Wales, Australia.
Air medical services are the use of aircraft, including both fixed-wing aircraft and helicopters to provide various kinds of medical care, especially prehospital, emergency and critical care to patients during aeromedical evacuation and rescue operations.
Scottish Specialist Transport and Retrieval (ScotSTAR) is the Scottish national service for adult, paediatric and neonatal patients. The service is run by the Scottish Ambulance Service and brings together NHS Scotland's three specialist transport and retrieval services: the Scottish Neonatal Transport Service (SNTS), the Transport of Critically Ill and Injured Children Service and the Emergency Medical Retrieval Service (EMRS). The service operates from a bespoke base near Glasgow and expects to be able to cater for 2,200 critically ill children and adults every year.
References
- ↑ Ron Walls MD; John J. Ratey MD; Robert I. Simon MD (2009). Rosen's Emergency Medicine: Expert Consult Premium Edition - Enhanced Online Features and Print (Rosen's Emergency Medicine: Concepts & Clinical Practice (2v.)). St. Louis: Mosby. pp. 2469–75. ISBN 978-0-323-05472-0.
- ↑ "Join Our Medical Crew – Clinician Recruitment". The Air Ambulance Service. Retrieved 2021-04-12.
- ↑ "Advanced HEMS Practice". Bangor University. Retrieved 2021-04-12.
- ↑ "Flight Paramedic (FP-C®) Recertification- IA MED". iamed.com. 5 January 2023. Retrieved 31 January 2023.
- ↑ Surgeons (AAOS), American Academy of Orthopaedic; Physicians (ACEP), American College of Emergency; UMBC (2017-03-20). Critical Care Transport. Jones & Bartlett Learning. ISBN 978-1-284-04099-9.
- ↑ Faudree, Kyle (2011-11-11). Flight Paramedic Certification: A Comprehensive Study Guide. Immediate Action Medicine, LLC. ISBN 978-0-615-56313-8.
- ↑ "Wisconsin Critical Care Transport Paramedic Curriculum" (PDF).