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A nontransporting EMS vehicle [lower-alpha 1] is a vehicle that responds to and provides emergency medical services (EMS) without the ability to transport patients. For patients whose condition requires transport (e.g. to a hospital), an ambulance is necessary. In some cases they may fulfill other duties when not participating in EMS operations, such as policing or fire suppression.
Non-transporting EMS vehicles come in many sizes and types, from bicycles and golf-carts that can access pedestrian walkways; to motorcycles that are able to fit through stopped or slow traffic; to sedans, station wagons, and SUVs that can carry almost as much equipment as an ambulance; to ATVs or UTVs that are capable of off-road rescue; to fire engines and rescue squads that may carry large crews and may carry specialized equipment. Essentially, any vehicle that lacks the ability to transport a patient may be used, depending on the needs of the local EMS system.
A non-transporting EMS vehicle can help emergency organizations use their resources more efficiently, assessing an incident's severity (especially where there is reason to suspect the injury or illness is not serious) and either treating the patient at the scene and then releasing them or calling in additional help if required. This saves resources on several levels, as most non-transporting vehicles cost much less than full-size ambulances, and because they may be staffed by a single person (ambulances require a minimum of two crew members). Non-transporting vehicles may be used by ranking EMS officers, who may need to move between calls to complete their supervisory duties, or by more highly or specially trained medical responders (e.g. a paramedic versus an emergency medical technician, or a physician, found commonly in European systems), saving those with higher or specialized training from being ensnared in calls that can be capably handled by emergency responders with a more basic level of training.
Non-transporting vehicles can also be used to improve response times. In areas such as busy roads, smaller nontransporting vehicles are able to move through traffic faster than full size ambulances can. Some non-transporting vehicles may also have off-road capabilities, giving them access to areas that traditional ambulances cannot reach. Golf carts and similar vehicles provide access to grassy areas, amusement parks, and inside large buildings, such as shopping malls.
Fielding multiple non-transporting vehicles may enable the EMS system to increase the number of units it has available to respond without the greater costs (money and personnel) associated with full-sized ambulances. Adding EMS capabilities to preexisting police or fire units yields similar results.
Several European countries with physician-led emergency services, such as Germany, Belgium and Austria, deploy Emergency Physician Rapid Response Cars (in German called NEF from Notarzteinsatzfahrzeug — "emergency physician deployment vehicle"), staffed with at least an emergency physician and a paramedic. These physicians are generally only called out to serious calls to coordinate multiple ambulances or provide intense on-scene care to serious or critical patients; paramedics and EMTs in ambulances generally can handle most calls by themselves.
In the Swedish medical system, a non-transporting vehicle (akutbil) can be equipped with a nurse specialized in anesthesia who is specialized in pain management, paired together with a paramedic. These vehicles can be staffed around the clock or during the busiest hours of the day and week in order to augment the capacity of the prehospital care provider and can respond both independently and in conjunction with one or more ambulances, air ambulance(s) and other emergency services. As a result of new (circa 2013) legislation requiring all ambulances to be equipped with at least one trained nurse, non-transporting vehicles have become less common. [4] [5]
In Belgium, a non-transporting vehicle (called Mobiele Urgentiegroep (MUG) in Dutch, Service Mobile d' Urgence et de Réanimation (SMUR) in French) is equipped with at least one emergency physician and one nurse specialized in intensive and emergency care. Standard Belgian ambulances only have EMTs and/or nurses on board and only provide basic life support. Non-transporting vehicles are only sent out for serious emergencies like drug overdoses and cardiac arrests and provide advanced life support on top of the services provided by ambulance crews.
In France, emergency medicine is generally handled by two services, the Fire Department red ambulances which provide basic life support, and Hospital-based yellow or white vehicles who provide advanced life support ambulances and emergency physicians who use fly-cars. In the French model of prehospital care, doctors may remain on scene to attempt procedures to stabilise patients prior to transport.
In the United States, several fire departments and private ambulance services have fly-car programs. The Fire Department of the City of New York (FDNY) added EMS capabilities to many of their fire engines, effectively adding dozens of EMS units to their fleet without having to purchase or staff additional ambulances. In 2016, the FDNY launched a formal EMS fly-car program to reduce EMS response times; [6] [7] this practice was suspended in March 2020 due to the COVID-19 pandemic. [8] The program received criticism from the FDNY EMS union, which argued that the fly-car program siphoned personnel and resources from the regular EMS ambulance service. [8] The New York City branch of Hatzalah, a Jewish volunteer EMS program, operates a two-tiered dispatch model where EMTs and paramedics respond to a call in their fully equipped private vehicles acting as fly-cars, while an ambulance is brought for transport if necessary. [9]
In Israel, Magen David Adom and other EMS organizations use motorcycles as non-transporting EMS vehicles to reach patients.
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.
An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medical emergencies by emergency medical services (EMS), and can rapidly transport paramedics and other first responders, carry equipment for administering emergency care, and transport patients to hospital or other definitive care. Most ambulances use a design based on vans or pickup trucks, though others take the form of motorcycles, buses, limousines, aircraft and boats.
A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. Certified individuals should have received much more instruction than someone who is trained in basic first aid and cardiopulmonary resuscitation (CPR) but they are not necessarily a substitute for more advanced emergency medical care rendered by emergency medical technicians and paramedics. First responders typically provide advanced first aid level care, CPR, and automated external defibrillator (AED) usage. The term "certified first responder" is not to be confused with "first responder", which is a generic term referring to the first medically trained responder to arrive on scene and medically trained telecommunication operators who provide pre-arrival medical instructions as trained Emergency Medical Dispatchers (EMD). Many police officers and firefighters are required to receive training as certified first responders. Advanced medical care is typically provided by EMS, although some police officers and firefighters also train to become emergency medical technicians or paramedics.
Hatzalah is the title used by many Jewish volunteer emergency medical service (EMS) organizations serving mostly areas with Jewish communities around the world, giving free medical service to patients regardless of their religion. Most local branches operate independently of each other, but use the common name. The Hebrew spelling of the name is always the same, but there are many variations in transliteration, such as Hatzolah, Hatzoloh, and Hatzola. It is also often called Chevra Hatzalah, which loosely translates as "Company of Rescuers", "Group of Rescuers", or "Rescue Squad". It is the largest volunteer medical group in the United States.
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.
Louisville Metro Emergency Medical Services is the primary provider of pre-hospital life support and emergency care within Louisville-Jefferson County, Kentucky. LMEMS is a governmental department that averages 90,000 calls for service, both emergency and non-emergency, each year.
In the United States, emergency medical services (EMS) provide out-of-hospital acute medical care and/or transport to definitive care for those in need. They are regulated at the most basic level by the National Highway Traffic Safety Administration, which sets the minimum standards that all states' EMS providers must meet, and regulated more strictly by individual state governments, which often require higher standards from the services they oversee.
Emergency medical services in France are provided by a mix of organizations under public health control. The central organizations that provide these services are known as a SAMU, which stands for Service d’aide médicale urgente. Local SAMU organisations operate the control rooms that answer emergency calls and dispatch medical responders. They also operate the SMUR, which refers to the ambulances and response vehicles that provide advanced medical care. Other ambulances and response vehicles are provided by the fire services and private ambulance services.
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.
Emergency medical services in Italy currently consist primarily of a combination of volunteer organizations providing ambulance service, supplemented by physicians and nurses who perform all advanced life support (ALS) procedures. The emergency telephone number for emergency medical service in Italy is 118. Since 2017 it has also been possible to call by the European emergency number 112, although this is a general police/fire/medical number.
The Park Slope Volunteer Ambulance Corps, or PSVAC, is a community organization that provides emergency medical response, rescue operations, patient assessment, treatment, and transport in Park Slope, Brooklyn, New York. Since 1992, members have responded to over ten thousand calls for help.
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 services in Israel are provided by the Magen David Adom (MDA) organization, and in some places by the Palestinian Red Crescent Society. The phone number to call for an ambulance is 101
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.
New Orleans Emergency Medical Services is the primary provider of advanced life support emergency medical services to the city of New Orleans, Louisiana, United States. Unlike most other emergency medical services in the United States, New Orleans EMS operates as a third service and is not part of the New Orleans Fire Department; rather, New Orleans EMS is operated by the New Orleans Health Department and the New Orleans Office of Homeland Security and Emergency Preparedness.
Emergency Medical Service in Austria is a service of public pre-hospital emergency healthcare, including ambulance service, provided by individual Austrian municipalities, cities and counties. It is primarily financed by the Austrian health insurance companies.
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.
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.
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