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.
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.
Paramedics in Germany are the main providers of emergency care in emergency medical services in Germany. There exist two professional levels regulated by federal law, the Rettungsassistent and the Notfallsanitäter.
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.
Wilderness medicine is defined by difficult patient access, limited equipment, and environmental extremes. Today, wilderness or expedition medicine is practiced by Wilderness First Responders, Wilderness EMTs, Remote/Offshore/Wilderness Paramedics and Physicians on expeditions, in outdoor education, search and rescue, mountain rescue, remote area operations including research, exploration, and offshore oil platforms, as well as tactical environments. In mainland Europe, where mountain rescue is done by paid professionals, there are courses for physicians that help qualify them to be mountain rescue or expedition doctors. Many of these courses lead to an International Diploma in Mountain Medicine, which is recognized by the Union Internationale des Associations Alpinistes.
Wilderness first responders are individuals who are trained to respond to emergency situations in remote locations. They are part of a wide variety of wilderness medical providers who deal with medical emergencies that occur in wilderness settings. While wilderness first responder can generically refer to anyone providing first response, this term typically refers to individuals trained and certified with specific Wilderness First Responder (WFR) certification.
Emergency Medical Service in Germany is a service of public pre-hospital emergency healthcare, including ambulance service, provided by individual German cities and counties. It is primarily financed by the German public health insurance system.
In the US, paramedicine is the physician-directed practice of medicine, often viewed as the intersection of health care, public health, and public safety. While discussed for many years, the concept of paramedicine was first formally described in the EMS Agenda for the Future. Paramedicine represents an expansion of the traditional notion of emergency medical services as simply an emergency response system. Paramedicine is the totality of the roles and responsibilities of individuals trained and credentialed as EMS practitioners. These practitioners have been referred to as various levels of Emergency Medical Technician (EMTs). In the United States paramedics represent the highest practitioner level in this domain. Additional practitioner levels in this domain within the U.S. include Emergency Medical Responders (EMRs), Emergency Medical Technicians (EMTs) and Advanced Emergency Medical Technicians (AEMTs).
Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies, typically before the arrival of an ambulance. 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. However, the EMR is not intended to replace the roles of such providers and their wide range of specialties.
State Medical Rescue in Poland is a system of free public emergency healthcare established by Ustawa o Państwowym Ratownictwie Medycznym, including ambulance service and Emergency Departments (EDs). While in Polish public hospitals and clinics NFZ common public insurance is required, PRM medical services in ambulances and EDs are completely free for everyone. Since 2018 emergency ambulances that operates in PRM, that is Polish 112 and 999 emergency numbers, are operated by public entities only.
The Wilderness Medical Society was created on 15 February 1983 by three physicians from California, United States — Dr. Paul Auerbach, Dr. Ed Geehr, and Dr. Ken Kizer. It is the largest international non-profit membership organization devoted to addressing wilderness medicine challenges, more specifically defined as "medical care delivered in those areas where fixed or transient geographic challenges reduce availability of, or alter requirements for, medical or patient movement resources". It also publishes Wilderness & Environmental Medicine Journal, Wilderness Medicine Magazine, and Wilderness Medicine Clinical Practice Guidelines.
The New York City Fire Department Bureau of Emergency Medical Services is a division of the New York City Fire Department (FDNY) in charge of emergency medical services for New York City. It was established on March 17, 1996, following the merger of the FDNY and New York City Health and Hospitals Corporation's emergency medical services division. FDNY EMS provides coverage of all five boroughs of New York City with ambulances and a variety of specialized response vehicles.
A wilderness medical emergency is a medical emergency that takes place in a wilderness or remote setting affinitive care. Such an emergency can require specialized skills, treatment techniques, and knowledge in order to manage the patient for an extended period of time before and during evacuation.
Wilderness medicine is a medical specialty concerned with medical care in remote, wilderness and expedition environments. The specialty includes prior planning, public health issues, a number of sub-specialties as well as responding to emergencies. One modern definition of wilderness medicine is "medical care delivered in those areas where fixed or transient geographic challenges reduce the availability of, or alter requirements for, medical or patient movement resources".
The Appalachian Center for Wilderness Medicine (ACWM) is a non-profit organization dedicated to promoting wilderness medicine in the southern Appalachian region of the United States of America. Dr. Seth C. Hawkins, an emergency physician who specializes in EMS and wilderness medicine, founded ACWM in 2007 in the state of North Carolina. It is the first regional wilderness medicine non-profit of its kind in the United States. Contemporary authorities in wilderness medicine have noted its importance in establishing a mechanism for regionally pooling information and resources in a field that otherwise has little connection between local or regional experts. Critical to that effort have been uses of the internet in ways not previously seen in wilderness medicine.
Seth Christopher Collings Hawkins is an American emergency physician, writer, anthropologist, and organizational innovator. He has made notable contributions to the fields of wilderness medicine, Emergency Medical Services (EMS), and medical humanities. His work has particularly specialized in EMS and wilderness medicine in the southeastern United States, where he is the founder of the Appalachian Center for Wilderness Medicine, the Appalachian Mountain Rescue Team, and the Carolina Wilderness EMS Externship.
The Carolina Wilderness EMS Externship (CWEMSE) is an out-of-hospital medical training for 4th year medical students and resident physicians interested in furthering their educational interests in wilderness EMS.
Wilderness & Environmental Medicine is a quarterly peer-reviewed medical journal covering wilderness medicine. It is the official journal of the Wilderness Medical Society and published its Wilderness Medical Society Clinical Practice Guidelines. The journal is published by Elsevier and the editor-in-chief is William D. Binder.
